What is Obsessive–Compulsive Disorder?
Obsessive–Compulsive Disorder (OCD) is an anxiety-related condition where a person experiences intrusive and unwelcome obsessional thoughts, often followed by repetitive compulsions, impulses or urges in order to stop, get rid of or neutralise the consequences of the thoughts. Often people go undiagnosed for long periods of time, sometimes years. This is often because the thoughts are so scary or embarrassing that people are afraid of sharing them with others.
One of the reasons why OCD can be extremely distressing is because the thoughts are often related to something that is important to us (e.g. thoughts or images of harming other people, including people we love, thoughts or images of sexual nature, thoughts or images that go against our religious beliefs, etc.). Some of the types of obsessions that people with OCD report are contamination and health-related fears, fears of harming self or other people, fears of being responsible for (or not doing enough to prevent) something bad happening.
The illness affects between 1-2% of the population, regardless of gender or social or cultural background. This means that in an average school, there will be 10-20 people who suffer from OCD.
In general, OCD sufferers experience obsessions which take the form of persistent and uncontrollable thoughts, images, impulses, worries, fears or doubts. These thoughts or images are intrusive, unwanted, disturbing and interfere significantly with the ability to function and do things we like.
Compulsions are physical behaviours and actions or mental rituals that are performed over and over again in an attempt to relieve the anxiety caused by the obsessional thoughts. Unfortunately, the relief that the compulsions provide is only temporary, creating a gradual worsening cycle of the OCD, as the person ends up doing the ritual again and again, and often more and more.
Treatment for OCD
The best evidence treatments for OCD are Cognitive Behaviour Therapy (CBT) and Exposure with Response Prevention (ERP), as indicated in the NICE guidelines. In CBT, we consider other ways of thinking about the intrusive thoughts and we practise alternative ways of responding and behaving when the thoughts are present. ERP is a behavioural approach that also helps to change the response to the obsessional thoughts, doubts and images.
It is important that CBT and ERP are adapted to the kind of intrusive thoughts someone experiences (e.g. contamination, harm, religious, sexual identity, etc.). When looking for a therapist, make sure that they do have vast experience of working with OCD, including the kind of OCD intrusions that you experience. Below is some advice on finding an experienced OCD therapist: