Have you ever thought that you might do something terrible and out of character? Or have you ever gone back to check that the house is locked, or the stove has been switched off? Or had an impulse to do something you didn’t really want to do?
These are intrusive thoughts, thoughts that interrupt what you are thinking about. These thoughts are unwanted and unacceptable, and can also appear as words, images or urges.
Because they stick out as repugnant or unacceptable, they are difficult to ignore. The trouble is the harder you try to get rid of them, the more troubling they become. Having these unpleasant thoughts can make you really anxious.
A couple of decades ago, Obsessive Compulsive Disorder (OCD) was a rare disorder. But now, there won’t be even a single day that a busy psychiatrist might not have to go through examining an OCD patient.
What are compulsions?
Compulsions are the physical or mental actions that neutralise intrusive thoughts and reduce the intense feelings of anxiety that accompany them. For example, by checking to make sure things are okay, or by putting something right to remove the causes of potential harm (like removing knives from sight if there is an intrusive thought about harming someone).
Gradually performing compulsive behaviours turns into a ritual which can take priority over other things and take up increasing amounts of time. It can be very distressing feeling that your life is out of control. Although some people can continue to work and have a social life, others find they have to give up most things.
Some people are aware of their intrusive thoughts but don’t think they have any compulsions. Usually these are hidden and may be related to avoiding certain activities, or using mental strategies, like thinking a positive thought to neutralise a bad one.
What is the cause of OCD?
Because people feel “mad”, ashamed, embarrassed or frightened of how others might judge them if they knew, treatment is often delayed. An important question that sufferers ask is “How did I get this?”. Less than 10% of OCD is attributable to genetic factors, and these factors have more to do with a vulnerability to anxiety in general. In fact, OCD is just the result of exaggerations of normal psychological processes, so it is very treatable.
How to treat OCD?
Understanding how it works is the key to beating it. OCD begins with how we appraise a situation, and the significance we give to intrusive thoughts. Studies have shown that everyone has intrusive thoughts, but people with OCD appraise these thoughts as having particular significance. Because OCD is all about how we think about things, the new CBT therapies are remarkably effective.
Understanding how it all works is a breakthrough in itself. Once that step is in place, you go through a treatment phase called exposure to prove to yourself that your new understanding does not need the old compulsive behaviours anymore. It is really wonderful to watch people go through these stages and finally be free of OCD.