Is the apartment locked? Check. Is the apartment locked? Check. Is the stove on? Check. Is the stove on? Check. Did I park in an illegal space? Check. Did I park in an illegal space? Check.
It is completely normal to have thoughts that you’ve not done these essential things and more, but becomes a problem for many—an estimated 3+ million Americans—when concern over checking and re-checking items, compulsive hand washing that can render the skin raw, becomes an obsession, and symptomatic of Obsessive-Compulsive Disorder (OCD). According to the DSM-IV, this behavioral health illness may be present if “obsessions or compulsions cause marked distress, are time-consuming (take more than one hour a day), or significantly interfere with the person’s normal routine, occupational (or academic) functioning, or usual social activities or relationships.”
According to Lawrence Robinson, Melinda Smith, M.A., and Jeanne Segal, Ph.D, obsessions are characterized as, “Involuntary, seemingly uncontrollable thoughts, images, or impulses that occur over and over in your mind. You don’t want to have these ideas but you can’t stop them. Unfortunately, these obsessive thoughts are often disturbing and distracting.” Compulsions, another hallmark trait of OCD, “are behaviors or rituals that you feel driven to act out again and again. Usually, compulsions are performed in an attempt to make obsessions go away. For example, if you’re afraid of contamination, you might develop elaborate cleaning rituals. However, the relief never lasts. In fact, the obsessive thoughts usually come back stronger. And the compulsive behaviors often end up causing anxiety themselves as they become more demanding and time-consuming.” People often recognize this disorder, realizing the obsessions and compulsions are excessive and unreasonable, but may have great trouble putting this knowledge into practice.
While this illness is a serious one, there are ways to combat it! An important step is recognizing the signs and symptoms of the disorder, and obtaining a professional medical analysis for appropriate diagnosis (there are usually co-morbid health conditions with most behavioral health issues) and developing concrete means of treatments. For an idea of what types of behaviors you find challenging to avoid and will want to address in therapy, consider taking the Brain Physics OCD Test. (Please note: This is not a substitute for treatment, but a tool that can be helpful in recognizing problematic symptoms).
Generally Accepted Types of OCD (individuals may have more than one):
- Washers. These individuals have a grave fear of germs, which causes them to compulsively wash their hands, hair, body, and even their home. As this is not healthy cleaning but one that often leaves the skin raw, it can become highly problematic.
- Checkers. This is characterized by irrational and gratuitous checking of objects associated with harm and danger. For example, the repeated checking of apartment locks, the stove, an iron, and so forth to insure safety, even when already checked and verified as being okay.
- Counters. People with this symptom of OCD are literally obsessed with counting and numbering, order and symmetry. They may even exhibit the irrational belief that certain colors or numbers are “evil” or “dangerous.”
- Hoarders. This is characterized by the extreme fear that something bad will happen if objects are thrown away, even if these objects are not needed or even used. As a result, some individuals save items to such an extent that their homes and cars are literally packed with rotting goods (i.e., old newspapers).
- Doubters/”Sinners.” This painful symptom can truly dictate one’s life if they are not careful and in professional care. “Doubters” generally hold the false belief that they will be punished or something terrible will befall them if they do not have objects in a specific and often extreme order.
Signs & Symptoms of OCD: Obsessions
- Fear of being contaminated by germs or dirt or contaminating others.
- Fear of causing harm to yourself or others.
- Intrusive sexually explicit or violent thoughts and images.
- Excessive focus on religious or moral ideas.
- Fear of losing or not having things you might need.
- Order and symmetry: the idea that everything must line up “perfectly.”
- Superstitions; excessive attention to something considered lucky or unlucky.
Signs & Symptoms of OCD: Compulsions
- Excessive double-checking of things, such as locks, appliances, and switches.
- Repeatedly (and irrationally) checking in on loved ones to make sure they’re safe.
- Counting, tapping, repeating certain words, or doing other senseless things to reduce anxiety.
- Spending a lot of time washing or cleaning.
- Ordering or arranging things so they are “perfect.”
- Accumulating “junk” such as old newspapers or empty food containers.
Treatment Techniques: You CAN get better!
Cognitive Behavioral therapy (CBT) has long been heralded as a frontline treatment for Obsessive-Compulsive disorder, which is sometimes complimented with anti-depressant medication. This class of therapy examines how negative thoughts contribute to anxiety and other behavioral health illnesses, and seeks to correct the behavior by examining how one reacts in anxiety-ridden situations. Once one understands why they engage in such actions, continued therapy can help one in actively resisting them. It is centered around identifying negative thoughts, challenging them, and ultimately replacing such notions with realistic ones.
Psychiatrist Jeffrey Schwartz of The Westwood Institute for Anxiety Disorders, has written a deeply helpful guide to combating and correcting urges, which has been widely used to treat OCD. His work offers four steps in combatting OCD urges and compulsions, which are as follows:
- Relabel. Recognize that the intrusive obsessive thoughts and urges are the result of OCD. For example, train yourself to say, “I don’t think or feel that my hands are dirty. I’m having an obsession that my hands are dirty.” Or, “I don’t feel that I have the need to wash my hands. I’m having a compulsive urge to perform the compulsion of washing my hands.”
- Re-attribute. Realize that the intensity and intrusiveness of the thought or urge is caused by OCD; it is probably related to a biochemical imbalance in the brain. Tell yourself, “It’s not me—it’s my OCD,” to remind you that OCD thoughts and urges are not meaningful, but are false messages from the brain.
- Refocus . Work around the OCD thoughts by focusing your attention on something else, at least for a few minutes. Do another behavior. Say to yourself, “I’m experiencing a symptom of OCD. I need to do another behavior.
- Re-value. Do not take the OCD thought at face value. It is not significant in itself. Tell yourself, “That’s just my stupid obsession. It has no meaning. That’s just my brain. There’s no need to pay attention to it.” Remember: You can’t make the thought go away, but neither do you need to pay attention to it. You can learn to go on to the next behavior.
As with all behavioral health illnesses, it is imperative people with OCD take care of themselves to ameliorate particularly baneful symptoms. Further, it is critical and beneficial for everyone, but especially those with a class of anxiety disorder, to practice relaxation techniques, maintain healthy eating habits, keep a mood journal, exercise regularly, acquire adequate sleep, and refrain from isolating oneself from loved ones.
And remember, you are engaging in difficult and important daily work. Be gentle with yourself in your recovery. You deserve it.