Understanding Obsessive-Compulsive Disorder (OCD)
Obsessive-Compulsive Disorder (OCD) is a mental health condition that leads to internal miscommunication and confusion inside the brain and body. This miscommunication induces anxiety and fear regarding things that are actually harmless or non-threatening.
A person’s brain’s alarm system malfunctions and tells the person there is danger and a need to do something to be okay, when, in fact, the person is safe, protected, and there is an absence of danger. The individual can manage their surroundings and emotions in a normal way, but their brain and body aren’t convinced.
At Health and Healing Therapy, we have trained therapists who can help individuals who are suffering with obsessions, compulsions, ritualistic avoidance, and/or obsessive compulsive disorder.
Effects of OCD: Impact on Relationships and Daily Functioning
People with OCD experience intrusive thoughts that trick their minds into fixating on perceived threats. They believe these threats pose a danger or will cause harm, leading to heightened anxiety levels. In an attempt to decrease their anxiety, they engage in specific behaviors to feel better. However, these behaviors can escalate into compulsions, ultimately disrupting their lives and causing considerable distress.
Managing the thoughts and behaviors that accompany Obsessive-Compulsive Disorder can consume a significant amount of time. A person may spend more than an hour each day focused on obsessive thoughts and compulsive behaviors. OCD can cause significant impairment in daily functioning in various life areas, including work, school, relationships, and social experiences.
Causes of Obsessive-Compulsive Disorder
People suffering with OCD devote significant time and energy to avoid anything that might trigger uncomfortable emotions, feelings, thoughts, or beliefs related to worry, fear, or perceived threats and danger.
Genetics, Biology, and Childhood Trauma
The exact cause or causes of OCD is unknown, but research suggests that differences in the brain and genes of those affected may play a role. Researchers have found three factors that increase the likelihood that a person will develop Obsessive-Compulsive Disorder.
- Genetics – studies have shown that if you have an immediate family member (parent, sibling, or child) who has OCD, then you have an increased chance of also developing the disorder
- Biological Influences – people with OCD often have differences in the frontal cortex and subcortical structures of the brain, which are areas of the brain that emphasize the ability to control our behaviors and emotional responses
- Childhood Trauma – research has identified an association between childhood trauma and obsessive-compulsive symptoms
OCD: Obsessions and Compulsions
People who have OCD experience unwanted and intrusive thoughts that cause anxiety, emotional intensity, and cognitive distress.
Obsessions
Obsessions are persistent, distressing, uncontrollable, and intrusive thoughts, ideas, urges, images, or impulses that often revolve around themes such as contamination, symmetry, orderliness, harm, or taboo subjects that are difficult to control and cause distress.
Common Types of Obsessions
- Persistent and intrusive thoughts, images, or urges that cause distress
- Fear of contamination or germs
- Need for symmetry, order, or exactness
- Fear of losing or misplacing something of importance
- Unwanted thoughts of aggression, violence, or harm to oneself or others
- Taboo or religious obsessions
- Fear of losing control
- Excessive doubts or need for reassurance
Compulsions
Compulsions are repetitive behaviors or mental acts that individuals with OCD feel driven to perform in response to their obsessions. These actions are typically performed in an attempt to reduce anxiety and distress, or prevent a feared outcome.
Common Types of Compulsions
- Repetitive behaviors or mental acts performed to alleviate anxiety or prevent a feared outcome
- Excessive hand washing or cleaning due to contamination fears
- Checking and rechecking behaviors (e.g., locks, appliances, or personal items)
- Counting, repeating words or phrases, or engaging in mental rituals
- Arranging or organizing objects in specific ways
- Repeatedly seeking reassurance from others
- Hoarding or collecting items that have no practical value
Impact of OCD on Daily Life and Mental Health
Obsessions can cause the person suffering from OCD to develop compulsions such as:
- Physical or mental acts
- Rigid rules that are aimed to decrease the anxiety/distress
- A much smaller and more controlled world
- Continual acts of protection and avoidance, etc.
