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Obsessive Compulsive Disorder

The International Obsessive Compulsive Disorder Foundation (iocdf) defines OCD as a mental health disorder that affects people of all ages and walks of life, and occurs when a person gets caught in a cycle of Obsessions and Compulsions. Obsessions are unwanted, intrusive thoughts, images or urges that trigger intensely distressing feelings. Compulsions are behaviors an individual engages in to attempt to get rid of the obsessions and/or decrease his or her distress.

Most people have obsessive thoughts and/or compulsive behaviors at some point in their lives, but that does not mean that we all have “some OCD.” In order for a diagnosis of Obsessive Compulsive Disorder to be made, this cycle of obsessions and compulsions becomes so extreme that it consumes a lot of time and gets in the way of important activities that the person values.

Obsessions

The IOCDF defines obsessions as thoughts, images or impulses that occur over and over again and feel outside of the person’s control. Individuals with OCD do not want to have these thoughts and find them disturbing. In most cases, people with OCD realize that these thoughts don’t make any sense.  Obsessions are typically accompanied by intense and uncomfortable feelings such as fear, disgust, doubt, or a feeling that things have to be done in a way that is “just right.” In the context of OCD, obsessions are time consuming and get in the way of important activities the person values. This last part is extremely important to keep in mind as it, in part, determines whether someone has OCD — a psychological disorder — rather than an obsessive personality trait.

Common Obsessions in OCD 

 

Contamination

  • Body fluids (examples: urine, feces)

  • Germs/disease (examples: herpes, HIV)

  • Environmental contaminants (examples: asbestos, radiation)

  • Household chemicals (examples: cleaners, solvents)

  • Dirt

 

Losing Control

  • Fear of acting on an impulse to harm oneself

  • Fear of acting on an impulse to harm others

  • Fear of violent or horrific images in one’s mind

  • Fear of blurting out obscenities or insults

  • Fear of stealing things

Harm

  • Fear of being responsible for something terrible happening (examples: fire, burglary)

  • Fear of harming others because of not being careful enough (example: dropping something on the ground that might cause someone to slip and hurt him/herself)

Obsessions Related to Perfectionism

  • Concern about evenness or exactness

  • Concern with a need to know or remember

  • Fear of losing or forgetting important information when throwing something out

  • Inability to decide whether to keep or to discard things

  • Fear of losing things

Unwanted Sexual Thoughts

  • Forbidden or perverse sexual thoughts or images

  • Forbidden or perverse sexual impulses about others

  • Obsessions about homosexuality

  • Sexual obsessions that involve children or incest

  • Obsessions about aggressive sexual behavior towards others

 

Religious Obsessions (Scrupulosity)

  • Concern with offending God, or concern about blasphemy

  • Excessive concern with right/wrong or morality

 

Other Obsessions

  • Concern with getting a physical illness or disease (not by contamination, e.g. cancer)

  • Superstitious ideas about lucky/unlucky numbers certain colours

Compulsions

Compulsions are the second part of obsessive compulsive disorder. These are repetitive behaviors or thoughts that a person uses with the intention of neutralizing, counteracting, or making their obsessions go away. People with OCD realize this is only a temporary solution but without a better way to cope they rely on the compulsion as a temporary escape. Compulsions can also include avoiding situations that trigger obsessions. Compulsions are time consuming and get in the way of important activities the person values.

 

Common Compulsions in OCD

Washing and Cleaning

  • Washing hands excessively or in a certain way

  • Excessive showering, bathing, tooth-brushing, grooming ,or toilet routines

  • Cleaning household items or other objects excessively

  • Doing other things to prevent or remove contact with contaminants

Checking

  • Checking that you did not/will not harm others

  • Checking that you did not/will not harm yourself

  • Checking that nothing terrible happened

  • Checking that you did not make a mistake

  • Checking some parts of your physical condition or body

Repeating

  • Rereading or rewriting

  • Repeating routine activities (examples: going in or out doors, getting up or down from chairs)

  • Repeating body movements (example: tapping, touching, blinking)

  • Repeating activities in “multiples” (examples: doing a task three times because three is a “good,” “right,” “safe” number)

Mental Compulsions

  • Mental review of events to prevent harm (to oneself others, to prevent terrible consequences)

  • Praying to prevent harm (to oneself others, to prevent terrible consequences)

  • Counting while performing a task to end on a “good,” “right,” or “safe” number

  • “Cancelling” or “Undoing” (example: replacing a “bad” word with a “good” word to cancel it out)

 

Other Compulsions

  • Putting things in order or arranging things until it “feels right”

  • Telling asking or confessing to get reassurance

  • Avoiding situations that might trigger your obsessions

Woman on Window Sill

OCD Misconceptions

OCD is not a choice, preference or quirk.

OCD is far from a choice. Many individuals you talk to who live with OCD will say they hate it. It's a disorder that robs peoples lives and leaves them in a state of panic almost constantly.

 

Even though most people who live with OCD know the obsessions are irrational, it's the feeling and manifestations of anxiety that urge the compulsions. 

 

The compulsions may offer temporary relief from the anxiety short term, but they reinforce and strengthen the OCD in the long term.

OCD often is called “the doubting disease.” Doubt is what fuels the fire for OCD, as sufferers feel the need to have total control over everything in their lives. There is no room for doubt or uncertainty. The irony is this quest for control inevitably leads to just the opposite — loss of control over one's life.

cognitive

distortions

Obsessive-compulsive disorder is often accompanied by some cognitive distortions, which are basically errors in thinking.

  1. OVER-ESTIMATION OF DANGER

  2. OVER-IMPORTANCE OF THOUGHTS

  3. OVER-ESTIMATION OF CONSEQUENCES OF DANGER

  4. IMPORTANCE OF CERTAINTY

  5. FEAR OF NEGATIVE EMOTIONS

  6. OVER-ESTIMATION OF RESPONSIBILITY