Obsessive Compulsive Disorder

Working with Obsessions and Compulsions

Obsessive Compulsive Disorder is a neurobiological disorder that affects men, women, and children of every race, religion, nationality and socioeconomic group. OCD is far more common than people think and is associated with high levels of anxiety which affect daily life.

Image by Annie Spratt

OCD is diagnosed when obsessions and compulsions: 

  • Consume excessive amounts of time (an hour or more each day) 

  • Cause significant distress 

  • Interfere with daily functioning at work or school, or with social activities, family relationships and/or normal routines. 

  • Obsessions are persistent, uncontrollable thoughts, impulses, or images that are intrusive, unwanted and disturbing.

Although most people with OCD realise their obsessions are irrational, they believe the only way to relieve their anxiety or discomfort is by performing compulsions. Compulsions are repetitive actions or mental rituals intended to relieve the distress caused by obsessions. For example, a person with an obsessive fear of intruders may check and recheck door locks repeatedly. Any relief provided by the compulsions is only temporary, however, and ends up reinforcing the obsession, creating a gradually-worsening cycle of OCD behaviour.

 

Here are basic examples of some of the most common OCD symptoms:-

ocd cycle image.png

Obsessions

FEAR OF CONTAMINATION

FEAR OF HARM ILLNESS or DEATH

FEAR OF VIOLATING RELIGIOUS RULES 

NEED FOR SYMMETRY

NEED FOR PERFECTION

NEED TO HAVE SOMETHING “JUST RIGHT”

Compulsions

Washing/cleaning

Checking

Praying

Arranging or “evening up”

Seeking reassurance

Repeating

Understanding what drives a person to continue performing the seemingly nonsensical and repetitive behaviours that obsessive compulsive disorder creates is difficult, but partly it is due to the perception of the perceived level of danger and threat that a person with OCD believes may cause harm to themselves or a loved one.

 

For many people with OCD there is also an over inflated sense of responsibility to prevent harm and an over estimation about the perceived threat the intrusive thoughts bring. It is these factors which help drive the compulsive behaviours, because people feel responsible to try and prevent bad things happening.

 

OCD creates an increase in anxiety. Whilst a usual response to an anxiety provoking situation is for the anxiety to slowly decrease after the initial event, for someone with OCD the anxiety is maintained and often increases, usually because of their overestimation of the perceived level of threat.

 

The anxiety is proportional to the persons perception of danger and risk. The worse the perceived consequences the greater is the fear of something bad happening.

 

This is where OCD becomes a vicious cycle. As the obsessional thought causes a person's anxiety to increase, they become besieged by the obsessive thoughts. Naturally the sufferer neither wants nor welcomes the obsessional thoughts and will go to extreme lengths to block and resist them.

 

People with OCD realise that their obsessional thoughts are irrational, but they believe the only way to relieve the anxiety caused by the obsessions is to perform compulsive behaviours, often to prevent perceived harm happening to themselves or more often than not, a loved one.

 

Unfortunately, any relief that the compulsive behaviours provide is only temporary and often reinforce the original obsession, creating a gradual worsening cycle of OCD.

Find out how I work with Obsessive Compulsive clients here