What is Obsessive Compulsive Disorder?

Obsessive Compulsive Disorder– Matone Counseling & Testing  – What is Obsessive Compulsive Disorder?

By: Simone Leavell-Bruce, PsyD

Obsessive Compulsive Disorder (OCD) is a mental health disorder characterized by obsessions and compulsions (DSM V, 2013). It is estimated that 6 million people in the United States have OCD. While boys have a slightly earlier age of onset, adult men and women develop OCD at a similar rate (Rasmussen & Eisen, 1990). Obsessions refer to intrusive and distressing thoughts, images, and/or impulses that repeatedly come into your mind despite trying to stop them.

Compulsions refer to both mental and physical attempts to reduce the anxiety by neutralizing the thoughts, images and impulses.

In popular media, most people are familiar with the person who is worried about dirt or germs and who washes their hands for long periods of time. In this example, the person’s worries about getting dirty or being contaminated by germs would be the obsession and the washing behaviors are the compulsions. The person engages in the compulsions in order to reduce the anxiety brought on by the obsession, but the compulsions only make things worse.


Symptoms of OCD?

People who suffer from OCD are plagued by uncertainty and doubt. For those who have moderate to severe OCD, the anxiety may begin to impact their daily functioning at work, school, home, and other settings (Ruscio, Stein, Chiu, & Kessler, 2008). People who suffer from OCD may often report first noticing symptoms during adolescent years. Many experience symptoms onset as gradual, with symptoms worsening over time. As symptoms increase, they can become very difficult to manage and can lead to other mental health disorders such as depression or generalized anxiety (Wynes, White, & Steketee, 1990). Symptoms can fluctuate in severity and intensity and stressful life events can sometimes cause symptoms to flare. People can have obsessions about a variety of things including thoughts about sexual identity, inappropriate or taboo thoughts such as pedophilia, religious themes, or health related issues. These thoughts, depending on the severity, often lead sufferers to spend exorbitant amounts of time trying to figure out if they have done something inappropriate or harmful to another person. They may engage in mental reviewing compulsions, where they try to remember all the details of a previous event to try to gain certainty that the content of their obsessions is not true. They may also avoid people, places, and things that trigger obsessive thoughts. Sufferers may seek reassurance from loved ones, which can often put a strain on relationships. For example, a person having obsessions about hitting someone with their car may avoid driving alone and may insist on having someone else in the car who can provide reassurance that they did not hit anyone while driving. 


Why do you have OCD?

Many people are curious about what caused them to develop OCD. While there are many hypotheses about this, there is no proven theory for why some develop OCD and why some don’t. Sufferers often report having a close family member or family history of OCD or other anxiety related disorder which suggests that there is a biological and genetic component. It is ill-advised to be overly-concerned about why someone developed OCD, as receiving adequate treatment does not require that your mental health provider understand why or how a person developed OCD.


Assessment & Treatment

OCD can be a chronic condition, but adequate treatment can provide substantial symptoms relief (Eisen & Steketee, 1998). The gold standard assessment is the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the treatment with the most empirical support is Exposure and Ritual Prevention (ERP). People try to reduce their symptoms by doing compulsions, but this only makes OCD stronger. After a thorough assessment, treatment would involve helping the client to confront the things, people, and places that trigger their anxiety without doing the compulsion. ERP therapy is designed to:

  1. Break the association between certain objects, thoughts, or situations and anxiety/discomfort. For example, if you avoid watching child sex crimes shows due to obsessions that you might be sexually attracted to children, then you have developed an assocation between watching material related to child sex crimes and anxiety/distress. 
  2. Break the association between carrying out compulsions and decreasing anxiety/distress. After carrying out compulsions, you may feel relief, but only temporarily. The relief felt is enough to convince people that they need to do the compulsions in order to feel better. Through treatment you will learn to resist the compulsions and practice new behaviors so that the association between doing compulsions and a reduction in anxiety can be weakened.


Getting Help 

Treating OCD on your own can be extremely difficult. For those with moderate to severe symptoms, trying to do the treatment on your own can lead to frustration. Unfortunately, finding a therapist who specializes in providing ERP therapy for OCD can be difficult. If you think you are experiencing symptoms of OCD, Matone Counseling & Testing can provide the evidence based treatment needed to help you live a better life. If you’d like to learn more about OCD please visit International OCD Foundation | Home (iocdf.org)

Written by: Simone Leavell-Bruce