What is OCD?

Obsessive Compulsive Disorder commonly referred to as OCD has a variety of sub-groups and can be left undiagnosed due to misconceptions in the media and TV. OCD is not about being a "clean freak" or being particular about how you order your DVD collection. OCD is a pervasive disorder that is characterised by seemingly uncontrollable intrusions that generate high levels of anxiety and are accompanied by rituals/compulsive responses which are designed to temporarily lower the anxiety. These responses can be both behavioural and cognitive. 

 

OCD often focuses on areas of your life that are important to you, generating thoughts that conflict with your values, morals or beliefs. As your life changes the focus of your OCD can also shift.

 

OCD can show up in many forms. Sometimes the obsessions/ intrusions can sound like "what if" questions, sometimes they are urges and even statements, they can also be images. Although the content can focus on anything there are common presentations which the OCD community typically refers to as themes. "Themes" in OCD can be really validating and reduce the sense of isolation however be careful not to assume you don't have OCD if your obsessions don't fit into a specific box. 

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Common themes:

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Contamination - Body fluids, germs/diseases, environmental contaminants, household chemicals, dirt.

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Losing control - Fear of acting on impulse causing harm to you or others, fear of violent or horrific images in the mind, fear of blurting out obscenities or insults, fear of stealing something. 

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Harm - Fear of being responsible for something terrible happening to others, or fear of harm coming to others as a result of not being careful enough, fear of self harm, hit-and-run OCD. This theme can be extremely common in new mothers and can be referred to as postpartum OCD.

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Perfectionism - Concerns with exactness or evenness, the need to know or remember, fear of losing or forgetting important information, inability to decide whether to keep or discard things, fear of losing things. 

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Unwanted sexual thoughts - Forbidden or perverse sexual thoughts or images, forbidden or perverse sexual urges/impulses towards others, fear of homosexuality or heterosexuality, obsessions about aggressive or violent sexual behaviour towards others, fear of being sympathetic towards those who commit sexual crimes

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Religious or Moral obsessions (Scrupulosity)- obsessions about offending God or committing blasphemy, excessive concern with right and wrong.

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Sensorimotor OCD - Hyper awareness of particular body sensations or parts, e.g. blinking, swallowing, breathing. 

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Body Dysmorphic Disorder (BDD) - appearance related obsessions, concerns with perceived defects or flaws on ones face of body, often something that is minor and goes unnoticed by others. 

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Relationship OCD (ROCD)- Obsessions about love and fidelity, concerns about rightness of relationship or fears of being in the wrong one, are your feelings "right", obsessions about the attractiveness of partner, Obsessions about being attracted to other people (commonly someone you know), obsessions about having to break up, Obsessions about your partner being a bad person or having severe flaws. Like with other forms of OCD those with ROCD experience an intense need to "figure it out" urgently and resolve the inner conflict and uncertainty. This often leads to break ups as it can seem like this is the only way to reduce the anxiety and guilt. 

 

Paedophile OCD (POCD) -  One of the more taboo themes in OCD where individuals experience sudden, unwanted and extremely distressing intrusive sexual thoughts about children. POCD is NOT the same as being a paedophile. Paedophile's experience pleasure in situations where they have the opportunity to find sexual gratification around children, those living with POCD experience the exact opposite. Many suffers experience intrusions which focus on being in denial about their sexual orientation towards children and given the intense shame and guilt these intrusions generate many individuals struggle to disclose their experience and seek help. POCD can be more difficult to spot as most of the compulsions take place in the individuals head; replaying scenarios, trying to "figure" it out, seeking reassurance by searching on google or trolling through forums online.

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Treatment 

The GOOD news ... OCD can be treated successfully with Cognitive Behavioural Therapy and an approach called Exposure Response Prevention (ERP). 

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ERP is a type of behavioural therapy which is used to gradually build up your confidence in confronting and overcoming your fears. It is a highly effective evidence based technique that is considered the treatment of choice for all themes of OCD meaning that once you have become skilled in using it, you will feel more able to deal with whatever your OCD throws at you.  ERP works through gradual and repeated exposure to triggers or intrusions which then leads to habituation - the decrease in response when faced with your fear. E.g. if you have a fear of spiders but never go near them, your fear remains the same, every time you find a gigantic 8 legged friend in your bath room you'll likely scream and experience panic. If however you got locked in the bathroom and couldn't escape for several hours the likelihood is that your anxiety would naturally come down and boredom would set in, if this happened repeatedly over a period of time you'd learn that the experience was safe and you would feel much less frightened. Although this is more of a phobia situation the logic applies to obsessions; if you confront situations which trigger your feared obsessions regularly and repeatedly without engaging in the compulsive behaviours your body will learn to respond more calmly when faced with them, loosing the grip OCD has on your life. 

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To find out more about how therapy can support you to begin your journey to overcoming OCD please get in touch. 

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