Do you struggle with Obsessive Thoughts -repetitive, unwanted & irrational thoughts, ideas, mental images or impulses? While obsessions can vary greatly, obsessions tend to fall into one of these categories –
- Fears of contamination &/or feelings of extreme discomfort when exposed to a “contaminated” environment or thing – Contamination OCD
- Thoughts of concern &/or doubt relating to performing an action, like turning off the stove or locking the door; inability to let go of disbelief/discomfort generated by the thought (If I feel so anxious, I must not have turned off the stove)
- Repeated thoughts of behaving in a grossly inappropriate sexual or harmful way, or just completely incongruent with your true character & actual desire – Sexual OCD & Sexual Orientation OCD
- Fears & thoughts of purposefully or accidentally committing a harmful or violent act – Harm OCD
- Thoughts & fears of committing sin, behaving in an immoral or sacrilegious manner
- Recurrent thoughts & discomfort when confronted with things that are not symmetrical, aligned, arranged or placed in just the right way or order
Obsessive thoughts hold such power as they are a pervasive source of DOUBT. Their mere existence causes us to question our ability to trust ourselves, creating self-talk that is based in self-doubt, that erodes our confidence & self-concept over time. Furthermore, obsessions with themes of violence, sexual depravity, sinful or sacrilegious acts or that call our sexual identity into question can create extreme levels of self-disgust, confusion, embarrassment & shame
By contrast, Compulsions are behaviors, acts or mental attempts to rid oneself of the obsession, discomfort & anxiety that it produces. This includes engaging in behaviors such as:
- Washing & cleaning of one’s body, clothing or environment or performing some ritual to dispose of the contamination or being forced to avoid something that is associated with contamination, including family & friends.
- Aggressive, repeated washing of hands to remove germs or contamination because they just feel dirty
- Engaging in time consuming, irrational cleaning of the genitals, buttocks or other body parts in response to using the toilet & belief that one is contaminated by urine or feces
- Can evolve into use of detergents, cleaners not suitable for skin contact or use of hot water causing visible skin damage &/or scarring
- Engaging in repeatedly rechecking, redoing or even performing a specific ritual to rid self of fear & doubt
- Inability to leave the house without engaging in repeated rechecking of appliances, locks, or other checking behaviors
- Need to perform nonsensical ritual in involving multiple steps out of fear that not doing so could result in harm befalling loved one
- Performing mentally or physically repetitive acts involving specific rules or guidelines, i.e.- engaging in a behavior a determined number of times or until it just feels right
- Having to take an “even” number of steps
- Feeling need to tap on a glass before taking a sip or open a cabinet a specific number of times until anxiety subsides or you no longer feeling compelled to do so
- Seeking frequent reassurance from a loved one or friend to lessen the discomfort caused by an obsession
- Mentally replaying statements, saying specific words or even being compelled to pray to ease discomfort & provide reassurance
- Repeatedly asking for outside reassurance to ease doubts & fears regarding one’s own behavior, actions or circumstances – requiring an outside individual to also engage in your compulsion to remove one’s own doubt & discomfort
Symptoms typically present as either both Obsessions & Compulsions, combined, or as what is referred as “Pure O”, comprising of more intense, often sexual, violent/harm or religiously based obsessions that are typically at conflict with who the individual is & what they believe & think.
OCD operates according to the Obsessive-Compulsive Cycle. Obsessions produce discomfort & anxiety; Wanting to relieve those emotions, the individual engages in a compulsion. Anyone who has suffered from this disease knows that despite acting on the compulsion, the anxiety never fully dissipates & is eventually follow by yet another disconcerting thought or obsession. Over time, anxiety becomes a learned response; meaning that the person becomes conditioned to anticipate the intense discomfort that occurs from merely thinking about something he/she associates with their obsession, without even coming into contact with it. As the anxiety becomes greater, the compulsions become more complex, intense & frequent. It is typical for OCD to morph from one thing or area to another to keep the cat chasing his proverbial.
Nearly 1 in 40 Adults, or 5 million American adults & 1 in 100 children are believed to meet the criteria for the diagnosis of Obsessive-Compulsive Disorder, OCD. It is among the top 20 causes of illness worldwide for people between the ages of 15-44.[i] While OCD isn’t curable, with the correct treatment, obsessions & compulsions can be targeted so effectively, most individuals can live happy, healthy & productive lives with greatly reduced or virtually no symptoms at all.
The APA, ADAA, NIMH & IOCD Foundation, all conclusively agree that the most effective form of treatment for OCD involves the use of Cognitive Behavioral Therapy with Exposure & Response Prevention Therapy. A form of Exposure Therapy, ERP, aims to teach the individual to face the anxiety & discomfort that is triggered during an obsession & to avoid engaging in any of the compulsive acts that essentially keep the cycle going. During an exposure, we begin to see that an individual’s anxiety does lessen; over time, we are able to sequentially target more complex obsessions & compulsions, with the same positive impact. Yes, this treatment is challenging at first, however, with an experienced & knowledgeable therapist, Jenifer understands how to effectively structure this therapy, integrate other CBT modalities into use & offer the correct amount of empathy & distance to enable you to become independent. It is also the undisputed gold standard for empowering individuals to learn to fight & eventually keep their OCD at bay. For clients that seek or require the additional support of medication management to treat their OCD, Jenifer is happy to work with your physician or psychiatrist as a team in your treatment. .[ii]
- [i] http://beyondocd.org-facts Citing study conducted by World Health Organization
- [ii]https://www.nimh.nih.org (National Institute of Mental Health/National Institute of Health
- https://www.adaa.org (Anxiety & Depression Association of America .
- https://www.apa.org (American Psychological Association)