Obsessive-compulsive Disorder (OCD)

“Security is mostly a superstition. It does not exist in nature…avoiding danger in the long run is no safer than outright exposure.

Life is either a daring adventure or nothing. ”

– Helen Keller

Are you having repetitive and distressing thoughts that are difficult to manage? Do you feel compelled to perform certain actions or rituals to lessen your feelings of anxious distress? If so, you might have obsessive-compulsive disorder.

Obsessive-compulsive disorder (OCD) is a mental health condition characterized by a cycle of uncontrollable, reoccurring thoughts or images called obsessions, and repetitive behaviors or mental acts called compulsions, which a person feels driven to perform in response to their obsessions. These symptoms are time-consuming and can cause significant distress, interfering with daily life. Individuals with OCD often recognize their thoughts and behaviors are irrational but feel unable to stop them.

OCD includes recurrent anxiety that involves these two core components:

Obsessions: Unwanted and persistent thoughts, urges, or images that cause anxiety or distress. Examples of common obsessional themes include: fear of contamination, doubts about actions, aggressive or taboo thoughts, and a need for order.
Compulsions: Repetitive behaviors or mental acts performed to reduce the anxiety caused by obsessions or prevent a feared event. Although compulsions can come in many forms, examples of common compulsions include: excessive washing, checking, arranging, counting, or seeking reassurance.

The exact cause of OCD is not fully understood, but it is believed to involve a combination of genetic, neurological, and environmental factors. While there is no cure, effective treatments which improve symptoms exist, and these include various forms of psychotherapy (e.g., Exposure and Response Prevention interventions, Acceptance and Commitment Therapy, Inference-based Cognitive-behavioral Therapy and Meta-cognitive Therapy).

Obsessions

An OCD obsession is an unwanted, intrusive, and recurring thought, urge, or mental image that causes significant anxiety, fear, or distress. These thoughts are typically ego-dystonic, meaning they are contrary to the individual’s values and sense of self, and most people with OCD recognize that the thoughts are irrational or excessive, but they struggle to refrain from their pull.
Obsessions often center around specific themes and intrude into consciousness when a person is trying to think about or do other things. The distress caused by these obsessions often leads to performing repetitive behaviors or mental acts (compulsions) in an attempt to alleviate the anxiety or prevent a feared outcome.

Common Themes of Obsessions

Obsessions can attach to virtually any topic, but some common themes include:

• Contamination: An excessive fear of coming into contact with germs, dirt, bodily fluids, chemicals, or getting or spreading an illness.
• Harm/Violence: Fears of losing control and physically or sexually harming oneself or others, or being responsible for something terrible happening (e.g., a fire or burglary).
• Order and Symmetry: A need for things to be arranged in a specific, precise way, or an intense distress when things feel “not right” or unbalanced.
• Forbidden or Taboo Thoughts: Intrusive thoughts, images, or urges involving sexual, religious (scrupulosity), or aggressive subjects that are often deeply disturbing to the person experiencing them.
• Doubt/Responsibility: Persistent doubts about having performed an action correctly, such as locking a door, turning off a stove, or making a mistake at work.
• Relationship-related: Excessive worry about whether a partner is “the one,” fixation on their flaws, or your feelings for each other.

compulsions

An OCD compulsion is a repetitive behavior or mental act that an individual feels driven to perform in response to an unwanted, intrusive thought or urge (an obsession). The goal of the compulsion is to reduce the intense anxiety or distress caused by the obsession or to prevent a feared outcome from occurring.

Key Characteristics of Compulsions

• Repetitive & Ritualized: Compulsions often follow rigid rules or patterns that must be applied exactly.
• Driven by Anxiety, Not Pleasure: People with OCD do not perform these acts for enjoyment, but rather because they feel they have no choice and to find temporary relief from anxiety.
• Excessive or Unrealistic: The behaviors are often excessive or not logically or realistically connected to the fear they are intended to neutralize.
• Time-Consuming and Disruptive: Compulsions typically take up a significant amount of time (more than an hour a day) and interfere with daily life, work, school, and relationships.

Common Examples of Compulsions

Compulsions can manifest as outward physical actions or internal mental activities.

Physical Compulsions:

• Washing and cleaning: Excessive and ritualized hand-washing, showering, or cleaning household items.
• Checking: Repeatedly checking locks, switches, appliances, or written work to prevent harm or mistakes.
• Ordering/Arranging: Arranging items in a specific, precise way until it “feels right”.
• Repeating: Performing routine activities, body movements (like tapping), or tasks a certain number of times.
• Seeking reassurance: Constantly asking others for confirmation that everything is okay or that a feared event hasn’t happened or won’t happen.

Mental Compulsions:

• Counting: Counting in specific patterns or silently to reach a “good” or “safe” number.
• Praying: Silently repeating prayers or words to “undo” a “bad” thought or prevent harm.
• Mental review: Repeatedly reviewing past events in one’s mind to check for potential mistakes or wrong actions.
• “Canceling” or “Undoing”: Replacing a “bad” thought with a “good” thought to neutralize it.

For individuals with OCD, resisting the urge to perform these compulsions commonly causes great distress.

Are you experiencing any of the above symptoms?

If so, it may be time to be assessed for obsessive-compulsive disorder (OCD) and explore your treatment options.
Contact me today, for a free 15 minute consultation regarding your symptoms and goals and how we can work together to address these issues.