What is OCD?
By Meghan Ringler, LCSW
Obsessive Compulsive Disorder (OCD) is commonly known, but rarely understood. Many can point to dramatized depictions in the media as their reference for what OCD looks like, which can leave sufferers feeling misunderstood and underrepresented. Essentially, the clinical definition of OCD consists of a presence of obsessions, compulsions or both. Obsessions are marked by recurrent and persistent thoughts, urges, or impulses that are experienced as unwanted and intrusive and in most cases cause anxiety or distress. Compulsions are marked by repetitive behaviors (hand washing, checking, counting, praying) that an individual feels driven to perform in response to an obsession with the goal of preventing or reducing anxiety (1). There are a variety of subtypes of OCD. Below are a few common ones to familiarize yourself with.
Contamination OCD
This subtype is characterized by more than just a fear of germs, but instead an intense fear of contracting an illness or spreading germs. The compulsion is often engaged in (excessive hand washing/showering, avoidance of common touch points) in order to relieve some of the intensity of the fear.
Just Right OCD
This subtype is characterized by a general but intense feeling that something just isn’t right. Compulsions may look like constantly having the urge to redo activities or rearranging in order for things to feel “just right.”
Scrupulosity (Religious) OCD
This subtype is characterized by unwanted obsessions centering around violating their religious, moral or ethical beliefs. To find relief, ritualistic compulsions are performed such as excessive praying or avoidance.
Harm OCD
This subtype is characterized by intrusive thoughts with content surrounding hurting others or hurting yourself. To find relief, often individuals will engage in neutralizing compulsions such as avoidance of objects, places, or certain people. It is important to note that those who experience harm OCD almost never actually engage in the act of hurting someone, however the uncertainty surrounding this is what plagues an individual. Typically those who experience harm OCD are in contrast incredibly empathetic, consciousness individuals.
Relationship OCD
This subtype is characterized by unbearable uncertainty within a relationship that results in obsessive questioning (am I really in love?, how will I know if I’m truly in love?, is this the right person?). It's completely normal to experience doubt and questioning within a relationship but with ROCD any sign of doubt can trigger an obsessive compulsive thought cycle that can be all consuming.
Other, subtypes include: Checking OCD, perinatal OCD, Postpartum OCD, Existential OCD, False Memory OCD, Pure OCD, Real Events OCD, Sexual Orientation OCD, Suicidal OCD. For a comprehensive list with definitions of each subtype visit NOCD to learn more. If you or your partner are struggling with any of these OCD subtypes, consider seeking support through couples therapy to navigate the challenges together. Engaging with a black therapist for couples therapy can offer a culturally sensitive approach, enhancing comfort and effectiveness for both partners."
I think I have OCD, what do I do?
If you think you may be experiencing symptoms of OCD, it is recommended that you talk with a trained licensed professional who is experienced in identifying and treating OCD. In the meantime, here are some tips and recommendations for living alongside OCD.
Tip 1: Face the Fear
OCD thrives under the guise that your fears and anxieties are something to be avoided at all costs. Our brain is a magnificent organ, however it has trouble deciphering at times what is dangerous versus uncomfortable. Through facing your fears or moving closer to situations that present anxiety you may find that over time with repetition your brain starts to learn that this is something mostly tolerable. Think of it like this- jumping or wading into a pool, you’re initially freezing and uncomfortable but with time and acceptance it's actually quite enjoyable. The same goes for making repeated contact with fears without using safety behaviors or compulsions.
Tip 2: Drop the Rope
Acceptance and commitment therapy has a helpful metaphor, “drop the rope,” which can be summed up to disengaging from the battle by “dropping the rope” and instead promoting acceptance versus resistance. Often we think the more we tug the rope (engage with the compulsion) the more it will provide a sense of relief and freedom. Though this may be true in the short term, this battle often leads to long term suffering (2). Once you drop the rope and disengage from compulsions, with time you may notice a sense of acceptance and freedom.
Tip 3: Do what matters to you (even if its hard)
OCD often acts in contradiction to our value system by feeding off our avoidance and perpetual suffering (ugh). The more you can “act as though you are your ideal self” when moving towards what matters to you, the less power and control OCD will have over you. Know that doing what matters to you WILL be a challenge, but it will come with a greater reward both in the short and long term. For example, let's say your sister just had a baby but you suffer from Harm OCD and have a repetitive fear of potentially harming a child. OCD may “trick” you into believing that you could do something terrible, but you take on the challenge of seeing this newborn because this is what matters to you, not the voice in your mind. At the end of the day thoughts are just thoughts. Thoughts do not equal action.
Tip 4: Externalize- you, me, and OCD
Externalize the voice in your mind, is this me or is this OCD. Be a detective. You will likely find that your OCD voice takes a certain flavor. What is its tone, what are its typical “hot” thoughts? Even personifying your OCS can be helpful for some. For example, your OCD as “an icky blob of stress and chaos named Patricia” may aid in decreasing some of the power it has over you. The more you can build awareness and begin to separate yourself from OCD, the more you will see with clarity the life in front of you. As you externalize your OCD, experiment with shrugging your shoulder at the messages it's telling you versus battling and dialoguing with it. You may find that your OCD will eventually get the message…that these obsessions aren’t worth your time and instead living life is.
Therapy can help you with symptoms of OCD. You can book an appointment with me here!
https://iocdf.org/about-ocd/
https://www.treatmyocd.com/blog/a-quick-guide-to-some-common-ocd-subtypes
https://www.ocd-anxiety.com/blog/drop-the-rope-anxiety
