What is OCD and Do I Have It?

Have you ever wondered, “What is OCD and do I have it?” Perhaps thoughts like these sound familiar: “Did I turn the stove off before I left for work?” “I need to make sure the locks are secure one last time or something bad will happen to my family.” “My hands feel dirty even after five times washing.” “If I don’t follow through with [this compulsion], I may be responsible for a loved one’s death.”

Do these or similar thoughts occupy your mind each day? Do you find yourself spending too much time ruminating on thoughts you didn’t choose to reflect on; thoughts you can’t seem to get out of your head? Are those thoughts often accompanied by behaviors others might consider bizarre or confusing?

These are just a few examples of the unsettling reality that obsessive compulsive disorder (OCD) sufferers battle every day. This article will explore facts vs. common myths related to OCD, the different variations of this unique disorder, and what we can do about it.

What is OCD?

OCD is a unique disorder that has origins in anxiety but is given its own category due to its complex profile. OCD is often chronic, meaning managing it will likely be a constant battle, but with help and treatment, symptoms can decrease significantly, and sufferers can find hope!

As the name suggests, it is characterized by both obsessions and compulsions. The obsessions take the form of intrusive, unwanted, and disturbing thoughts that cause significant anxiety for the sufferer. Compulsions are then used to find temporary relief from these thoughts, offering the sufferer the feeling of control.

Unfortunately, when compulsions are carried out, this only increases the likelihood of intrusive thoughts recurring and strengthens the association between the thoughts, anxiety, and relief found in the behaviors. As with any uncomfortable feeling or situation, when avoidance strategies are employed, we only strengthen our brain’s association with the feared object, convincing our brain that it must be truly dangerous.

This creates a strong feedback loop, causing our brains to obsess over the anxiety-producing thought or event to keep us safe. Although the brain is doing its job, these obsessions can cause suffering, and so the brain finds ways to avoid the painful feelings through compulsive behaviors. Remember – avoidance increases anxiety symptoms. The most helpful way to reduce these uncomfortable experiences is to face them with the help of a trained professional.

Obsessions vs. Compulsions

Obsessions are preliminary to the compulsive behaviors individuals employ to alleviate discomfort. The person begins to ruminate on the intrusive thoughts, and significant amounts of time are spent worrying about the obsessions and practicing compulsions. Compulsions always come out of obsessions as a response to the discomfort they cause, though the link may appear subtle at times.

One thing to note about obsessions is they almost always manifest as an attack on something we deeply care about. This may be a faith belief, part of your character, someone you love, your health, and even your worth. These disturbing intrusive thoughts carry so much powerful weight because they strike to the heart of your deepest values and hidden fears.

Doubt is a common byproduct of the OCD experience, partly because these obsessions can lead you to doubt your morals, beliefs, reality, and even your humanity. But remember, the key thing to understand about obsessions is that they are intrusive – meaning unwanted. They are not a description of who you are or what you believe.

When intrusive thoughts wage war against your mind, the doubt and distress you have are evidence that these thoughts do not come from your character. They are not true beliefs or true moral dilemmas.

If we were to externalize intrusive thoughts and imagine them as a person, they would be manipulative, using your deepest-held values to create false allegations against you, using lies to confuse you and make you wonder whether your character ever had morals or integrity in the first place. And they would be doing all these things in the shadows, making you feel isolated and alone.

Hold on to your values and remember that intrusive thoughts are lies and they function like a bully. They don’t get to tell you who you are, and although at times it may not feel like it, they only hold as much power as you allow.

Common OCD Misconceptions

As with many mental health conditions, popular culture has created stereotypes that can increase confusion between the facts and the myths surrounding OCD. Many people will use the phrase “I’m so OCD” or “you are being OCD” to describe someone who tends toward perfectionism, values organization, or has challenges related to hypochondriasis or germophobia.

There is confusion about what OCD truly is, how the symptoms can present, and the severity of symptoms that lead to a diagnosis. Phrases and stereotypes like these can have a minimizing effect for those truly suffering with the condition.

