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Obsessive–compulsive disorder (OCD) is an anxiety disorder characterised by intrusive thoughts that produce uneasiness, apprehension, fear or worry, by repetitive behaviours aimed at reducing the associated anxiety, or by a combination of such obsessions and compulsions. Symptoms of the disorder include excessive washing or cleaning; repeated checking; extreme hoarding; preoccupation with sexual, violent or religious thoughts; aversion to particular numbers; and nervous rituals, such as opening & closing a door a certain number of times before entering or leaving a room. These symptoms can be alienating and time-consuming, and often cause severe emotional & financial distress.
“The acts of those who have OCD may appear paranoid and potentially psychotic, OCD sufferers generally recognise their obsessions and compulsions as irrational, and may become further distressed by this realisation.”
OCD is the fourth most common mental disorder, and is diagnosed nearly as often as asthma and diabetes. Obsessive compulsive disorder affects children and adolescents as well as adults. Roughly one third to one half of adults with OCD report a childhood onset of the disorder, suggesting the continuum of anxiety disorders across the life span.
Obsessions are thoughts that recur and persist despite efforts to ignore or confront them. People with OCD frequently perform tasks, or compulsions, to seek relief from obsession-related anxiety. Within and among individuals, the initial obsessions, or intrusive thoughts vary in their clarity and vividness. A relatively vague obsession could involve a general sense of disarray or tension accompanied by a belief that life cannot proceed as normal while the imbalance remains.
A more intense obsession could be a preoccupation with the thought or image of someone close to them dying. Other obsessions concern the possibility that someone or something other than oneself – such as God, the Devil, or disease – will harm either the person with OCD or the people or things that the person cares about. Others may sense that the physical world is qualified by certain immaterial conditions. These people might inuit invisible protrusions from their bodies, or could feel that inanimate objects are ensouled.
Some people with OCD experience sexual obsessions that may involve intrusive thoughts. As with other intrusive, unpleasant thoughts or images, most ‘normal’ people have some disquieting sexual thoughts at times, but people with OCD may attach extraordinary significance to the thoughts. For example, obsessive fears about sexual orientation can appear to the person with OCD, and even to those around them, as a crises of sexual identity. Furthermore, the doubt that accompanies OCD leads to uncertainty regarding whether one might act on the troubling thoughts, resulting in self-criticism or self-loathing.
“People with OCD understand that their notions do not correspond with reality; however, they feel that they must act as though their notions are correct. “
For example, an individual who engages in compulsive hoarding might be inclined to treat inorganic matter as if it had the sentience or rights of living organisms, while accepting that such behaviour is irrational on a more intellectual level. In severe OCD, obsessions can shift into delusions when resistance to the obsession is abandoned and insight into its senselessness is lost.
Some people with OCD perform compulsive rituals because they inexplicably feel they have to, others act compulsively so as to mitigate the anxiety that stems from particular obsessive thoughts. The person might feel that these actions somehow either will prevent a dreaded event form occurring, or will push the event from their thoughts. In any case, the individuals reasoning is so idiosyncratic or distorted that it results in significant distress for the individual with OCD or for those around them. Excessive skin picking or hair plucking and nail biting are all on the Obsessive-Compulsive Spectrum. Individuals with OCD are aware that their thoughts and behaviour are not rational, but they feel bound to comply with them to fend off feelings of panic or dread.
Some common compulsions include counting specific things (such as footsteps) or in specific ways (for instance, by intervals of two) and doing other repetitive actions, often with atypical sensitivity to numbers or patterns. People might repeatedly wash their hands or clear their throats, make sure certain items are in a straight line, repeatedly check that their parked cars have been locked before leaving them, constantly organise in a certain way, turn lights on and off, keep doors closed at all times, touch objects a certain number of times before exiting a room, walk in a certain routine way like only stepping on a certain colour of tile, or have a routine for using stairs, such as always finishing a flight on the same foot.
People rely on compulsions as an escape from their obsessive thoughts; however, they are aware that the relief is only temporary, that the intrusive thoughts will soon return. Some people use compulsions to avoid situations that may trigger their obsessions. Although some people do certain things over and over again, they do not necessarily perform these actions compulsively. For example, bedtime routines, learning a new skill, and religious practices are not compulsions. Whether or not behaviours are compulsions or mere habit depends on the context in which the behaviours are performed. For example. Arranging and ordering DVDs for eight hours a day would be expected of one who works in a video shop, but would seem abnormal in other situations. In other words, habits tend to bring efficiency to one’s life, while compulsions tend to disrupt it.
In addition to the anxiety and fear that typically accompanies OCD, sufferers may spend hours performing such compulsions every day. In such situations, it can be hard for the person to fulfil their work, family, or social roles. In some cases, these behaviours can also cause adverse physical symptoms. For example, people who obsessively wash their hands with antibacterial soap and hot water can make their skin red and raw with dermatitis.
People with OCD are trapped in a primitive mind cycle of anxiety. Hypnotherapy can help by encouraging activity in the left-prefrontal cortex where the ‘feel-good’ neuro-transmitters are made.
OCD has been linked to abnormalities with the neuro-transmitter serotonin, although it could be either a cause or an effect of these abnormalities. Serotonin is thought to have a role in regulating anxiety. To send chemical messages from one neuron to another, serotonin must bind to the receptor sites located on the neighbouring nerve cell. It is hypothesised that the serotonin receptors of OCD sufferers may be relatively under stimulated.
Solution Focused Hypnotherapy enables the brain to produce more serotonin in the left pre-frontal cortex thus reducing anxiety and enabling positive control over the mind.
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