What is OCD?
You often hear the phrases that someone is “So OCD” or that they wish they had “a little OCD” so they would be better about cleaning their home. As someone who has spent much of my professional life helping those rebuild their lives that have been taken by OCD, these are painful to hear. OCD, or obsessive-compulsive disorder, is often misunderstood. While most people think of OCD as being a fear of germs or someone who keeps everything nice and neat, OCD is much more than that.
OCD has 3 main components:
- intrusive, distressing, unwanted thoughts, images, or urges (obsessions)
- repetitive behaviors (mental or physical) to try to stop the fears or get rid of the images/thoughts (compulsions/rituals)
- these experiences have a significant and negative impact on one’s life
Obsessions and compulsions/rituals can take many different forms. Some common obsessions include fears that one might be a pedophile, harm other people, get an illness, harm the environment, act immorally, have a different sexual orientation, have a feeling that something is “off,” or that something bad will happen to their loved ones.
Wait, I have thoughts like that…
We all have thoughts like this. Have you ever been driving and thought, “What would happen if I drove into that tree?”… I have. If you have too, you’ve had an intrusive thought — a thought that you didn’t choose to be there, but it just showed up. The difference in having intrusive thoughts and OCD is what we do with those thoughts when they are there.
For some, it is easier to see that thought as random information our minds give us. For others, that thought is taken seriously, is terrifying, and is tied to who they are and how they behave. They might think, “Because I had that thought, it must mean I want to do it! What if I lose control one day and end up doing it? I need to make sure I never do that. My kids are in the car. I could hurt them. It would be all my fault.” If this is how you respond to that thought, it makes sense that you would start doing things to prevent your children from being hurt. You might avoid driving near trees, avoid driving all together, only drive alone, try convincing yourself that you would never do that, or say prayers before driving. The behaviors done to avoid these feared outcomes, images, or urges can be logically tied to the outcome or not. For example, tapping the car 3 times before driving with your children, while not logically tied to the safety of your children, may still provide some relief.
These rituals, or compulsions, can be time consuming, frustrating, and can impact your ability to live your life the way you want to. While these are logical responses to fear, they can limit how your life is lived and can lead to more elaborate systems to avoid fear. When the fear and the related behaviors become excessive and interfere with your life, that’s when it starts to become OCD.
I think I have OCD, what should I do now?
When people come to me for treatment, they are often terrified by their thoughts and exhausted from their rituals. Some of the great joys of my work are helping people see that their thoughts are normal, that they are normal, helping them stop their rituals, and getting their life where they want it to be. There are some really effective treatment options for OCD that are relatively brief (several months of weekly sessions).
Exposure and Response Prevention (ERP) and/or medication are the best places to start because they have shown to be the most effective treatments for OCD. However, these treatments don’t work for everyone. For those people, a treatment called Acceptance and Commitment Therapy (ACT) is the next recommended option. I was one of the therapists and researchers on a study looking at the effectiveness of ERP alone compared to ERP+ACT, which found them to be equally effective. ACT may be useful for people that do not respond to ERP alone. There are other treatment options, but if you have never had treatment for OCD, these are where you should start.
Finding an OCD Specialist
OCD is a more complex and debilitating experience than the phrase of “being so OCD” suggests. If you or a loved one are experiencing OCD, I recommend speaking with someone that specializes in OCD treatment. The International OCD Foundation has a wonderful guide to finding a therapist that understands and treats OCD. Be wary of providers promising quick fixes and cures, these don’t exist. I recommend finding a provider that will be a compassionate guide to do the hard work. Treatment for OCD is effortful, but I think you will be pleased with the results you get from going through a course of quality OCD treatment.
You can learn more about OCD and its treatments on our resource page.
Dr. Kate Morrison is a psychologist in Utah. Her career has focused on evidence-based treatment of OCD, anxiety, and related concerns. She is the owner of an all telemental health practice, Juniper Mental Health. If you would like to learn more about working with her, contact her or schedule a free consultation.