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Understanding Obsessive Compulsive Disorder

Written by Ivette Moutzouris

What is Obsessive Compulsive Disorder (OCD)?. According to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, you have to meet certain criteria to be diagnosed with this disorder. It is important to understand this because increased awareness of OCD has also been met with more people thinking they have OCD when in fact their obsessions and compulsions may not be frequent enough for the diagnosis.

OCD is essentially characterized by the existence of obsessions and compulsions but not necessarily both. In regards to Obsessions they usually are recurrent, persistent and intrusive and lead to increasing degrees of anxiety because these thoughts are not usually welcomed. As a result most people will try to reduce or suppress these intrusive thoughts through avoidance behavior or engaging in a behavior they have grown to believe will neutralize the thoughts and reduce the anxiety.

Another component of OCD is of course the presence of compulsive behavior. These rituals or compulsions are often repetitive behaviors or mental acts and can include behaviors such as hand washing, repeated checking, repetition of words/prayers and a need for pattern and symmetry. Another significant obsession which is less common but still present is the existence of obsessions around unwanted sexual thoughts, blasphemous thoughts, and acts of violence. It is important to remember here that these thoughts are unwanted by the individual and in no way means that they will act out on these thoughts. In fact the opposite is usually the case and that is why these thoughts can cause an increasing amount of anxiety and distress. It also is a reason why individuals with OCD will often avoid getting help because they are embarrassed or ashamed of these thoughts.

Another characteristic is that the obsessions and /or compulsions take up a large amount of time. Usually more than 1 hour daily but on average can spend up to 6 hours a day on obsessions and 4 hours daily on compulsions.

There are also related disorders to ODC which share obsessive/compulsive characteristics and they include Hoarding disorder , Exoriation (Skin Picking) Disorder, Body Dysmorphic Disorder and Trichotillomania (hair pulling) Disorder.

It is important to note that we all experience intrusive thoughts and some of these thoughts are similar to thoughts that people with OCD struggle with. However the difference is that we learn to ignore or dismiss the thought if they are irrational and if the thought does cause distress/anxiety it is because it is rational in nature needs to be addressed. In comparison OCD thoughts are irrational and at the core they are ‘ego-dystonic’ which means they are not in line with core beliefs about the self and others.

OCD doesn’t only involve an internal struggle and a behavioural problem but it can also impact your ability to work effectively, socialize appropriately and generally interfere with day to day functioning.

The causes of OCD are still not definitive but the general idea is that it could be related to neurobiological, behavioural, cognitive and environmental factors. It can begin in early teens although children may also exhibit some signs of the disorder and it can last a very long time.  With adequate treatment which may involve a combination of medication and therapy a person with OCD can learn to rewire the brain and challenge some of the irrational beliefs that keep the behaviors and thoughts alive. We know that about 80% of people diagnosed with OCD are unlikely to improve without some type of help. At present the best non-medication treatment to help with OCD symptoms appears to be a cognitive behavioral approach. This involves challenging the irrational thoughts by a combination of cognitive and behavioral strategies. Medication alone does not appear to have long lasting effects compared to this therapeutic approach.


Purton, Christine & Clark, David. 2005. Overcoming Obsessive Thoughts. New Harbinger Publications, Inc.

Adam, David. 2014. The Man Who Couldn’t Stop. Macmillan Publishers Limited.




Ivette Moutzouris
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