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What is OCD?

*Before I say anything, I would just like to be honest in saying I'm not in a position to treat or diagnose any forms of OCD, but rather create a positive sounding board for those in need.*

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What a loaded question that shouldn’t have to be.

 

OCD stands for Obsessive Compulsive Disorder. And it is, well, exactly how it’s defined.

 

For somebody who has OCD, a lot of their time is occupied through a series of obsessions and compulsions. 

 

Now this always brings people to ask: What is an obsession? What is a compulsion?

 

Obsessions in OCD are defined as unrealistic/unwanted intrusive thoughts that cause extreme levels of distress and anxiety. It’s important to remember that these thoughts are unwanted, and entail no meaning to the person’s morals, ethics, or values.

 

Compulsions are anything the person does to get rid of that distress and anxiety. Whether it is a physical action, or a mental one. 

 

This description may seem very minimal, but it’s actually very involved. An obsession isn’t a one and done thought, and a compulsion isn’t a one and done action. They are repetitive. They are sticky. They are hard to get rid of. They are the biggest bullies of your brain. 

 

Everyday humans get intrusive thoughts that are odd, weird, and extremely bizarre. No one ever talks about them because of how incredibly strange the fleeting thought was that just entered their mind out of left field. 

 

What if I swerve off the road while I’m driving right now? What if I just robbed that bank? What if I just jumped off that 10 story building? 

 

Everyone gets them. Yes everybody. Whether you have paid attention to them or not, everyone has gotten an intrusive thought at least once in their life. The average person without OCD is able to pass the thought off as a “nothing thought”. I don’t want to swerve my car off the road. I don’t want to rob that bank. I’m obviously never going to jump off that 10 story building. Somebody with OCD thinks these thoughts are reality based. Their brain works to trick them. Compulsions seem like they are there to help you, but they actually pour gasoline on your fire. The more you engage, the more you think. The more you think, the more you engage. Vicious cycle right? 

 

It’s important to note that intrusive thoughts are never things people act on. There is also a stigma around intrusive thoughts. A stigma stacked on a stigma. What people believe to be intrusive thoughts are actually impulsive thoughts. “I just got the intrusive thought to cut bangs so I did it”. This is an example of acting on impulse, not acting on intrusion. Intrusions are never desired to be acted on.

What are the different kinds of OCD?

OCD manifests differently for different people. It is an extremely distressing disorder interfering with one's ability to function properly in their daily lives. What many aren't aware of is just how many different kinds of OCD there actually are. I'm only listing very common ones, or ones that I myself have experienced. Anyone can have OCD about anything. It's not contained to what is listed below.

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Organization OCD:

 

This is probably the most recognizable form of OCD. What everyone thinks "OCD" is. It involves a series of obsessions and compulsions related to organization. If things aren't organized a certain way, the person experiences extreme distress related to their intrusive thoughts.

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Obsessions:

  • If I don't organize my desk the exact same way everyday my family is going to die

  • My pantry has to be labeled or else I'm going to get into a car crash later today

  • All of my money has to be organized facing the same way or something harmful will happen to my partner

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Compulsions:

  • Making sure your desk is exactly the same way everyday. The same pencils are in the same spot, facing the same way, etc.

  • Labeling everything in your pantry to prevent yourself from getting into a car crash

  • Organizing your money perfectly in order to stop your partner from being harmed

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Contamination OCD:

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Contamination OCD relates to obsessions and fears surrounding one's personal health, cleanliness, etc. 

 

Obsessions:

  • I just touched the table and I can feel the germs on my hand. If I don’t wash them immediately I’ll never be clean.

  • I just touched my mom’s food without washing my hands first, now she’s going to get sick

  • That place is so dirty, I’m going to get cancer if I go in there.

 

Compulsions:

  • Repeatedly washing your hands

  • Constantly cleaning everything before you touch it

  • Avoiding certain places that may trigger you

  • Constantly searching the internet asking if it’s possible to get cancer from a public place

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Checking OCD:

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A subset of OCD involving a lot of checking based compulsions and behaviors. 

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Obsessions:

  • Did I remember to turn my curling iron off? 

  • Am I 100% positive I turned the stove off?

  • What if I start a fire? What if I injure my family

  • Is my car safe to drive?

  • What if my mom drives my car and it breaks down on the highway?

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Compulsions:

  • Repeatedly checking multiple times to see if you turned the stove off

  • Repeatedly checking multiple times to see if you turned the curling iron off

  • Asking people to double check you turned things off even after you have checked multiple times

  • Taking your car to the mechanic for an inspection

  • Not trusting the mechanic so taking it to a different one

  • Making your mom stay on the phone with you so you can know if something bad happens

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False Memory OCD:

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False memory OCD surrounds obsessions and fears that you did something in the past, but have no memory of it happening.

