Obsessive-Compulsive Disorder (OCD)

Obsessive-Compulsive Disorder is characterised by the presence of obsessive thoughts and compulsive actions / rituals to manage the distressing thoughts and associated feelings. Severity can vary among individuals with OCD. Some people experience obsessive thoughts and compulsions that do not highly interfere with their day-to-day life. However, for others, these can significantly impact their daily functioning.

Understanding Obsessive-Compulsive Disorder (OCD)

For some people, having OCD can be a real challenge as the obsessions and compulsions can highly impact their relationships, self-esteem and self-confidence, academic and work careers, social life and mood. Some people will isolate themselves for fear of acting on compulsion during a social event and other people notice that.

An obsessive thought can be described as an unwanted, persistent, and intrusive thought that keeps entering the individual’s mind. A thought that won’t go away. The obsession in OCD can also be an image or an urge. Obsessive thoughts, urgers or images can cause the individual who experiences them to feel anxious, uncomfortable, scared, or disgusted.

A compulsion can be described as repetitive behaviour that the individual feels compelled to perform -even if they don’t want to- to find relief from the uncomfortable feelings triggered by the obsessive thought. Acting on their compulsion will provide temporary short-term relief. The compulsion in OCD can also be a repetitive mental behaviour.

There is a difference between an occasional unwanted thought or a superstitious ritual performed as good luck before an important event and OCD. A person that suffers from OCD will have persistent and distressing thoughts or images and will have an urge to engage in specific actions / rituals.

The obsessive thoughts characteristic of OCD might feel too shameful or bad to talk about with others. People might feel they are bad people because they have those thoughts. This, together with the stigma around mental health, can make it difficult for individuals with OCD to receive support and treatment and make them feel significantly more hopeless and isolated. Current treatments for OCD can make a significant difference in the quality of life of the individual and in the management of the symptoms.

What Are The Main Symptoms Of OCD?

OCD symptoms are categorised under obsessions and compulsions. They can manifest in different ways in different people. Another symptom is anxiety. Obsessions trigger high levels of anxiety and stress.

Often these symptoms impact the person’s daily life as they can be time-consuming. For instance, if a person has the compulsion of needing to touch the door handle three times before leaving the room, they will be compelled to do it even when it is not convenient - such as in an emergency.

- Obsessions:

Obsessions or obsessive thoughts are different from day-to-day worries or anxious thoughts. A person with OCD might try to relieve the anxiety associated with the obsessive thought with a compulsion or eliminate the thoughts by substituting them with a different thought.

OCD can manifest in many different ways. However, some common obsessions are fear of contamination, the extreme need for symmetry and order and fear of purposely hurting others or themselves. Common obsessions or obsessive thoughts could include, for example:

• Thoughts that the person considers shameful or bad

• Thoughts or images of hurting others or themselves

• Thoughts of being contaminated by infection, germs or disease

• Urge for symmetry among objects

• Thoughts or images of losing control

Usually, obsessions are constant, and it’s common for the person with OCD to experience the same type of obsession / the same specific thought. However, the thought can also develop and change over time. Therapy for OCD usually involves gradual exposure to situations which trigger the obsession, helping the individual to manage the anxiety rather than engaging in compulsive behaviours. You can read more about the treatment in the section below: ‘Treatment for OCD’.

- Compulsions:

Compulsions are repetitive behaviours / rituals that the person with OCD is compelled (feels the urge) to perform to relieve the anxiety associated with an obsession.

Similarly to obsession, compulsion also can vary significantly from individual to individual. However, common compulsions could include, for example:

• Hand washing and cleaning

• Checking windows, doors, locks, and others

• Mentally repeating phrases or single words

• Counting or other rituals to prevent something bad from happening

• Overthinking excessively

• Repetitively seeking reassurance

• ‘Undoing or neutralising’ bad thoughts

The compulsion might not always appear to be directly linked to the obsession. For instance, a person with OCD with obsessive thoughts of hurting others would feel unease and upset by these and might feel the compulsion to walk fast for a specific number of steps to relieve the distress triggered by the intrusive thought. Further, compulsions can be acted out with actions as well as with thoughts.

What Causes OCD?

Treatment for OCD

Therapy for OCD can be highly effective. The most effective treatment for OCD is Cognitive Behavioural Therapy. The therapist will gradually expose the client to situations that trigger their obsessive thoughts and help them experience the thoughts without seeking relief / neutralising them by engaging in compulsive and avoidance behaviours; this technique is called Exposure and Response Prevention (ERP). In some cases, if OCD is very severe, it might require medication support to manage symptoms, used in conjunction with psychological therapy.

Other techniques might be used in addition to ERP, such as psychoeducation around OCD, techniques to manage anxiety such as breathing, mindfulness and relaxation techniques and others.

Please get in touch with us to learn more about therapy for OCD or schedule an appointment for a free initial consultation.