In my last blog, I share my personal story of what living with OCD is like and how Solution Focused Hypnotherapy helped turn my Obsessive Compulsive Disorder into Optimistic, Courageous and Daring!
But just what is OCD?
OCD comes in 2 specific parts, obsessions that cause anxiety and compulsions which drive temporary relief. The obsessions will always precede the compulsions.
What are Obsessions?
I’m totally obsessed with David Beckham (he’s so pretty) but does that type of obsession mean I have OCD? The simple answer is, no, unfortunately, that is not the sort of obsession an OCD sufferer would experience. OCD obsessions manifest as intrusive negative thoughts, images or feelings which are vivid and feel very real.
What is interesting about thoughts is that the brain can’t tell the difference between imagination and reality. When we watch a scary movie such as Jaws the ‘der dum’, ‘der dum’ music creates a state of alertness or mild anxiety. Even though we consciously know we are probably miles away from any shark-infested seas there is a part of our brain which thinks we really are in that water, about the be eaten. Another example of our brain not knowing what is real or imagined is to create an image in your mind of a delicious glass of fresh, citrus sweet lemonade, ice-cold and sparking ready for you to drink on a hot summer’s day. Notice how your mouth starts to water just thinking about it. So, you can see that the subconscious brain thinks that your conscious thoughts are real. The brain of an OCD sufferer will feel like their intrusive obsessions are very real too.
A person experiencing an obsession is driven around the notion that harm or even death may come to themselves or others.
An obsession is often irrational or may not make any logical sense, nevertheless, it is always presented from the worst possible perspective. Sometimes the obsessions can be graphic and of a violent or of a sexual nature creating embarrassment and even shame leaving the person wondering why they are able to think such bad things.
During my time as a new Mum, I would experience intrusive thoughts of my new-born son and I free-falling down the stairs together and gaining severe injuries and I would worry that would actually happen and that I was a bad mother for even thinking it in the first place.
Obviously, this is not true and so it is important here to understand that the obsessional thoughts are fear-based only. In fact, an OCD sufferer will be in the mindset of prevention rather than intention and it is highly unlikely that they would proceed to carry out an act of danger or cause harm. People living with unwanted obsessions will quite often develop further anxiety issues and/or depression as part of their disorder.
Here is a list of the types of obsessions that can be experienced by someone suffering from OCD:
- Health – Worrying about health and physical symptoms of themselves and others
- Contamination – The contamination of chemicals, dirt, bodily fluids, viruses etc
- Harm – Harm or death coming to others and/or self
- Spiritual – This can include the sacrilegious concern over physical items or people
- Sexual – Worrying that you are a paedophile or concerns over sexual orientation
- Hoarding – Holding onto physical items and worrying about throwing things away. This includes not being able to sperate items
- Violence or aggression – The worry of causing harm to others through a violent act
What are Compulsions?
An OCD sufferer will respond to an obsession and the anxiety it creates with a compulsive behavioural pattern which offers temporary relief from the anxiety.
These can manifest as physical behaviours, mental behaviours or even avoidance. The compulsions can be completely unrelated to the obsession and make no logical sense. A bit like me and the flight stairs at the shopping centre. By missing the steps (compulsion) to prevent a car accident (Obsession). This is not a rational based action however it created access to temporary relief from the obsessional anxiety.
Having OCD feels like carrying a huge responsibility to control and prevent bad things from happening. Quite often just one compulsive act is not enough to satisfy the anxiety relief so therefore the compulsive act is repeated until the anxiety is reduced, this can be very time-consuming. There can be incidences where the obsession is not as strong and at the forefront of the mind, but the unpleasant feeling remains to create a ritual that is difficult to be broken.
The need for control over the obsession can encourage complex rule-setting too (e.g. only missing specific steps on the way up the stairs and then different steps on the way down the stairs) which are tailor-made by the sufferer and can change and adapt throughout time.
Compulsions can be really obvious and visible to spot, but they can also be hidden, which makes covert cognitive compulsions very hard to recognise. One of the most common signs to notice is repetition in external behaviour.
Here is a list of the types of compulsive behaviours that can be experienced by someone suffering from OCD:
- Constant checking – Checking that the door is locked, the light switch is turned off, taps are turned off
- Repeating special words or numbers spoken out loud or via inner speech
- Visual switching of eyes onto and away from objects
- Hoarding collection of items
- Excessive cleaning
- Arrangement order and symmetry
- Avoidance of places, people, and things
- Needing reassurance from others did I lock the door, did I wash my hands, did I hurt her? Do you still love me? Never being satisfied with the answer and reinforces the issue
How to find out if you have OCD?
Anyone can experience unpleasant obsessions from time to time throughout their life depending on stress levels and their mental wellbeing. It is important to understand that although everyone can experience obsessions it is how we respond to them that determines OCD. We probably all know a friend who always wears their lucky pants when they play a football match or someone who is highly cautious about contamination and washes their hand religiously. However, without the obsession, these are termed as traits of the disorder. Obsessions or compulsions on their own are not determined as OCD it is how they work together that ascertains the disorder. Diagnosis of OCD is a complex process and should only be diagnosed by a health professional.
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