Understanding OCD: Common Obsessions & Compulsions

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We hear “OCD” (obsessive compulsive disorder) being used to describe someone who likes things neat or done a certain way, so much so that it’s become a “common” adjective. But did you know that the reality of someone diagnosed with OCD could be much worse, and not as you think? In fact, OCD is categorised as an anxiety disorder, because they will feel anxious due to their obsessional thoughts and/or when they are unable to carry out their compulsive behaviours. The next time you want to use the term OCD, even on yourself, think again! Here’s what people with OCD commonly face, and also a little explanation on what it is.

Common Obsessions

According to Nolen-Hoeksema in Abnormal Psychology, Fifth Edition, obsessions are “thoughts, images, ideas or impulses that are persistent, that uncontrollably intrude on consciousness, and that cause significant anxiety or distress”.

Contamination: Body fluids; germs/disease; dirt; environmental contaminants; household chemicals

Losing control: Fear of acting on an impulse to harm oneself/others; violent/horrific images in one’s mind; blurting out obscenities or insults; stealing things

Harm: Fear of being responsible for something terrible happening; harming others because of carelessness

Perfectionism: Concern about evenness/exactness; concern with a need to know or remember; fear of losing/forgetting important information when throwing something out; inability to decide whether to keep/discard things; fear of losing things

Religious Obsessions (Scrupulosity): Concern with offending God or blasphemy; excessive concern with right/wrong or morality

Other Obsessions: Concern with getting a physical illness/disease not by contamination (e.g. cancer); superstitious ideas about lucky/unlucky numbers, colours etc.

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Common Compulsions

According to Nolen-Hoeksema in Abnormal Psychology, Fifth Edition, compulsions are “repetitive behaviours or mental acts that an individual feels he or she must perform”.

Washing/Cleaning: Washing hands excessively or in a certain way; excessive showering, bathing, tooth-brushing, grooming or toilet routines; cleaning household items/other objects excessively; doing other things to prevent/remove contact with contaminants

Checking: You did not/will not harm others/yourself; some parts of your physical condition/body; that nothing terrible happened/that you did not make a mistake

Repeating: Rereading/rewriting; repeating body movements (e.g. tapping, blinking); routine activities (e.g. going in/out doors, getting up/down from chairs); activities in “multiples” to feel “good”, “right” or “safe”

Mental Compulsions: Mental review of events/praying to prevent harm to oneself, others or to protect from terrible consequences; counting while performing a task to end on a “good”, “safe” or “right” number; “cancelling”/”undoing” (e.g. replacing a “bad” word with a “good” word to cancel it out)

Other Compulsions: Hoarding; arranging things until it “feels right”; telling, asking or confessing to get reassurance; avoiding situations that may trigger obsessions

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A Little Bit More About OCD

For people with OCD, they know that their thoughts and behaviour are irrational, but they are unable to control them. Obsessional thoughts are disturbing to them, and their compulsive behaviours can be time-consuming and/or harmful. Sometimes, they may also engage in “magical thinking”, which is the belief that repeating a certain behaviour will help them ward off danger to themselves or others. It is very common for most of us to experience negative thoughts, but what differentiates people with OCD from people without it is the inability to turn these thoughts off. The onset of OCD often begins at a young age, and as many as 66% of people with OCD also face depression.

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An OCD Scenario

Just to put things into perspective, here’s an example of what a person with OCD might be like. Let’s say that A is obsessed with the number “5” and with neatness. A would therefore be compelled to arrange things in 5s. Perhaps when A enters a room, he/she would knock on the door 5 times. A would maybe engage in repetitive behaviour such as drumming his/her fingers five times in a row, pause, and repeat. As OCD is an anxiety disorder, A might not be able to keep eye contact with someone he/she meets, and instead be obsessed with any small detail about the person, such as clothes or accessories.

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People with OCD have it tough having to deal with mental obsessions and behavioural compulsions, so let’s not use this term too liberally! It’s not an adjective, but a serious illness!