ASCBT
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Bangor, County Down

BT20  5BD

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What is OCD?

OCD (Obsessive Compulsive Disorder) is a term that gets banded around a lot - "She is so OCD" or "He is OCD about being tidy", however the term really shouldn't be used as an adjective. OCD-type behaviours can be found in anybody, that does not mean that they are suffering from this very serious illness.

OCD consists of having frequent unwanted or intrusive thoughts that cause distress and this distress then causes a reactive threat-neutralising behaviour. The behaviour may be a physical OR mental action taken to deal with the perceived danger. OCD as a clinical disorder involves a frequency of this type of thinking and behaviour that causes the sufferer serious impairment in their functioning and quality of life. Clinically OCD is the presence of intrusive unwanted thoughts and/OR compulsive ritualistic behaviours.  

OCD thoughts are Ego-dystonic in nature, meaning that they go against our very core value base, the thoughts are terrifying or repulsive to the sufferer and therefore cause extreme distress. The greater the perceived damage the threatening thought can do the greater the sufferer feels a need to act. It is the actions however that maintain the thoughts as with action we give further belief that these thoughts actually carried some kind of meaning and such threat increases our anxiety and feelings of a need to act further.

The following list is taken from www.ocduk.org which would be a very good place to start if you wished to learn more about OCD or seek some support.

Common obsessive thoughts include:
 

  • Worrying that you or something/someone/somewhere is contaminated.

  • Worrying about catching HIV/AIDS or other media publicised illnesses such as Bird Flu or Swine Flu.

  • Worrying that everything needs to be arranged symmetrically or at perpendicular angles so everything is  ‘just right’.

  • Worrying about causing physical or sexual harm to yourself or others.

  • Unwanted or unpleasant sexual thoughts and feelings, including those about sexuality or fear of acting inappropriately towards children.

  • Intrusive violent thoughts.

  • Worrying that something terrible will happen unless you check repeatedly.

  • Worrying that you have caused an accident whilst driving.

  • Having the unpleasant feeling that you are about to shout out obscenities in public.
     

Common compulsive behaviours include:
 

  • Excessive washing of one’s hands or body (thought of being contaminated, by chemical or body fluids from oneself or another person).

  • Excessive cleaning of clothes or rooms in the house,  (thought of having come into contact with germs from the outside or perceived contaminants from bodily fluids   For example contact with dog mess, needles or used condoms).

  • Checking that items are arranged ‘just right’ and constantly adjusting inconsequential items, such as pens on a table, until they are aligned to feel ‘just right’ as opposed to looking aligned (thought that something bad may happen to a loved one if not aligned correctly).

  • Mental rituals or thought patterns such as saying a particular phrase, or counting to a certain number, to ‘neutralise’ an obsessional thought (thought that something bad may happen to a loved one if not carried out).

  • Avoiding particular places, people or situations to avoid an OCD thought (be it about harming someone, or contamination fears).

  • Repeatedly opening and sealing letters / greetings cards that one has just written, maybe hundreds of times (fear of writing something offensive by mistake within the letter/card).

  • Constant checking of light switches, handles, taps, locks etc to prevent perceived danger from flooding, break in, gas leak or fire. Checking can be a set number of times to a magical number, and often takes hours at a time to the point where sufferers often avoid going out so as not have to go through the rituals.

  • Saying out loud (or quietly) specific words in response to other words (to prevent disaster happening).

  • Avoidance of kitchen knives and other such instruments, (for example locking them in a drawer) to prevent coming into contact with them (thought of harming someone with a knife inadvertently).  

In therapy we will begin by learning about your OCD, its origin and build an understanding of how it has reached the point that it has. We will discuss the processes that maintains and progresses OCD and obtrusive thoughts will be normalised. It is important to remember that everybody has intrusive thoughts but it is the meaning we attach and our reaction to them that create OCD cycles that cause distress and negative impacts on our functioning.

You will learn about the various cognitive distortions and biases that are commonly at play in OCD presentations and in session we will discuss analogies and do small tasks to test out these biases and the logic that lies behind them.

When you fully understand your OCD and the processes at play, with support we will gradually expose to the anxiety experienced when we do not carry out the compulsion. We will carry out numerous behavioural experiments progressing at a pace you feel comfortable at and challenge and extinguish your anxiety. 

CBT for OCD