Obsessive Compulsive Disorder (OCD)

Obsessive Compulsive Disorder (OCD) is characterized by thoughts, images, or impulses that come into one’s mind and occur over and over again. The thoughts, images, or impulses (obsessions) are perceived an unwanted and inappropriate. They are often of an aggressive, sexual, or religious nature. Typical examples include: “What if I accidentally ran someone over with my car?” “What if I throw my baby off the balcony?’ “What if I am contaminated and spread contamination to others?” “What if I put my hand down that woman’s pants?” “What if I shout an obscenity in public?” Thoughts of this sort are actually common; almost everyone experiences them on occasion. But people with OCD are highly bothered by the thoughts and, for them, the obsessions trigger feelings of considerable anxiety or discomfort. 

Different people attempt to manage obsessions in different ways. Some people just think about the obsessions a lot, and try to reassure themselves that there is nothing to worry about, but do little else. These are the “obsessive only type.”

Other people engage in rituals, called compulsions, in an attempt to manage the obsessive thoughts and the distress they arouse. Thus the person who fears he may have ran someone over with his car may retrace his route, repeatedly checking whether he hit someone or not. The person who fears contamination may repeatedly wash herself, or clean objects in the house, to reduce the likelihood of contamination.  Alternatively, in response to an obsessive thought, a person might deliberately think a different thought, or series of thoughts, often in a rigid, stereotyped way (mental compulsion). These are examples of the “obsessive-compulsive type.”

The compulsions usually bring on some degree of anxiety reduction. This sense of relief makes it more likely the person will engage in the compulsion in the future. However, as the disorder progresses, the compulsions take up more and more time, interfere with the person’s life, and therefore become part of the problem as well.