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What is OCD? And how to deal with it...

Obsessive-Compulsive Disorder (OCD) is the name given to a condition where people are having uncontrollable and unreasonable obsessions or compulsions that are excessive.

Obsessions

Intrusive or inappropriate recurring thoughts or impulses such as:

  • Obsessing about dirt and contamination, fear of coming into contact with germs or anything perceived as ‘unclean’. 
  • The sufferer has constant doubts about whether they have done something or not — did they lock the door, turn of the taps, run over somebody etc. 
  • They believe that things ‘must be kept tidy’, an endless quest for orderliness. 
  • They have impulses or thoughts about doing something aggressive or embarrassing which they may or may not contain. 

Compulsions

Repetitive behaviours or rituals that the sufferer feels compelled to do to lower his or her anxiety levels. Relief is only temporary so the compulsions are weaved into the person's daily routine and are not always directly related to the obsessive thought, for example, a person who has aggressive thoughts may count bricks or words in an effort to control the thought.

Common compulsions

  • Cleaning — sufferers obsess about germs and contamination and tend to clean constantly, either repeatedly washing their hands, showering, or constantly cleaning their home;
  • Checking — individuals may check whether they have done something, locking doors for example, several or even hundreds of times ‘just to make sure;
  • Repeating — one form of OCD is when the person repeats a name, phrase or action over and over;
  • Going slow — some individuals take an excessively slow and methodical approach to ordinary daily activities. They might, for example, spend hours organizing and arranging objects, food or timetables;
  • Hoarding — some OCD sufferers are unable to throw away useless items, such as old newspapers, junk mail, even broken appliances; sometimes the hoarding reaches the point that whole rooms are filled with junk that they have to carve passages through. 

'Official' diagnosis

For a diagnosis of OCD the obsessions and/or compulsions must take up a considerable amount of the person’s time and interfere with normal routines and activities including domestic, social and working relationships.  

OCD, like all anxiety disorders and highly emotional states, interfere with the ability to think and concentrate. It is not uncommon for a sufferer to avoid certain situations, for example, someone who is obsessed with cleanliness may be unable to use toilets other than ones they have cleaned themselves. 

Onset of OCD is usually gradual and most often begins in adolescence or early adulthood. Children with OCD, unlike adults, do not usually realize that their obsessions and compulsions are excessive. 

Treatment

Effective treatment would include a mix of all of the following:

  • relaxation techniques, 
  • doing an emotional needs audit, formally or informally, to see where stresses are coming from, 
  • separating the person’s core identity from the OCD so they can challenge the obsessive thoughts and behaviours, 
  • educating them about how the OCD process works, 
  • instilling in them the idea that the OCD is ‘bullying’ them and that they must not allow themselves to be bullied, 
  • rewinding extreme examples of the behaviour and any traumatic incidents that may have triggered it in the first place. 
  • guided imagery to rehearse not doing the behaviour in situations where they have been doing it. 
  • showing them how to get their innate emotional needs met in their lives. 
     

 

Further learning

• Undertanding OCD and how best to treat it   (1-day course)

Understanding Anxiety – and managing it without drugs  (online course)

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Date posted: 14/02/2024