July 19, 2021

Overcome OCD with RIP-R Therapy

by Ilisa Kaufman, Psy.D.

I was diagnosed with obsessive compulsive disorder (OCD) after the birth of my son. My symptoms began in my third trimester. I was cheated out of what should have been the happiest time of my life. I was on my way to getting the life that I thought I had always wanted. I earned a doctorate degree, I worked in my own psychology practice, I had a gorgeous home, and a brand-new baby boy on the way. Having lost my parents, traumatically, when I was a teenager, I fought so hard to get this far in life; when horrible contamination OCD came and took it all away.

Of all the hardships I have ever experienced in life, being trapped inside my own mind has been the worst. Back then, I woke up every single day vowing that today would be different, and that today would be the day that I face my fears, and do not use compulsions. Only to wind up feeling terrified all day long, and giving into all kinds of compulsive behaviors, in order to find peace. My functioning was impaired, my friends and family couldn’t tolerate me, and I could not enjoy my baby.

My treatment journey began, a lot like other OCD sufferers, by going to a talk therapist, whom I found on my insurance plan. This “therapy” made my OCD much worse. Unfortunately, she, like many other “therapists” knew nothing about OCD or what the correct treatment for it is. Even though, I was struggling with the most common and obvious type of OCD, she still managed to incorrectly diagnose me. She told me I had delusional disorder. Which is simply very disturbing, since, even the cashier at the grocery store knew I had OCD. She used to call me a “germaphobe.” This is a huge problem that OCD sufferers face, and explains why so many sufferers keep their symptoms to themselves; as to not be seen or diagnosed as “crazy.”

I finally ended up finding a clinician who specialized in the treatment of OCD. I, thankfully received an accurate diagnosis of both OCD and PTSD. He then began treating me using what is known as the “gold standard therapy” for OCD, Exposure and Response Prevention (ERP).

While I was definitely headed in the right direction, this did not help me. I was not properly driven / motivated.  I spent my sessions doing the “exposure” and following it up with tons of compulsions, that I hid from my therapist. So, I continued to deteriorate and get worse.

Finally, in the summer of 2010, I had something horrible happen to me. A consequence of my compulsive behaviors catching up to me. Finally, the consequences of my actions seemed more terrifying to me than my “OCD fear”. I call this moment, “rock bottom.” As broken as I felt, I capitalized on this “rock bottom moment”. I spent the next week resisting compulsions with great ease.

After about a week, my motivation started dwindling, and the urges to do compulsions began getting stronger. Since, I did not want to go backwards, I began creating “games” that I would play in my mind that helped me continue to resist compulsions. I played these “games” all day, every day for the next month. Soon, I found myself behaving like most other non-OCD moms. I call this OCD recovery. I have been in recovery from OCD for 10 years now, with no relapse.

I decided to build a psychology practice, Compulsion Control, LLC, exclusively treating those struggling with OCD, addictions, and other compulsive behavioral problems. Instead of using ERP, I use the same steps that got me into recovery. I call this method Rock bottom, Interruption, Practice, and Replacement Therapy (RIP-R).

Similar to ERP, the objective of RIP-R treatment is to teach the sufferer how to face their fears, while resisting compulsions, in order to improve functionality. There are some core differences. While ERP is more focused on exposures, and developing hierarchies in order to get stronger in the face of triggers. RIP-R is more focused on motivation; a sufferer does not even enter the Interruption phase of therapy, until they feel they are properly motivated.

The idea is, until the sufferer is fully driven, and feels a strong sense of urgency, they will not be strong enough to resist the compulsions. This is why most sufferers start off in the Rock-bottom phase of therapy, they learn very specific ways to build drive and get them ready for the difficult journey of response control.

Additionally, In RIP-R therapy, the clinician does not use a hierarchy, and does not need to concoct in vivo exposures. The philosophy of RIP-R is that life will throw triggers every day, all day, and it is the sufferers’ responsibility to practice and learn the “mind games.” Therefore, when triggers arise, they have the weapons to resist.

What might be the most important phase of RIP-R therapy is the “P” for practice. All sufferers must practice the “mind games” throughout the entire day in order to become stronger and more skilled in resisting certain unproductive behaviors. Lastly, RIP-R has a Replacement phase. This is where clients are taught to apply their compulsive energy into behaviors that are productive and will help sufferers build the life that they desire; as opposed to spending countless hours on behaviors that will only destroy their dreams.

To learn more about RIP-R therapy, or schedule a 10-minute complimentary consultation, please visit my website at www.compulsioncontrol.com or my Instagram page @ocd_help_now.


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