Written by the clinical team at THIS WAY UP
Obsessive-Compulsive Disorder, commonly known as OCD, is a mental health condition that is often misunderstood. People commonly use the term ‘OCD’ to describe a preference for keeping things clean, tidy, and organised. However, this does not accurately capture the experience of OCD, and this misunderstanding can contribute towards stigma encountered by people living with the real struggles that can come with OCD.
This month we’d like to shed some light on OCD and explain how people living with these symptoms can learn to overcome the vicious cycle of obsessions and compulsions.
So, what actually is OCD?
OCD is a mental health condition that is characterised by two types of symptoms: obsessions and compulsions.
Obsessions are thoughts, images or worries that keep coming into your mind, no matter how hard you try to block them out. For people with OCD, obsessions tend to be very distressing, and often involve thinking about something bad happening to themselves or other people. For example, worrying about getting very sick from germs or contamination, or having unwanted intrusive thoughts about their loved ones being harmed.
People with OCD may fear that having an unwanted distressing thought immediately increase the likelihood of the thought coming true, a phenomenon known as thought-action fusion. Whilst this is not the case, and our thoughts are simply thoughts (not facts), continual worry about the nature of our thoughts can lead to difficulties staying present in day-to-day life.
Compulsions are behaviours that a person engages in in an attempt to get rid of, or ‘neutralise’ obsessive thoughts. We call these behaviours ‘compulsions’ because they are repetitive (happen over and over) and are often experienced as an urge or impulse that the person feels they ‘must’ complete in order to manage their distress.
Compulsions can be visible behaviours, such as repeatedly washing our hands or repeatedly checking that the stove is turned off, or they may be less obvious mental behaviours that we cannot ‘see’, such as repeatedly praying, counting, or checking our memory over and over to eliminate doubt. Compulsions are often repeated until the person feels that they’ve been done ‘just right’. Because of this, compulsions can take up a lot of time, and impact relationships, work, study and other areas of day-to-day life.
It is common for people with OCD to have a range of compulsions, including both physical and mental checking behaviours, that they do in an attempt to manage their obsessive thoughts. The compulsive behaviour initially develops as an attempt for the person to feel better when they are anxious, and whilst they might provide some short-term relief, in the long-run the compulsion reinforces their obsessive thoughts and leads to a vicious cycle.
Demystifying Obsessive-Compulsive Disorder (OCD)
Now that you have a clearer understanding of OCD, read on to demystify some of the common myths associated with this mental health condition.
Myth: Only people with OCD have strange, intrusive thoughts
Fact: This is incorrect! We all experience bizarre intrusive thoughts from time to time. Research conducted over the span of several decades has shown that the vast majority of the population experience unwanted intrusive thoughts, images, doubts and urges. For people without OCD, these thoughts are dismissed as being fleeting and random – they don’t hold any particular meaning and are therefore are quickly forgotten.
For people with OCD, these unwanted intrusive thoughts become ‘stuck’ because they are interpreted as meaningful. For example, a person with OCD may have an unwanted intrusive thought about harming a loved one, and worry that experiencing the thought means they are bad or dangerous in some way, even though it’s not at all what they would want or desire to do.
Myth: Everyone is ‘a little bit OCD’, right?
Fact: Whilst it can be common to like things to be organised, to doubt whether you’ve locked the door, or double-check that the stove is off, these symptoms alone do not indicate a diagnosis of OCD. OCD is a mental health condition that can lead to significant challenges in our day to day life. It involves intense, distressing symptoms that can significantly interfere with a person’s wellbeing, relationships, and general functioning.
Using the term OCD incorrectly, whilst often done without ill-intent, can be invalidating to the very real struggles of coping with unwanted obsessive thoughts and related compulsions.
Myth: People with OCD have to learn to live with it
Fact: People with OCD do not have to suffer alone. There are accessible, evidence-based treatments available. Cognitive Behavioural Therapy (CBT) is one of the most effective treatments for OCD. This treatment teaches people a very important skill called Exposure and Response Prevention (known as ERP) which involves graded exposure to the obsessive thoughts and feared situations without engaging in compulsions. This allows the person to learn that they can cope with having an obsessive thought, and learn that over time, the related distress reduces and the compulsion is not needed. This treatment helps us learn we can ‘sit with’ our thoughts, we don’t need to push them away, and in time, they bother us less.
ERP is an effective, step-by-step approach that has helped many people gain back their confidence, and tackle OCD symptoms. Medications can also be a helpful treatment for OCD – we encourage you to speak with your doctor if you are suffering from symptoms for their guidance and treatment recommendations.
With effective treatment, people can get back in control of their lives.
Recognising signs of OCD
If you are concerned about yourself or others, click through to discover some common obsessions and compulsions seen in individuals with OCD. It’s important to note that this is not an exhaustive list, and individuals with OCD may experience a combination of different obsessions and compulsions.
If you or someone you know identified with symptoms of OCD and are looking for assessment and treatment, you may wish to speak with your local doctor/GP.
THIS WAY UP also offers an OCD program, accessible here, so you can get started today on learning effective skills to improve how you feel and get back to the things that matter to you.