It begins with a reasonably standard "What is OCD" chapter, running quickly through common obsessions and compulsions. The descriptions of obsessions probably could have been a little longer, with more examples, for people trying to figure out if their thoughts are OCD-related. He considers what I call rumination (AM I gay? DO I love my boyfriend? Maybe I AM a pedophile, how can I be sure? what does this mean about me? what if the garbage can DOES tip over, what should I do if it does, I'll map out a plan now) a "neutralization strategy." I suspect for many with OCD, myself included, this type of overanalyzing makes up a large percentage of our "OCD time," and it's not always addressed in books about OCD, so I'm glad to see it included.
A brief section called "How The OCD Ball Keeps Rolling" touches on the cognitive distortions common in OCD.
Next Tompkins addresses diagnosis and treatment. His main emphasis is on exposure and response prevention, with general information about medication and when it might be helpful in addition to other treatment. He addressed other therapies often encountered as well: possible "yeas" for cognitive therapy and acceptance and commitment therapy (ACT) but "nays" for talk therapy and hypnosis. Ultimately, his recommendation is strongly for ERP over other options.
Next, he includes a nice section on questions to ask potential therapists, while acknowledging that we won't all be fortunate enough to choose an therapist with perfect answers to those questions. A late chapter covers information I'm not sure I've ever seen before about whether you should disclose at work or school and on seeking accommodations under the Americans with Disabilities Act and in a school setting.
He spends a fair amount of time on the importance of a healthy lifestyle, including eating right, getting exercise and sleep and not trying to escape through substance abuse or other bad habits. Since these are not much of an issue for me, I skimmed here.
My favorite chapter by far addresses "Developing a Recovery Attitude," including keys to treatment success. I like this for several reasons: it's something that isn't included in most books on OCD, at least not so clearly and succinctly, and these are in my opinion the biggest roadblocks for overcoming OCD. I expect that when I'm struggling I will refer to this chapter for inspiration. Among the ideas addressed: accepting uncertainty and imperfect information, practicing every day, avoiding reassurance, not giving OCD an inch, and (I LOVE this one) "looking for opportunities to step into discomfort."
This book has a specific focus. Could you use it to learn the details of ERP? No, but it's a great general reference, and while written with an eye to those new to OCD, there's information for us old hands as well. It's a quick read at just under 160 pages and is available as a hard copy, and ebook or a pdf version.
I'll close with an excerpt about stepping into discomfort that I liked so much I highlighted it:
No longer are you searching for quick ways to escape your discomfort. Instead, you are looking for little ways to enhance your discomfort, such as running your fingers along a dusty windowsill or scanning the newspaper for an article on a topic that, in the past, you would have avoided reading. Viewing discomfort as an opportunity rather than a burden will help you manage your OCD over the years.