When a person experiences OCD, their brain is constantly telling them that danger is just around the corner. As a result, they experience frequent and distressing obsessions and feel driven to carry out compulsions, which impact their ability to engage in life (work, school, relationships). A person can be diagnosed with OCD if they experience either obsessions or compulsions; however, people often experience both.
Obsessions are thoughts, impulses, and images that happen over and over again. The person feels overwhelmed by these thoughts and often finds it hard to focus on anything else. Common obsessions include thoughts and images of harming others, religious obsessions, concerns about physical illness, superstitious thoughts, perfectionism, losing control, unwanted sexual thoughts and impulses, and contamination/germ concerns.
Compulsions are the ritualistic behaviors a person feels they must complete in order to get a small, and usually temporary, reduction in anxiety. These behaviors can be extremely time-consuming and lead to a high level of embarrassment when they are noticed by others. Common compulsions include washing and cleaning, mental compulsions (counting or praying), checking that you did something (turned off the oven), or repeating things multiple times.
Cognitive Behavioral Therapy is an effective treatment for OCD. Exposure and Response Prevention (ERP) is the strategy used in the behavioral component of CBT. In ERP, the client is supported in facing their obsessions without acting on the compulsions. At first, clients experience a high level of anxiety, but over time this anxiety drops as they realize that the awful things their mind told them would happen didn’t actually happen or aren’t actually true.
In some cases, medication may be recommended, and it may only be needed temporarily, depending on the specific symptoms, how much they impact functioning, and how much a person benefits from exposure and response prevention and other therapeutic strategies.
