Obsessive Compulsive Disorders (OCD)
The term ‘OCD’ is often thrown around but it is in fact a serious and debilitating anxiety disorder that affects 1 in 50 people in the UK. Sufferers experience obsessive thoughts and compulsive behaviours that can, and often do significantly impact work, relationships, and life.
What Is OCD?
“I’m a bit OCD” is common parlance because we all possess traits that are somewhat obsessive or compulsive. OCD is more than this. It’s an anxiety disorder that is characterised by obsessions, compulsions, and irrational and unhelpful beliefs. It’s also highly distressing because of how time-consuming and draining it can be, which can be highly disruptive for daily life, relationships, and other obligations like work.
Unhelpful beliefs: These underpin OCD and relate to a fear about something. For example, someone might be a perfectionist and worry about falling short in some way. Some people overestimate danger and therefore feel they must do things to protect themselves or their loved ones. Some people feel overly responsible meaning they overcompensate. And for others, a fear of uncertainty means they overprepare for things.
Obsessions: These are frequent and repetitive unwanted thoughts, images, or urges that relate to unhelpful beliefs. They feel intrusive and are hard to control or ignore, which makes them very anxiety provoking or distressing.
Compulsions: To manage obsessive and intrusive thoughts, and attempt control and relief, people feel compelled to do something. Compulsions are behaviours or rituals and can be physical or mental. For example, if someone is obsessively worrying about the safety of their family, they may check locks multiple times, believing that this will protect their family. A mental compulsion might be when someone believes they have to count up to a certain number in their head, believing this will offer some kind of relief about the obsessive anxiety.
Most OCD sufferers are aware their thoughts are irrational. This makes it more frustrating because they are unable to stop themselves from acting on compulsions. The momentary relief gained, reinforces the behaviour. Unfortunately this relief is short term and only maintains the problem in the long term, often increasing the frequency of obsessions and compulsions. The solution (that is, the compulsive ritual) becomes the problem because it maintains OCD.
Contamination
One way OCD symptoms manifest is a fear of contamination. People can obsessively worry that being contaminated will harm them or loved ones. This means they may avoid shaking hands with people, touching door handles or things that are shared (like public phones, remote controls, keyboards, money, or cutlery, plates, or glasses in restaurants), or visit medical buildings, or others’ homes. These fears can result in constant cleaning (even if clean by most people’s standards), avoidance, or both.
Counting, Ordering, and Symmetry
Some people’s OCD manifests as a need for order and symmetry. Things need to be just so, or something bad will happen. This might mean they repeat words under their breath, align things to ensure they’re straight, or make sure things are facing forward. They may also want to make sure there are a particular number of items, an even number of them, count to a particular number, or in a standard sequence of numbers, repeatedly.
Hoarding
Hoarding can be a form of OCD if it is accompanied by obsessive thoughts. This can result in the compulsion to collect, buy, and store things that are not needed. This often relates to fears that something bad will happen to the person, or a loved one if they throw something away, or if they become emotionally attached to things, or because they believe the item may be needed later.
Intrusive Thoughts
Intrusive thoughts are upsetting and unwelcome thoughts, they can manifest as images, urges, and thoughts. Thoughts are repetitive and disturbing and can emerge in different ways or themes. Some common ones relate to:
- Sexual thoughts or images about family members or children.
- Relationship worries, constantly worrying about things going wrong with it, or about one’s sexuality.
- Violent thoughts, images, or urges towards others or oneself.
- Witnessing a serious event and worrying that one’s actions or inaction caused it.
- Thoughts that relate to one’s faith, its importance, or things that oppose one’s religious beliefs.
Repeatedly Checking
Some people have a compulsion to repeatedly check things because of an irrational fear that something bad will happen to someone or something if they don’t. So they may check if things are switched off (like light switches, appliances), or ensure they are safe by checking if doors or windows are closed or locked. They may check medical symptoms online, or that they have their phone or keys, or repeat tasks like reading something over again to ensure they’ve understood everything.
What Causes OCD?
There is no known direct cause for the development of OCD. As with all mental health conditions, there are multiple factors that can play a role. This includes genetic inheritance, and one’s personality, which is shaped by environment and upbringing. For example, the experience of trauma is thought to be a risk factor for many disorders.
How Phinity Can Help
At Phinity we offer various options for the treatment of OCD. The National Institute for Health and Care Excellence (NICE) is a UK body that provides guidance for the treatment of many mental health problems, including OCD. NICE recommends cognitive behavioural therapy (CBT), including exposure and response prevention (ERP), due to the strong evidence base that has demonstrated their efficacy for the treatment of OCD.
CBT is a ‘here-and-now’ approach, focusing on the problem from the perspective of the present, rather than attempting to understand the origins of a problem in great detail. By exploring how your thoughts, feelings, and behaviours all connect and maintain the problem, CBT allows individuals to learn about the unhelpful vicious cycles that are being repeated and offers techniques like ERP to help break these cycles, and replace them with helpful ones.
Exposure and response prevention (ERP) is a technique within CBT in which you will be supported by your therapist to expose yourself to situations that are currently anxiety provoking, and perhaps frightening, or panic inducing. Our therapists are highly trained and skilled and will design a treatment plan with you to gradually help you to become habituated to the situations you are currently avoiding, at a pace that feels manageable. Over time, the frequency of the obsessional thoughts and compulsions reduces, and the anxiety you face when exposing yourself to the problem becomes less intense.
What Causes OCD?How Phinity Can Help
Clients' Common Questions
- Recommendations | Obsessive-compulsive disorder and body dysmorphic disorder: treatment | Guidance | NICE. (n.d.). Www.nice.org.uk. https://www.nice.org.uk/guidance/cg31/chapter/Recommendations#steps-3-to-5-treatment-options-for-people-with-ocd-or-bdd
- What is Obsessive Compulsive Disorder (OCD)? (n.d.). What Are the Signs and Symptoms of Obsessive Compulsive Disorder (OCD). Retrieved October 12, 2022, from https://www.rethink.org/advice-and-information/about-mental-illness/learn-more-about-conditions/obsessive-compulsive-disorder-ocd
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