Obsessive-Compulsive Disorder (OCD)
David Anderson, MS, LCPC, RPT-S, specializes in the diagnosis and treatment of obsessive-compulsive disorder (OCD) in Wichita, Kansas. As the founder of Wichita OCD Center, David uses Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP) as medication-free behavioral therapy for both adults and children with OCD.
What is OCD?
Obsessive-compulsive disorder (OCD) is a mental health disorder that involves a cycle of thoughts (obsessions) and behaviors (compulsions). OCD can affect both children and adults. The obsessive, intrusive thoughts are unwanted and cause intensely negative feelings like anxiety. The rituals or compulsions are behaviors that attempt to relieve the distress and/or eliminate the obsessions. Eventually, it feels impossible to control or stop the obsessive-compulsive cycle.
Diagnosis
An OCD diagnosis is made when the obsessions and compulsive behaviors become so time-consuming and extreme that they interfere with everyday life and activities. OCD affects women, men and children equally across all backgrounds, ethnicities and races. It can begin at any age, but generally OCD appears in individuals between the ages of 8 and 12 and from the teen years into early adulthood.
What Causes OCD?
According to the International OCD Foundation (IOCDF), the exact cause of OCD is unknown. However, research has shown that brain and genetic differences may be factors in the development of OCD.
What are Obsessions?
Obsessions are thoughts, impulses or images that happen repeatedly and feel uncontrollable. They’re often described as “intrusive thoughts”, because people with OCD don’t want them and find them distressing. Obsessions usually make the person feel intensely uncomfortable, fearful, disgusted, doubtful, or that things must be done in a specific way.
It’s important to understand that OCD is a psychological disorder, so it’s not the same thing as having an obsessive personality trait. Movies and TV often portray OCD as a funny quirk that makes people “want” things to be super clean all of the time. For a person who truly has OCD, the reality is that the obsessions are uncontrollable and trigger anxiety, and the compulsions are attempts to relieve that anxiety.
We also may hear people say they’re “obsessed with” or “obsessing over” something or someone, like a new band. What they mean is that they’re preoccupied with a thing, person or idea. However, they’re still capable of doing all of their normal day-to-day activities. When it comes to OCD, obsessions cause extreme feelings of anxiety and interfere with basic daily functions like going to work and school.
Common OCD Obsessions and Themes
Contamination
Contamination obsessions go beyond simply avoiding germs and dirt. OCD contamination fears can include objects, thoughts, ideas, and even people. A person with contamination themes may recognize that their fear is illogical, and they may not even be able to articulate the reason for their feelings. For example, OCD sufferers may believe that a single drop of blood can spread over a large area, or that thinking the name of a disease will somehow cause them to catch it.
Examples of contamination fears include dirt, bodily fluids, trash, soap, household cleaners, asbestos, radioactivity, germs, diseases, pets, broken glass, colors, words, and mental images,
Scrupulosity
Scrupulosity is a form of OCD that centers around moral or religious obsessions. There is an overwhelming concern that a thought or action may have been a sin or may have violated some type of moral or religious tenet. Scrupulosity obsessions include excessive worry about things like:
Moral behavior
Death
Blasphemy
Committing a sin
Going to hell
Losing impulse control
Purity
Harming Self or Others
Harm OCD is characterized by aggressive obsessions and unwanted thoughts about acts of violence toward oneself or others. For example, a fear of harming someone by accidentally dropping something on the ground that causes them to slip and fall.
The person experiencing this manifestation of OCD isn’t able to dismiss intrusive thoughts of aggression or harming someone. Instead, they worry that having such thoughts means they will actually carry out the violent actions. The person with Harm OCD wants to be reassured that they won’t act on the thought, so they complete compulsions and rituals to try and address their fear.
Relationship Themes
Relationship OCD is a subtype of OCD that’s been drawing more attention in recent years. It’s characterized by intrusive obsessions about intimate relationships. These may be partner-focused or relationship-centered. While it’s common to have doubts about a relationship or a partner’s compatibility, in some cases these concerns become more and more distressing and time-consuming, to the point that they impair everyday activities.
Relationship obsessions may include questioning their own thoughts, feelings or behaviors. Other relationship themes include comparing their partner or relationship to others. People with relationship OCD may have strong beliefs about the consequences for being with the wrong person, for example. They may have strong feelings of distress about anything negative that happens in the relationship. As a result, a person with relationship OCD will exhibit compulsions such as avoiding situations that make them feel uncertain or anxious about their relationship, such as watching romantic movies.
Sexual Themes
People with OCD who have sexual obsessions are often misdiagnosed. This is because sexual obsessions in OCD are often not reported or recognized, so they go untreated. Sexual themes in OCD are unwanted images or thoughts about doing perverse, forbidden or embarrassing sexual acts. Examples of these obsessions include aggressive sexual behavior or sexual obsessions that include incest or children.
People who are plagued by sexually intrusive thoughts feel horrified and disturbed because the repugnant thoughts are so contrary to their moral compass and values. People who suffer from sexual obsession develop self-disgust that can lead to crippling fear that they will act on the thoughts. In fact, they often misinterpret their feelings of anxiety about the thoughts as arousal or an impulse to act on them. Although they’d never act on the obsession, a person with OCD sexual themes may shut themselves away and avoid interacting with others, including family and friends, as a protective measure. While this type of ritual or compulsion isn’t as obvious or visible as others, it can still impede everyday activities.
