OCD is considered an anxiety disorder characterized by certain thoughts reoccurring involuntarily (called ‘obsessions’) as well as a felt need to perform certain routines repeatedly (called ‘compulsions’) to an extent which generates distress or impairs general functioning. Hence the name Obsessive-compulsive disorder – OCD.
What is an obsession? Obsessions are thoughts (ideas, mental images, mental impulses) that appear in one’s consciousness repeatedly. The thoughts are unpleasant, and many try to make them go away. If you have OCD you are aware that the thoughts are your own and that they are just thoughts. Nonetheless there is a wish for the thoughts to stay away because they often don’t fit with one’s self-image. Here is an example illustrate this: A person is cutting vegetables. While doing so thoughts about harming oneself or someone else runs through the mind. Naturally, the thoughts scare the person who has no wish to harm either oneself or the other person. Being violent doesn’t fit with the person’s self-image which is why they are unpleasant. Sometimes the thoughts will lead to further thoughts on why one has these thoughts and if they might be some truth to it deep down. This in turn can lead to certain behaviours/compulsions.
What is a compulsion? Compulsions/rituals are actions that are repeated again and again. The purpose is usually to prevent something from happening. It could be checking if one has turned off the oven 10 times. In itself it is reasonable to check if the oven is off. But the action as a compulsion is repeated even though one has confirmed that the oven is off. The compulsion is connected to obsessions centered around doubt on having done the action and possible dire consequences (e.g., being the cause of the building burning down with people in it). These make it difficult to convince oneself that it is unnecessary to check the oven again. The compulsions are as such a way of lessening the discomfort brought on from the obsessions.
How do you determine if it’s OCD?
It can be hard to determine if your are suffering from OCD. A lot of people know of having a few rituals – something you do at certain occasions. This is seen among children as well as adults. Most people can refrain from doing the actions if told to do so. It is however much harder if the actions are connected to obsessions. It is therefore worth noticing the degree to which the thoughts and actions become governing – if it strongly impacts ones general functioning and/or leads to great distress.
Prevalence of OCD
Surveys suggest that approximately 2 percent of the danish population are struggling with OCD. These are equally distributed between men and women.
Causes for developing OCD
There is no simple answer as to why some people develop OCD. In most cases it is a complex interaction between genetic, neurobiological and psychoilogical factors that all have significance for the development of OCD.
Treatment of OCD
Several surveys show that Cogntive Behavioral Therapy is an effective form of treatment for OCD. The target of the treatment is to reduce the client’s obsessions and compulsions. This is done with the use of two methods: Exposure and Ritual Prevention.
Exposure and Ritual Prevention
Exposure refers to the strategically designed and planned exposure to situations that normally trigger discomfort to the client and/or the need to perform rituals. Ritual Prevention refers to the client deliberately abstaining from doing the rituals. This can cause a lot of discomfort. The result is however that the level of discomfort decreases with repeated exposure. The client experiences that the discomfort lessens even if the rituals aren’t done. Often the discomfort even decreases faster than expected.
Improved quality of life
When exposure and ritual prevention are utilized at a daily basis there will eventually be experienced less and less discomfort in the feared situation. The need for doing the rituals will become smaller and the OCD will consume less time and energy and open for greater quality of life. It is hard work challenging the obsessions and compulsions and a commitment to work with the methods daily is essential. This also applies after progress where methods are used to prevent relapse. All the effort however is to be seen as an investment in a life with less impact from the OCD and with greater quality of life.