Obsessive Compulsive Disorder

Mental Compulsions

  • Mental review of events to prevent harm (to oneself others, to prevent terrible consequences)
  • Praying to prevent harm (to oneself others, to prevent terrible consequences)
  • Counting while performing a task to end on a “good,” “right,” or “safe” number
  • “Cancelling” or “Undoing” (example: replacing a “bad” word with a “good” word to cancel it out)


Other Compulsions

  • Putting things in order or arranging things until it “feels right”
  • Telling asking or confessing to get reassurance
  • Avoiding situations that might trigger your obsessions


Obsessions are thoughts, images or impulses that occur over and over again and feel outside of the person’s control. Individuals with OCD do not want to have these thoughts and find them disturbing. In most cases, people with OCD realize that these thoughts don’t make any sense. Obsessions are typically accompanied by intense and uncomfortable feelings such as fear, disgust, doubt, or a feeling that things have to be done in a way that is “just right.”


Compulsions are the second part of obsessive compulsive disorder. These are repetitive behaviors or thoughts that a person uses with the intention of neutralizing, counteracting, or making their obsessions go away. People with OCD realize this is only a temporary solution but without a better way to cope they rely on the compulsion as a temporary escape. Compulsions can also include avoiding situations that trigger obsessions. Obsessions and compulsions are time consuming and get in the way of important activities the person values.  Exposure and Response Prevention is the first line treatment of obsessive compulsive disorder

Common Obsessions in OCD:

Contamination                                                       

  • Body fluids (examples urine feces)                                                                    
  • Germs/disease (examples herpes HIV)
  • Environmental contaminants (examples: asbestos radiation)
  • Household chemicals (examples cleaners solvents)
  • Dirt


Losing Control

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


Obsessions Related to Perfectionism

  • Concern about evenness or exactness
  • Concern with a need to know or remember
  • Fear of losing or forgetting important information when throwing something out
  • Inability to decide whether to keep or to discard things
  • Fear of losing things


​Harm

  • Fear of being responsible for something terrible happening (examples: fire burglary)
  • Fear of harming others because of not being careful enough (example: dropping something on the ground that might cause someone to slip and hurt him/herself)​


Unwanted Sexual Thoughts

  • Forbidden or perverse sexual thoughts or images
  • Forbidden or perverse sexual impulses about others
  • Obsessions about homosexuality
  • Sexual obsessions that involve children or incest
  • Obsessions about aggressive sexual behavior towards others


Religious Obsessions (Scrupulosity)

  • Concern with offending God, or concern about blasphemy
  • Excessive concern with right/wrong or morality


Other Obsessions

  • Concern with getting a physical illness or disease (not by contamination, e.g. cancer)
  • Superstitious ideas about lucky/unlucky numbers certain colors​

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Common Compulsions in OCD:

Washing and Cleaning

  • Washing hands excessively or in a certain way
  • Excessive showering, bathing, tooth-brushing, grooming ,or toilet routines
  • Cleaning household items or other objects excessively
  • Doing other things to prevent or remove contact with contaminants


Checking

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


Repeating

  • Rereading or rewriting
  • Repeating routine activities (examples: going in or out doors, getting up or down from chairs)
  • Repeating body movements (example: tapping, touching, blinking)
  • Repeating activities in “multiples” (examples: doing a task three times because three is a “good,” “right,” “safe” number)
obsessive compulsive disorder