OCD consists of, as the term implies, obsessions and compulsions. Obsessions are unwanted and persistent thoughts and images that enter your mind that cause you to feel uneasy, anxious and/or disgusted. Examples of common obsessions are:
- fear of contamination/germs
- fear that something awful might happen (e.g. house will burn down, someone will break in) if you don’t take sufficient precaution
- thoughts or images that you will cause harm or have caused harm (such as physical or sexual harm) to others
- thoughts or images of your loved ones dead or coming to harm
- things in your life not being correct or symmetrical or in the right order
- blasphemous thoughts
A compulsion is a repetitive behaviour (either an action that you/others can see or an action you may do in your mind) that you feel compelled to do to relieve the unpleasantness brought on by the obsession. You may feel you need to carry out the compulsion to prevent a bad thing from happening. Common examples of compulsions are:
- checking doors and windows are locked
- checking plug sockets and appliances are switched off
- tapping things
- having a particular routine that, if not done in what you deem to be the correct way, you feel you have to repeat from the beginning
- doing things a certain number of times or until it feels right
- washing and cleaning excessively
- thinking something to yourself to put right frightening thoughts
- avoiding situations where you feel you could cause harm to others e.g. avoid being around knives
Treatment for OCD
Cognitive Behavioural Therapy (CBT) is the therapy of choice for OCD. The first step is trying to make sense of your OCD and what is maintaining it. This involves exploring the links between your obsessions, feelings and compulsions.
Research shows that most people experience somewhat odd thoughts, however they do not all go on to develop OCD. The difference is that those who go on to develop OCD give meaning and significance to the odd thoughts. This gives the odd thoughts power which leads to anxiety and the urge to relieve this anxiety by carrying out a compulsion. Not only that, seeing the initial odd thought(s) as threatening leads to more of these thoughts in the future. Whereas those who do not go onto develop OCD see the odd thought for what it is, just a thought. It is not interpreted as threatening, therefore passes more quickly and will pop up less frequently (if at all!) in a person’s mind.
Carrying out a compulsion relieves anxiety in the short term, however it keeps it going in the long term. This is because it is not learnt that by not carrying out the compulsion the fears would not have come true anyway. You can address this by gradually reducing your compulsions. This will likely be scary, however in therapy you can learn various tools to help you manage the discomfort this brings.