Understanding OCD

Obsessive-compulsive disorder, or OCD, is a commonly misunderstood disorder. Phrases like “I’m so OCD” have painted a picture of a condition marked by extreme organization, colour-coding, and particularity. While these can be symptoms for some people, they come from a place of extreme distress. What you’ve seen about OCD in pop culture has likely not been representative of the disorder at all.

OCD is made up of two parts: obsessions and compulsions. Obsessions, or intrusive thoughts, are unwanted and involuntary thoughts that enter the individual’s brain and get “stuck.” When thoughts enter a typical brain, the less applicable ones (even when intrusive) pass as though through big holes in a net. When someone has OCD, the thoughts are much more distressing and the holes in the net are much smaller. 

Intrusive thoughts can present as images, words, or ideas. The individual doesn’t see or hear them as hallucinations, but as sort of involuntary daydreams. The content of the thoughts follow themes that vary from person to person and over time. The themes typically contrast the individual’s morals and are disturbing, often relating to harm, sexuality, or disaster. In an attempt to make sense of the unwanted thoughts, the individual may feel an elevated sense of responsibility or fear. This is where compulsions begin.

Compulsions are the brain’s attempt to neutralize or eliminate the thought. They can be physical, mental, or spiritual. 

An example of this: An individual has an intrusive thought about a loved one dying in a fire. They may feel the need to check a “safe” number of times to make sure their appliances are unplugged in order to “satisfy” their OCD. They feel an intense sense of panic until this is completed, and it may not fully subside afterward. This obsession-compulsion cycle often takes up a significant portion of the individual’s day, making day-to-day tasks extremely difficult.

The more the OCD cycle is carried out, the stronger it becomes. 

Treatment for OCD involves weakening this cycle by interrupting it. In Exposure Response Prevention (ERP) therapy, individuals practice encountering triggers, experiencing intrusive thoughts, and preventing their compulsions. Each time a compulsion is prevented or delayed, the brain becomes slightly more confident that it is safe to resist it. Medication, therapy, grounding exercises, and external support can be helpful tools for lessening the anxiety associated with this process.

If you or a loved one are affected by OCD, please know that recovery is absolutely possible. Many individuals with the disorder live vibrant and fulfilling lives. Understanding how OCD works and how to interrupt its cycle  is the first step toward healing.

If you’re interested in finding a therapist who specializes in OCD, Psychology Today is a great place to start: https://www.psychologytoday.com/ca/therapists

If you’re a caregiver looking for support, please click here.