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Jon Lukas: Behavior Therapist’s Take on ‘The OCD Project’

The VH1 television show takes treatment of the disorder to the extreme

As a cognitive behavioral therapist specializing in obsessive compulsive disorder and anxiety disorders, I tend to pay close attention to the portrayal of these disorders in the mass media. Television shows such as Obsessed, Hoarders and now VH1’s The OCD Project in one way or another have their finger on the pulse of obsessive compulsive disorder and deliver the issues for public consumption.

Jon Lukas
Jon Lukas

But how realistic, accurate and responsible are these portrayals for the real person suffering from OCD?

I just watched the premiere episode of The OCD Project, and I must say that it raises some real concerns for me as a professional. The show has taken cognitive behavior therapy to a whole new level.

The show gathers several people dealing with extreme forms of OCD, puts them together in a home for several weeks and attempts to challenge each person’s OCD through exposure and response prevention with a respected behavioral therapist.

What I anticipated was a show that would be entertaining but also — and most importantly — educational. However, from the looks of the first episode, it seems as though the show is done mostly for shock value, ratings and perhaps some actual therapeutic benefit.

I was genuinely surprised to see the exaggerated level of exposure therapy, and the personal style and methods of the doctor on the show. It was discouraging to see this psychologist yelling and cursing in order to motivate his patients. He appears as a drill sergeant at times through clips for the following weeks’ episodes.

There is one especially alarming clip of the doctor inviting a patient to hold a knife to his neck as an exposure for the patient’s obsession of harming others. In a very controlled environment, you might see this kind of exposure and response performed, but this is by no means the norm. (For one thing, there are liability issues, and another issue is that one must be extremely knowledgeable about the treatment of OCD to perform this kind of exposure, in order to rule out any co-occurring disorders, such as psychosis, etc.)

In yet another fantastical clip of the television show, the doctor and other patients are throwing dolls at the windshield of a car driven by a patient, while other patients are screaming at her, in order to challenge her obsession of driving over a child. Again, this is a very extreme form of ERP, and one that I view as slightly over the top and done mainly for entertainment value.

Let me emphasize that from my own personal experience at some of the best inpatient and intensive OCD treatment centers in the country, I have never seen or experienced a behavior therapist, or team of therapists, use that level of confrontation and/or exposure methods. But then I have to remind myself that this show is on VH1, a channel geared toward a younger audience, and the name of the game is ratings. Shock and overdramatization make for good television.

As a professional, I feel a little uneasy about whether the show will help or hinder those who desire to seek help. I want people with OCD to know that while exposure and response prevention is critical for the treatment of OCD — and while most ERP can be intense and extreme at times — it is compassion, rapport-building, trust and hard work that are the foundations of overcoming this disorder.

Most people with OCD will not live in a home for three weeks doing extreme exposure therapy but will need longer-term treatment, a steady and consistent buildup of exposure and response prevention, and a true understanding by their treatment specialist of the person they are trying to help. I want those who have OCD and their loved ones to know that it takes extremely hard and ongoing work on the part of both the patient and the therapist to reduce the symptoms of OCD. I don’t want people who need the help to watch a show like The OCD Project and decide they would rather continue living with OCD than be put through the unusually extreme experiences that this show portrays.

I do applaud the doctor on this show for pushing his patients to overcome this disorder, but it’s so important to emphasize that the real work of real people battling OCD happens when the cameras aren’t rolling.

Jon Lukas MFT is a psychotherapist specializing in cognitive behavioral therapy. He is in private practice and runs The OCD Treatment Center of Santa Barbara, working with adolescents and adults with anxiety disorders. Click here for more information or call 805.453.2347.

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