Hit & Run Themes
OCD can make people feel unsure about things they see, think, hear and experience. A prime example of this is hit and run obsessions. Someone with hit and run themes suffers from excessive worry that they’re hitting people with their car, even with no evidence that they have. People with hit and run themes may stop frequently and get out of the car to look for a pedestrian, cyclist or animal that they’ve hit. Obsessive thoughts often relate to needing reassurance that they did not kill someone. As a result, the person engages in compulsive behaviors to make sure they didn’t hit anyone, such as driving around the block multiple times to look for a person lying in the street.
Health Anxiety Themes
Health Anxiety OCD is also referred to as Illness Anxiety Disorder, Somatic Symptom Disorder and Hypochondriasis. In this case, obsession centers around the belief that they either already have, or will have, a serious disease or illness. A person with health anxiety may overestimate the danger associated with normal physical discomforts, bodily functions and physical abnormalities. These worries may include a preoccupation with a specific organ, such as the heart, or a disease such as cancer.
A person who is continually worried about their health may fear that they’ll miss out on living a full life because of an unknown illness. As a result, they spend much of their time and attention trying to make sure they’re not sick in order to relieve their anxiety. This response to the obsessive thoughts actually takes away from their ability to enjoy life and pursue their dreams. Health anxiety OCD carries feelings of responsibility for:
Getting a diagnosis
Monitoring for symptoms
Avoiding contracting a disease or illness
Getting someone else sick
Accurately reporting symptoms
Although people with health OCD themes seek medical tests and care from doctors, often multiple times, they may be hesitant to obtain mental health treatment because they believe they have a medical condition. Unfortunately, the relief from a doctor’s reassurance that there’s no serious physical condition or illness is only temporary.
What are Compulsions?
Compulsions are thoughts or behaviors that are done repeatedly in an attempt to make an obsession go away or to decrease its impact. As with obsessions, compulsive behavior can also simply be a personality trait or personal preference for having things done a certain way. For people with OCD, however, the compulsive behavior is not something they want to do. It’s time-consuming and it’s done as what feels like a necessary response to anxiety or obsessions.
People with OCD know that their compulsion only provides short-term relief from the obsession, but they don’t have a better way to cope. Over time, the compulsive behavior feeds the OCD and increases the power and/or frequency of the obsessive thoughts. Rituals grow to the point that they begin to consume significant portions of a person’s day and their ability to function in society.
Common OCD Compulsions
Checking Rituals
Checking compulsions can be connected to any type of obsession, such as fear of accidentally causing harm. They’re completed in an attempt to relieve the stress that comes from uncertainty about a negative outcome. For instance, a person who worries about someone might break into their home might check to see if their door is locked as reassurance that no one’s going to break in. Checking can be cued by situations or reminders, such as leaving the house or seeing a light switch, and it can also be a response to thoughts that come to mind and are perceived as being dangerous. In these types of obsessions, the person may believe that a bad event is more likely to happen if they think of it, and checking is performed to in an attempt to prevent this.
People with OCD may check window latches and car or home door locks repeatedly to ensure that they’re secure. A person with OCD may also check appliances, light switches and faucets to make sure that they’re turned off, due to fears of causing a flood, fire or other catastrophe. It’s also common for someone with OCD to check to make sure that they haven’t harmed someone else or themselves. This is due to an overwhelming feeling of causing or being responsible for harm. Other common checking rituals include checking documents and forms repeatedly for errors, as well as checking their body for signs of health issues.
Cleaning and Decontamination
Cleaning and decontamination compulsions are actions a person takes to either remove contamination or to prevent it. These could include changing clothes frequently, avoiding going certain places or touching specific things, creating “clean” spaces that others aren’t allowed in, disinfecting and sterilizing, throwing things away, hand washing in an excessive or ritualistic manner, showering for long periods of time. Some contamination OCD sufferers may ask others to check for signs of contamination in places they can’t go or on parts of their body that they can’t see. Cleaning compulsion is more than just wanting things to be clean; it’s an unwanted response to anxiety caused by contamination fear and obsession.
Repeating
Repetitive behaviors or habits are those that a person feels compelled to perform in response to obsessive thoughts. These rituals are unwanted and they interfere with a person’s daily life. Examples of repeating behaviors include:
Repeating words
Rereading or rewriting
Doing routine activities repeatedly
Completing activities a certain number of times because it’s a “safe” or “good” number
Physical tics or repeated body movements like blinking or tapping
Vocal tics like throat clearing
Mental Compulsions
Compulsions can be classified into two categories: mental and behavioral. While behavioral compulsions can be observed, mental compulsions happen in a person’s mind. These rituals may include silently counting, repeating special images, words or numbers, reviewing past events over and over, and more. The intent is the same as for behavioral compulsions: to reduce distress and the chances of something bad happening. In some cases, individuals, and even therapists, may describe this as “pure obsessional” or “Pure O”, which means they have obsessions but no compulsions. However, mental compulsions are typically present.
Treatment for OCD
OCD can lead to feelings of hopelessness but help and treatment are available. At Wichita OCD Center, our founder, David Anderson, uses the proven methods of Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP) as effective treatments for OCD. Acceptance and Commitment Therapy (ACT) is another. Through treatment, our clients gain long-term solutions for managing their OCD and leading fuller lives.
Request an Appointment for OCD Treatment
OCD treatment with David Anderson can be requested online. We’ll contact you as soon as possible to confirm and schedule your appointment.
