Have you ever heard someone say, “I’m so OCD about this!” when they have a need to get something just right?
Most people only have a surface-level understanding of OCD, but those who suffer from it know how difficult it can be. The reality looks more like frequent anxiety, constant checking, and exhaustive effort to prevent disasters.
This article is going to explain what OCD really is and how it can be treated. If chronic obsessions have you feeling trapped in your own head, this is how you can learn to break free.
What People Should Know About OCD
Obsessive Compulsive Disorder (OCD) is an anxiety disorder characterized by frequent, unwanted, obsessive thoughts, accompanied by attempts to quell the anxiety caused by those thoughts, known as compulsions.
Cycles of obsession and compulsion can become severe, and at times debilitating.
According to OCD UK:
“…if a person is suffering with Obsessive–Compulsive Disorder then it will be impacting on some or all aspects of their daily life, sometimes becoming severely distressing leading to some nature of impairment or even disablement for hours at a time, each and every day.”
The types of obsessions reported by OCD patients are as vast and diverse as the human imagination. However, the one question that rests at the core of every OCD fear is, “What if?”
What if I get a disease? What if my hands are still dirty? What if I’m a bad person? What if the world falls apart if I don’t align this properly? OCD is a condition of overactive doubt, often called “the doubting disorder.”
OCD patients may know logically that their obsessions are irrational, but what matters is the feeling. They need to feel a sense of assurance, and compulsions are how they generate that feeling.
Let’s look at some specific examples of how OCD manifests:
What OCD Looks Like
There are several broad categories that OCD obsessions and compulsions fall under.
But there is one important phenomenon that must be explained first if you want to understand and heal from OCD.
Intrusive thoughts are a staple for OCD patients. All fear-based obsessions occur through them.
Here’s a basic definition according to Psychology Today:
“Intrusive thoughts are unwanted thoughts, images, or urges that seem to pop into your mind out of nowhere. Such thoughts can take the form of any number of offensive ideas. The content is commonly violent, sexually explicit, or otherwise socially inappropriate.”
Intrusive thoughts are actually normal, and they happen to everyone. For OCD patients, however, their behaviors and lifestyles are built around preventing and reacting to intrusive thoughts.
Think of it like this: Some people have stickier brains than others. Their intrusive thoughts get caught in the web of their sticky brains, and it’s hard to let them go. A person with a non-stick brain might have the same intrusive thoughts, but the thoughts don’t hang around for too long. It’s the people with sticky brains that struggle the most with intrusive thoughts.
Trying to repress intrusive thoughts is like trying to “not think of a pink elephant.” The more you resist intrusive thoughts, the more frequent they become, and the more they drive your behavior.
Intrusive thoughts for OCD patients are best thought of as an elaborate way of your brain warning you of something. It’s testing you by asking you the question, “Are you really this?” Responding with compulsions and reassurances validates the brain’s fears, and so the thoughts continue to arise.
Intrusive thoughts do not denote flaws in character or the repression of something actually evil. It’s the obsession with the possibility of those things being true (What if?).
An OCD patient with violent intrusive thoughts might be the sweetest person in the world. They are just constantly vigilant about the possibility that they could harm others.
That being said, let’s examine some common OCD obsessions:
This is a fear of causing harm to others. Those with an aggression obsession might struggle with violent images or urges popping into their minds.
This is the fear of being contaminated or contaminating others. This can mean germs, or it can even mean becoming infected by the immorality of other people (If a bad person touches me, I will become like them).
This is an obsession with being pure in the eyes of a higher power, or being preoccupied with big existential questions that don’t have definitive answers.
This is a fear of being sexually deviant or having thoughts that are sexually inappropriate. Like aggression obsessions, these usually come in the form of thoughts, images, or urges.
- Symmetry/ Exactness
This is an obsession with having to do things in a balanced or exact way.
OCD with relationships is the obsession with the quality of one’s relationships, either self-focused or partner-focused.
How OCD Therapists Treat OCD
OCD therapists treat OCD in several clinically effective ways:
EXPOSURE AND RESPONSE PREVENTION THERAPY (ERP)
ERP therapy encourages OCD patients to face their obsessive fears, identify the compulsions they use to quell those fears, and delay or prevent performing them.
Compulsions can be thought of as the fuel for OCD obsessions. If patients can learn to gradually expose themselves to their fears without performing compulsions, their obsessions will start to decrease in strength and frequency.
By sitting in the discomfort of fear without performing compulsions, OCD patients learn that they can survive their worst fears without anything bad happening.
COGNITIVE BEHAVIORAL THERAPY (CBT)
CBT is more about examining the underlying beliefs of an OCD patient, as opposed to exposing them to fears. This is usually done as a prerequisite to ERP, which involves directly facing a source of anxiety.
CBT helps OCD patients rethink and revalue their fears, allowing them to see that instead of “having” to perform a compulsion, they have a choice in the matter.
They can learn to see their fears as alarms going off in their brain, and not entirely truthful or valid things to worry about. It’s about coming to a rational understanding of why their fears might be unfounded.
As difficult as OCD can be to deal with, adopting a sense of humor around your treatment can help quite a bit.
Coping humor is the act of taking something that triggers painful emotions and making something funny out of it. If you can get to the point where you can see the goofiness in your OCD thoughts, that will greatly reduce their power over your behavior.
After all, if you can prevent a climate disaster by touching a doorknob 55 times every morning, you are clearly a wizard.
What OCD Really Is
The heart of OCD is the need for certainty.
“You have to make everything certain so you’ll never have to worry about anything,” the OCD brain says. And yet, all it does is worry.
Nothing in life is certain, and the key to recovering from OCD is coming to accept and love that fact. No amount of compulsive action will bring absolute certainty into the world. And it’s not your responsibility to make it so.
Facing fear is walking voluntarily into uncertainty, and as the evidence shows, courage is curative.
You can win against your OCD, you just need to be a little brave.