Obsessive Compulsive Disorder
Obsessive-Compulsive Disorder (OCD) is characterized by unwanted, uncontrollable thoughts and repetitive or ritualized behaviors or avoidance of triggers. Typical OCD presentations fall into the following areas:
- Compulsive Checking and Obsessive Fear of Harm (self/others) such as by damage, fire, leaks or harm. Often those with OCD check their memory, stove knobs, water taps, door locks, house alarm, windows, house lights, car doors, re-reading things they’ve written, route after driving, wallet or purse, illnesses and symptoms online, call and text loved ones, re-reading words or lines in a book over and over again.
- Contamination – cleaning and washing compulsively (excessive bathing, showering, grooming, toilet routines, washing hands in a certain way or excessively, engaging in behaviors to remove or prevent contact with contaminants, cleaning objects or household item excessively) due to obsessive fear of contamination (e.g., body fluids, germs, disease, environmental contamination, household chemicals, dirt, etc.) that may cause illness and/or death of self or loved one. Problem areas include using public toilets, coming into contact with chemicals, shaking hands, touching door knobs/handles, using public telephones, visiting hospitals, eating in public, washing clothes in a launderette, touching staircases and doorknobs, being in a crowd, avoiding red objects and stains, dirty clothes, excessive tooth brushing, cleaning of kitchen and bathroom.
- Mental Contamination – can be evoked when the person with OCD perceives they have been badly treated (physically or mentally) through critical or verbally abusive remarks creating a feeling of internal uncleanliness. The person will engage in repetitive and compulsive attempts to wash the “contamination” away in a similar manner to traditional contamination OCD.
- Hoarding – the inability to discard useless or worn out possessions (including data) resulting in excessively cluttered and/or unusable spaces.
- Rumination – which is prolonged thinking about specific things that are considered undirected and unproductive. Although ruminations are not considered to be objectionable by they person with OCD, they often cause dysfunction by being excessively time and attention consuming. Examples may be religious, philosophical, or metaphysical topics (origins of the universe, life after death, nature of morality, etc.).
- Intrusive thoughts and Neutralizing Compulsions – These “thoughts” are repetitive, disturbing and often horrific and repugnant in nature. Examples include, thoughts of causing violent or sexual harm to loved ones, Postpartum OCD – Fear of harming the baby or something bad happening to the baby (Example: thoughts of dropping the baby, stabbing the baby, image of the baby dead), obsessive doubts over the suitability of a relationship, infidelity, sexual orientation, fearing being a pedophile, fear being sexually attracted to members of one’s own family, intrusive sexual thoughts about God, saints or, religious figures, fear that thinking about something bad will make it more likely to happen or that certain benign thoughts will lead to bad outcomes, religious intrusions (concern with offending god or blasphemy, excessive concern with right / wrong or morality), violently harming children or loved ones, killing innocent people, jumping in front of a train or fast moving bus, poisoning the food of loved ones, acting on unwanted impulses. May attempt to avoid situations, places, people, or thoughts that might trigger obsessions, seeking reassurance, arranging / ordering things until it “feels just right.”
- Obsessions and Compulsions Related to Perfectionism – Fear of losing important information when throwing something out, difficulty deciding whether to discard or keep something, fear of losing things, fear of not being able to remember something, concern about exactness or evenness. Needing to repeat behaviors until done perfectly such as rewriting or reading, repeating body movements (ex: touching, tapping), repeating behaviors / activities in multiples (ex: doing a task a certain number of times until it feels “good” or “safe”), repeating activities (ex: getting up or down from sitting).
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