Obsessive-Compulsive Disorder (OCD) is a psychological disorder that impacts people of all ages, and that occurs when a person becomes stuck in a stressful and exhausting cycle of obsessions and compulsions. While most typically associated with anxiety, OCD can also involve excessive disgust, guilt, jealousy, or other emotions.

Obsessions

Obsessions are unwanted, intrusive thoughts, images, or urges that trigger intensely distressing feelings. While people with OCD are often aware that their obsessions are irrational/illogical, they still feel out of the person’s control.

In OCD, obsessions are time consuming and interfere with the person’s ability to complete activities in line with their values.

Common Obsessions:

• Contamination/Health - e.g., thoughts about contracting an illness
• Harm to Self or Others - e.g., images or thoughts of hurting oneself
• Sexual/Taboo Thoughts - e.g., images of personally disturbing sex acts
• Religious/Morality (i.e., Scrupulosity) - e.g., worries about being a bad person for seemingly minor actions
• Relationship/Partner - e.g., excessive doubt about if romantic partner is right for you
• Numbers/Ordering - e.g., thoughts about a specific number being an unlucky and harmful number
• Sexual Orientation - e.g., excessive doubt of one’s own established sexual orientation
• Perfectionism or things being/feeling “just right” - e.g., feeling that one walked through a door the “wrong” way

Compulsions

Compulsions are repetitive behaviors or thoughts an individual engages in to attempt to neutralize, counteract, or get rid of obsessions and/or decrease his or her distress. An individual with OCD might also compulsively avoid situations that trigger obsessions. Like obsessions, compulsions are time consuming and get in the way of important activities the person values.

Not all repetitive behaviors are compulsions. In the majority of cases, those with OCD feel pressured to engage in compulsive behavior and would rather not. The function of the behavior matters too. In OCD, compulsive behavior is done with the intention of trying to escape/reduce anxiety/distress or the presence of obsessions.

Common Compulsions:

• Washing
  • Washing hands excessively
  • Showering excessively
  • Cleaning items excessively
• Checking
  • Repeatedly checking that a certain feared event did not happen
  • Repeatedly checking locks/plugs
  • Repeatedly checking work
• Reassurance Seeking
  • Repeatedly asking friends/family if something bad will happen
  • Repeatedly asking friends/family if you are a good person
  • Repeatedly asking friends/family if items are clean/safe
• Repeating
  • Repeating activities
  • Repeating body movements
  • Repeating thoughts purposefully
• Cognitive Compulsions
  • Undoing or canceling “bad” words or images with “good” ones
  • Praying or wishing that bad things do not happen to self or others
  • Trying to think “good/safe/neutral” thoughts when completing a given action
• Counting/Ordering
  • Ordering items in a symmetrical way
  • Counting items (e.g., counting books on a bookshelf, ceiling tiles, words on a page, etc.)
  • Counting footsteps when walking/running

Shame

The fact that individuals with OCD typically understand that their obsessions and compulsions are irrational/illogical, yet understandably struggle to prevent/control them, often leads the individual to experience shame. Shame can also be triggered by the fact that OCD frequently involves thoughts that directly contradict the individual’s values system, resulting in thinking that one is a “bad person” for having such involuntary thoughts. Due to this shame, those with OCD might avoid disclosing symptoms to others or avoid seeking treatment. We want to emphasize that this shame is entirely undeserved. You are not alone and you deserve support. Together, we will reclaim the areas of your life that OCD has tried to control.

Treatment

The gold-standard therapy for OCD is Exposure and Response Prevention (ERP). We specialize in this form of therapy and will supplement ERP with Acceptance and Commitment Therapy (ACT) and other Cognitive Behavioral Therapy (CBT) techniques as clinically indicated.

Medication may also be indicated as part of treatment. We will work together with your prescriber to ensure good treatment coordination and can make referrals to trusted providers as needed.

For additional information about OCD and its treatment, visit the International OCD Foundation.