Obsessions & Compulsions in Obsessive-Compulsive Disorder (OCD)

The media often portrays Obsessive-Compulsive Disorder (OCD) as handwashing, organizing, and counting. These are only some of the many ways OCD shows up, and this misunderstanding often leads to underrecognizing OCD symptoms.

Obsessions in OCD

OCD consists of obsessions which are intrusive, unwanted, or distressing thoughts, urges, images, or doubts. These often cause discomfort and are ego-dystonic meaning they aren't in line with the actual values of the person.

• Contamination concerns (about germs and also emotional contamination)

• Harm OCD (will I hurt myself, a loved on, a pet, or someone else accidently? Will I SA a child? Do I possibly want that?!)

• Perfectionism

• Concerns about making religious or moral mistakes. (People with and w/o faith backgrounds experience this.)

• "Taboo" thoughts that feel icky about sex, sexuality, religion, or violence.

• Need for order or symmetry

• "Good" or "bad" colors, words, numbers, etc.

• An urge to do something shocking, embarrassing, or harmful

• Feeling that something bad will happen if you don't do a specific "ritual" (set of patternized behaviors)

• Concerns about being in the "right" relationship and feeling the "right things" (Relationship OCD)

• Fears of your sexual orientation changing without you wanting it to (Sexual oreintation OCD).

Remember!! Obsessions are “ego-dystonic” meaning they are not wanted, enjoyed, or in accordance with one's actual value system.

Compulsions in OCD

OCD consists of compulsions which are behavioral responses aimed at reducing the anxiety and distress caused by the obsessions. Hand washing, organizing, and counting are just some of the examples. Compulsions are an attempt at finding certainty that the feared obsession thought won't come true or to alleviate discomfort from the obsession thought.

Other less known compulsions include:

• Rumination (thinking about something over and over and over!)

• Reassurance seeking (asking others repeatedly if they think your fear will come true, researching online and reading the same info in an attempt to find certainty, telling yourself you would never want to actually act on or want those thoughts.)

• Avoidance

• Compulsive confession

• Compulsive prayer

• Reverse rumination (trying to ensure you've thought about ALL possible future outcomes and prepared for them just in case.)

• Checking

• and so many more

• Some people don't know they have OCD and are experiencing the symptoms I mentioned above thinking there is something seriously wrong with them.

OCD is a jerk, a bully, and a waste of time. It is a distraction from the present and it steals lives. If you ever hear someone say they are "Sooo OCD" like it's a good thing - they are likely not talking about actual OCD. Please be mindful to not downplay OCD with this language.

If any of this sounds like you too, know there are resources out there. The International OCD Foundation (www.iocdf.org) is one of my favorites.

OCD Treatment in California, Nevada, New Mexico and Vermont

I offer OCD assessments and treatment for residents of California, Nevada, New Mexico, and Vermont. I also provide training and consultation for mental and medical health professionals interested in learning more. Reach out today to schedule an appointment today: theonlinecounselor.com/schedule