This week is OCD Awareness Week. It is a time when our goal – as therapists and as a society – is to talk more about obsessive compulsive disorder and help people understand what it is, who it affects, and why seeking treatment is worthwhile.
We’ve touched on this topic in the past, but in honor of OCD Awareness Week, it’s discuss OCD in a way that is simple, easy to understand, and helps people see why many struggle with OCD without realizing it.
Obsessions and Compulsions
Let’s start by talking about “obsessions” and “compulsions.”
Before we can talk about them, we have to first forget what the words mean in normal conversation. In normal conversation, an “obsession” is a desire. We use the term endearingly to talk about people or things that we love.
In the mental health world, an “obsession” is something entirely different. It is a recurring, intrusive thought – one that we do not want, and one that we cannot stop. It is an “obsession” because our brain cannot stop thinking about it no matter how much we want it to.
Because these are thoughts we *do not want*, they cause us to feel distress.
Because we cannot stop these thoughts, we feel distress over and over and over again.
Eventually, we find that some behavior provides some relief from the thoughts. Examples include:
- Contamination Obsession – If someone has obsessions about germs or illness, they may wash their hands to feel relief.
- Sin/Hell/Religious Obsession – If someone has obsessions about sinning or ending up judged by God, they may pray often.
- Perfectionism Obsession – Someone that has an obsession with perfectionism may organize things or be constantly cleaning.
Compulsions can occur entirely organically. If a person has a harm obsession, and finds that they get relief from that thought when they make a noise or touch their knee, they may continue to do so to get some relief. Other times, it relates back to the obsession, like in the case of hand washing.
When these behaviors are visible, some people are encouraged to get help.
But they’re also not always visible.
The Hidden Struggles of Some OCD Types
OCD is also not always easy to see or diagnose.
One of the most common types of “compulsions” is what’s known as “checking.” Checking is where a person physically or mentally tests the obsession to make sure it’s not true. For example, a heterosexual person that has obsessions about being homosexual (again, remember that this person is likely not homosexual, it is just a recurring intrusive thought) may “check” to see if they’re homosexual by thinking about men in sexual encounters, and trying to determine if they’re aroused.
These types of checking behaviors occur entirely internally, which makes them both hard for others to notice and create a sense of extreme distress and self-judgment. People can have these obsessions about sexual violence, causing harm, causing self-injury, and more, and their “checking” behavior is imagining thoughts about it in order to see if it is real.
Not only do obsessions cause distress, but many people also worry that these obsessions mean something negative about themselves. For example, a person may have an “obsession” over sexual violence. Keep in mind that this person is typically *not* a sexually violent person, which is why the obsession causes such distress.
Internally, not only is this person experiencing distress at the obsession, but they may – because of the recurring thought – think they are a sexually violent person and be afraid to tell others. They may not seek help, worried about being branded or judged for these thoughts. Over time, it can be more and more destructive to their mental health and self-esteem.
OCD is Out There – But Not Always Seen or Understood
There was a time when obsessive compulsive disorder was not well known. Most people were unaware how many types of obsessive compulsive disorder exist or how they manifest.
Now, people are more familiar with the term “OCD” but rarely truly understand it. They may even say it as a descriptive tool. For example, they may organize a shelf a specific way and say “I’m a little OCD about this.”
True obsessive compulsive disorder can be very distressing, damaging, and challenging to those that experience it. It can also cause people to feel shame, further anxiety, depression, and more.
This OCD awareness week, it’s important to truly be aware of OCD – what it feels like, what it looks like, and what it means. The more we as a society really understand OCD, the better position we will be in to address it.