Ever had the feeling that you are constantly doubting every decision that you make? Or that you are constantly on alert all of the time? Well you're not alone. In any one year, around half a million Australians suffer from OCD. People struggling with OCD are troubled by what is called obsessions and compulsions. An obsession is a recurring and unwanted intrusive thought that is experienced as highly distressing. A compulsion is a repetitive behaviour that a person feels driven to perform in order to reduce distress and/or prevent a feared outcome related to an obsession. In many cases, people suffering from OCD are aware that obsessions and compulsions are not rational or are excessive, however, they feel they have little to no control over obsessions and find it very difficult to resist compulsions.
Obsessions
Obsessions arise from intrusive thoughts. Intrusive thoughts are involuntary thoughts that can come in the form of ideas, mental images, memories, or urges, and can be about just anything. In fact, almost everybody experiences intrusive thoughts from time to time1. Intrusive thoughts are not necessarily problematic, rather it is the way we respond to them that can lead to obsessions and distress.
Examples of Obsessions:
· Fears of contamination, such as fears of dirt, bodily waste, or toxins
· Fears of harm to self or others, for example, fears of causing an accident or stealing
· Intrusive sexual obsessions, such as unwanted thoughts about children or relatives
· Intrusive violent or aggressive obsessions, for example, images of murders or blurting out obscenities
· Concerns about religion or morality, such as worries of blasphemy or right/wrong actions
· Obsessions about symmetry/exactness, for example, paper and books being aligned
· Urges or sensations of feeling “not just right” or incompleteness
Compulsions
Compulsions, which are also commonly referred to as ‘rituals’, are carried out in response to obsessions. They can include both actions and thoughts. Compulsions can be very time-consuming and are often not realistically linked to preventing a feared outcome.
Examples of Compulsions:
· Excessive and ritualistic washing/cleaning, such as handwashing, bathing, toileting, or avoiding handling certain items
· Repeated and excessive checking, such as of locks and appliances, or seeking reassurance from others that you have not hurt anyone
· Mentally repeating words, numbers, or images
· Repeatedly needing to touch, tap, order, or move body parts or objects in a certain way
· Excessive superstitious behaviours, such as avoiding ‘unlucky’ or ‘bad’ numbers
Causes and Treatment
Although the exact causes of OCD are not fully understood, it seems likely that there is no single cause of OCD. Rather, research suggests it is probably a result of the interactions between genes, beliefs, personality factors, and environments.
There are a number of evidence-based treatments for OCD, including psychological treatment. Currently, one of the most effective interventions for OCD is a psychotherapeutic treatment called Exposure and Response Prevention (ERP). To find out more about ERP, check out (the upcoming) tip sheet on “What is ERP?”.
- Written by Ms Stephanie Fung - Psychologist at Melbourne Wellbeing Group. To make an appointment with Stephanie to discuss OCD with her in more detail, or to book an appointment for treatment for OCD, then don't hesitate to contact us on (03) 9882-8874.
References:
1. Radomsky, A. S., Alcolado, G. M., Abramowitz, J. S., Alonso, P., Belloch, A., Bouvard, M., ... & Garcia-Soriano, G. (2014). Part 1—You can run but you can't hide: Intrusive thoughts on six continents. Journal of Obsessive-Compulsive and Related Disorders, 3(3), 269-279.
2. Sookman, D. (2015). Specialized Cognitive Behavior Therapy for Obsessive Compulsive Disorder: An Expert Clinician Guidebook. Routledge.