Obsessive Compulsive Disorder (OCD) 


Obsessive Compulsive Disorder:  Obsessive Compulsive Disorder, or OCD, is a persistent pattern of unwanted thoughts, images or impulses called obsessions, that cause the sufferer significant discomfort and anxiety, oftentimes due to their frightening or taboo nature. In order to alleviate the pain caused by these unwanted thoughts, sufferers engage in repetitive or ritualistic actions called compulsions, which can temporarily relieve the anxiety caused by the obsessions. Notably, the OCD sufferer does not want to have these thoughts and finds them very distressing or counter to their values and beliefs. Frequently, the nature of one's obsessions are considered taboos in society, which increases the feeling of shame and secrecy the OCD sufferer experiences. This feeling of shame, as well as the high likelihood of misdiagnosis, can prolong the time it takes to receive the right kind of treatment, with the average time it takes a person to receive proper treatment between 7-9 years.

Common themes in Obsessive Compulsive Disorder

·      Contamination OCD: A preoccupation with the presence of germs or a feeling of dirtiness or contamination, often times associated with the compulsion of hand washing, excess use of Purell, and avoidance of 'contaminated' objects. 

·      Harm OCD: Intrusive thoughts and fears about the possibility of causing harm to others or to oneself. Obsessions include a fear of stabbing, shooting, insulting or injuring others, while compulsions may include isolating from household items such as knives, confessing repeatedly to avoid feeling 'bad' or compulsively researching how to identify signs of a harmful person. Harm OCD can also include suicide obsessions, where the sufferer is plagued with a fear of taking their own life. 

·      Scrupulosity: Often times includes obsessions around one's relationship to God, morality or core goodness. Sufferers become obsessed with the possibility of being excluded from heaven or redemption, and can engage in many ritualistic compulsions to try to 'wipe clean' their thoughts. Moral Scrupulosity includes an obsession with goodness and an extreme intolerance for behavior perceived of as 'bad' or immoral. 

·      Relationship OCD: A constant and persistent doubt about the 'rightness' of ones relationship, or the 'correct' amount of love or attraction one feels for their partner. Compulsions can include constant scrutiny of partner's percieved flaws, checking to assess how attracted or 'in love' one feels towards their partners multiple times a day, or incessant mental comparison to others or past relationships. This debilitating and frequently mis-diagnosed category of OCD is unique in that the sufferer fundamentally wants to stay in their relationship, but is plagued by the presence of doubt. 

·      Sexual Orientation OCD: Oftentimes called "Gay ocd," sexual orientation obsessions can include worries about being gay when one identifies as straight, heterosexual, worries about being transgender when one identifies as heterosexual, or worries about being straight when one identifies as being gay. Common compulsions include checking against members of the same sex to 'test' attraction, checking oneself for signs of groinal response around members of the same sex, and avoiding members of the same sex for fear of experiencing the anxiety. 

.      Pedophile OCD: Frequently referred to as "POCD" this theme revolves around the fear that one could be attracted to children or might secretly want to molest, sexually assault or otherwise harm children. Common compulsions include avoiding children, checking one's arousal level when around children, and excessive googling around the topic in an effort to gain certainty. Due to its troubling content, those suffering with this OCD theme can experience an extreme amount of shame and guilt about these thoughts, and some find expressing the content of their intrusive thoughts very difficult, even to a mental health professional. 

·      Post Partum OCD: A fear of hurting or wanting to hurt ones child. Frequently experienced during the first few months of infancy but can extend into childhood as well. Common compulsions include not wanting to stay alone with ones child, removing objects that could cause harm in the home, confession to one's partner or others to alleviate a sense of responsibility, and excessive researching. 

·      Symmetry Obsessions: A preoccupation with the exact order or appearance of things in ones home or in ones life. Compulsions include excess time spent organizing and putting objects in certain orders, and a rigid adherence to things being in their place. 


Treatment for OCD 

The prognosis for OCD is very positive with the right treatment. Cognitive Behavioral therapy (CBT) is considered the gold standard for OCD treatment, and is used at the onset of therapy to challenge the distorted thoughts and promote rational thinking. Mindfulness and Acceptance therapies are then employed to help the client manage the anxiety and discomfort which accompany these oftentimes horrific thought patterns, and finally, exposure and response prevention (ERP) is used to gradually challenge the client to face their fears. Often, when we face our feared scenario in small, manageable ways, we discover that the outcome we expect either does not occur, or is far more manageable than we might have thought. Exposure therapy should always be done with the help of a licensed professional, and preferably someone who specializes in the treatment of Obsessive Compulsive Disorder.