Obsessive Compulsive Disorder (OCD)
Most people have experiences the occasional thought that seems odd, or have had the urge to double-check something that they know they have already done (like going back to make our the iron is turned off, or the car is locked). However, individuals with obsessive-compulsive disorder (OCD) have these types of experiences repeatedly and frequently, and find them so frustrating and intrusive that they interfere with their day-to-day life.
OCD is characterised by the following:
- recurring, persistent, and distressing thoughts, images or impulses known as obsessions;
- the need to carry out certain repetitive behavioural, rituals or mental acts, known as compulsions.
Obsessions are not merely worries about everyday concerns, and compulsions are more than just habits. Many people with OCD experience both obsessions and compulsions, whilst others have only one or the other. The symptoms of OCD are often upsetting or embarrassing to the individual, and can lead to significant avoidance or situations which trigger their OCD thoughts and/or behaviours. The repeated behaviours or rituals are generally carried out as an attempt to reduce anxiety, or with the idea that it prevent a fear outcome. However, the temporary relief provided by these behaviours, and the individual’s release upon them to manage their distress is actually part of the OCD cycle.
Common obsessive thoughts may include the following: contamination from dirt or germs, concern with personal safety or the safety of others, concern with order or symmetry, thoughts that are generally inconsistent with the individual’s values, such as aggressive, sexual or blasphemous thoughts.
Common compulsive behaviours include excessive or repeated behaviours including: cleaning, checking for whether doors are locked, or appliances are switched off, ordering items or behaviours, placing objects in a particular pattern, mental acts (such as reciting phrases or counting), collecting old items that aren’t useful or of value.
In some individuals, there is no clearly identifiable trigger for the onset of their OCD, whilst for others, a major life event may be associated with the onset of symptoms. Factors that have been associated with an increased risk of developing OCD include:
- a family history of OCD
- unhelpful thinking styles such as perfectionism
- neurological or biological factors
Cognitive-Behavioural Therapy (CBT), specifically exposure and response prevention (ERP) is considered the most effective treatment for OCD. In ERP, a series of goals are developed between the Clinical Psychologist and the client, based around the situations that typically trigger obsessions and compulsive behaviours (including avoidance). Over time, and with the Clinical Psychologist’s help, the client confronts these situations (exposure), and practices responding without using their usual OCD behaviours (response prevention). Through this process, the individual leans to tolerate their anxiety, and as they do, the distress and obsessions gradually decrease. At the same time, more adaptive ways of responding to anxiety are developed.
Cognitive therapy is another approach that has been found to be helpful for individuals with OCD. This therapy supports clients to identify and challenge unhelpful patterns for thinking that contributes to their anxiety, as well as the beliefs around the usefulness of their compulsive behaviours.
In many cases, the use of psychological approaches alone will be effective in treating OCD. However, in some instances, individuals may respond better with a combination of both psychological intervention and medication.
If you are experiencing symptoms of OCD, and find that they are impacting upon you work performance, school life or your relationships, a Clinical Psychologist may be able to help. Clinical Psychologists are highly trained and qualified professionals, skilled in diagnosing and treating a range of mental health concerns, including OCD. A Clinical Psychologist can help you identify and address factors that might be contributing to your anxiety and other symptoms, as well as help you to develop alternative coping responses.