WHAT IS OCD?

OCD stands for Obsessive-Compulsive Disorder. A very simple description of OCD is that it is a condition in which an individual experiences recurrent obsessions and/or compulsions. Obsessions are defined as repetitive thoughts, ideas, or impulses that an individual experiences as inappropriate, intrusive, and unwanted. Compulsions are defined as repetitive behaviors that an individual feels driven to perform in an effort to avoid or decrease the anxiety created by obsessions.

In OCD, obsessions are not just exaggerated fears about real-life situations, and usually are not directly connected to commonplace problems such as normal relationship, academic, or financial concerns. In fact, the individual with OCD is quite often very distressed precisely because he or she recognizes that the thoughts are excessive, irrational and/or inappropriate. OCD compulsions may appear in various forms, including recurrent observable behaviors such as hand washing, repetitive "mental compulsions" such as praying rituals, or avoidant behaviors that have an almost phobic quality. Often, the obsessions and compulsions seen in OCD are a source of considerable shame and embarrassment, leading the individual to go to great lengths to hide his or her symptoms. OCD obsessions and compulsions can be extremely time-consuming, often taking up many hours of a person's day. As a result, OCD frequently causes significant emotional distress, and may greatly interfere with academic and professional functioning, as well as interpersonal relationships.

Common Symptoms of OCD

Obsessions seen in OCD vary widely from person to person. Some examples of common OCD obsessions are:

• exaggerated fears of contamination from contact with people or everyday items
• nagging doubts about having locked the windows or the doors to the home, car, or garage
• excessive concerns about having turned off the stove, hair dryer, coffee pot, or other household appliances
• overwhelming urges to arrange items in a particular order so that they are "just right"
• fears of committing a harmful, violent, sexually inappropriate, immoral, or sacrilegious action

As with obsessions, the compulsions seen in OCD vary from person to person. Some examples of common OCD compulsions are:

• repeatedly washing hands or showering
• excessively using anti-bacterial cleaning products in an effort to eradicate potential contaminants
• avoiding contact with everyday objects such as sinks, toilets, doorknobs, money, or virtually anything that an individual could construe as being contaminated
• frequently checking door locks, windows, light switches, electrical outlets, etc.
• unnecessarily arranging the contents of one's desk, closets, cabinets, bookshelves, etc., or straightening household objects such as window blinds or rugs
• hoarding useless items such as old newspapers, magazines, receipts, worn-out clothes, or other objects that most people would perceive as garbage
• repeatedly saying prayers to ensure that one has not or will not commit an unacceptable, inappropriate, or immoral action
• continually seeking assurance from others that one has not or will not commit an unacceptable, inappropriate, or immoral action

Pure Obsessional OCD

Some individuals may suffer from "pure obsessional" OCD in which they report experiencing obsessions without observable compulsions. These obsessions often manifest as thoughts, impulses, or "mental images" of committing an act they consider to be harmful, violent, immoral, sexually inappropriate, or sacrilegious. To learn more about pure obsessional OCD, click here.

The Obsessive-Compulsive Cycle

Perhaps the most salient characteristic of OCD is the cyclical process by which the symptoms intensify. Initially, individuals with OCD perform compulsive and/or avoidant behaviors in an effort to reduce the anxiety caused by their obsessions. Unfortunately, while performing these behaviors may at first reduce the anxiety and obsessions, it actually reinforces and worsens both in the long-term. This in turn leads to an increase in compulsions, which leads to even more obsessions and more anxiety.

While the specific thoughts and behaviors of OCD may vary with each individual, this process, called the Obsessive-Compulsive Cycle, is identical. In the course of going through this cyclical process, the individual becomes emotionally "sensitized" to specific thoughts, objects, or situations. In other words, they develop a "learned response" in which they automatically become anxious in reaction to these thoughts, objects or situations. For those with OCD, this can become a near-constant cycle of obsessive thoughts and compulsive behaviors. To learn more about the Obsessive-Compulsive Cycle, click here.

Frequency of OCD in the General Population

Traditionally, OCD was thought to be quite rare, and was frequently misdiagnosed by psychotherapists who didn't understand the disorder. However, research over the past fifteen years has resulted in an improved understanding of OCD, along with a much better idea of just how prevalent this disorder actually is. It is now estimated that OCD affects roughly 2-3% of the population. This finding suggests that over six million Americans will experience OCD in their lifetimes.

Treatment of OCD

Fortunately, OCD treatment has also improved dramatically over the past fifteen years. For many years, OCD was thought to be extremely difficult to treat. However, advances in the field of Cognitive-Behavioral Therapy (CBT) have led to the development of a therapeutic approach that is remarkably effective in treating OCD. This treatment, called Exposure and Response Prevention (ERP), or "exposure therapy", has dramatically altered the therapeutic management of OCD. ERP is far more proactive and less time-consuming than psychoanalysis and other "talk therapies," and has consistently been found by researchers to be the most effective treatment for OCD. To learn more about CBT and exposure therapy, click here.

OCD is a widespread disorder with extremely challenging symptoms. Fortunately, using Cognitive-Behavioral Therapy, it is also a very treatable disorder. The OCD Center of Los Angeles offers individual therapy for OCD, as well as five weekly, low-fee, therapy/support groups for people with OCD and related conditions. For more information on these groups, click here. If you are experiencing any of the above OCD symptoms, and would like to discuss individual or group treatment at the OCD Center of Los Angeles, you can call us at (310) 335-5443, or click here to email us. If you live outside Southern California, we recommend that you contact a licensed Cognitive-Behavioral therapist in your local area.