What Is OCD?
Obsessive-compulsive disorder (OCD) is characterized by obsessions (recurring unwanted thoughts) and compulsions (repetitive behaviors in attempt to relieve emotional distress). Some individuals with OCD only experience obsessions, while others only experience compulsions, and others struggle with both.
There is a misconception that OCD is merely a disorder of needing cleanliness and organization, but that’s only one way that OCD can manifest. Not everyone with obsessive-compulsive disorder is clean and tidy. Obsessions and compulsions can consume a person’s thoughts to where it interferes with daily functioning.
Types of OCD
Contamination OCD
People with contamination OCD have excessive and irrational fears of coming into contact with germs, chemicals, or harmful substances. They often fear contracting or spreading disease and illness. They typically engage in compulsive behaviors such as excessive hand-washing, house cleaning, disinfecting, and avoiding objects they fear may be contaminated in some way.
Harm OCD
Harm OCD is a disorder characterized by unwanted intrusive thoughts or images of doing harm to oneself or others. This may include harming a loved one, child, friend, neighbor, or innocent bystander. They engage in compulsions to reassure themselves they won’t act upon their disturbing thoughts. These compulsions can include avoiding sharp objects, repeated checking to see if they harmed anyone, or repetitive praying or counting.
Relationship OCD
ROCD is characterized by distressing thoughts and obsessions related to romantic relationships. Those with ROCD may often doubt their feelings for their partner, question their attraction to them, and repeatedly wonder if they’re with the right person. These obsessions can lead to compulsions to gain certainty about their relationship. The compulsions can include repeatedly seeking relationship advice, comparing their relationship to others, going on dating apps to see what else is out there, or going on other dates to test one’s feelings.
Pure OCD
People with ‘Pure O’ have obsessive thoughts without outwardly engaging in compulsive behaviors. Often upsetting and distracting, their thoughts can lead to repetitively circular thinking patterns in attempt to “think their way out” of the distress. Some examples are mentally reviewing events over and over, excessively ruminating on solving problems or making decisions, and silently repeating phrases to try to neutralize negative thoughts or thwart negative events.
Religious OCD
People with religious OCD can have irrational fears or doubts about their religious beliefs, practices, or morality. Their obsessions often revolve around breaking religious laws or moral codes, committing blasphemy, or fearing punishment by a higher power. Compulsions to alleviate their anxiety can include excessive praying, repeating religious rituals, carrying around religious objects or ornaments, and enforcing self-imposed punishments.
Just Right OCD (Perfectionism)
Spending hours writing and rewriting an email or text until it’s “just right”. Hanging shirts in a closet so they’re perfectly aligned. Walking along the sidewalk and avoiding cracks in the pavement. These are some common behaviors of Just Right OCD, a form of obsessive-compulsive disorder whereby the person is obsessed with doing things perfectly, often related to organization, symmetry, and sequencing.
OCD Symptoms
There are many signs and symptoms of OCD, the most common include:
- Intrusive thoughts: Intrusive thoughts are distressing ideas and images that come to mind uninvited and unwanted. They can be scary, threatening, violent in nature, morally reprehensible, and not always reflective of the person’s actual beliefs or desires. These thoughts can be difficult for the person to control or dismiss.
- Obsessions: Uncontrolled thoughts that infiltrate a person’s daily life are known as obsessions. They are involuntary and can come in many forms.
- Compulsive checking: Many with OCD use checking as a way to soothe their obsessive worries. They may feel the need to check the stove repeatedly or check the door locks multiple times before leaving home.
- Rumination: Many feel they cannot stop their thoughts about a certain worry and think about it over and over again. They may ruminate on the worry itself or repeatedly try to “think their way out” of the distress.
- Ordering: The need for order is a well-known trait of OCD. It becomes a problem when it takes over a person’s daily routine. Some may spend hours rearranging and organizing items.
- Obsessive cleanliness: It’s common for someone with OCD to engage in behavior to avoid contamination, such as washing their hands multiple times within an hour, using gloves to open a public bathroom, or sterilizing surfaces before touching them.
