Obsessive-Compulsive Disorder (OCD)

People with obsessive-compulsive disorder suffer from repetitive unwanted and intrusive thoughts, images, or urges. These obsessions tend to cause high levels of distress, discomfort, and anxiety for the person. It is common for people suffering from OCD to engage in compulsive acts or “rituals” to reduce the distress associated with their obsessions for a brief period; however, those rituals ultimately perpetuate the person’s anxiety as well. Compulsions may be overt (outwardly visible) behaviors, or they may be covert mental rituals such as counting, replacing a “bad” thought with a “good” thought, praying in a certain manner, or mentally reviewing their recent actions to make sure they have not done anything “wrong.” Individuals with OCD often describe feeling as if they have little to no control over these thoughts and behaviors. OCD is also characterized by doubt and difficulty tolerating uncertainty. There are numerous “sub-sets” of types of OCD, but OCD can manifest itself in an endless number of ways. Still, common obsessions include:

  • fear of contamination (dirt/germs, diseases/HIV/STDs, feeling “stained,” feeling “not right,” contaminating others with a negative emotion or thought)
  • thoughts/images of harming others (especially loved ones) or oneself,   commonly referred to as “Harm OCD”
  • unwanted sexual thoughts/images (including loved ones and children)
  • excessively questioning one’s own sexuality, often referred to as “HOCD”
  • symmetry/order, exactness, things have to be “just right”
  • unwanted religious thoughts, fears of saying/doing something blasphemous
  • excessive doubting, questioning numerous things and/or everything
  • unreasonable and unjustified doubts/fears about intimate relationships, often referred to as “Relationship OCD” or “rOCD”
  • not feeling “just right” about numerous (or single) thoughts, objects, emotions, or body sensations

Common types of rituals may include:

  • hand washing, excessive showers/bathing, excessive cleaning, avoiding others and places for fear of contamination
  • excessive checking (physical or “mental checking”/self-reassurance)
  • arranging or ordering things until they feel “just right”
  • praying or mental compulsions like replacing or “neutralizing” a bad thought with a good thought
  • mentally reviewing situations, mentally retracing steps and past actions
  • continually searching for answers and trying to “figure it out”
  • checking one’s own feelings to see if they are “right”
  • repeating (e.g., erasing, re-ordering or adjusting, re-reading)