 

Obsessions:

  • I just woke up hungover. What if I cheated on my boyfriend and forgot about it because I was so drunk?

  • What if I got into a car crash and killed someone by accident?

  • What if my mind blocked this memory because it was so traumatic for me? Is that why I can’t remember?

  • I wouldn’t have come up with such an elaborate story in my head if it never happened

 

Compulsions:

  • Going through your texts, saved pictures, social media posts to make sure there was never a time you could have cheated 

  • Asking your partner if you were ever gone for an extended period of time that night

  • Checking your local newspaper to make sure there were no reports of a car crash

  • Looking at your car to make sure there are no marks

  • Mentally checking over and over again to make sure this event could have never happened. 

  • Telling yourself it is impossible to have happened (this is always combated with a “well what if it was possible?” This is an example of how a compulsion can pour gasoline on the fire.)

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Relationship OCD:

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Relationship OCD is centered around intrusive thoughts and compulsive actions related to your partner. You may have OCD about yourself in your relationship, or OCD about your partner. It's important to note OCD is NOT reality based. A lot of what makes relationship OCD so difficult to understand is that a lot of the obsessions look like "normal thoughts" to the average person. What makes it OCD is how unrealistic the obsessions are, and the compulsions that follow it. 

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Obsessions:

  • What if I don't actually love my partner?

  • What if my partner doesn't actually love me?

  • What if I'm settling in my relationship?

  • What if I marry my partner and we have to end up getting divorced because I realize I don't actually love him?

  • What if my partner is lying to me every time they say "I love you"?

  • I'm never going to be happy if I keep having these thoughts

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Compulsions:

  • Making a list of everything you value about your partner to remind yourself that you do love them

  • Asking your partner for reassurance about the state of your relationship

  • Mentally checking if you will enjoy a future with your partner 

  • Mentally envisioning yourself with someone other than your partner to see if you want to break up and date someone else

  • Looking online to see if anyone else has experienced a similar situation- "is this OCD or am I actually falling out of love?"

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P.S. if you're asking yourself "is this OCD, or am I ...?", chances are it is indeed... OCD. 

 

Sexual Orientation OCD:

 

​Sexual Orientation OCD includes a series of disturbing/unwanted intrusive thoughts and compulsions related to your sexual identity.

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Obsessions:

  • I just thought that woman was attractive, does that mean I'm gay?

  • What if I turn gay one day and I'll have to break up with my partner?

  • What if I've been gay my whole life and never realized it?

  • Is this OCD, or am I just in denial? I'm having these thoughts, which mean they must be true

  • What if I'll never be happy with the person I end up with?

  • Why am I having these thoughts if I know they aren't true? 

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Compulsions:

  • Picturing yourself with someone of the non-preferred sex to reassure yourself that you don't like it

  • Avoiding tv shows, movies, social media posts that may include media that would trigger you

  • Picturing yourself with someone of the preferred sex to prove that you are the orientation you thought you were

  • Wearing extra "girly" or "manly" clothing so people don't think you are gay

  • Asking other people for reassurance that they never thought you were gay

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Pedophilia OCD:

 

Pedophilia OCD is a subset of OCD that involves a series of disturbing intrusive thoughts and compulsions related to children.

 

Obsessions:

  • What if I'm attracted to children?

  • What if I lose control and harm a child by accident?

  • What if I'm a monster? Do these thoughts make me a monster?

  • Is this just OCD, or am I in denial?

 

Compulsions:

  • Avoiding children so you never "lose control"

  • Avoiding looking, or making eye contact at a child

  • Looking for reassurance online that you aren't a monster

  • Looking online for the difference between intrusive thoughts and desires

  • Asking loved ones for reassurance that you aren't a freak

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Harm OCD:

 

Harm OCD involves a series of disturbing unwanted thoughts/images and compulsions related to harming others.

 

Obsessions:

  • What if I lose control while I'm cutting food and stab my partner?

  • What if I have a secret desire to hurt someone?

  • What if I snapped and started hitting my mom?

  • What if I have the same mental health problems that a serial killer has?

 

Compulsions:

  • Imagining yourself committing harmful acts to see if you actually want to do it

  • Never going near anything sharp out of fear that you will lose control

  • Thinking back to your childhood to see if you ever did anything that serial killers did as a child

  • Looking online to see if you have any similarities to a serial killer

  • Avoiding public places because you think people would be "safer" without you around

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Cheating OCD:

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Cheating OCD involves obsessions and fears related to cheating on your partner.

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Obsessions:

  • Did I just accidentally flirt with that guy? Did he think I was flirting?

  • I think that person is attractive which means I’m being unfaithful to my partner

  • What if I lose control and cheat on my partner?

