The key features of OCD are obsessions and compulsions.
Obsessions are unwelcome and sometimes unpleasant thoughts, images, urges or doubts that spring into our mind on a repeated basis. Having these occasional thoughts on their own are actually very common and we often call them “intrusive thoughts”. However those with OCD find these thoughts particularly distressing and are troubled by them on a frequent basis. These thoughts cause intense feelings of anxiety and/or physical symptoms which compel the person to act in response to them.
Examples of obsessional themes:
- Thoughts to directly harm oneself or others
- Unwanted sexual thoughts
- Thoughts of being contaminated by germs, dirt, dangerous substances or illnesses or bad thoughts
- Thoughts or images that ones actions, or lack of action may cause harm to others such as causing a gas explosion or fire, or doors or windows being left open
- An urge for things to “feel right”, for example that things which are not in a certain order or symmetrical
- A fear that we have inadvertently done something ‘bad’ without our awareness (i.e. running someone over in the road, writing inappropriate content in written work)
- Blasphemous thoughts, doubts or just generally thoughts that go against your religious or moral beliefs
- A feeling that there is special significance or attachment to certain items
Compulsions are what we do in response to the unpleasant thought, which can be repetitive and sometimes appear completely unrelated to the thought. Sometimes these compulsions are “behavioural” where we take physical action (such as checking taps), however sometimes the compulsion just happens in our head (mentally saying a special word). Compulsions are completed with the aim to reduce emotional and physical distress, as well sometime to prevent harm or bad things from happening. However the relief is often short lived, and the thoughts or images come back.
Examples of compulsions:
- Checking (doors, windows, physical sensations and changes, written work etc)
- Cleaning and washing (hands, the house etc)
- Counting (sometimes this is linked to having “good” and “bad” numbers)
- Repeated actions (flicking a light switch on and off, retracing steps whilst trying to have a good thought)
- Replacing ‘bad’ or unwanted thoughts with ‘good’ thought or prayer. Sometimes this involves certain words, mantras, rhythms or tunes
- Avoidance (avoiding pictures of children or the opposite sex or avoiding public toilets)
- Seeking reassurance from others
- Inability to throw items away, or urge to acquire items (hoarding)
Most of us will experience these “intrusive thoughts”, and we may even on occasion respond to this i.e an urge to straighten the papers on a desk or repeatedly check our hair straighteners are off. However this only becomes a problem when it starts to impact our life or the lives’ of others around us.
Those with OCD can often recognise that their fears or behaviours are excessive or irrational, but the associated distress is so strong that it feels almost impossible to break the cycle.
It can have a huge impact on the family, friends and colleagues of those suffering as well. If you are supporting someone with OCD and would like to know how to help see our Supporting Loved Ones page.