What is OCD?

Oct 25, 2011   //   by Richard Figueira   //   Blog, East Providence, Lincoln, Rhode Island, Mental Health, cranston  //  No Comments

Obsessive-Compulsive Disorder

As clinicians at Anchor Counseling Center, a question we don’t often hear anymore is, “what exactly is obsessive-compulsive disorder?” Many times we see character depictions of an individual with OCD, such as Nicholas Cage in “Matchstick Men,” or Jack Nicholson in “As Good as it Gets,” but is that really what having OCD is like? Most people don’t actually realize that an obsessive-compulsive disorder does not look the same for every one person. Generally when we hear OCD we picture someone constantly cleaning for fear of attacking germs, or an anal retentive person that must have everything symmetrically in order. Neither of these illustrations should go unnoticed when considering an OCD diagnosis; however, an obsessive-compulsive disorder takes on many forms.  You may recall San Francisco Detective Adrian Monk from the television show Monk and his obsessive-compulsive cleaning behaviors.  For some people, OCD can be that severe, or disruptive to their daily lives. However, according the Diagnostic Manual used by psychologists, OCD can be defined by either obsessions or compulsions and obsessions—you don’t necessarily have to have both.

Obsessions are generally viewed as recurrent and persistent thoughts, images, or impulses that the individual deems intrusive and/or inappropriate. Take for example, Joe Smith. Mr. Smith comes into therapy because his wife says he refuses to help with their newborn child—he even avoids being left alone with the baby.  Mr. Smith then tells the therapist that he has persistent thoughts that he will hurt his infant child, despite the fact that he doesn’t think he could ever hurt his kid, the thoughts still persist.  As seen with Mr. Smith, obsessive thoughts are not extreme real-life worries; they are thoughts, impulses, or images the everyday person does not encounter consistently.

Compulsions, on the other hand, are repetitive behaviors or mental acts that the person does to reduce the anxiety produced by an obsession or prevent some dreaded event from occurring. There have been clients who’ve feared that unless they closed a door eight consecutive times, the house would be robbed while he/she is gone. Other clients have feared that they would hurt themselves even though they didn’t have the desire to die, and to reduce the distress from that thought he/she would repeat the same word twelve times and then be okay.  Other repetitive behaviors include, hand washing, placing things in specific orders, checking and rechecking items (i.e. the door is locked, the lights are off).  Most people don’t think about compulsions as mental acts, but they can include counting or repeating words/phrases silently.

Two other important aspects of OCD is that these obsessions or compulsions are time consuming, and that at some point the individual does recognize the obsessions/compulsions as excessive or unreasonable (usually adults). Many OCD clients will describe their thoughts and compulsions as making “no sense.” Often-times clients feel frustrated because the thoughts and impulses continue to persist even though they know that it’s an illogical thought.  The more severe the case of OCD the more time-consuming the thoughts and compulsions are.  It’s important to recognize how much time acting out the compulsive behaviors takes from your daily routine or how much it interferes with your ability to do your job (or school work) and your ability to function in social or relational situations.

At Anchor Counseling Center we treat many clients suffering from OCD, and we know that for many clients the first step to getting help may be embarrassing or distressing.  OCD is not a disorder that usually just disappears on its own, often times it will rear its ugly head again if the individual is not taught how to take control of his/her thoughts.  At Anchor, we use a variety of techniques to first reveal clients thinking and behavior patterns to themselves, teach them how to address their thought process and adjust their behavior accordingly, and finally we allow them to experience a new way of being. At Anchor we generally use cognitive behavioral therapy (CBT) in conjunction with exposure and response prevention therapy when possible. If you are struggling, and would like to take back control of your thoughts and behavior, please come see us at Anchor Counseling Center.

By: Aryssa Washington

References

Abramowitz, J. (2008). Obsessive-compulsive disorder. In E.Craighead, L. Craighead & D.Miklowitz, Psychopathology: History, Diagnosis, and Empirical Foundations (pp.159-191). Hoboken, NJ: John Wiley & Sons

Abramowitz, J., McKay, D., & Taylor, S. (2009). Obsessive-Compulsive Disorder. Lancet, 374,491–99

Coles, M. & Hayward, L. (2008). Elucidating the relation of hoarding to obsessive compulsive disorder and impulse control disorders. Journal of Psychopathology Behavioral Assesments, 31, 220-227. doi: 10.1007/s10862-008-9106-0.

Jane L Eisen; Meredith E Coles; M Tracie Shea; Maria E Pagano; et al (2006). Clarifying the convergence between obsessive compulsive personality disorder criteria and obsessive compulsive disorder. Journal of Personality Disorders; 20(3) 294-305.

Frost, R., Mataix-Cols, D. & Pertusa, A. (2010). When hoarding is a symptom of OCD: A case series and implications for DSM-V. Behaviour Research and Therapy, 48, 1012-1020.

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