- Give yourself permission to set a basic safety plan based on the recommendations of trusted health organizations, and do not add to it.
- Disinfect surfaces once a day. Focus on the surfaces in your home that are frequently touched, and think about whether this is truly needed (for example, if you stayed home all day and had no visitors, do you really need to disinfect that doorknob?). This process shouldn’t take you more than a few minutes per day.
- Wash your hands with soap and water for 20 seconds after being outside or in public, before eating, after going to the bathroom, and after you’ve coughed/sneezed/blown your nose. If soap and water are not available to you, use hand sanitizer that contains at least 60% alcohol.
- Remember that washing your hands for more than 20 seconds and using harsh chemicals to disinfect hands will not lower risk of becoming infected with the virus. 
- If you want to do more than this, pick a person to help you figure out what might be a reasonable and rational safety measure to take.

Combatting Contamination Obsessions

- Remind yourself that no one can protect themselves “perfectly” from COVID-19, and no one expects you to. Times like these call for using your common sense instead of going to perfectionistic extremes. 
- Remember that trusted health organizations aren’t thinking about people with OCD and/or perfectionism when they set public health guidelines, and thus it might be helpful to talk to a trusted friend, family member, and/or your therapist to help figure out what “common sense” might mean. Your therapist can be especially helpful in figuring out how to apply these guidelines in a way that meets health standards without sending you deeper into your OCD.

Combatting Perfectionism

- Be mindful that your OCD may take advantage of COVID-19 fears by telling you that you might have infected someone or that you are going to infect someone in the future, whether accidentally or on purpose.
- If you’re noticing these intrusive thoughts, or that you’re doing compulsions related to these thoughts, check in with your therapist and let them know how your symptoms might have changed. They can work with you to come up with new exposures and/or homework activities to help contain them.

Combatting Thoughts on Harming Others

- Seek reliable information from trusted resources such as the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) for a limited time per day. 
- As parents, reduce the load and frequency of information provided to children and adolescents. 

Combatting the Need For Certainty and Updates 

- Contamination Obsessions
- Perfectionism
- Possibility of Harming Others
- The Need for Certainty and Updates
- Overestimation of Threats

City University of New York

University of California, Davis

Smith College

Obsessive-compulsive disorder (OCD) is a disorder in which people have recurring, unwanted thoughts, ideas or sensations (obsessions) that raises their level of anxiety and drive them to perform certain ritual or actions (compulsions) that serves to lower their anxiety about their thoughts. The compulsive behaviors can significantly interfere with a person’s daily activities and social interactions. Some people with OCD have faced psychological distress and worse "symptoms" in the wake of the pandemic.

Obsessive-Compulsive Disorder (and COVID-19)

There are concerns that the increased focus and normalization in hygiene and washing may worsen the symptoms of OCD, especially when contamination obsessions and hand washing compulsions are some of the commonest symptoms of OCD. For people who have went and have responded well to therapy, the stress and anxiety related to to the pandemic may also trigger a relapse.

The other side of COVID-19: Impact on obsessive-compulsive disorder (OCD)

International OCD Foundation. 2020. COVID-19 Vs. Your OCD Symptoms. https://iocdf.org/covid19/covid-19-vs-your-ocd-symptoms/    [Accessed 6 July 2020].

COVID-19 Vs. Your OCD Symptoms

Shafran, R., Coughtrey, A., & Whittal, M. (2020). Recognising and addressing the impact of COVID-19 on obsessive-compulsive disorder. The Lancet Psychiatry, 7(7), 570-572. DOI:https://doi.org/10.1016/S2215-0366(20)30222-4
https://www.thelancet.com/action/showPdf?pii=S2215-0366%2820%2930222-4 

Recognising and addressing the impact of COVID-19 on obsessive-compulsive disorder

Types of Obsessions related to Covid-19 Pandemic

Cognitive behavioral therapy is a type of psychotherapy that helps individuals to identify their negative thoughts and behaviors and think of alternative and effective ways to view, respond and resolve difficult situations. They are able to develop new patterns of thinking, as they create coping strategies to manage their challenges. This type of therapy is commonly used to improve several types of mental health disorders, including obsessive-compulsive disorder. 

Cognitive Behavioral Therapy as Treatment for Obsessive-Compulsive Disorder

- Normalization of Compulsions 
- Balancing of ERP with Risk of Transmission

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