Obsessive Compulsive Disorder
What is Obsessive Compulsive Disorder?
Obsessive Compulsive Disorder (OCD) is characterized by the existence of obsessions and/or compulsions. Individuals with OCD recognize that their obsessions or compulsions are excessive or unreasonable but are unable to control them. The symptoms cause marked distress, are time consuming, and may cause significant interference to their daily lives. OCD affects approximately 1% of the population. It can occur in childhood, adolescence or early adulthood with onset typically either around early puberty (8-12 years old) or around the later teen and early adulthood years. Adult onset is less common but does occur and OCD can occur related to pregnancy and the postpartum period. Over the course of one's lifetime, a person may have several episodes of OCD.
What are Obsessions?
Obsessions are not simply worries about real-life problems. Obsessions are recurrent and persistent thoughts, urges, or images that are experienced as intrusive and unwanted. They cause anxiety or distress and often interfere with a person's ability to concentrate on daily tasks. Individuals with obsessions often try to ignore, suppress, or neutralize the obsessions, usually with little success (DSM-5, APA, 2013).
Common obsessions include:
What are Compulsions?
Compulsions are repetitive behaviors or mental acts that are done in response to an obsession or according to a set of rigid rules. Compulsions are aimed at preventing or reducing anxiety or distress, or preventing a feared event or situation, but they are either not realistically connected to the obsessions or are clearly excessive (DSM-5, APA, 2013).
Common compulsions include:
How is OCD treated?
The most effective psychological treatment for OCD is a form of cognitive-behavioral therapy called Exposure and Response Prevention.
Exposure & Response Prevention (ERP) involves exposing patients to the obsessions that create anxiety and preventing them from engaging in their compulsions. After repeated exposure without the compulsions, the patients learn that their anxiety is irrational and that their worst fears are not realized, and subsequently their anxiety decreases. They also learn that they can tolerate and are more capable of coping with their anxiety than they anticipated.
Treatment for OCD typically begins with education about the disorder and the treatment. Then the patient and the therapist build an anxiety hierarchy, in which OCD symptoms and situations are identified and ranked from least to most anxiety provoking. Cognitive therapy is used to challenge those beliefs that maintain the OCD and to help the patient prepare for beginning ERP. With the therapist's support, and at a pace that is comfortable for the patient, ERP begins and the patient is exposed to each situation on the anxiety hierarchy until that situation no longer provokes anxiety. Homework assignments including self-monitoring of symptom frequency and intensity and at-home ERP exercises are assigned to further facilitated symptom improvement. As treatment progresses, core beliefs about the patient inability to tolerate anxiety, cope with distressing situations, and their overall need for control are challenged and changed.
Medication is also used to treat OCD. Depending on the severity of the patient's symptoms, various classes of medications are helpful in alleviating symptoms and decreasing the patient's anxiety so that they can engage in the psychotherapy. If the use of medication is warranted, the therapist works with a psychiatrist to find the right balance of medication and therapy to best treat the patient.
OCD Links
International OCD Foundation (IOCDF) - The international not-for-profit organization composed of people with obsessive compulsive disorder (OCD) and related disorders, their families, friends, professionals and other concerned individuals.
National Institute of Mental Health - OCD Page
www.geonius.com/ocd - A website with links to just about anything and everything about OCD.
Association for Behavior and Cognitive Therapies - ABCT OCD Fact Sheet
A list of books on OCD can be found on the IOCDF website - click here.
Obsessive Compulsive Disorder (OCD) is characterized by the existence of obsessions and/or compulsions. Individuals with OCD recognize that their obsessions or compulsions are excessive or unreasonable but are unable to control them. The symptoms cause marked distress, are time consuming, and may cause significant interference to their daily lives. OCD affects approximately 1% of the population. It can occur in childhood, adolescence or early adulthood with onset typically either around early puberty (8-12 years old) or around the later teen and early adulthood years. Adult onset is less common but does occur and OCD can occur related to pregnancy and the postpartum period. Over the course of one's lifetime, a person may have several episodes of OCD.
What are Obsessions?
Obsessions are not simply worries about real-life problems. Obsessions are recurrent and persistent thoughts, urges, or images that are experienced as intrusive and unwanted. They cause anxiety or distress and often interfere with a person's ability to concentrate on daily tasks. Individuals with obsessions often try to ignore, suppress, or neutralize the obsessions, usually with little success (DSM-5, APA, 2013).
Common obsessions include:
- Contamination worries (germs, dirt, etc.)
- Aggressive thoughts or images (harm to self and others)
- Sexual thoughts or images
- Religious thoughts or images
- Thoughts about symmetry, order or perfectionism
- Recurring words, sentences, songs, numbers
- Thoughts of losing control
What are Compulsions?
Compulsions are repetitive behaviors or mental acts that are done in response to an obsession or according to a set of rigid rules. Compulsions are aimed at preventing or reducing anxiety or distress, or preventing a feared event or situation, but they are either not realistically connected to the obsessions or are clearly excessive (DSM-5, APA, 2013).
Common compulsions include:
- Hand Washing / Cleaning
- Ordering / Arranging
- Checking
- Touching
- Repeating / Reviewing
- Reassurance Seeking
- Doing things until it feels "just right"
How is OCD treated?
The most effective psychological treatment for OCD is a form of cognitive-behavioral therapy called Exposure and Response Prevention.
Exposure & Response Prevention (ERP) involves exposing patients to the obsessions that create anxiety and preventing them from engaging in their compulsions. After repeated exposure without the compulsions, the patients learn that their anxiety is irrational and that their worst fears are not realized, and subsequently their anxiety decreases. They also learn that they can tolerate and are more capable of coping with their anxiety than they anticipated.
Treatment for OCD typically begins with education about the disorder and the treatment. Then the patient and the therapist build an anxiety hierarchy, in which OCD symptoms and situations are identified and ranked from least to most anxiety provoking. Cognitive therapy is used to challenge those beliefs that maintain the OCD and to help the patient prepare for beginning ERP. With the therapist's support, and at a pace that is comfortable for the patient, ERP begins and the patient is exposed to each situation on the anxiety hierarchy until that situation no longer provokes anxiety. Homework assignments including self-monitoring of symptom frequency and intensity and at-home ERP exercises are assigned to further facilitated symptom improvement. As treatment progresses, core beliefs about the patient inability to tolerate anxiety, cope with distressing situations, and their overall need for control are challenged and changed.
Medication is also used to treat OCD. Depending on the severity of the patient's symptoms, various classes of medications are helpful in alleviating symptoms and decreasing the patient's anxiety so that they can engage in the psychotherapy. If the use of medication is warranted, the therapist works with a psychiatrist to find the right balance of medication and therapy to best treat the patient.
OCD Links
International OCD Foundation (IOCDF) - The international not-for-profit organization composed of people with obsessive compulsive disorder (OCD) and related disorders, their families, friends, professionals and other concerned individuals.
National Institute of Mental Health - OCD Page
www.geonius.com/ocd - A website with links to just about anything and everything about OCD.
Association for Behavior and Cognitive Therapies - ABCT OCD Fact Sheet
A list of books on OCD can be found on the IOCDF website - click here.