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OCD - Obsessive Compulsive Disorder

By Max Eames Adv Dip Therapeutic Counselling MBACP (Accred)


What is OCD?

OCD stands for Obsessive Compulsive Disorder. It causes a person to have intrusive thoughts of a frightening nature, which in turn may cause that person to do things repeatedly. For example, he or she might perform certain ‘rituals’ to guard against perceived danger, or might fear the consequence of thoughts (e.g. racist or sexual thoughts) and/or actions (e.g. when driving a car or bathing a child). Almost everybody has fleeting thoughts of this nature, but most people are able to dismiss them out of hand. OCD is something entirely different. People with OCD simply cannot dismiss such thoughts, and thus find themselves paying undue attention to them. Whilst the condition can adversely affect every aspect of a person’s life, many with OCD can appear to function normally in the eyes of others. In fact, actors, professional sportsmen, company directors and engineers are frequently able to excel in high-powered careers, tolerating the condition in secret.

How Common is OCD?

OCD is much more common than was previously thought, and the ability to keep the condition secret – as well as the fear of seeking help – means that the actual numbers have been underestimated for many years. Whilst many worry that others will experience them as either ‘mad’ or ‘dangerous’ (neither of which describes a person with OCD), they often don’t realise that the medical establishment officially classifies OCD as an anxiety disorder. It is known as an anxiety disorder because the ‘obsessive’ thought-patterns generate a great deal of anxiety – and this frequently results in the urge to perform ‘compulsive’ behaviours in order to achieve temporary relief from the anxiety symptoms. The repetitive nature of this ‘chain reaction’ can be emotionally traumatic, and it is believed to adversely affect one person in every 40.

What are some of the Signs and Symptoms of OCD?

Thought and behaviour patterns associated with OCD vary widely. What they generally have in common is that such thoughts and behaviours are unwanted, yet occur with frustrating frequency; typically several times a day – or several times an hour. These patterns can progress to the stage of influencing the entirety of every waking day. This is not an exhaustive list, but persons with OCD might struggle with: checking things repeatedly (e.g. doors, locks, and gas or electrical appliances); the fear of endangering nearby persons whilst driving; having to do things repeatedly or in a certain order (such as in the shower or whilst travelling to work); counting footsteps or other repetitive actions; avoiding certain sequences of numbers (e.g. “666”); arranging everyday objects according to imaginary grids, symmetries, odd-numbered combinations, or suchlike; fear of being gay, being a paedophile, etc. with no evidence to support such a premise; music, words or images that cannot be eradicated from the person’s mind; hoarding of objects with no apparent value; and fear of contamination or of contaminating another person.

If a Person has any of the above Symptoms, does it mean they have OCD?

No, it doesn’t. That is to say, not necessarily. It all depends on the degree to which the thought-patterns or behaviour-patterns interfere with the person’s reasoning, thinking, and life-functioning. OCD manifests itself in a variety of ways, and individuals who have the condition usually experience a variety of symptoms. Moreover, most untreated people with OCD experience a degree of difficulty with daily activities, such as tendencies toward lateness, perfectionism, procrastination, indecision, low self-esteem and difficulties with family or personal relationships. A person experiencing an array of these symptoms would find it reassuring to discuss them with an experienced practitioner who specialises in the condition.

Is OCD a Psychological Condition, a Biological Imbalance, or Both?

OCD is generally accepted to have both psychological and biological elements. In fact, OCD-like behaviour has been observed in horses, dogs and birds. The cause of OCD is not exactly known at this stage, but is likely to result from a combination of factors. Having said all that, people who have the condition are generally held to have been born with a predisposition for OCD. Some might never experience symptoms throughout their entire lifetime, whilst others will experience a trigger (a traumatic or stressful event, a drug-misuse episode, or even a common childhood illness such as ‘strep throat’), causing that predisposition to manifest in the form of noticeable symptoms. This can happen at any time, and it is very common for those with the condition to show symptoms from a very early age.

Is ‘Scrupulosity’ something to do with OCD?

A fair proportion of people with OCD experience a mild or acute form of ‘scrupulosity’ at one time or another. Scrupulosity is an excessive fear of having done or said something that might be blasphemous in its nature. Scrupulosity concerns and worries, unsurprisingly, can vary according to the person’s faith group. For example, an Orthodox Jew might be plagued by fear of not having performed a religious ritual properly, whilst a Catholic might worry about having colluded with ‘the Devil’ in some manner. This complex phenomenon often goes unnoticed – family and friends can seldom see the debilitating effects of the condition – where rituals, incantations, and muttering are the secret ‘antidote’ administered by the person who fears he or she has somehow blasphemed.

Can Other Medical Conditions, or even ‘Stress’, be Related to OCD?

Some disorders, such as clinical depression, bipolar disorder (manic depression), social phobias, and panic disorders can be quite common in persons with OCD. Whilst there is as of yet no established link, other disorders can appear similar to OCD; namely OC Spectrum Disorder, Impulse-Control Disorder, Body-Dysmorphic Disorder, Asperger’s Syndrome, Tourette’s Syndrome and trichillomania (chronic hair-pulling). It is typical to experience a worsening of OCD symptoms during a stressful period of one’s life: death of a relative, impending pregnancy or birth of a child, relationship difficulties, relocation or employment changes can all affect the severity of the condition.

What sort of Results can a Person undergoing Treatment Expect?

OCD is not ‘curable’ as of yet; thus any treatment approach aims to render it controllable. And it is possible to attain an exceptionally high degree of mastery over the condition. ‘Mastery’ is achieved when a person regains a balanced sense of perspective on the thought-patterns that generally characterise the condition. A person who is prepared to work diligently can expect to achieve very good results; it is believed that up to 80% of persons with OCD improve significantly. Whilst many clinicians favour a drug-and-therapy regime, many persons with OCD are understandably reticent about the use of prescribed medication, and achieve remarkable results without the use of any prescription medication whatsoever.

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Issue area(s): Obsessive Compulsive Disorder (OCD)
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