Focus On... Obsessive Compulsive Disorder

Obsessive Compulsive Disorder is an anxiety disorder marked by the presence of obsessions and compulsions severe enough to interfere with the activities of daily life.

Dr Karin Carter, a Clinical Psychologist based at GMMH’s Psychology Department in Prestwich, explains more about this severe condition.

What is OCD?

Obsessive Compulsive Disorder, or OCD, is classified as an anxiety disorder. It has two main components, obsessions and compulsions, which can be present together or singularly.

Obsessions can be thoughts, images, impulses or urges and they can be very distressing, inappropriate or persistent. The sufferer may respond to these thoughts with actions to remove or ‘neutralise’ them.

Compulsions, also known as rituals, differ from obsessions, in that they are behaviours rather than thoughts. The suffer sets strict rules in an attempt to prevent or reduce distress. These behaviours can be visible, for example, checking, washing, repeating actions, or may be internal to the sufferer, praying, counting, and repeating words.

In order to meet the diagnostic criteria of OCD, the symptoms must be seen as unreasonable, excessive, distressing, time consuming and interfere with the normal everyday functioning of the individual.

Do rituals actually make sufferers feel better?

Rituals, or compulsions, may temporarily reduce the individual’s distress, but this reduction is often short lived and the sufferer feels they have to repeat the ritual to relieve their distress again.

What causes OCD?

This is a difficult question to answer. Some research suggests that it is linked to stressful life events. From a professional perspective, different professional groups may see the problem as starting in different ways.

To the best of my knowledge, no single cause has been identified. The problem is linked to our brains, however, depending on the emphasis and type of training of the clinician, one might have a more medical or psychological hypotheses to account for the condition.

A psychological explanation may focus more on beliefs that the client has compared to a medical perspective.

Can it be treated?

Yes it can. The National Institute of Clinical Excellence (NICE), recommends Cognitive Behavioural Therapy (CBT) with Exposure and Response Prevention (ERP). Medication in the form of selective serotonin re-uptake inhibitors (SSRI’s) may also be a component of treatment.

What should I do if I think I have OCD?

If you have symptoms that concern you, the first place to start would be to speak to a GP that you feel comfortable with. Individuals are often too embarrassed and feel very isolated, but it is important to make sure the problem is actually OCD. Some of the symptoms, such as unwanted thoughts and checking behaviours, can occur with other conditions.

Once a firm diagnosis has been made, you and your GP can explore the available options. This might include a referral to a service offering psychological therapies (in particular CBT).

Myth Busting

  • "People with OCD are just careful and fussy": This is not true. In order to be diagnosed as having OCD the individual must meet specific diagnostic criteria.
  • "Messy people can’t get OCD": Not true – anyone can get OCD. Rituals such as cleaning are only part of the symptomatology.
  • "OCD is a congenital condition": This is not true.
  • "OCD can be managed but not cure"d: This depends on how you define ‘cure’. Research shows that with Behaviour Therapy or Cognitive Behaviour Therapy 50-60% of people can show recovery.

No treatment works 100% for everybody. There may be other factors that make it hard to gain the full benefits of CBT, for example.

These might include:

  • Not being able to commit fully to (attending therapy sessions (because of work, family etc.);
  • Not being ready to work on the problem;
  • Someone else sees it as a problem but the individual may not wish to pursue this path;
  • Only wanting to work on part of the problem. There are other factors interfering with the work such as low mood.

I personally do not believe that OCD cannot be cured. I would encourage anyone with OCD to seek help.

Useful Links

Anxiety UK
OCD Action
OCD UK