Obsessive-Compulsive Disorder (OCD)
Obsessive compulsive disorder is a type of anxiety disorder primarily characterised by obsessions and compulsions. Obsessions are distressing, repetitive, intrusive thoughts or images that the person realises are irrational. Compulsions are repetitive behaviours that the person feels forced or compelled into doing in order to relieve the anxiety brought about by obsessions. In other words, compulsions are actions that are used to suppress the obsession and provide relief from distress and anxiety caused by the obsession (Barrow & Durand, 2009).
Typical obsessive thoughts include worry about being contaminated, fears of behaving improperly or thoughts of impending danger. The obsessions lead the person to perform a ritual or routine (compulsion) which typically involves such activities as hand washing, counting, repeating phrases or hoarding. This temporarily relieves the anxiety caused by the obsession as it neutralises the obsession, but is not a long-term solution. It is important for a person suffering from the disorder to recognise that the obsession is a result of their thoughts.
The compulsive behaviours are conducted with a goal of preventing distress or to prevent some dreaded situation. Washing and cleaning behaviour is considered the most common compulsion and is experienced more by women (Andrews et al., 1996). This is characterised by a fear of contamination.
Checking behaviours are the second most common, used by sufferers as a ritual to prevent something bad from happening. Repeating behaviours including counting or touching certain objects or repeating certain words or numbers. Ordering is another compulsive behaviour, used to arrange objects according to a particular set of rules. Sufferers often have more than one form of ritual which may change over time.
The OCD thought pattern has been likened to superstitions: if X is done, Y won’t happen in spite of how unlikely it may be that doing X will actually prevent Y. For example, the compulsion of turning lights on and off in a certain pattern may be used to alleviate the obsession that something bad is about to happen. Lights and other household items are common objects of obsession. Another example of this behaviour would be obsessing that a door is unlocked, which may lead to a compulsive constant checking and rechecking of the doors.
- Common obsessions: Pathological doubt, contamination, aggressive impulses, need for symmetry, sexual obsessions.
- Common compulsions: Checking, washing hands, praying, ordering/arranging, mental Rituals (counting, praying), hoarding.
I work in a psych ward and am privileged to have access to information that I wouldn’t normally have access to through my counselling dip. In my normal workday I meet people with a disorder that’s similar to OCD on the surface but differs from it significantly in one area. OCPD – Obsessive-Compulsive Personality disorder occurs in people who display similar obsessions and compulsions to those with OCD, except that their obsessions and compulsions cause no anxiety for them. It’s as though they have no insight into the fact that their behaviour is unusual in any way as it causes them, in their perception, no problems. However, it can cause extreme difficulties for those who interact with them, particularly those who love them, like their spouses and families. In my observation, this lack of insight makes OCPD even more difficult to treat than the more familiar OCD. If there’s no perceived problem, then the motivation to change is going to be largely missing. Even when marriages break down and families fall apart, there is the tendency to blame external circumstances and other people. I just thought it was worth mentioning because the difference may seem subtle but has implications for treatment. I think that referral to a clinical psychologist is probably a good course of action for those displaying the symptoms of OCPD.
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Thank you for the article on OCD I have been diagnosed as suffering with OCD which is all part and parcel to do with my anxiety and depression. Even though medication helps to keep my behaviours in check I still have my daily rituals, they are just not as intense. It’s a good reading and it helps to be able understand what?OCD is.