Everything You Need to Know About OCD by Dr. Lynne M. Drummond with Laura J. Edwards is, as the title suggests, a comprehensive book covering OCD and its treatment. The lead author clearly has considerable clinical expertise working with clients with hard-to-treat OCD.
The book looks at the processes involved in OCD, including distressing thoughts increasing when one tries to suppress them, and thought-action fusion (the belief that having a thought is the moral equivalent to performing the act that the thought relates to). It covers different types of OCD as well as common co-occurring conditions. Autism spectrum disorder is one of the co-occurring conditions mentioned, and the author explains how to differentiate between autistic rituals and OCD rituals.
There’s a chapter devoted to medication treatments, side effects, and commonly asked questions about med use. I found it interesting that the author chose to use the term “dopamine blockers” rather than “antipsychotics.” Dopamine blocker is actually a more accurate term than antipsychotic, but the choice definitely seemed like an acknowledgement of the associated stigma. There’s also a chapter on emerging research that looks at the role of treatments like neurosurgery (a far cry from the icepick lobotomies performed back in the day) and deep brain stimulation (which is also used for depression)
The book gives a lot of attention to exposure and response prevention (ERP). The author recommends constructing a hierarchy for exposures, but not for compulsions. She writes, “It can often be tempting to gradually reduce compulsions or even place these on a hierarchy. In reality, this rarely works because it is extremely difficult to cut down on such behaviours. It is much better and easier in the long term to stop the compulsive behaviours entirely.” For exposures to be most effective, the author recommends doing them three times a day and for long enough each time for the anxiety level to drop by half, which she says initially might take a couple of hours. There’s definitely no promising an easy fix here.
A lot of the example exposures the book offered are things that are more extreme than what a “normal” person would typically do. The author explained this in terms of a treatment pendulum. If OCD is at one end and extreme risk-taking is at the other, exposures should swing past normal into risk-taking territory to make people less likely to return to the slippery slope back to OCD.
In the chapter for family and caregivers, the book emphasizes the importance of not going along with OCD compulsions and reassurance-seeking. The author recommends calling the police if not going along with the OCD results in threats or violence. The fact that this was mentioned a few times hints at how profoundly unwell her patients are.
There are lots of case examples throughout the book, and many of these involve patients who were extremely debilitated by their illness. Many of these examples include ERP programs, and there are a number of these for each different OCD theme (e.g. contamination, symmetry, taboos like pedophilia, and fear of harm to self/others through either thoughts/actions or failure to act).
The author explains that the term pure-O OCD that’s sometimes used is actually inaccurate, as obsessive rumination has two parts: the distressing thoughts (obsessions) and mental compulsions to ward off harm from distressing thoughts, reduce distress, or put things right. She writes about how to differentiate these two parts and offers strategies to overcome the fact that mental compulsions can occur involuntarily even if one tries not to do them.
The author is based in the UK, so some of the discussion about treatment availability won’t be relevant to readers outside of the UK, but I don’t think that detracts from its suitability for an international reader base.
This book isn’t a light read. The language used isn’t difficult, it’s laid out well, and there are concise point-form summaries at the end of each chapter, but it’s packed with facts. There are lots of details, but they’re relevant rather than extraneous. The book would be a great choice if you’re wanting to learn a lot about OCD or if you’re looking for information related to difficult-to-treat OCD. For people whose OCD is on the milder side and isn’t causing a massive disruption in their lives, some of the other books on OCD that I’ve reviewed would probably make a better starting point, but if you’re looking for a really comprehensive resource, this is it.
Everything You Need to Know About OCD is available on Amazon (affiliate link).
I received a reviewer copy from the publisher through Netgalley.
You can find my other reviews on the MH@H book review index or on Goodreads.
It sounds like a very well-written book!
Yeah, something so in-depth could easily have been quite dry, but it wasn’t.
I think the general public, including me, needs to stop throwing around, like confetti at a wedding, the self-diagnosis of OCD. Yes I am precise in how I order my world and I really (REALLY) prefer things done a certain way and wall decorations that aren’t straight drive me batso and I will try to, unobtrusively, straighten them BUT I can also say – “Not perfect or the way I want exactly but good enough” and carry on. OCD can be so debilitating it boggles the mind.
Yeah, it does get misused a lot. If once things are done “right” it feels good/satisfying, then it’s probably not OCD.
I didn’t have time to read this post yet but since I have severe ocd I bookmarked it will read it in a bit 😁
I think you would find this book interesting.
Nope, not OCD tho people call my super-organizing OCD – it’s not – it’s laziness. I always have to explain that – that I am super organized because I am the laziest person on the planet – I don’t want to waste time and energy looking for something. I think my drawers and closets are downright pretty organized into usage or colors which is not to say I don’t have a tray in my closet with assorted junk even tho I make sure that the junk I use most is always on top LOL I have gotten snappish with my husband for not putting something back EXACTLY where and how I want it. And I have tableware with colored handles so it’s easy to put them back in the right compartments …oh my, you don’t really want to know about my dishes, do you.
Being really organized makes my life so much easier. It might take a bit more initial effort to come up with a system, but then one it’s in place, there’s no need to fuss over looking for anything because it always lives where it’s supposed to live.
Exactly – I don’t know why people don’t understand that *sigh* A place for everything and everything in its place…that’s what my father always said.
Yes!!!
It’s so hard not to give reassurance to people you love when their ocd makes them seem it 😞
For sure ❤️❤️❤️
This sounds like a really good, thorough read. Well reviewed as always, Ashley. I remember when I was a kid I used to do “weird” things and there was never a name for it, or at least nothing we’d known about. It could take my mum ages just to get my shoes on for school when I was in primary (age 5/6 maybe) because each shoe needed to be the same tightness. If one was slightly more tight than the other, the laces or velcro were undone and started again. Or I’d touch the table with my left hand, then have to do the same with my right, but then it’s not the same place or the same way I’ve touched it so I have to touch both sides again equally. Over and over. I feel bad for my mum thinking back to that! Back then though, I was just a bit “weird”, albeit nothing extreme and in no way debilitating like OCD can be for children and adults alike.
The lighter type of OCD I experienced changed as I got older but I’ve still got certain elements left over and some things can set me off. I think social understandings of OCD can be quite limited, such as to thinking it’s about checking the door is locked several times or excessive handwashing. It can be so much more than that and very varied in the types of behaviours and such, as well as having different levels of severity. x
Yes, it’s definitely a lot more complex than that limited social understanding.
I love the way you write book reviews
Thank you!
My pleasure 😁
What I particularly appreciated about this book is how it tackles the misconceptions surrounding OCD and provides a comprehensive overview of the different types of OCD, as well as the various treatment options available. Thanks for posting this article. This is really helpful. However, I also found this article on deep brain stimulation for OCD, which I found very interesting and would definitely recommend you to read.