Today we’re getting insight from Christopher Schoenstedt, MA, an OCD therapist with a practice in downtown St. Paul, Minnesota. (Currently, due to COVID-19, he’s only doing teletherapy.) Thank you, Christopher!
How long have you treated OCD?
I have treated OCD in different capacities for around five years.
What led you to focus on anxiety, OCD, and panic?
One of the first mental health clients I worked with at a county social services department was someone who had suffered with harm OCD for decades. In my research on harm OCD (I didn’t know much about it), I found an article detailing mental health treatment unlike anything I had heard of before. The writer was a psychologist explaining how he uses exposure and response prevention (ERP) to deal with violent obsessions. He gave the example of a young man who was having intrusive thoughts about killing his father. As one part of his treatment, the client was told to hold a large knife while sitting next to his father on the couch. Every once in a while, his father was instructed to turn to him and say, “Please don’t kill me, son.”
Without having knowledge or experience with this type of treatment, it can sound very counterintuitive and even dangerous. In reality, it is a very effective and empirically validated treatment. The more I learned about ERP, the more I wanted to continue working with the populations best treated by this type of therapy. I liked the idea of using a very action-oriented approach to help people get better, and oftentimes rather quickly, by facing their fears rather than continuing to run from them.
What can a newly diagnosed person with OCD expect if they come to you for treatment?
First and foremost, I like to establish a relationship with the client that fosters trust in me and the process. I want to give them hope that it is possible for them to feel better, and oftentimes rather quickly. As part of the process, I also have to ask a lot of questions at first so that I can get a complete picture of what the client’s experience is and has been; what prompted them to seek treatment; and what their idea of a better life looks like.
ERP is a first-line treatment for these disorders, so, after the initial questions I really try to educate people on how it works and why it is so effective. I want the client to understand how different it is from the other types of treatment they might have received. A hallmark symptom of these disorders is avoidance. People fail to get better because they go through life avoiding or running away from all the things that frighten them and cause anxiety. ERP works because it involves the client moving toward the sources of their fear and anxiety in order to develop more optimal responses to those feelings. At first glance, this can sound incredibly scary, which is why I make it a point to build trust in the process. I will always try to move at the pace that is right for them.
Finally, we will begin the process of creating a plan to systematically target those symptoms that are having the most negative effect on the client’s life.
Some therapists practice within the four walls of their office, but you meet your clients in their homes or in the community. Why do you travel to see your clients? How does this benefit them?
A person who hasn’t left their home for years because of a mental health condition is most likely unable to leave their home to go to a therapy appointment. My whole manner of helping people is centered around meeting them where they are at and moving at a speed they can handle. If the first step they are able to make is to meet with me in their home, then I want to give them that opportunity. I don’t want a whole segment of the population who could benefit greatly from mental health treatment to suffer needlessly simply because they were unable to take that first step. Additionally, because I utilize a very action-based approach, being able to work with the client within their environment and in the context of the things they actually fear is essential.
What do you consider the biggest misconception people have about OCD, and how can we combat it?
I think that many disorders, such as OCD, are greatly misunderstood and even used as punchlines or derogatory labels in popular culture. For anyone who has suffered with this disorder, OCD is not a punchline at all. It can be a very debilitating mental illness that has the power to ruin the life of the individual sufferer and even the lives of the people around that person. It can take years away from a person’s life and make living nothing more than a miserable endeavor. I would love for the public to be more knowledgeable and empathetic toward individuals suffering with this disorder so that these people will feel more comfortable coming out of the shadows and receiving treatment. It is very sad when I hear someone tell me their story of being in mental anguish for decades because they never received appropriate treatment.
If you could offer just one piece of advice to someone with OCD, what would it be?
In life in general and when trying to help other people, I always make it a point not to offer false hope. I don’t want to diminish what a person is experiencing, and oftentimes doing so just isn’t helpful. That being said, when it comes to OCD, I can say emphatically that there is great hope for success in treatment. Even if you have been dealing with this illness untreated for years, a better life is possible. It begins by you taking the first step.