 

Compulsions

  • Constantly mentioning your partner so people know that you’re loyal to them

  • Mentally checking if you could see yourself cheating on your partner

  • Constantly checking if you think your partner is more attractive than the other person

  • Finding flaws in the person you were “flirting” with to confirm you aren’t attracted to them

  • Asking your partner if they ever think you’d cheat

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Self-Harm OCD:

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Self-Harm OCD is defined as a series of obsessive fears and compulsions related to suicide.

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Obsessions:

  • What if I just jumped off that high building?

  • What if I lose control and hurt myself?

  • What's the purpose of life? Is there a purpose?

  • Have I ever been suicidal? Do I want this?

  • I know I don't want to do it, but what if I secretly do? 

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Compulsions:

  • Avoiding anything that you could harm yourself with

  • Closing the blinds so you don't have to look out the window

  • Making a list of everything you want to do before you die

  • Mentally checking to see if you want to do it, or if you could ever do it

How Is OCD Treated? Does It Ever Go Away?

Unfortunately, OCD will never be 100% cured. Once you are diagnosed, it's something you will have forever. The good thing is, is that there are a bunch of really good ways to manage it so it is not so debilitating. 

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What you think will help will actually make things worse, and what you think will make things worse will actually help.

 

What do I mean by that?

 

Compulsions are thought to be helpful. Telling yourself you will never ever do something. Checking over and over again to make sure you aren’t a bad person. Avoiding things that may trigger you. Getting reassurance from a loved one that there’s no way what you’re thinking may be true. 

 

Why are these so harmful?

 

Well, they are always and will always be followed by more questions. More obsessions. More things to give you anxiety over. People with OCD crave certainty. When in reality, you can never be certain about anything in your life. Tomorrow will always bring new things you didn’t account for and you have to be okay with accepting the uncertainty surrounding that. 

 

“I will never ever do something like that” turns into “but what if I do? What happens then? What if I lose control and do something I don’t want to do?”

 

Avoiding things that may trigger you turns into you wondering what would have happened if you never avoided the kitchen knife, that tv show, or that offer to babysit. “What if you had lost control in those moments? You have to keep avoiding them.”

 

Getting reassurance from a loved one about your character turns into you wondering if they are just lying to make you feel better. If they actually believe what they are telling you. And if they do believe it, they MUST be the only one right? So then you say “okay, let me ask someone else just to make sure”. 

 

And this is how the cycle repeats.

 

So how is it broken?

 

By doing nothing. Yup. 

 

How is doing nothing helpful? Well, see how trying to do everything gets you nowhere? How trying to fight illogic with logic sends you to ruminate? So what if you also became illogical with your OCD? What if instead of trying to do everything, you did nothing?

 

The gold standard treatment for OCD is something called Exposure Response Prevention Therapy (ERP). Bear with me. It’s going to sound like it makes no sense, but neither does OCD so they’re actually perfect for each other 🙂

 

ERP is designed to allow people to face their fears in order for them to get desensitized by what they’re so afraid of. The point is for you to allow yourself to feel all the anxiety that rises, while actively doing nothing to stop it. You accept what you are thinking as just a thought. You accept you can’t solve it. You accept you have to sit with it. You accept you have to accept it. You aren’t going to engage with it, you aren’t going to fight it, and you are going to allow it to be there. Accept you are having OCD thoughts, and carry on with your day as you would have if these thoughts weren’t present. 

 

ERP forces you to face your OCD rather than run from it. Embracing uncertainty about the future while living peacefully in your present moment.

 

Examples of ERP: 

  • Writing a story in which you cheat on your partner

  • Looking at images of attractive people

  • Writing a story about falling in love with a member of a non-preferred sex

  • Holding a knife

  • Climbing a high tower

  • Going to a playground full of children

  • Watching a tv show involving murder

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*All exposures should be carried out in the hands of a mental health professional who is trained in ERP*

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Other healthy ways to manage your OCD:

  1. Seeing an OCD specialist who will guide you through ERP

  2. Spoil the thought --> answer the "what if" with a "what if"

  3. Remind yourself that the second you start imagining is the second you have crossed the bridge over from reality

  4. Feelings are not facts: just because it feels real doesn't mean that it is

  5. Focus on the here and the now: what do you want now?

  6. Thoughts are just thoughts. Separate yourself from your OCD, "I'm having OCD thoughts"

  7. Focus your attention into something more values based

  8. Look at your body as a whole: acknowledge where you feel your anxiety and what is causing it

  9. Trust in what you want, what you know, and what you value

  10. OCD logic is not real logic: don't try to fill in the blanks

  11. Judgement free zone: the second you become judgmental, you have already lost the battle

  12. Embrace uncertainty and accepting that you don't have to know everything right now

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