What is OCD?

What is Obsessive Compulsive Disorder?

Obsessive Compulsive Disorder (OCD) is a disorder characterised by person experiencing intrusive and unwanted thoughts that cause them distress. Common emotions include anxiety, anger, shame and guilt that subsequently lead to compulsive behaviours performed in order to rid themselves of the intrusion. Obsessions can be very challenging to control, with the person often experiences an increase in obsessions, rather than a decrease over time. In the short term, compulsions may reduce a range of unwanted feelings, but in the long term the obsessions and compulsions are likely to get worse.

Compulsive behaviours can include one or more of the following: checking, reassurance seeking, avoiding, washing, mental problem solving, mental recall and mentally neutralising any unwanted thoughts. Compulsions can very quickly become time consuming, exhausting and lead the person to feel depressed and unmotivated. The is particularly true for those that experience obsessions around harming others, sexual orientation and sexual abuse. Although OCD can centre around areas such as contamination, physical checking and counting, these symptoms merely scratch the surface when it comes to how many people experience their obsessions and compulsions. For such behaviours to be classified as OCD, symptoms need to be intense, emotionally distressing and significantly interfere with a person’s life.

The OCD Cycle

The OCD cycle offers a step by step understanding of how OCD unfolds for the individual. By clicking on the sub headings, you can read a little more around each of the steps that make up the experience of OCD.
(Please click the labels to read more)

Obsessions are reoccurring thoughts, images, impulses or worries that come into your head, which seem to intensify the more you try to push them away. These obsessions tend to only exist around areas that the sufferer cares about, which in turn make the person begin to feel extremely anxious and out of control. For example, “I really love my partner, but I am worried that I cheated on them last night” or “I would never want to harm my children, but I am worried that I may want to, or could do by accident”.

Obsessions can exist around almost anything, although common traits include those centred around feeling overly responsible for something or others, desperately wanting certainty around a particular subject or generally feeling distressed by the content that comes into person head. To control these obsessive intrusions, the sufferer begins actively performing behaviours to rid themselves of such thoughts, giving those very thoughts more meaning than if they learnt to simply ignore them.

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Compulsions can be anything that the person partakes to neutralise or take away the unwanted feeling that originates form the obsession and unwanted emotion. Common examples include repeatedly checking, seeking reassurance from loved ones, self-soothing and reassuring through mental checking, washing, rumination and avoidance.

Compulsions can be broken down into two different types of compulsions, those that we can see that take place outside of the body (overt), and those that happen solely inside of the head (covert), known as rumination or mental problem solving. Compulsions give the person a false sense of control, making them feel like if they only perform the compulsion perfectly or one more time, then they will be relieved of the anxiety. However, in the longer term this only sets the person up to fail and in turn experience such intense unwanted emotions more regularly.

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The emotional response for someone with OCD is a key contributing factor within the OCD cycle. Without intrusive thoughts being compounding by such overwhelming emotions, it is likely ignoring the thoughts would be considerably easier. One of the key brain areas that becomes activated during the emotional response is the amygdala, a part of the brain that becomes active when we are in danger. Although in everyday life this is an extremely helpful part of the brain, for those with OCD the amygdala begins to fire to perceived threats, rather than real ones. Due to the intensity of emotions such as anxiety, dread, guilt and shame this becomes an increasingly alarming, scary and overwhelming experience. Due to such high levels of distress, the person begins performing ‘compulsions’ or ‘rituals’ to reduce the unwanted emotions. 3 of 4 Marker Text The core belief is particularly important for people with OCD, as this is encompasses the core drivers behind almost all obsessive compulsive symptoms. It is important that for true management and recovery from OCD, a person’s core belief is both identified correctly, as well as effectively challenged. 4 of 4

OCD subtypes

Before reading through the different sub types, we want to clarify that this is simply just to help you make sense of your symptoms. Although it can be helpful to obtain some clarity here, it is also important to recognise that most people’s symptoms are likely to encompass two or more of the below themes. It is also common to display symptoms from almost every theme, so if this is you, please don’t panic as this is completely normal.

Cognitive Distortions

Cognitive Distortions are biased perspectives that we can come to believe about others, and the world around us. Although some may be subtle, others can have an extremely negative impact on a person’s day to day quality of life. For those the experience OCD, the following cognitive distortions are often present.

All or Nothing Thinking (also known as black and white thinking)

This distortion manifests around a person’s inability or unwillingness to see the shades of grey that make up the world and our experiences. Based in perfectionism, this distortion leads to extreme thinking, such as something being brilliant or awful or that if everything isn’t perfect that it must be a total failure.

