Obsessive Compulsive Disorder (OCD) is an anxiety disorder which affects approximately 3 in one 100 people and is found world wide. People with OCD experience intrusive thoughts that they feel are dangerous to themselves or others. People who experience these thoughts, try to avoid them, as much as someone with a snake or spider phobia. People with OCD battle the intrusive thoughts all day everyday and for some, most of their lives. And unfortunately they often fail in their attempts to to stop the thoughts.

Obsessions are intrusive and mostly nonsensical thoughts, images or urges that the individual tries to resist or eliminate. In a sample of 100 people suffering from OCD 55% experienced contamination thoughts, 50% experienced aggressive impulsive thoughts. While 32% experienced sexual content, 35% experienced somatic concerns while 37% had a need for symmetry. A need for symmetry refers to keeping objects in perfect order or doing something in a specific way. At least 60% of people sampled had multi obsessions. People with OCD may feel the need to constantly wash their hands to avoid contamination or to shout out obscenities in a religious institution.

Compulsions are the thoughts or actions used to suppress the obsession and provide relief. The most common forms of compulsions are checking, ordering, arranging along with washing and cleaning rituals. The majority of people suffering from OCD present with cleaning and washing, and checking rituals. For those people who have a fear of objects or situations that may be contaminating, then washing and cleaning restores a sense of safety and control. Checking rituals are predominately used to prevent a perceived disaster. In most situations they appear to be quite logical, for instance repeatedly rechecking the stove or the iron. But in very severe cases the checking can become illogical. In a reported case a young man had to repeatedly eat in a particular way to avoid a disaster happening to his family. Checking may also be a mental act like counting or praying to avoid a disaster.

Certain types of obsessions appear to be associated with certain types of rituals. For example, sexual and aggression obsession seem to lead to checking rituals. While obsessions with symmetry lead to ordering and arranging or repeating rituals.

Hoarding has been recently identified as Obsessive Compulsive Disorder. Those people who suffer from compulsive hoarding fear throwing anything away just in case they may need it in the future. It is very common for people with extreme hoarding condition to come to the attention of local councils, neighbours or public health authorities. This is due to the house and garden being stockpiled with junk and rubbish. This may lead to fire hazards and health risks for neighbours. One of the treatments for people suffering with hoarding disorder is to assign different values to objects to begin the process of throwing items away.

OCD appears to fall on a continuum, we all experience intrusive thoughts sometime during our lives and try to avoid them by distracting ourselves. It is quite common when people are bored to have unusual intrusive sexual thoughts or aggression thoughts. For most people who experience intrusive thoughts they let them pass without attaching to them. But for those with OCD they become horrified by the thoughts and may consider them a sign of an alien, intrusive evil force. The majority of suffers of OCD are adult women. In children there is a higher percent of boys than girls with OCD as they tend to develop symptoms earlier. This changes during mid-adolescence with the gender differences becoming fairly equal. Research has indicated that once OCD is developed it will become chronic.

The best treatment for OCD appears to be a combination of psychotherapy and medication. The most effective psychotherapeutic approach is called exposure and ritual prevention (ERP). This is a process where the ritual is actively prevented while systematically and gradually being exposed to the feared thoughts or situations.

Christopher Swane - Depression and Anxiety Psychotherapy - Wellington New Zealand