Obsessive Compulsive Disorder: Symptoms and Treatment
Obsessive Compulsive Disorder (OCD) involves obsessions AND compulsions. An obsession is an intrusive and unwanted thought that creates significant anxiety and discomfort. A compulsion is an overt or covert behavior done in attempt to reduce the discomfort of intrusive thoughts and feelings.
Symptoms and Types of Obsessive Compulsive Disorder (OCD)
Contamination OCD –
Obsession: Thoughts and fears surrounding germs, chemicals and contaminants.
Compulsion: Hand washing, use of antibacterial products, avoidance of feared substances.
Symmetry OCD –
Obsession: Fear or discomfort about objects that do not line up correctly, symmetrically or in preferred pattern.
Compulsions: Repetitively moving or re-aligning objects or avoiding using objects in fear that they will get stuck having to be re-aligned again.
Sexual Orientation OCD, also know as HOCD-
Obsession: Fear of being of a different sexual orientation.
Compulsion: Avoidance of anything that represents their fears’ sexual orientation, mental rumination, in attempt to figure out what sexuality best describes them. Or, if they are in “denial”, online reassurance seeking, or repetitively questioning if they actually have OCD.
“Just Right” OCD –
Obsession: Fear of the “not right” feeling.
Compulsions: Repetitively doing behavior (checking, walking through doors, cleaning items) until experiencing the “just right” feeling. Avoiding events, numbers, colors or words that result in the “not right” feeling.
Harm OCD –
Obsession: Fears of violently hurting others.
Compulsions: Avoidance of loved ones, avoidance of potential harming objects (knives, cars, sharp objects etc), asking for reassurance that they will not or did not hurt another. Mental rumination in hope to find certainty about the intentions of these thoughts or repetitive questioning if they actually have OCD
Pedophile OCD –
Obsession: Fear of being attracted to a minor, fear of performing a sexual behavior with a minor.
Compulsions: Avoidance of areas where children gather (schools, daycare centers). Mental rumination, in hope to find certainty about the intentions behind these thoughts. Mentally checking for arousal, seeking reassurance from loved ones or internet, repetitive questioning if they actually do have OCD.
Post Partum OCD –
Obsessions: Fear of harming ones baby and/or child.
Compulsions: Avoidance of ones’ baby and/or child, repetitive reassurance seeking from loved ones and the internet, mental rumination, in hope to find certainty about the intentions of these thoughts or repetitive questioning if they actually have OCD.
Scrupulosity or Moral OCD-
Obsession: Fear of offending God or fear of doing a behavior that doesn’t line up with their morals/religion, fear of not having salvation.
Compulsion: Repetitive and ritualized praying, avoidance of blasphemous thoughts.
Relationship OCD or ROCD –
Obsession: Fear that they will never definitively know if their partner is “the one”.
Compulsion: Mentally scrutinizing their partners every move, mentally scrutinizing their feelings and emotions towards their partner.
Emotional Contamination OCD –
Obsession: Fear that contact with a person will alter them or endanger them.
Compulsions: Avoidance of feared person, mental review of the proximity of feared person during recent exposure, repetitive and ritualized overt behaviors in hope of neutralizing their recent exposure to the feared person.
Existential OCD –
Obsession: Repetitive questioning about the purpose of ones life.
Compulsion: Mental rumination about the purpose of life, repetitive research or inquiry about the meaning of life.
Obsessing about Obsessing-
Obsession: Fear that one will never be able to stop obsessing or having intrusive thoughts.
Compulsions: Repetitive mental avoidance of feared thoughts, avoidance of events that may trigger obsessions.
Obsession: Fear that one will never stop noticing a sensation or feeling (breathe, hands tingling, a specific side of their body or body part, itches).
Compulsions: Mental rumination over the sensation or how to get rid of the sensation, avoidance of behaviors that increase the awareness of uncomfortable sensations.
Obsession: Fear of not being perfect or being perceived as not perfect in one or more areas of life
Compulsion: Attempting to be “perfect” (high grades, hobbies, social skills, friendships, not hurting peoples feelings, not being vulnerable).
Obsession: Fear of being responsible for a tragic event.
Compulsion: Repetitively checking (stoves are off, doors are locked, matches are out, no one was hurt etc), mentally reviewing or asking for reassurance to be sure no one was physically hurt or no ones feelings were hurt.
Treatment: Cognitive Behavioral Therapy (CBT) and Mindfulness
It is widely know that Cognitive Behavioral Therapy (CBT) is the most successful treatment modality for Obsessive Compulsive Disorder and OCD spectrum disorders. The treatment for OCD using CBT involves learning how to identify distorted thoughts and restructure them into more reasonable and rational thoughts. This is commonly called Cognitive Therapy. Treatment also involves Exposure and Response Prevention (ERP), which is a component of Behavioral Therapy used to help a client to desensitize to their feared stimuli. Using a hierarchy (created by the client), the client will slowly expose themselves to their fear and learn mindfulness tools to manage their anxiety and other emotions that they experience, instead of doing compulsive behaviors (Read more about Mindfulness here).
If you have some or all of these OCD symptoms and you feel like the above information describes you, see a qualified mental health professional for an assessment. Click here to contact Kimberley Quinlan, LMFT