Obsessive Compulsive Disorder (OCD)

Obsessions

Obsessions are unwanted recurrent intrusive thoughts, impulses, or images that cause marked distress and are not simply excessive worries about real life problems.

Examples of common obsessions are:

  • Doubts about causing/failing to prevent harm related to dirt, chemicals or germs
  • Thought or images of causing harm to vulnerable people.
  • Imagining or wishing harm upon someone close to oneself
  • Impulses to violently attack, hit, harm or kill a person, small child, or animal.
  • Impulses to shout at or abuse someone, or attack and violently punish someone, or say something rude, inappropriate, nasty or violent to someone.
  • Images/impulses related to kissing, touching, fondling, oral sex, anal sex, intercourse, rape with strangers, acquaintances, parents, children, family members, friends, co-workers, animals and religious figures, involving heterosexual or homosexual content with persons of any age
  • Blasphemous thoughts
  • The urge to make areas of work or home symmetrical or ‘just so’.
  • To name but a few……(!)

People who have OCD attempt to ignore, suppress, or neutralise their obsessions, which will often make the thought, impulse, or image more frequent and/or more intrusive.

In response to their obsessions, many people carry out actions (including activities carried out in their mind) aimed at reducing or preventing harm, doubt or discomfort called compulsions. These might include:

  • Checking
  • Reassurance seeking
  • Washing or decontaminating
  • Repeating activities
  • Rearranging items
  • Repeating a word or phrase in your mind
  • Mentally reviewing actions/experiences to try to ‘know’ or remember
  • Touching or tapping
  • Counting
  • Monitoring yourself for ‘inappropriate’ emotional, physical or psychological reactions
  • Again to name but just a few…

A further way in which people try to cope with their obsessions is to avoid people, places, substances, images, stories, activities etc. that trigger their obsessions.

The psychological treatment of choice for OCD is cognitive behavioural therapy specifically tailored for OCD. This usually involves normalising and ‘allowing’ doubts, images, thoughts, and impulses to occur naturally in your mind without responding to them. Very often it also involves deliberately confronting triggers for obsessions and stopping rituals, called ‘exposure and response prevention’ (ERP). OCD can also be helped by high dose SSRI type anti-depressants, which can be combined with CBT.

To learn more about OCD take a look at the following websites:

OCD Action

OCD-UK