- Repetition and rituals: The need for repetition and routine is common in people with OCD. This can include repeating phrases, flicking light switches multiple times, tapping doors, and counting objects. These rituals are comforting to the person with OCD because they worry something bad may happen if they don’t do them.
OCD Therapy
Exposure Response Prevention (ERP) is a treatment for OCD in which the person is gradually exposed to their feared object or situation in a safe environment. The person learns ways to tolerate their anxiety during the exposure so they can refrain from compulsions. Over time and with practice of ERP, clients can become less afraid and choose healthy behaviors consistent with their true values, freeing them from their OCD.
Cognitive behavioral therapy (CBT) is a therapy method that encourages clients to observe how their thought patterns influence their actions and choices in life. This therapy involves examining unwanted thought processes and working to change them. Identifying and modifying unwanted thought patterns can make it easier to engage in ERP therapy.
Acceptance & Commitment Therapy teaches you to experience unwanted thoughts, feelings, and sensations without attempts to control or eliminate them. This can help those with OCD gain greater psychological flexibility, allowing obsessive thoughts to be viewed as “just thoughts” versus actual threats that need a response. In turn, this can help OCD sufferers refrain from performing compulsions and live a more productive life.
What Causes OCD?
OCD Examples
The following are examples of how different types of OCD may present in daily life:
- A man obsesses at work for hours over sending a client email. He reads his draft over and over making small revisions after each read until it’s “perfect”. He might even show his email draft to his co-workers to get reassurance it’s “just right”.
- A girl feels the need to count all of the floor tiles in a room, worrying that otherwise, her mother may get into an accident.
- A man in a romantic relationship has obsessive thoughts about whether he’s made the right choice in a partner. These obsessive thoughts lead to compulsive reassurance-seeking behaviors such as repeatedly asking advice from friends, comparing his relationship to others, and browsing dating apps. All of which are attempts to reduce his anxiety over the choice he’s made to be with his partner.
- A woman thinks obsessively about the germs that are on every surface in a shopping center and refuses to touch anything without a tissue or glove.
When to Seek OCD Treatment
Whether your OCD is moderate or severe, it may be time to seek help if:
Benefits of OCD Therapy
OCD therapy (ERP) can greatly improve the lives of those affected. Some benefits of OCD treatment include:
- Symptom Reduction: Exposure and response prevention (ERP) therapy is highly effective in reducing obsessive thoughts and compulsive behaviors. It provides practical tools to reduce symptoms.
- Behavioral Changes: ERP involves exposing individuals to anxiety-provoking situations while preventing the usual compulsive responses. This helps break the cycle of obsessive-compulsive patterns and encourages adaptive behavioral changes.
- Improved Functioning: As symptoms diminish, individuals often experience improved overall functioning in various areas of their lives, including relationships, work, and daily activities. This can lead to a greater sense of accomplishment and satisfaction.
- Enhanced Quality of Life: ERP therapy can contribute to an improved quality of life by addressing the interference of OCD in daily activities. Individuals may find greater enjoyment in social interactions, leisure activities, and personal pursuits.
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Frequently Asked Questions
Obsessive-compulsive disorder used to be classified as an anxiety disorder, and many symptoms of OCD can cause anxiety, such as rumination and obsession over fears. However, the DSM-5 moved OCD to be classified under a new category of its own: OCD and Related Disorders.
OCPD, or obsessive-compulsive personality disorder, is a personality disorder ruled by a need for control and perfectionism. It is generally consistent over time, while OCD fluctuates with stress and life changes. OCD is not a personality disorder and is ruled by obsessive thoughts and compulsions.
The Americans with Disabilities Act (ADA) considers OCD to be a disability. If OCD has caused significant impairment in your everyday life, accommodations and other resources may be available to you.
OCD often begins in childhood or early adolescence. Children with OCD may experience excessive worry or engage in repetitive behaviors without knowing why. They may understand that their behavior is abnormal or irrational, and not disclose why they don’t want to touch certain objects or why they need to perform certain rituals. Creating an environment where children can openly discuss their struggles is essential to identifying OCD.