OCD

Adapted from the DSM-5 by the American Psychiatric Association

OCD is a rather common mental disorder (2-3% of the population in the U.S.) with a strong neurological link. It is a disorder characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions).

Obsessions are unwanted, intrusive, undesirable, uncontrollable persistent thoughts, including images, internal commands, even urges, that initially cause significant anxiety and distress for individuals who experience them. Typically, people make every effort to neutralize or dismiss those thoughts with behaviors they may repeat over and over in order to reduce anxiety. The most common categories of obsessions include aggression/violence, sexual themes, sins, and religious issues, superstitions, hoarding, or contamination. The most important thing to remember is that obsessive thoughts are UNWANTED. They do not mirror the sufferer's value system (i.e. what they “think in their heart”). Ironically, it’s quite the opposite: Often, OCD “attacks” the most precious values of someone with OCD. For instance, a priest may obsess about being a child molester when all of their life they’ve defended the cause of children; or a student may obsess about being a cheat when all of their life they’ve strived to be honest.

Some individuals only experience obsessions without compulsive urges to do something about them.

Compulsions are repetitive behaviors that people feel driven to perform in response to obsessions OR according to rigid rules that they must immediately enforce. The aim is to reduce anxiety or distress or prevent some dreaded event or situation. However, these behaviors are not connected in a realistic way with what they are designed to neutralize/prevent or are clearly excessive. Examples include frequent hand-washing to the point of bleeding, checking and rechecking multiple times the same door lock, repeated confessions for the same perceived sin, repeating words silently multiple times, saying the same prayer unceasingly. Note some compulsions are mental acts, therefore not visible to observers and frequently unrecognized for a long time. They can feel automatic and involuntary.

Some individuals only experience compulsions without obsessing first. However, compulsions are always a way to reduce distress and anxiety about perceived threats.

Obsessions and compulsions are time-consuming and/or cause significant distress or impairment in social, academic, personal, and/or other important areas of life.

Fortunately, treatment for OCD is available from both fields of medicine and behavior therapy. Simple and commonly used medications may reduce the severity and frequency of obsessive thoughts and compulsions. Counseling can help individuals understand what OCD is and how it works, thus removing the guilt that often plagues individuals, establish new responses to unwanted thoughts, decrease the impact of those thoughts, allowing people to move on with their lives. With treatment, individuals acquire tools for life in case OCD thoughts and actions start to creep in again. The sooner a person is able to apply learned strategies, the quicker OCD will dissipate.