What is OCD?
Obsessive Compulsive Disorder (OCD) is an anxiety disorder characterized by consuming and unwanted thoughts followed by ritualistic behaviors to ease the anxiety from the thoughts. Even though you may be able to recognize your thoughts as irrational, you may not be able to break free of them. OCD causes the. brain to get stuck on certain patterns and thoughts. For example, it's normal to double check if you locked the door but OCD would have you check the door 12 times instead of just once because you are fearful someone will break in and harm you if you don't keep checking. These repetitive thoughts are only relieved with compulsive behaviors that temporary ease the anxiety associated. Obsessions are defined as involuntary thoughts, images, ideas or impulses that occur over and over again. Most people find them distressing and do not want to be having this thoughts but find it difficult to control. Compulsions are defined as behaviors or rituals that you believe you have to act on in order to ease the anxiety however the relief never lasts long before the thoughts come back. OCD is a ruthless cycle that at times seems like no way out.
Categories of OCD:
Checkers- Those who repeatedly check doors, windows, oven is turned off etc. This person typically associates their compulsion with danger or harm.
Washers- Those who frequently wash hands or use germ-x (think pre-Covid). This person typically has a compulsion of cleaning themselves from germs.
Counters- Those who frequently count objects, spaces, or arrangements.This person typically has an obsession with symmetry, color, or numbers.
Sinners- Those who frequently worry if they don't complete a task or arrange something "just right" they will be punished. This person may make their bed 5 times each morning or touch their Bible 5 times before leaving the house etc.
*Hoarding was previously a category of OCD but is now not listed on it's own. While 1 in 4 of people with OCD may hoard objects, treatment manuals now list a Hoarding Disorder as a separate condition apart from OCD.
Tips for combating OCD:
Self-Awareness- Recognize your triggers that bring on your obsessions or compulsions. Keep track through a log if needed. Rate the intensity of the anxiety it brings on a scale of 1-10.
Find ways to resist compulsions- Much easier said then done I know! Exposure and Response Prevention (ERP) is effective in helping with this. The main goal with ERP is to repeatedly expose yourself to your trigger and resist the compulsion that follows. Implementing CBT coping skills can be helpful at this point as well to reduce the anxiety you feel as you wait for the urge with the compulsion to decrease.
Build your Fear Ladder- Take one trigger from #1 and put a list together of steps you can take to overcome this fear. (I.e. if you are triggered by touching a door knob then write out ways to slowly accomplish your goals of touching the doorknob and not immediately washing your hands.) These steps will increase in difficulty which goes with the saying . baby steps first! The first step should make you slightly less anxious and be more manageable in execution then the last step on the ladder.
Implement CBT Cognitive Restructuring to combat your obsessive thoughts- When you are not feeling triggered, make a list of your anxious thoughts. Take each thought one by one and list out counter evidence to why this is not rational or true. I typically recommend 3-5 counter statements for every 1 anxious statement you list. Read over these daily. Read them when you are not triggered or anxious and read them when you start to have the obsessive thoughts.
Set aside time each day to "worry."- For some people they are able to push away anxious thoughts and compulsion if they know they will have time later in the day to think about them. For example, you touch a doorknob at work and instead of going to the bathroom to wash your hands, you tell yourself that at the end of the work day you have your "worry time" to address this. Knowing you are not completely dismissing the trigger but are allowing time later to contemplate it more may ease your anxiety and compulsion in the moment. For most people this is best scheduled at the end of their day. If you have severe OCD then you may start with 2 times a day but make sure to schedule during longer break. For instance, the first during your lunch break and the second after work at the end of the day. Gradually you can cut out the lunch one and only use the end of the day period.
Record your anxious or intrusive thoughts- Technology has greatly aided us with this one! You can grab your smart phone and record yourself saying your trigger thought and play over and over to yourself. Try using other coping skills as you hear your own voice say the trigger in the recording. By continuing to expose yourself to the though, in your own voice, you should be able to reduce the anxiety around it. Repeat this for each trigger though individually.
Manage Stress- Make sure to manage your stress in other areas. When you mind or body is bogged down in other areas it will make combating your OCD much more difficult.
Self-Soothe- Use your senses to self-soothe. Learn grounding techniques to help remind you that you are safe.
Make Lifestyle Changes- Find areas of your life that you can cut back in or change to help manage your OCD better. This is not avoiding your thoughts altogether but finding ways to manage. Avoid alcohol and nicotine, get plenty of rest and exercise regularly!
Reach out for help- Know your limit of handling this on your own. You are not alone in this so don't be afraid to ask for professional help!
Maybe you know someone with OCD and are wondering how to help! To start, try to avoid any judgments or criticism. Those are rarely helpful and can lead someone to having more negative thoughts about themself. Be as kind and patient as possible! Telling your friend to hurry up in the bathroom isn't helpful. Laughing at your family member for how long it takes them to get in bed at night isn't helpful. Don't join in on the rituals either. This will only reinforce them for the person and not aid in treatment. Keep communication open and show support. Let your loved one know you are there for them and ready to listen if they need you. Sometimes a listening ear can make all the difference in the world! Keep the communication open in the family also. Find ways to help the member struggling with OCD while keeping the family functioning.