Obsessive Compulsive Disorder

Obsessive Compulsive Disorder (OCD) is one of the most chronic and debilitating mental health conditions.  OCD is more than the fear of germs or needing to create order that is often portrayed in pop culture.  OCD is a very diverse and complex disorder that can cause a significant disruption to an individual’s life and well-being. 

Individuals with OCD experience obsessions and compulsions.  Obsessions are intrusive or unwanted thoughts, images, memories, and urges that trigger anxiety, uncertainty, and emotional distress.  Many people experience intrusive thoughts at some point in their lives.  For people without OCD the intrusive thoughts are fleeting, while for individuals with OCD the intrusive thoughts are long-lasting and uncontrollable.  Even though many individuals with OCD recognize that their worry thoughts are not logical they still experience heighten emotional distress and overwhelming urges for immediate relief. 

Common Obsessions:

  • Contamination and Germs

  • Responsibility for Harm or Mistakes

  • Losing Control

  • Symmetry/Evenness

  • Religion Scrupulosity

  • Just Right or Completeness 

  • Superstitious 

  • Perfectionism

  • Hit and Run

  • Relationship Doubts or Jealousy

  • Existential Concerns

  • Sexual Orientation and Gender

  • Emotional Contamination

  • Aggression/Violence

  • Physical Illness or Disease

  • Magical Thinking

  • Postpartum Concerns

Compulsions are any behaviors, urges, or mental actions that an individual feels compelled to perform or engage in to alleviate or neutralize distress. 

One reason OCD can be a complex disorder is because compulsions can take any form and tend to change, shift, and intensify over time.  Sometimes the link between obsessions and compulsions seems logical such as I am fearful of germs so I will repeatedly wash my hands; however, this is not always the case.  Accurately identifying compulsions that are maintaining OCD is an important component of effective treatment. 

Common Compulsions:

  • Reassurance seeking

  • Handwashing or cleaning

  • Checking for completeness, accuracy, and full understanding

  • Apologizing or confessing 

  • Checking for safety

  • Scanning physical sensations and experiences

  • Mental review or analyzing

  • Counting

  • Repeating 

  • Arranging or creating order

  • Collecting or holding onto items

  • Body movements

  • Grooming behaviors or picking

  • Neutralizing word or image

OCD Cycle

OCD is developed and maintained through the same anxiety-avoidance cycle as other anxiety disorders. 

  • Obsessions are intrusive or unwanted thoughts, images, memories, and urges that trigger anxiety, uncertainty, or emotional distress.

  • Humans are naturally wired to avoid unpleasant experiences. Compulsions are any mental thoughts or behavioral actions taken to quickly decrease, escape, or neutralize unpleasant and undesirable emotions or sensations.

  • Initially, compulsions are highly effective and provide immediate relief from emotional distress. This creates an illusion of certainty and emotional control that makes is more likely these compulsions will be used in the future to respond to unwanted thoughts, sensations, and emotions. However, the relief from distress is only short-lived and the obsessions and emotional distress inevitably come back stronger and more intense next time. As a result, compulsions are used more frequently and become more time-consuming in attempt to create the same level of emotional relief. When compulsions become less effective over time it can set the stage for individuals to engage in new or more intense and severe avoidance responses in attempt to get instant emotional relief.

  • In the long-term this pattern results in OCD symptoms becoming more intense and impairing. Individuals who experience OCD often feel stuck in the cycle and tend to make decisions and live their life in service of emotional relief rather than living the life they truly want.

Treatment for OCD and Family Involvement in the OCD Cycle

The family system is often a primary source of support and comfort for many individuals, especially during times of stress.  It is normal and healthy to provide support and care for a loved one when they are experiencing distress.  However, sometimes well-intended family actions of support and accommodation inadvertently strengthens and grows OCD.  Family support and accommodation can take many different forms.  When family members modify their own behaviors to help their loved one avoid or minimize distressing emotions, they are unknowingly contributing to the OCD cycle. For instance, this might look like modifying family schedules or routines, answering your loved ones repeated anxious questions, taking on extra responsibilities, or not doing or going to meaningful or important activities.   Initially, these actions provide immediate relief from distress for their loved one and they can seem very helpful, but the relief is only short-lived and the unwanted emotional distress and obsessions come back stronger.  As a result, a persistent pattern of avoidance and compulsions tend to develop with a greater need and reliance on family members to provide relief from distress. 

Many times, family members unintentionally and naturally get entangled with OCD and it can significantly impact their own quality of life.  These actions of family accommodation do not mean that parents, partners, or family members are at fault or caused their loved one’s anxiety.  It actually means that parents, partners, and families are an important part of the solution to helping their loved one overcome OCD.

OCD Therapy in Doylestown, PA

OCD is highly treatable and can be well managed when the treatments and tools that have been scientifically proven to work are used. 

ERP and CBT for OCD

Exposure with Response Prevention (ERP) and cognitive behavioral treatments (CBT) are the first line treatment approaches for OCD.  One key to overcoming OCD is learning to take action towards the life you want while learning to embrace your emotional distress rather than trying to work around or avoid it.  There are several factors that contribute to overall treatment success.  Working with a mental health professional that you trust and can effectively guide you on your desired life path not ruled by OCD is an important one. 

Schedule a Free Consultation