Obsessive-Compulsive Disorder (OCD) is a serious but treatable mental health condition. As the name implies, this disorder is characterized by both obsessions and compulsions. Obsessions are intrusive and disturbing thoughts that one has over and over again, even though they try to stop or suppress them. Obsessions often lead to anxiety, distress, or discomfort. Compulsions are an attempt to alleviate the negative emotions brought on by the obsessions. For example, as this video explains, compulsions such as repetitive hand washing in response to a fear of contamination can take up many hours a day, and be quite debilitating.

Unfortunately, the relief attained by engaging in compulsions is short-lived, and actually ends up feeding into the OCD cycle. Performing the compulsion reinforces the belief that the obsessive thought is significant and needs to be prevented, increasing the likelihood of this thought occurring again. As well, by performing the compulsion, the person with OCD may come to believe that the compulsion was the only thing that prevented harm from occurring.

Understanding the “O” in OCD: Obsessions

The thoughts and images that a person with OCD has are actually NOT abnormal. Oftentimes people come to therapy thinking that there is something wrong with them for having these fears or thoughts. That is not the case!

As an example, let’s focus on violent obsessions. Although most people in our society do not behave violently, we know that thoughts of violence are actually pretty common. Violent thoughts can occur even when we are not upset or angry about anything. For example, as you are driving down the street, the thought, “I could run over that pedestrian walking on the sidewalk,” might pop into your head.

“Thinking about running someone over means I’m a bad person.”

A person without OCD may picture running over a pedestrian while driving their car, but brush this off as just a thought. A person with OCD on the other hand, is more likely to assume that this thought is meaningful. For example, they may conclude that this thought means they are actually a violent, aggressive person, even though there is no other evidence to suggest that this is the case. Although they do not want to run over a pedestrian, they become fearful that this is likely to happen.

Due to worry and distress over the meaning of this thought, the person may then spend a lot of time worrying about or trying to suppress the thought, which ironically increases the likelihood of having these thoughts. The thoughts become Obsessions when they are repetitive, intrusive, and associated with a lot of distress and interference in daily life.

Understanding the “C” in OCD – Compulsions

“The bus takes longer, but at least I know I won’t hurt anybody.”

Compulsions are behaviours or rituals intended to temporarily decrease anxiety. A person with a fear of running over pedestrians may respond by returning to roads driven earlier in the day to ensure there are no injured pedestrians, constantly monitoring their rearview mirror to make sure there is no one lying in the road behind them, or saying a prayer or mantra while driving. People with OCD often give up certain activities because the compulsions involved become too distressing or time-consuming; for example, someone afraid of hitting pedestrians might give up driving altogether.

There are many different types of obsessions and compulsions and it may not be clear, even to the person with the disorder, whether or not they have OCD.  If you think you, or someone you love, may have OCD, the first step toward treatment is getting an accurate diagnosis. Our psychologists at the Waterloo CBT Clinic have specialized training and many years of experience diagnosing and treating OCD. Give us a call at 226-686-0848 if you have any questions.

Want more information? Check out our list of resources including books on OCD as well as other topics.

Author: Dr. Jennifer Boyd, C. Psych.