Obsessive Compulsive Disorder (OCD)

What is obsessive compulsive disorder?

At its core, obsessive compulsive disorder (OCD) is an anxiety disorder. Sometimes, it’s referred to as a “doubting disorder” because it makes you doubt yourself and everything you think you know. Part of the big picture in learning to manage OCD is having the understanding that you actually don’t know very much at all. The emphasis here is on the word “know.” When most people say they know something, they usually mean they’ve learned something either from a previous experience, a reliable teacher/caregiver/mentor, or from their own five senses. This is problematic because most things in life are uncertain. We actually have very little certainty about anything in life. 

For example, you might think you know that your parents are safe, but unless you’re in the room with them, looking right at them, you can’t really “know” for sure. And even if you are in the room with them, looking right at them, something might be happening to them on a molecular or biological level that might hinder their safety that you wouldn’t necessarily know just by looking at them. 

People with OCD (unintentionally) fall into the trap of thinking there are certain things that everyone knows and that they should know, too. And they think they must know these things with a 100% certainty or else it means something is wrong with them. However, you’ll be hard-pressed to find something that you know for certain 100%. Much of the time we fool ourselves into a sense of security. For example, whenever you leave the house you might get hit by a car. If this thought occurred in your mind, you might assume you won’t be so you leave your house anyway, but you can’t really know for sure. Some people did get hit by a car on a day they left their house and assumed they would be safe. This is some pretty abstract stuff. No wonder you might be confused or scared! 

For those of you who don’t have OCD, your advantage is being able to live with the fact that there might be some things you don’t know for sure. In fact, you couldn’t care less about those things or consider them irrelevant, so you don’t think about them at all. For example, questioning your sexual orientation, even though your track record clearly shows a distinct preference. Or whether or not you might be a pedophile, even though you love children and have never hurt anyone. Or knowing whether or not you might get sick if your pots and pans aren’t pre-washed before every time you use them just in case when you last cleaned them it wasn’t good enough. I know. If you don’t have OCD, thinking about these things might sound very strange to you. 

If you do have OCD, thinking about these thoughts as actually being relevant is torturous. You don’t think they’re true, but you can’t prove for sure that they aren’t, so it feels like you have to keep thinking about them until you can prove it. Or if only you do this one thing, then you’ll know. Or if you just ask one more person what they think, then you’ll feel better. 

Of course, anytime you do any of these things, even though you might get relief for a period of time, it’s never permanent. This feeling that you just can’t know for sure or that there’s a problem you need to solve, or something you just need to do, always comes back. 

Here are some common OCD themes and typical thoughts clients might notice:

• What if I’m gay/straight/bisexual? 

• What if I’m really a man/woman/transgendered individual?

• What if I’m a pedophile? What if I touched/will touch someone inappropriately?

• What if I can’t remember something awful I may have done?

• What if I said/will say something inappropriate? (Racially, sexually, blasphemous, profane, etc.)

• What if I don’t really love my partner? How do I know I’m in the “right” relationship?

• What if there’s something terribly wrong with him/her/them/me?

• What if I hurt myself? What if I hurt someone else? 

• What if I’m a “bad” person? How do I know I won’t go to hell? What if I make God mad?

• What if I’m not practicing my religious faith like I’m “supposed to?”

• What if I get sick? How do I know I’m really healthy?

• I need to feel “just right,” “I need to do it until “it feels right”

• I need to do things a certain way or else

• If I don’t do/think/say/ask ___, then something bad will happen

If you detect a theme here, you can see that it’s all about not-knowing or being certain, or doubting. It’s looking for facts, needing to know the “truth,” and having absolute confidence. These are things that most of us can’t know for sure or don’t have 100% of the time. But for the person with OCD, that’s not good enough. Their brain tells them they need these things in order to survive.

Why Do I Have OCD?

Simply stated, you have OCD because of a combination of genetics, biology, DNA, and learning. Your brain thinks it needs to protect you from something dangerous, which usually is a very useful thing. However, if you have OCD, the things your brain labels as “dangerous” are your own thoughts, emotions, and sensations. You can’t trust your senses because you “feel” as though you are in danger and just need to do something, in situations when there’s no actual threat present, and nothing actually needs to be done (most of the time).  

→ For example, if you don’t have OCD and you notice the thought, “what if I were a pedophile?” You might respond by dismissing it as ridiculous, reminding yourself that you love children, may want to have your own, that this is a stupid or silly thought that’s in your head (maybe because you watched a serious documentary or film, or read a book, or heard something on the news, or just out of the blue), and you feel pretty confident that you would never even dream of acting on it. And then you would move on with your day. 

→ If you do have OCD, specifically pedophilia OCD (POCD), you might think there’s a reason this thought popped up in your mind (e.g., “I’m evil/bad,” “I’m a pervert,” “I have subconscious/latent desires,” etc.) and you will feel like your whole body is on fire and think that the only way to put it out is to prove with a 100% certainty that you in fact are not a pedophile. Only you get stuck because there’s no way to prove this. So you might look at children and try to “test” yourself to see if you’re physically aroused (maybe by checking your groinal response or heart rate). And you might think that maybe because your heart sped up, you started sweating, and maybe you noticed something “down there,” then that may mean that you were right to think that you’re perverted or that there’s something wrong with you, and now everyone will hate you if they find out. But you’re horrified with yourself because you love children and you don’t want to hurt them. Just thinking about this makes you anxious and like you need to do something to get rid of the thoughts. So you stay away from kids, and parks, and schools, and maybe even kids in your own family, “just in case” you have a feeling or a thought like this around them. 

In the end, the person with OCD suffers tremendously because they’re stuck in a loop where they feel trapped. They can’t know for sure what they know or don’t know. And a lot of the time they’re afraid to talk about it because they believe no one will understand. They feel alone and their world keeps shrinking. 

Can OCD Be Cured?

The good news is OCD is treatable. With evidence-based treatment such as exposure and response prevention (ERP), individuals can learn to respond differently to these anxiety-provoking thoughts, feelings, and sensations. So much so, that they can actually live meaningful and fulfilling lives. After a while of not acting on obsessions and compulsions, even a person who was once diagnosed with OCD, can live free from it by making choices in line with their goals and values and not based in fear or doubt.

To learn more about OCD, contact me for a free consultation and look into exposure and response prevention (ERP).