Obsessive-Compulsive Disorder (OCD) is a mental health condition that can cause significant distress and negatively impact a person’s quality of life.
It is characterized by obsessions—unwanted, intrusive thoughts and ideas that arise involuntarily—and, in many cases, by accompanying compulsions. Compulsions are repetitive behaviors or mental rituals that individuals feel compelled to perform in an attempt to neutralize or reduce the anxiety caused by obsessions.
What is an Obsession?
An obsession is an intrusive, persistent thought, idea, or mental image that arises without the person’s intent and causes anxiety, tension, or discomfort. Obsessions are typically distressing and unwanted, and individuals often feel unable to control their duration or stop them.
The impact of an obsession on a person varies depending on its content, intensity, and duration, which in turn affects the level of anxiety it generates.
A key characteristic of obsessions is their intrusive nature and the way they affect the individual’s psychological state. Importantly, people with OCD usually recognize that these thoughts are irrational, absurd, or inconsistent with their actual beliefs and values. However, despite this awareness, they find it difficult or impossible to suppress or alter them.
Obsessions can involve a wide range of topics, but some are more commonly observed than others.
Frequently Manifested Obsessions:
- Fear of contamination
- Fear of forgetting something important (e.g., turning off the gas, locking the door)
- Fear of losing control and engaging in inappropriate behavior
- Fear of harming oneself or others
- Intrusive thoughts involving negative expectations that something bad will happen (either to oneself or to a loved one)
- Excessive superstitions (e.g., believing that stepping on a specific spot could harm one’s family)
- Unwanted intrusive thoughts, including those of a sexual or religious nature
- An excessive preoccupation with symmetry and order
- Persistent thoughts related to safety
Specific Obsessions May Manifest in the Following Forms:
- Fear of contamination from touching objects that others have touched
- Doubts about whether doors have been locked or appliances (such as the oven) have been turned off
- Anxiety when objects are not arranged in a specific or “acceptable” order
- Disturbing mental images or thoughts of causing physical or other harm to others
- Intrusive thoughts about engaging in inappropriate behavior, shouting, or acting in a socially unacceptable way in public
- Unwanted sexual thoughts or mental images that cause distress
- Avoidance of situations where one would need to shake hands or come into physical contact with others
What is a Compulsion?
A compulsion is a repetitive behavior or mental act that an individual intentionally performs in an attempt to neutralize obsessive thoughts or reduce anxiety related to a specific fear.
These behaviors are aimed at relieving the distress caused by obsessions, but in reality, they only provide temporary relief. Over time, compulsions can become rigid, ritualistic, and difficult to resist.
Compulsive actions are often performed according to specific rituals or rules that the individual feels compelled to follow, even if they recognize that the behavior is irrational or excessive. Despite this awareness, the urge to carry out the compulsion remains strong.
Attempting to resist or avoid performing a compulsion typically results in increased anxiety, making it even harder for the individual to break the cycle.
Common Forms of Compulsions:
- Excessive washing or cleaning
- Repeated checking (e.g., ensuring doors are locked, appliances are turned off)
- Repetitive counting (e.g., counting objects or actions)
- Strict adherence to routine (e.g., performing tasks in a specific, unchangeable order)
- Maintaining symmetry or order (e.g., arranging items in a particular sequence)
- Ritualistic thoughts aimed at reducing anxiety (e.g., mentally repeating certain phrases or images)
Specific Manifestations of Compulsions:
- Washing hands a set number of times with soap
- Checking the door multiple times to ensure it is locked
- Checking the stove, sometimes filming it for future reassurance
- Counting according to specific, predetermined rules
- Silently repeating prayers, phrases, or words to reduce anxiety
Triggers and Risk Factors:
- Familial predisposition, indicating a genetic factor, although specific genes have not yet been identified
- Biological factors
- Environmental and stress-related factors
Treatment:
Obsessive-Compulsive Disorder (OCD) has a significant impact on various aspects of our stability and quality of life.
Treatment Includes Several Approaches:
- Psychotherapy
- Cognitive-Behavioral Therapy (CBT)
- Exposure-Based Therapeutic Methods (ERP, EMDR, PET)
- Medical treatment
- Antidepressants that Reduce Anxiety and the Intensity of Obsessions
- Alternative Approaches
- Meditation
- Physical Activity
- Psychological Support
- Group Therapy
- Family Support
In many cases, it is recommended to use a combination of different treatment methods simultaneously, such as medication and psychotherapy.
It is important to consult with a specialist in a timely manner.
Author: Marita Kerdikhoshvili
Editors: Giorgi (Guga) Sikharulidze, Elene Khomeriki