Obsessive compulsive disorder (OCD) is a complex disorder that is often misunderstood. This disorder is not a preference for certain things. It is obsessive, unwanted thoughts or mental images that flood the brain and create discomfort that seem to only be relieved through ritualistic behaviors.

What Is OCD?

The Diagnostic and Statistical Manual of Mental Disorders (DSM-V) classifies OCD as an anxiety disorder. It is defined by obsessions and compulsions, which are overwhelming intrusive thoughts and the ritualistic behavior to keep them at bay. 

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People with OCD experience recurrent, unwelcome, obsessive thoughts that cause anxiety. As a response, individuals will turn to specific, repetitive behavior in attempts to quell the anxiety.

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OCD is made up of two elements—obsessions and compulsions. Most people only think about the compulsion part of the disorder. However, both of these components are key to identifying OCD.

Obsessions

Intrusive thoughts seem to be a trend right now. However, most people misunderstand what they mean. It’s true that most people experience quick intrusive thoughts, but they’re typically fast and easy to shrug off. On the other hand, Individuals with OCD experience intrusive thoughts that stay a long time and consume them. 

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These thoughts are anxiety-inducing and may seem illogical to others. These repeated images, ideas, and urges can be about many different things. Some obsessions include:

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• thoughts of aggression
• fear of germs
• a desire for symmetry
• unwanted sexual thoughts

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These unwanted thoughts are what guide the individual into performing compulsive behaviors.

Compulsions

Compulsive behaviors are behaviors and rituals meant to keep obsessions at bay. Some of the most common compulsions include:

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• Washing hands
• Checking if doors are locked
• Checking if the stove is off
• Arranging items so they’re symmetrical
• Repetition of prayers or phrases

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Most of these compulsions can also be regular behaviors. Some people enjoy having their desk items lined up symmetrically, and most people check if the door is locked nightly. The difference is that compulsions feel uncontrollable and create significant problems in day-to-day life. 

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These compulsions may not seem related to the obsessions and might look illogical. However, to the person experiencing obsessive thoughts, these compulsions feel absolutely essential.

What Does OCD Look Like?

Not everyone experiences obsessive compulsive disorder in the same way, though all obsessions stem from the thought of severe harm either to themselves or others, or fear of harming others. 

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Differences begin to emerge in what the person obsesses over and what rituals they perform. They’re wildly different from person to person. However, there are five types of OCD that help frame the disorder.

Contamination

This category is one of the two “classic” forms of OCD. It's also one of the most widely known forms. This type is often simplified as people who like cleanliness or are germaphobic. This isn’t the case. Remember, people with OCD experience intense intrusive thoughts that often compel them to do something they don’t want to do. 

Intrusive thoughts

The intrusive thoughts that accompany this type are thoughts of harmful or deadly germs, bacteria, or dirt. There’s an intense fear of sickness and disease.

Compulsions

Compulsions most associated with contamination include:

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• Avoiding public restrooms
• Avoiding shaking hands
• Excessive cleaning
• Excessive hand washing

Symmetry and Ordering

The second “classic” and most known form is symmetry. This form includes thoughts that something bad will happen if things aren’t “perfect.” The intrusive thoughts include strong urges for things to be symmetrical and in order.

Ordering

A need for organization, order, and perfect arrangement. Some compulsions would include an intense aversion to clutter, and a need for clothes to be winkless.

Symmetry

Symmetry is similar to ordering, but can also include actions. Some examples would be brushing your hair equally on both sides or having the same number of books on each shelf.

Checking

Compulsions in this category involve constantly checking on things. The most common example is that if you don’t check your stove “enough”, your house will burn down. Instead of checking on the stove once, individuals have a nagging thought that they should look again (sometimes many times) to make sure it’s off. 

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A second common example is making sure the door is locked. The fear is that someone will break in and harm them or their family. To quell anxious thoughts, individuals compulsively check the lock.

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Counting is a similar compulsion to checking. It involves internal counting or counting objects in an attempt to quiet impulsive thoughts. This could also include counting things to make sure they’re still there.

Hoarding

The compulsion of hoarding is not the same as hoarding disorder. Hoarding disorder is keeping things because of a perceived value. However, compulsive hoarding involves scary intrusive thoughts that someone’s well-being is attached to an object. These obsessions and compulsions might sound like, “if I don’t keep grandma’s wedding picture, my mom will die.”

Pure Obsessional OCD

Pure obsessional OCD (Pure-O) is a form that is purely the obsession aspect of OCD. There are no visible compulsions. However, it is just as serious as other forms because it still creates daily hardship for those who experience it.

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Although there are no visible compulsions, individuals may still be performing rituals mentally. These silent rituals can include counting in your head, repeating saying, or replaying memories. 

Fighting Harmful Stereotypes

This disorder has been misunderstood for a long time, and it’s often used as slang for someone who prefers things to be neat and clean. This diminishes the actual effects of OCD.

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Those experiencing this disorder don’t just have strong preferences, but they experience a consuming belief that harm will come to them or others if certain things don’t happen. It interferes with their daily life and is often debilitating.

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Similar to phasing out other harmful terms, it’s time to let go of the flippant use of “OCD”

Causes of OCD

It is known that brain biology is different in those with OCD, but like most mental health disorders, we don’t know what the cause is. 

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The current working theory includes a mixture of genetics, biology, and learned behaviors. Currently, no genes have been identified as causing this disorder. It is also believed that obsessive thoughts and compulsions can be learned over time.

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Although how it develops is mostly unknown, there are a handful of risk factors that could increase the likelihood of developing OCD.

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Risk factors include:

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• Environment
• Life events
• Family history
• Other mental health conditions

Treating OCD

Obsessive-compulsive disorder is treatable. Treatment for OCD will vary case by case. Typically, treatment will involve talk therapy and medication. 

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Research shows the most effective form of talk therapy for this disorder is cognitive behavioral therapy (CBT). CBT helps make positive connections between thoughts and behaviors. 

OCD Treatment at Inner Balance

At Inner Balance, we specialize in CBT, DBT, and EMDR. Each of these talk therapies can be tailored for those suffering from OCD. Our compassionate staff is here to help you. 

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If you or a loved one is struggling with OCD, find help at Inner Balance by requesting a consultation. Together we can find a treatment solution for you.

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