Obsessive Compulsive Disorder (OCD) is mental health condition in which a person gets stuck in a cycle of obsessions, compulsions, or both.
Obsessions are unwanted and distressing thoughts, urges or images. They are not pleasurable or voluntary. In fact, the nature of the thoughts may contradict one’s personality or values which only contributes to the distress. Obsessive thoughts, urges, or images repeatedly enter one’s mind and are experienced as intrusive
To find relief from the anxiety, individuals with OCD perform compulsions or “rituals”. These are repetitive behaviors or mental acts that one feels driven to perform to decrease anxiety, even though it may not make sense or be excessive.
OCD is thought to be somewhat organic/hereditary and built through behavioral reinforcement.
Here is a sample of a client experience:
Scary thought: “What if somebody breaks into my home?”
Behavior (AKA compulsion, avoidance, safety behavior, compensatory behavior): I check the door to make sure it’s locked.
Feeling: Relief (temporary)
Now I’m back in bed, and I think: “Did I really check the door? Or am I remembering checking it yesterday?”
Feeling: More anxiety!
Now I want to check again in order to get relief…
Thus, the compulsion/safety behavior is reinforced and the cycle repeats. The need to know for sure is what drives OCD. OCD is not logic based; therefore, rationalizing is not going to be effective. The acceptance/tolerance of uncertainty is the treatment for OCD which includes exposure as part of Exposure and Response Prevention (ERP).
When people think of OCD behaviors, handwashing, cleaning, and being hyper-organized tend to come to mind. This is only a small percentage of compulsions that may be done in response to contamination, cleaning, perfectionistic, or “just-right” obsessions. Other common obsessions can be categorized into themes such as aggressive, sexual, religious, harm and doubt, hoarding, superstitious, and somatic. The OCD behaviors may include things like checking, repeating the same action over and over, counting, seeking reassurance, mental reviewing, and more.
For more detail about what OCD may look like, check out this video:
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