Obsessive Compulsive Disorder

Obsessive compulsive disorder, or OCD, is a common anxiety disorder.

Obsessions are intrusive thoughts that seem to "hook" the mind, making it difficult to think of anything else.

Obsessions are often triggered by external events or features, such as certain colours, words, or numbers. These are followed by an intense desire to "undo" the negative feelings created.

Sometimes the trigger bears a clear relationship to the content of the thought. For example, leaving home might produce a worry that one may have left the oven on.

Sometimes obsessions take the form of intrusive images, concerns, or impulses (often violent or sexual in nature) that are unwelcome and seem nonsensical.

Compulsions are behaviours designed to undo or "unhook" the mind from the obsession. A person might check a lock over and over, clean counters to avoid bacteria, or repeat messages to be sure they have been understood by others.

Sometimes compulsions seem nonsensical, even to the person carrying them out. Counting backwards, avoiding sidewalk cracks, or engaging in other superstitious behaviour briefly helps the person deal with the anxiety.

Some people experience obsessions but no compulsions. Others experience compulsions but are unaware of any corresponding obsessions.

Treatment

Cognitive behavioural treatment of OCD can be remarkably helpful.

Cognitive work is designed to investigate the logic of the obsessions and compulsions. The person may discover half-hidden distorted ideas that serve to maintain the problem.

Behavioural work involves exposure to obsession triggers without engaging in any "undoing" behaviours or rituals. Exercises are chosen to be tolerable and easily completed. Once successful, the person develops the confidence to attempt more difficult exposures.

Therapy for OCD must be tightly structured and carefully carried out to maximize improvement. Most individuals are able to achieve significant gains over the problem, and learn valuable techniques for continued practice once therapy is over.