Obsessive-Compulsive Disorder (OCD)
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OCD is characterized by recurrent obsessions (which cause anxiety or distress) and compulsions (which serve to neutralize the anxiety). These symptoms form the basis of obsessive-compulsive disorder. The obsessions and compulsions interfere with daily routine and functioning due to the fact that they are intense, persistent, distressing, and very time-consuming (more than 1 hour a day). A person with OCD recognizes that the obsessions or compulsions are excessive or unreasonable. The sufferer is not delusional.
Obsessions
When persistent unwanted thoughts, images, or impulses occur over and over again, we refer to them as obsessions. Obsessions are excessive and unreasonable in nature. These repetitive ideas and thoughts continually preoccupy and intrude upon the mind, causing great distress. It’s difficult to resist the urge to think about them because the mind sees them as something worthy of being ruminating about.
It’s quite normal to have occasional distressing thoughts, images, and worries. But if the thoughts are very difficult to deal with, are marked by significant distress, occupy excessive amounts of time, and interfere with daily functioning, OCD may be the culprit.
Common Obsessions
- Contamination Obsessions (examples: germs, diseases, chemicals, body fluids, dirt).
- Loss of Control Obsessions (examples: performing unlawful, taboo, or embarrassing behaviors, committing a violent acts, fear of harming oneself or others, committing a crime, hallucinating, going 'crazy,' blurting out obscenities).
- Sexual Obsessions (examples: unwanted sexual images or thoughts, committing unlawful or unwanted sexual acts such as child molestation or sexual abuse, obsessions about one's sexual identity, fear of losing control and committing rape or incest).
- Perfectionist Obsessions (examples: being perfect, being exact, concern with remembering, keeping things even or precise, memory obsessions).
- Religious Obsessions (Scrupulosity) (examples: blasphemy obsessions, sacrilegious images or thoughts, obsessions about morality).
Compulsions
To try and counteract the intrusive thoughts, a person tends to engage in rituals or neutralizing behaviors. These behaviors are referred to as compulsions. Compulsions come in the form of specific urges to behave in a specific ways. The aim for a compulsion is to try and reduce the obsession. Unfortunately, the compulsion simply reinforces the validity or effectiveness of the obsession as something worthy of being afraid of, causing further anxiety. Thus, starts the vicious cycle of obsessing, ritualizing, and obsessing again. For example, a person who just touched a door handle may have an obsession that he/she is contaminated with harmful germs. The intrusive thought causes anxiety. To reduce this anxiety, the person engages in a ritual of washing his/her hands. Temporarily, the person feels some relief, but the relief is not sustained and rarely gets rid of the obsession.
Common Compulsions
- Repeating (examples: repeating body movements, tapping, blinking, going in and out of the house, setting up and dissembling things, rereading or rewriting things).
- Collecting (see hoarding)
- Checking (examples: repeated visits to a physician for feared health issues, checking up to make sure nobody was harmed by you, heckling up on loved ones excessively, repeatedly checking for mistakes).
- Washing/Cleaning (examples: hand-washing, excessive grooming, excessive cleaning, avoiding perceived "contaminated" spaces that are usually not avoided by people.
- Praying (to prevent harm)
- Mental Compulsions/rituals (see below):
Mental Rituals
Compulsions do not have to be behavioral (the way they are portrayed in the movies). They can also be mental. A person may engage in a mental ritual to try counteracting the obsession. For example, a person may have an intrusive image of doing something taboo like harming a child. In order to counteract this obsessive thought, the person may engage in a mental ritual of repeating a prayer or religious image to try and replace the thought.
Mental Rituals may consist of:
- Replacing negative thoughts with more positive ones.
- Over-analyzing behavior, thoughts, or other events in order to reduce the intrusive thought.
- Counting or repeating “good” numbers.
- Repeating phrases, words, prayers, confessions, mantras, or images in order to counteract the unpleasant thought or image.
- Trying to control a thought through thought suppression or other thoughts.
- Repeatedly checking the mind to gain some sort of evidence.
- Repeatedly checking one’s body to gain some sort of evidence.
- Repeatedly reassuring oneself in a way that replicates how someone else would reassure.
- Superstitious rituals that are performed solely in the mind.
Some frustrating thoughts that fuel the fire of OCD:
- If I act on these thoughts, I can prevent something bad from happening.
- Why is this happening to me?
- I have no future. I will be like this forever.
- I don't want to do that, but what if I lose control and do it?
- What if I secretly want to do that?
- What if I lose all control over my actions?
- I need to know everything will be okay
Pure-O OCD (Pure Obsessional OCD)
There is a mistaken belief that a person with Pure Obsessional OCD suffers with obsessions but not with compulsions. This is simply not the case. A person with pure obsessions engages in many rituals, but the rituals are mental – not behavioral. A mental ritual is performed solely in the mind. A person might try counteracting "negative thoughts" with "positive thoughts." A person might use the mind to review things, check one's sanity, count things, make lists of things, suppress thoughts, compulsively reassure oneself, compulsively pray or repeat words, etc.
Hoarding
Hoarding is a stand-alone subtype of OCD, although it is also a trait of Obsessive-Compulsive Personality Disorder (OCPD). Hoarding OCD is characterized by a fear of wasting possessions, the accumulation of clutter, excessive acquisition, and difficulty with disposing things. Hoarders accumulate large amounts of objects that are seen as having "possible" value. The hoarder imagines they can "one day" make use of the object, regardless of how dubious it is. In order to avoid the uncertainty of not knowing if something is needed in the future, they save, and the result can lead to unsanitary conditions and fire hazards. A home may be filled to capacity with newspapers, magazines, junk mail, worthless objects, trash, old food, useless clothing, boxes, excessive amounts of the same thing, canned food, dirty containers, old toys, cardboard boxes, broken appliances, and other non-functioning objects. In severe cases of hoarding, the person saves unsanitary things like feces, urine, smelly garbage, mold, and other things that can be dangerous and also attract insects or rodents.
Aside from saving, a person may spend time purchasing large quantities of endless goods and merchandise. The person may purchase out of fear that the bargain will never happen again or that they will not have enough money or capability to purchase in the future.
It's difficult for a hoarder to stop collecting because anxiety is experienced when discarding things. It's as if a part of them is being thrown out. A relatively new type of hoarding is information hoarding. A person might spend countless hours saving documents, images, videos, PDFs, or music from the Internet. Their computer can be seen as the 'space' in which the clutter emerges. Hoarding OCD has been associated with perfectionist beliefs, issues surrounding control and low self-worth, obsessions surrounding symmetry, ordering rituals, and perfectionist beliefs. Some hoarding (like animal hoarding) do not show the same repetitive behavior. But the home may be filled with cats, dogs, birds, or other animals.
Page Disclaimer
The OCD information on this site has not been evaluated nor has it been written by a physician or medical doctor. The information contained on this site is for entertainment purposes only and should not be used to diagnose, treat or prevent a medical or psychological disorder.
