Obsessive Compulsive Disorder
What is it
Obsessive compulsive disorder (OCD) is a specific anxiety disorder in which people experience recurrent, obsessional, intrusive thoughts and images. As these can be extremely unpleasant and unwanted, they cause significant emotional distress for the person. People with OCD are often aware their obsessions are a product of their mind and they attempt to ignore or neutralise them with compulsions. Also known as rituals, these repetitive behaviours or mental acts assist in reducing the distress caused by the obsessional thoughts. In the short term this can often prove effective, but long term these behaviours increase and maintain the condition, leaving people feeling helpless and overwhelmed in resisting urges to perform them.
What does it include
People with OCD often report the following types of obsessions –
- Concerns about germs or contamination
- Concerns about dirt, cleanliness or symmetry
- Concerns about harming or injuring themselves or others
- Somatic and health related concerns (i.e. vomiting)
- Pathological self-doubt (i.e. turning iron off)
- Performing unacceptable sexual acts or religious expectations (i.e. blasphemy)
People with OCD also report the following types of compulsions –
- Cleaning, washing, list writing or re-arranging.
- Checking and reassurance seeking
- Mental rehearsal and counting
- Hoarding, tapping or touching objects
As OCD becomes more severe, individuals notice they spend more time engaged in adhering to their rituals, and put other important areas of their life aside. Relationships with friends, family and at work may suffer and people may also start avoiding these people or the situations altogether as they trigger further distress.
How can a psychologist help
If you or someone you care for is displaying symptoms of OCD it is important that they have a thorough assessment with a GP, psychologist and/or psychiatrist so a personalised treatment plan can be developed. OCD commonly co-occurs with other depressive and anxiety disorders (trichotillomania, body dysmorphic disorder, hoarding disorder) so it is important to consider the impact of these on the treatment during the assessment process.
Often treatment takes several months and starts with psychoeducation about OCD. This can help in normalising people’s experiences and break feelings of isolation or helplessness. Cognitive behavioural therapy (CBT) has the strongest research support to date and is proven to be effective in people who attend their sessions regularly and in those willing to undertake the recommended interventions outside of their sessions.
Psychologists using CBT often use a combination of exposure and response prevention to challenge the beliefs associated with specific obsessions and the overestimated threat around resisting compulsions. Experiments are often undertaken in a structured manner, once the therapist and patient have a good understanding of the person’s OCD, to enhance confidence. Coping skills are also taught to manage the distress experienced when fears are confronted and rituals resisted. Medication is also considered as effective, particularly for those demonstrating moderate to severe symptoms and significant distress.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Clark, D. A. (2007). Cognitive-Behavioral Therapy for OCD. New York: Guilford Press.
Veale, D., & Willson, R. (2009). Overcoming Obsessive Compulsive Disorder. London: Robinson.
If you require additional information, please call our office on 07 3256 6320. Our mental health focused reception staff will be only too happy to assist you with your enquiry about our service and can suggest the most suitable Psychologist for your concern.