Obsessive-compulsive disorder (OCD)
Obsessive-Compulsive Disorder is marked by recurring, unwanted thoughts, images or urges, followed by the urge to perform behaviours or mental rituals to relieve the distress they cause.
These cycles can take up a significant amount of time, interfere with everyday life, work and relationships, and are often highly distressing.
Obsessions
The unwanted thoughts, images or impulses, obsessions, arrive uninvited and feel difficult to control. Nobody chooses them, and they often bring intense anxiety, doubt, guilt or shame. Many people recognise their obsessions aren't realistic, and that awareness alone doesn't stop them returning.
The thoughts run against what a person actually values. That mismatch is part of what makes them so distressing, not a sign of what someone secretly wants.
Compulsions
What follows, compulsions, are repetitive behaviours or mental acts performed to reduce that anxiety: washing, checking, counting, reassurance-seeking, mental reviewing, ordering and arranging, or avoiding what triggers the obsession in the first place.
Think of it like an itch. The obsession is the itch, the compulsion is the scratch.
The relief is real but short-lived, and it reinforces the cycle over the longer term. Most people would prefer not to perform compulsions, and feel unable to stop.
Common subtypes
OCD tends to cluster around themes. These aren't separate conditions, and most people can relate to more than one. This isn't an exhaustive list, and the theme can change, but the cycle underneath stays the same.
- Contamination
- Checking
- Symmetry and order, or "not just right" experiences
- Harm
- Relationship
- Scrupulosity
- Sexual orientation
- Perinatal and postpartum
Treatment
OCD is highly treatable. The gold-standard approach is Cognitive Behavioural Therapy, particularly Exposure and Response Prevention, which involves gently facing feared situations while resisting compulsions, so the anxiety has room to settle on its own and the cycle loses its grip.
Medication, most commonly SSRIs, is often used alongside therapy, and is prescribed by a GP or psychiatrist. Acceptance and Commitment Therapy and Schema Therapy aren't first-line treatments for OCD, but are sometimes used as an adjunct, alongside ERP or where broader patterns are also part of the picture. Psychoeducation and support, for the person and the people around them, is part of treatment too.
You don't need a diagnosis in hand, or certainty about which category fits, to bring any of this into a session.
Talk to Sarsha
If you'd like to talk it through, you're welcome to get in touch, in person in Fremantle or by telehealth anywhere in Australia.
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