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What is OCD?

By Jeff Szymanski, PhD

Here is one way to think about what having obsessive compulsive disorder or OCD is like:

Imagine that your mind got stuck on a certain thought or image…

Then this thought or image got replayed in your mind over and over and over again no matter what you did…

You don’t want these thoughts — it feels like an avalanche.

Along with the thoughts come intense feelings of anxiety.

Anxiety is your brain’s warning system. When you feel anxious, it feels like you are in danger. Anxiety is an emotion that tells you to respond, react, protect yourself, DO SOMETHING!

On the one hand, you might recognize that the fear doesn’t make sense, doesn’t seem reasonable, yet it still feels very real, intense, and true.

Why would your brain lie?

Why would you have these feelings if they weren’t true?

Feelings don’t lie… do they?

Unfortunately, if you have OCD, they do lie. If you have OCD, the warning system in your brain is not working correctly. Your brain is telling you that you are in danger when you are not.

Those tortured with OCD are desperately trying to get away from paralyzing, unending anxiety.

I try to make this distinction when someone says to me: “I use a lot of hand sanitizer, check my alarm four times before going to bed, and don’t like to be touched by other people. Do I have OCD?” In other words, what does it really mean to have OCD? OCD includes:

Obsessions

  • Thoughts, images, or impulses that occur over and over again and feel out of the person’s control.
  • The person does not want to have these ideas.
  • He or she finds them disturbing and unwanted, and usually know that they don’t make sense.
  • They come with uncomfortable feelings, such as fear, disgust, doubt, or a feeling that things have to be done in a way that is “just right.”

AND

Compulsions:

  • Repetitive behaviors or thoughts that a person engages in to neutralize, counteract, or make 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.

In addition, the obsessions and compulsions are time consuming (at least one hour per day), and they get in the way of important activities the person values, such as working, going to school, or spending time with friends.

Worrying now and then about getting sick or about having something done “just right” is not the same as experiencing obsessions. Everyone experiences unwanted, intrusive thoughts that cause anxiety. Similarly, not all repetitive behaviors or “rituals” are compulsions. For example, bedtime routines, religious practices, and learning a new skill involve repeating an activity over and over again, but are a welcome part of daily life. Consider the function of your daily routines and rituals. They are soothing, enjoyable, and confidence building. If someone interrupted your routine, while you might feel uncomfortable or annoyed, you don’t necessarily get overrun by intense feelings of anxiety that you can’t escape.

Keep in mind, OCD is an anxiety disorder. This means that individuals with OCD experience intense, frequent, debilitating anxiety as a result of their obsessions and resort to repetitive, time consuming compulsive behaviors as a way to quell that anxiety, if only for a short period of time. Effective treatment can get someone’s life back on track. For more information about OCD and effective treatment, please visit the International OCD Foundation.

Dr. Jeff Szymanski received his PhD in Clinical Psychology from Northern Illinois University in 1997, and has a long track record of teaching and training. He is the author of the upcoming book “The Perfectionist’s Handbook,” and is the Executive Director of the International OCD Foundation.

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