What is Obsessive-Compulsive Disorder?

The first thing you should probably know is that there is OCD and then there is the “OCD” we typically see in movies and TV shows. The later is often depicted as a charming personality quirk centered around neatness or handwashing. The reality of OCD is strikingly different.

In reality OCD is an often debilitating mental health disorder that affects about  1 in 100 adults, and 1 in 200 kids and teens in the United States. It occurs when someone becomes trapped in a cycle of obsessions and compulsions.

What are Obsessions?

Obsessions are unwanted and disturbing thoughts, images, or impulses that occur over and over again and feel beyond a person’s control. Obsessions are generally accompanied by intense feelings of fear, shame, disgust, uncertainty, or a feeling that things must  be done in a way that is “just right.”

Of course nearly all of us, from time to time, experience thoughts or concerns like the above. The difference between someone who has OCD and someone who does not is that the person without OCD can generally dismiss these thoughts as unimportant and move on from them fairly quickly. A person with OCD cannot. Even if someone with OCD recognizes that these thoughts are illogical, even absurd, they often feel helpless to ignore or dismiss them.

So if they can’t dismiss these thoughts how do they cope with the distress associated with them? In a word, Compulsions.

What are Compulsions?

Compulsions are repetitive thoughts or behaviors  that a person uses to neutralize or counteract an obsession and soothe the distress associated with it. While compulsions can be effective at relieving the distress created by an obsession this relief is only temporary.  Soon enough, the obsessional thought, image, or sensation emerges again, demanding the continued performance of rituals. Thus, the sufferer becomes trapped in a continuous cycle of obsession, compulsion, temporary relief, and obsession again.

Common obsessions include:

  • Contamination: Fears of coming into contact with substances perceived to be contaminated

  • Harm: Fears of acting in a way that might bring harm to oneself or others.

  • Sexuality: Experiencing unwanted sexual thoughts or images, often

    of a taboo nature.

  • Identity: Concerns over one’s identity. This often relates to one’s “true”

    sexual or gender identity.

  • Moral Scrupulosity: An excessive concern with morality or religious purity.

  • Relationships: As excessive concern with your partner’s perceived flaws

    and/or if they are the “one.”

  • Existential issues: Obsessions with philosophical ideas, often around the

    nature of death, reality, or one’s role in the ”grand scheme of things.”

  • Perfectionism: Excessive concerns around performing tasks in ways that

    are perceived as correct or perfect. A preoccupation with exactness or

    evenness.

Common compulsions include:

  • Washing or cleaning: Excessive showering, bathing, or handwashing.

    Cleaning household items beyond what most would consider necessary.

  • Checking: Repeatedly checking that you did not/will not harm others or yourself. Repeatedly checking on the condition of some aspect of your body, physicality, or the status of some household object.

  • Repeating: Repetitive actions often done in proscribed numbers or

    patterns.

  • Avoidance: Avoiding situations that may trigger an obsession.

  • Mental rituals: Repeated counting, praying, repeating of thoughts, or mentally

    reviewing events. Mentally cancelling out “bad” thoughts with “good”

    thoughts. This is often done in proscribed numbers or patterns.

  • Reassurance Seeking: Continually asking for reassurance that a feared outcome has not come or will not to pass.

This sounds familiar. Do I have OCD?

It’s possible, but let’s not jump to any conclusions quite yet. It’s not unusual for the above cycle of obsession and compulsion to seem familiar even to people without OCD. Who among us hasn’t felt anxiety or distress, taken some kind of action that earned us temporary relief, only to feel the distress quickly return?

For people with OCD however this cycle causes extreme and persistent levels of distress, consumes great amounts of time (more than an hour a day) and drives them away from relationships and activities they enjoy and value.

The International OCD Foundation provides a great free screening tool for people who think they may have OCD. You can find it here.

When you’re ready to talk some more, or you’re ready to begin treatment, go ahead and get in touch!