Obsessive Compulsive Disorder

What is the Obsessive Compulsive Disorder?

Obsessive Compulsive Disorder (OCD) is an anxiety disorder that implies the presence of obsessions and very often compulsions as well.

What is an Obsession? Obsessive Compulsive Disorder

An Obsession is a frequent, intrusive, unwanted and stressful thought, image or urge that comes up in the mind of the person. Obsessions cause extreme anxiety or disgust and the person is not able to control them.

The most common contents of obsessions are:

  • contamination: the person may fear a possible contamination from dirty objects or from people.
  • doubts;
  • aggressiveness: the patient is extremely worried the he/she could harm himself/herself or other people;
  • order and symmetry;
  • sexual fantasies.

The content of obsessions is usually considered as totally unacceptable and conflicting with the believes of the patient.

What is feared would bring such horrible consequences that the person feels obliged to avoid every possible risk.

The person usually tries to cope with obsessions by ignoring them, neutralising them (es. by applying compulsions), suppressing them or asking other people to reassure him/her.

What is a Compulsion?

On the contrary a Compulsion is a behaviour or a mental act that is repetitively performed in order to cope with the anxiety caused by the obsession.

Compulsions are usually very repetitive and executed in rigid and specific ways: the person feels the compelling need of performing them.  Not performing the compulsion can indeed cause a state of extreme anxiety.

Compulsions are usually linked to the content of obsessions.

Here are some examples of compulsions:

  • repetitively washing a part of your body;
  • checking;
  • rearranging things in a specific order;
  • counting;
  • repeating specific words.

People suffering from OCD tend to experience severe consequences in their work, social and personal life.

Usually OCD is accompanied by feelings of shame and guilt about obsessions, that contribute in keeping the disorder secret, delaying help seeking.

OCD often alternates periods of intense anxiety to improvements, but in the long-term, without appropriate treatment, chronicity is the most frequent outcome.

How can OCD be treated?

OCD can effectively be treated combining psychiatric medication and psychotherapy, depending on the severity.

Cognitive Behaviour Therapy is the most recommended kind of psychotherapy; it aims to reduce symptoms and prevent relapses.

The main technique with proven efficacy is Exposition withe Response Prevention (ERP).

This technique will gradually expose the patient to the content of the obsessions without performing the compulsion, so that the person will get used little by little to the anxiety provoked and will develop new coping mechanisms.

Beyond ERP, cognitive behavioural therapy will work as well on the cognitive rigidities and strengthening self-esteem.

Related articles:

“When a distressful thought becomes an obsession”, by I. Tedeschi

Useful links:

NICE guidelines for OCD