The obsessional theme of organization and sanitization has gained popularity in recent years, leading many people to understand OCD from this one-dimensional frame. However, there are several different categories of obsessions, some of which may be surprising. If you wonder about OCD but don’t obsess about germs or organization, this list may interest you.

Common Obsessional Themes and Related Compulsions

This is a list of common OCD themes found in the DSM. This list is not exhaustive and, as with all mental health topics, everyone will experience the condition differently. Someone may only have one type of OCD; another person may struggle with several of these. These themes can change over time, and you may develop away from one obsession into new ones. There are also varying levels of severity that may change in different seasons of life.

Often, during high-stress seasons, OCD symptoms may flare, a common phenomenon shared by many disorders. Some themes of OCD obsessions include contamination, sexual, harm/violence, scrupulosity (religious), sensorimotor, and responsibility. Here we will provide a quick overview of each theme listed, but more information is available on trusted websites, such as the International OCD Foundation, for those who are interested in a deeper dive.

Contamination OCD is one of the more widely known subtypes because of its exposure in popular culture. People with this subtype of obsession are preoccupied with cleanliness and sanitation and excessively worry about becoming contaminated with illness or germs. A person may feel “dirty” until they can sanitize to a satisfactory level, sometimes at the risk of skin harm from excessive washing.

Some people may need to wash a certain number of times or practice compulsions until they “feel right.” Another common compulsion related to contamination OCD is rigid behavior around eating, and a highly controlled environment to avoid feeling contaminated.

Sexual OCD involves distressing thoughts related to sexual orientation or unwanted images. People with this subtype may experience shame related to mental images of performing inappropriate sexual acts or participating in sexual ways not acceptable to the individual. Another common theme in this subtype includes doubt about sexual orientation.

An individual may have doubts about their identity and where the thoughts and feelings come from. Common compulsions related to this subtype include reassurance seeking, mental avoidance of unwanted images and thoughts, or monitoring their reactions to the thoughts.

People experiencing Harm/Violence OCD often experience disturbing thoughts and images related to harming themself or a loved one. Additionally, thoughts related to fear of loved ones being hurt if compulsions are not performed are common.

Compulsions related to harm OCD include mental efforts to avoid distressing material, avoiding triggers, avoiding objects that could be used to cause harm, seeking reassurance, and mental checking of one’s character or morals. Sometimes, seemingly unrelated compulsions may include ensuring the right outfit is picked out, or other elements of the environment are under control to prevent the terrible end of a loved one that day.

Scrupulosity is a form of OCD that focuses on faith and religion. The scrupulous individual is consumed by the fear of offending God, sinning, or morally compromising their beliefs. Disturbing images related to sinful acts commonly coincide with this subtype.

Individuals may perform compulsions through ritualistic patterns, such as saying the “right” prayers, repeatedly asking for forgiveness, mental assessments of one’s character and morals, reassurance seeking, mental rationalizing to “argue” with the thoughts, and repeating Scripture a preset number of times, or until it “feels right.”

Elements of prayer, scripture memorization, and repentance can look like regular behaviors for someone practicing faith, but they become compulsions when they are done ritualistically in an effort to offset the discomfort from obsessions, rather than stemming from devoted practice. The individual may also practice their faith alongside the ritualistic compulsions. The difference is subtle, but important to recognize.

Sensorimotor (somatic) OCD includes obsessions related to bodily functions and feelings. Individuals may become hyper-aware of automatic body processes such as blinking, heartbeat, and breathing, and compulsions may include trying to take control over blinking and breathing through patterns and rigid rules related to the number of blinks or breaths in a given amount of time.

Individuals may spend large amounts of time monitoring somatic processes, avoiding situations that trigger hyper-awareness, and seeking reassurance and validation through research and questioning others’ experiences.

Responsibility OCD involves feelings of being responsible to prevent bad things from happening, or fears and doubts related to your behaviors causing a negative event. Those suffering from this subtype often feel responsible for the emotions of those around them and try to control the environment to prevent a negative outcome.