While these coping methods may provide temporary relief, avoidance and other compulsions actually reinforce the cycle of OCD, making the anxiety and obsessions more intense over time.
Effective Treatment for OCD: Exposure Response Prevention
Exposure Response Prevention (ERP) therapy has been shown to be highly effective in treating OCD. By confronting fears and preventing compulsive responses, individuals gradually experience a reduction in anxiety and an increase in their ability to manage obsessions without resorting to repetitive behaviors. It empowers individuals to gain control over their thoughts and reduces the impact of OCD on their daily functioning and quality of life.
Overall, ERP therapy aims to break the cycle of obsessions that lead you to unhelpful, compulsive behaviors. By gradually exposing you to the things you fear and by preventing you from doing your usual response(s), you begin to break the unhelpful cycle, strengthen your anxiety reduction skills, manage your emotional response, and – most importantly – retrain your brain. You will also learn more about your safety, your brain’s misjudgment of threat, and your ability to decrease uncomfortable emotions.
OCD Related Disorders: Body Focused Repetitive Behaviors
In addition to providing therapy treatment for individuals with Obsessive-Compulsive Disorder, we also work with those who have a related disorder, the category of which is known as Body Focused Repetitive Behaviors (BFRB’s). Two of the related disorders that our clinical therapists treat at Health and Healing Therapy are Trichotillomania and Excoriation.
Trichotillomania (Hair-pulling Disorder)
Some details about Trichotillomania are:
- People usually have a strong urge to pull their hair most commonly from their scalp, eyebrows, eyelashes; however, it can be from elsewhere on their body
- Hair pulling can provide a temporary sense of relief or gratification
- Hair pulling disorder usually begins in later childhood or teen years
- A person’s Trichotillomania can vary in level of severity and response to treatment
- Consequences of Trichotillomania often include low self-esteem, and feelings of guilt, shame, regret, or embarrassment
- Treatment usually includes Habit-Reversal Training or Cognitive Behavioral Therapy (CBT) which helps individuals gain insight on the things that trigger their compulsion to pull their hair and helps them learn helpful skills while challenging negative thoughts related to Trichotillomania
- We know that without professional intervention and treatment, hair pulling disorder will most likely continue and will be chronic with various levels of severity over a person’s lifetime
Excoriation (Skin Picking Disorder)
Some details about Excoriation are:
- Approximately 1% to 2% of the population is challenged by skin picking
- People repetitively pick their skin to the extent that it causes damage
- The most commonly picked areas include the face, arms, and hands
- People with SPD may often spend hours picking at their skin
- Skin picking of skin often results in scabs, sores, infections, permanent scarring, and disfigurement
- The causes of Excoriation disorder are unknown, but it is believed to be a combination of genetic, environmental, and psychological factors
- Skin picking episodes often occur in response to certain triggers, such as stress, anxiety, boredom, or feeling a bump, different sensation or imperfection in the skin
- Picking can provide temporary relief or a sense of control, which reinforces the behavior and makes it more difficult to stop
- Consequences of Excoriation often include social isolation, low self-esteem, and feelings of shame or embarrassment
- Treatment usually includes Cognitive Behavioral Therapy (CBT) which helps individuals identify triggers, develop more helpful coping mechanisms, and challenge negative thoughts and beliefs related to skin picking.
Further Reading & Resources
- International OCD Foundation Fact Sheets
- Beyond the Doubt: As part of Psychology Today’s blogging network, OCD advocate Jeff Bell offers his inside perspective on life with OCD and the lessons of uncertainty.
Meet our Therapists
At Health and Healing Therapy we help individuals who have OCD with Exposure Response Prevention. Together, you and your therapist will identify and confront any OCD-related fears and obsessions you struggle with and develop new ways to reduce your anxiety and sense of danger.
Create the Life You Want and Deserve
You can create a life where your fears, worries, obsessions, and compulsions are no longer holding you hostage. Our therapists can help you Grow, Heal, and Thrive.