Constant hand washing, repetitive touching of doorways, checking ten times to make sure the stove is turned off: these are all examples of behaviors we frequently associate with obsessive compulsive disorder, or OCD.
The nature of obsessive compulsive disorder
OCD is a type of anxiety disorder, characterized by unwanted, uncontrollable thoughts as well as repetitive or ritualized behaviors. While the thoughts and actions are irrational and unproductive, the affected individual is unable to resist the urge to express them.
An obsession is a frequent and uncontrollable impulse, thought, or mental image that an individual experiences. They are often quite disturbing or unpleasant, as well as distracting.
A compulsion is a behavior or ritual that an individual repeatedly completes as a way of trying to make an obsessive thought go away. Individuals with obsessive thoughts about being unclean may wash their hands until they are raw. However, compulsive behavior not only does not reduce an obsession; these frustrating and time-consuming acts usually increase anxiety.
Treatment of obsessive compulsive disorder
OCD is a mental disorder that responds successfully to treatment. The two most effective types of OCD treatment are cognitive-behavioral therapy and medication, often used in combination.
Cognitive-behavioral therapy, or CBT, is a type of psychotherapy that involves retraining one’s thought patterns so that compulsive behaviors no longer feel necessary.
Two CBT components are most effective in treatment of obsessive compulsive disorder:
- Exposure and response prevention, or ERP, is a treatment that involves repeated exposure to a source or common cue for an obsession, while the individual refrains from the associated compulsive behavior. Using the previous example of compulsive hand washing, an individual might be asked to repeatedly touch a public restroom’s door handle and then be prevented from hand washing. Gradually the individual learns that nothing catastrophic occurs when the behavior is not performed. The more an individual is exposed to an anxiety-provoking trigger without incident, the more the association weakens. ERP is a therapy based upon literally facing one’s fears.
- Cognitive therapy focuses on the obsessive thoughts themselves. Individuals with OCD often think of “worse-case” scenarios or experience an exaggerated sense of personal responsibility for things they cannot really control; e.g., a plane crash. Through “cognitive restructuring,” harmful thought patterns can be challenged and healthier, alternative ways of thinking can be developed. For example, the hand-washing individual may explore the underlying belief prompting this behavior, such as “I am unclean.” Once an unrealistic belief is discovered and challenged, the need to engage in the anxiety-reducing behavior may disappear over time.
Medication has also been found to be effective in obsessive compulsive disorder treatment for many individuals. Some psychiatric or psychotropic medications help control obsessions and compulsions. These include antidepressants that increase serotonin levels in the brain, which may be low in individuals with OCD. Medication, if indicated, is normally used in conjunction with psychotherapy.
Professional treatment for OCD is highly effective, with research findings of long-term recovery rates of up to 75% or more. With proper intervention, individuals struggling with the anxiety and frustration of obsessive compulsive disorder can resume productive lives.