Obsessive-Compulsive Disorder (OCD) is a mental health disorder that impacts individuals across the lifespan. Although often used as an adjective in popular culture to describe a preference for cleanliness, organization, and strongly engrained habits (“I’m so OCD”), individuals who experience this disorder understand that having OCD often means that they face incredible challenges in daily functioning and generally, do not experience their symptoms as desirable. Effective treatment of OCD requires specialized training in Exposure and Response Prevention. Other therapy approaches used to treat OCD may actually exacerbate symptoms of OCD.
Obsessions are thoughts, images, and impulses that occur repeatedly, often feel uncontrollable and cause great distress. We all experience these thoughts at some point in our lives, and they come and go without much distress or effort. For individuals who suffer from OCD, these thoughts get “stuck” playing over and over in their minds, cause great distress, and seem uncontrollable and intolerable.
Compulsions are things people do to reduce the distress associated with the obsessions and to stop the obsessions themselves. Compulsions can be behaviors and mental processes. Many of us engage in compulsive behaviors from time to time in our lives. For individuals who suffer from OCD, these compulsions are often undesirable and extremely difficult, if not impossible to stop, while at the same time often recognized as excessive and unnecessary responses.
Common Obsessions
Contamination
Concerns or disgust with bodily waste or secretions, dirt, germs, environmental contaminants, cleaners, sticky substances/residues
Concerns about becoming ill (contracting HIV/AIDS, cancer), spreading germs and making others ill
Concerns about somatic symptoms
Sexual Obsessions
Personally unacceptable sexual thoughts
Symmetry or Exactness
Distress about things not being lined up or being in order, concerns about losing or throwing out items by mistake, concerns about not knowing or forgetting information.
Aggressive Obsessions
Violent or horrific images, fears of acting on unwanted impulses, fears of harming others, fears about being responsible for something else terrible happening.
Religious Obsessions/Scrupulosity
Concerns with sacrilege and blasphemy, excess concern with right/wrong and morality.
Pathological Doubt
Doubts about whether or not a certain routine was performed after completing the routine.
Common Compulsions
- Washing and cleaning to avoid contamination
- Checking and repeating to prevent something bad happening and to increase certainty
- Ordering – Placing things in a particular order and experiencing extreme distress if things are not in a specific way
- Mental Rituals – Specific mental rituals that are aimed at reducing distress associated with obsessions (i.e., praying, mental “undoing”, counting)
