What is OCD (Obsessive Compulsive Disorder) and What to do About It?

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What is Obsessive Compulsive Disorder (OCD) and What Can be Done About It?
Dhyan Summers, MA, LMFT

The term ” OCD” is bandied about a lot these days, particularly by young people. It seems to be a short hand for all kinds of behavior from neatness to perfectionism. But what is OCD really, what is it not, and what can be done about it?

Obsessive Compulsive Disorder (OCD) involves feelings, thoughts and behaviors. For many people with OCD, the feeling of anxiety stands out as prominent.

For example, a man with OCD might have an obsessive thought that a doorknob is contaminated and the thought of touching the doorknob causes him great anxiety. He takes a spray bottle of disinfectant and sprays the doorknob, which decreases his anxiety. Then he reaches for a Kleenex to give him a barrier from any possible remaining germs. He feels relieved. And that momentary relief feels pretty good; well, that is until the next doorknob appears.

The pattern repeats: an obsessive thought, an overestimation of danger or risk, increased anxiety, a compulsive action, and then feelings of relief provided by the compulsive action.

OCD also involves thoughts. For some people with OCD, their obsessions and compulsions are more in their heads than in their guts. Consider a woman who feels compelled to count everything she sees—ceiling tiles, stairs, books on a shelf, you name it; she counts it. But she actually reports feeling not particularly anxious at all. It’s just that she feels things aren’t “right” if she doesn’t count everything. Her feelings are more about distress over things being out of order rather than anxiety.

OCD can also show up primarily in behaviors. For example, a man might feel a driven need to go through doorways in a particular manner. Until he gets it “right,” he can’t let himself continue on his way. He can’t come up with any particular thoughts about why he needs to go through doors in this way; he just feels he must. And that feeling of having things be “just so” isn’t exactly the same thing as anxiety.

As these examples illustrate, OCD manifests itself in many widely different forms. The prominent feature(s) may involve anxiety, thoughts, behaviors, urges, or distress. Although OCD is currently considered a type of Anxiety Disorder, many professionals believe it deserves its own separate diagnostic category. In part, that’s because much of the urges and distress brought on by OCD just don’t look like classical anxiety.

What OCD is not: OCD is not the same as perfectionism. See my blog on Perfectionism for more information. You can be a perfectionist, which can be trying and anxiety creating, but not have OCD. Nor is OCD the same as liking to be neat and clean, although in very extreme situations it can look like it. Jerry Sienfeld was neat and orderly but definitely did not have OCD! Also, OCD and anxiety are not one and the same. As mentioned above, OCD frequently can involve anxiety, but many, many people have anxiety who do not have OCD.

The take home message is that this is a complex disorder, and can be debilitating, yet it is treatable. If you think you might fit into one of the categories mentioned above, consider seeking professional consultation. This is one problem that you don’t want to self-diagnose. The good news is that treatment for OCD, particularly Cognitive Behavioral Therapy (CBT) works very well. As does some of the newer medications if OCD is extreme.

If you have questions about this or related mental health topics, feel free to contact us directly at info@expatcounselingandcoaching.com.

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