OCD
Obsessive compulsive disorder (OCD) is a common mental health condition where an individual
experiences obsessive thoughts and compulsive behaviours. It usually develops during early
adulthood, but some people start to have symptoms earlier, during puberty [1]. OCD is relatively
common – about 1 in every 50 people in the UK suffer from it at some point in their lives – affecting
both men and women equally [2]. However, there are still common misconceptions and generalisations about the experience of having OCD. For example, it is not uncommon to hear the
label “OCD” misused to describe a preference for keeping things clean or neat, where people may
say things such as “They are so OCD about mess”. And sometimes the words “obsessive” or
“compulsive” are used to describe someone with extreme feelings or tendencies, such as “She is
obsessed with animals” or “He is a compulsive liar”. But the obsessions and compulsions of OCD are
more than individual personality quirks or traits and can often be very distressing and disruptive to
daily life.
There are three main components to OCD:
Obsessions – the thoughts that cause anxiety
Emotions – the feelings of anxiety
Compulsions – the things done to reduce anxiety [2]
Obsessions are unwanted thoughts that reoccur uncontrollably. They can come in different forms,
such as mental images, doubts, or urges, as well as perfectionism and rumination. Individuals with
OCD often have symptoms such as a fear of germs or contamination, or a need to have things a
certain way. Some individuals experience uncomfortable thoughts of a religious, aggressive, violent,
or inappropriate nature, or ruminations that something bad will happen to themselves or their loved
ones. Due to their nature, obsessional thoughts are extremely difficult to ignore and occur
repeatedly and persistently, lasting for hours if not days [3]. This can be very disturbing and create
feelings of anxiety, disgust or guilt for the individual experiencing them. Having these thoughts leads
to behaviours called compulsions that are done to attempt to neutralise or reduce the
overwhelming negative feelings from the obsessive thoughts. Compulsions could be rituals, such as
frequent cleaning or hand washing, repeatedly checking things or avoiding particular objects or
places related to the thoughts. Many people with OCD feel as though compulsions such as praying,
counting, or repeating certain words correct the obsessional thoughts and will prevent something
bad from happening. Often the correlation between the obsessive thoughts and the compulsions is
not completely logical or rational, but for many people, the behaviours are the only thing that can
relieve the feelings of anguish and despair.
This makes it difficult for the individual to function on a day-to-day basis, as obsessive thoughts, the
anxiety they cause, and the need to carry out the compulsions can be mentally and physically
exhausting, interfering with the ability to go about daily life. The symptoms of OCD can completely
take over a person’s life, making it nearly impossible to maintain a job or close relationships.
Particularly when compulsions start to involve those around the individual, such as friends, partners
or family members, the relationships can become very strained and troublesome for those involved.
A specific cause for the development of OCD is not always clear, but it has been found that the risk
factors that increase a person’s chance of developing OCD come from both biological and
environmental sources [4]. Biological factors include family history and differences in brain
structure. For example, it has been found that those who are a parent, sibling, or child of someone
with OCD are at a higher risk of developing it themselves. There is also some research investigating
the brain areas that are linked to the symptoms of OCD, and how abnormalities in these areas can
lead to the occurrence of obsessions and compulsions. Environmental factors like an individual’s
background, life events and experiences also play a part in the development of OCD, for example it
has found to be more commonly diagnosed in people who have been bullied, abused, or neglected,
or who have recently endured an important life event such as childbirth or bereavement. Not all
people who have these experiences will develop OCD, but it has been observed that individuals with
generally higher levels of anxiety or a methodical and meticulous personality are more inclined to
developing the disorder.
OCD can be treated with either psychotherapy or medication, depending on the severity, but often a
combined approach is required. Treatments such as cognitive behaviour therapy (CBT), which aims
the help understand and reshape the way that thoughts, feelings, and behaviours interact with and
influence one another [5]. Exposure and response prevention (ERP) is a therapy designed specifically
to treat OCD, as it encourages the individual to confront their obsessions and resist the urge to carry
out compulsions [6]. ERP is conducted in a safe environment with the help and support of the
therapist in order to help the individual to see how the uncomfortable feelings can eventually go
away without the need to perform a compulsion. In severe cases of OCD, medication may be
required to moderate symptoms before the individual can start to interact with or respond well to
talking therapies. Living with OCD can be extremely difficult, especially when an individual has not
responded well to the available treatments. The exact form of treatment that will be effective varies
depending on the individual. Treatment can help to improve symptoms or make them go away for
some time, but they often do return, sometimes slowly over time and sometimes when the
individual is stressed or low. Charities such as OCD Action [7] and OCD-UK [8] provide further
sources of help and guidance, such as support groups for people with OCD and advice for their
friends and families on how to support them.
Although many people experiencing symptoms of OCD may feel embarrassed or ashamed, it is
important to seek professional help when they become too difficult to manage. Raising awareness
and understanding of the causes, symptoms, and help available for treating OCD can help encourage people to be more open about their experiences and challenge the common misconceptions and stigma around it. Here at Surrey Therapy Practice, we have a team of experienced professionals who offer treatments for OCD, using an integrative approach to tailor their treatment plans to specific individual needs. If you or anyone you know is experiencing symptoms of OCD, get in touch and make an enquiry here.
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