Though their intentions are noble, symptoms of responsibility OCD can quickly become consuming, causing significant distress to the sufferer and tension in social relationships. Efforts to control the environment can overtake an individual’s time and energy, leaving little left over for necessary tasks, such as taking care of health, housekeeping, work, and social spheres.

Responsibility OCD can also coincide with memory OCD, where an individual may doubt their memories or believe they have forgotten something important. Those suffering from this subtype may believe they hit someone with their car or were responsible for a negative situation although there is no proof of it ever occurring. These individuals seek reassurance and compulsively check for evidence to relieve the doubts about their memories.

How do I know if it’s an obsession?

We all have intrusive thoughts sometimes – those thought darts that seem to come out of nowhere and attack our innermost value systems. The experience can be alarming, but individuals without OCD can move on and not become consumed by the thought. OCD obsessions are different because they become consuming. They are distressing, often disturbing thoughts that feel like an onslaught the sufferer cannot prevent.

Obsessions take up time and mental space, and lead to compulsions to alleviate the pain these intrusive thoughts are causing. Although compulsions can be ritualistic, time-consuming, and energy-draining, many individuals battling OCD find comfort in the control that compulsions offer, and in the temporary relief from anxiety. Unfortunately, the anxiety comes back quickly when the intrusive thoughts return, making the association with fear stronger.

The Reassurance Feedback Loop

Seeking and receiving reassurance from anxiety can be a helpful way to connect with a trusted friend, validate your feelings, or gain a new perspective. However, reassurance seeking can become a compulsion when it is done continually and with an attempt to relieve anxieties and doubts generated from OCD obsessions.

Just like with any other compulsion, the association between relief from anxiety and reassurance seeking can be powerful, leading to a rigid pattern of behavior. Seeking reassurance can become a trap when an individual can no longer trust their own thoughts and may even feel like they cannot trust their reality without the input of another.

It can become a form of dependence when we continually seek validation from others to find relief. It is important to learn tools that bolster your inner strengths and aid in overcoming doubts without needing reassurance from others. Freedom from the reassurance feedback loop can increase autonomy and the quality of your relationships.

Put your mind at ease

Remember, OCD obsessions often target our most cherished beliefs and values. If you are having uncomfortable intrusive thoughts and are wondering whether they inform your character, remind yourself that these thoughts are unwanted and direct contradictions to your inner value set.

They do not come from a hidden desire, and your feelings of anxiety or disgust related to these thoughts are evidence of this discrepancy. Don’t let OCD’s manipulations fool you. If you are distressed by the obsessions trying to take over your mind, you can find comfort remembering these intrusive thoughts are evidence of the very values they are trying to attack.

Consider counseling

In counseling, you can explore OCD symptoms and how they affect your life. Your counselor will help you add tools that can equip you for battling and overcoming obsessions and compulsions. Cognitive Behavioral Therapy (CBT) and Behavioral Therapy are two of the most common treatments that offer relief from OCD symptoms.

Many individuals also find relief through medication. Through counseling, you can find the support and training needed to find freedom from compulsions and minimize the impact of obsessions on your life. Suffering in silence can increase OCD’s power.

Although it can be uncomfortable or feel embarrassing to openly discuss and dissect OCD obsessions and compulsions with someone, you can find significant relief in shifting the power dynamic away from the OCD.

Conclusion

Obsessive-compulsive disorder is an exhausting condition that causes great distress and can become debilitating when left untreated. Individuals may feel trapped by OCD obsessions and compulsions and consumed by the amount of time and mental effort exerted through simply trying to make it through the day.

Unfortunately, most of the time, compulsive efforts to relieve the discomfort created by OCD obsessions only reinforce the cycle and can make the distress and obsessions stronger. Counseling can help sufferers find relief, valuable education, and new tools to manage OCD symptoms and reduce their impact on your life.

Although OCD is most often a chronic condition, you can find great relief by developing insight and skills to battle obsessions and compulsions. Consider reaching out to our team today to find a counselor and begin your journey of discovery and renewed freedom.

And always remember – self-compassion goes a long way when learning new skills! No one is going to get it perfect, and that is okay. It is important to offer yourself grace when working toward new goals.