Overgeneralization

In this cognitive distortion, a person comes to a general conclusion based on a single incident or a single piece of evidence. If something bad happens just once, they expect it to happen over and over again. Although this is not based in reality, it much very much feels this way to the person.

Filtering

A person engaging in filter (or “mental filtering) takes the negative details and magnifies those details while filtering out all positive aspects of a situation.

Blaming and Poor Personal Responsibility

When a person engages in blaming, they hold other people responsible for their emotional pain. They may also take the opposite track and instead blame themselves for every problem — even those clearly outside their own control.

Heavens Reward (the cosmic scorekeeper)

The final cognitive distortion is the false belief that a person’s sacrifice and self-denial will eventually pay off, as if some global force is keeping score. This is a riff on the fallacy of fairness, because in a fair world, the people who work the hardest will get the largest reward. A person who sacrifices and works hard but doesn’t experience the expected pay off will usually feel bitter when the reward doesn’t come.

Catastrophising

When a person engages in catastrophizing, they expect disaster to strike, no matter what. This is also referred to as magnifying, and can also come out in its opposite behavior, minimizing. In this distortion, a person hears about a problem and uses what if questions (e.g., “What if tragedy strikes?” “What if it happens to me?”) to imagine the absolute worst occurring.

Should Statements and Demands

Should statements (“I should pick up after myself more…”) appear as a list of ironclad rules about how every person should behave. People who break the rules make a person following these should statements angry. They also feel guilty when they violate their own rules. A person may often believe they are trying to motivate themselves with should’s and shouldn’t’s, as if they have to be punished before they can do anything.

Thought-Action Fusion

The person experiences such intense intrusive thoughts that they begin to get confused with what is ‘real’ and what is in their imagination. Often spoken about when a person is experiencing false memories symptoms, simply having a thought can feel the same as doing the act itself. Although this can latch onto anything, common obsessions revolve around harming others, child abuse and other abhorrent or embarrassing acts.

Emotional Reasoning

This is where the person takes things that others do and say far too personally. They may also perceive their own actions to have far more importance than they really do. This can lead to feelings that they may have offended others, are disliked, or that they may have somehow embarrassed themselves, although they may not be sure how these things have come about.

Personalization

This is where the person takes things that others do and say far too personally. They may also perceive their own actions to have far more importance than they really do. This can lead to feelings that they may have offended others, are disliked, or that they may have somehow embarrassed themselves, although they may not be sure how these things have come about.

Neuroplasticity and it’s role in OCD

You may have heard of the saying, our brain is made of plastic, or malleable. This refers to the brains ability to physically change to adapt to new situations, as well as the implementation of newly learnt skills. We now know that this also includes the development of many anxiety disorders. Our brain has an amazing ability to learn, whereby through changing our behaviour we can essentially reprogram the way our brain works, biologically. The brain can break and reformulate new, healthier pathways, creating changes that are more consistent with a less anxious life. The most exciting thing is that the Science backs it up!

During all of our therapeutic programs we utilise this knowledge, explore the scientific findings and educate clients as to what it means in relation to their OCD, in order to start making the brain work for the person, rather than against them.

Further empirical research supports these findings. Dr Saxena , a Psychiatrist of the University of California, San Diego, School of Medicine concluded that after 4 weeks of intensive treatment for patients with OCD, patients showed significant improvements in their OCD symptoms, and their ability to function, based on PET scans. Result success was also found in patients that had previously not responded successfully to standardized CBT.

Dr Saxena concluded: “Our study reinforced the efficacy of the treatment, and now we've shown how it works in the brain."

Accessing effective treatment for OCD

We have been there. We have recovered. We can show you how.

All our intensive treatment programs are written by a range of fully qualified professionals that have first-hand experience of living with the disorder. We believe that this is particularly important when working with OCD as there truly is no replacement for the experience gained from living with OCD day in day out. Our programs include a wide range of therapeutic tools and techniques, from a range of different therapies. In our experience this is most effective way of working successfully with OCD, as in our experience a one size fits all approach to OCD just doesn’t cut it. Below is a list of what is included in every one of our intensive therapeutic programs:

  • Psychoeducation, including an introduction into Neuroplasticity
  • Mindfulness Based Stress Reduction (MBSR)
  • Cognitive Behavioural Therapy (CBT) & Exposure Response Prevention Therapy (ERP)
  • Rational Emotive Behavioural Therapy (REBT)
  • Acceptance and Commitment Therapy (ACT)
  • Compassionate Focussed Therapy (CFT)
  • Talking therapy

All delivered to you in a safe, private and comfortable environment.

To find out more, please see our treatment options page here, or alternatively, get in touch

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