Obsessions are involuntary, intrusive thoughts that feel uncontrollable. They can be frightening, shameful or unpleasant in nature, and can come in the form of images, thoughts, ideas, or horror scenarios. These can be, for example, 'I will get sick and die', 'I will be humiliated in front of all my colleagues', 'I will hurt someone I care about', or 'my house will burn down'. Many who suffer from obsessions also experience it as distressing and therefore go through a long period of time without telling others or seeking help. Many may also have doubts about whether the obsessions represent actual desires they themselves have, and may feel shame and disgust about this.
Compulsions are ritualized actions that one feels compelled to perform. These can include excessive hand washing, checking closed doors and windows, and excessive cleaning. They can also be rituals such as knocking, counting rules, or repetitively listing words to prevent misfortune. The actions will often be connected to the obsessive thoughts and are the 'executive' part, and a kind of extension of the obsessive thought. Often one feels compelled to perform the compulsion because one has a feeling that it will have catastrophic consequences if one does not. With OCD, the person is rationally aware that the consequences are not real, but the fear and discomfort of not doing so will build up until it becomes too overwhelming, and one performs the compulsion. This will have a redeeming effect, but only temporarily.
The primary treatment for OCD is psychological treatment with a cognitive behavioral therapeutic approach. In the conversations, you will uncover which situations the obsessive thoughts/behavior occur in, and further work on creating distance between your obsessive actions/behavior and yourself. Here, you will practice an observing, registering approach to the unpleasant thought content, where you are increasingly gripped by fear and anxiety. Through the therapy, you develop alternative ways of relating to the thoughts, without acting on them or being overwhelmed by them.
3 questions to help you understand your own problem
- What is the content of my obsessions and what am I actually doing in my compulsions? Write down a list, try to include as many details as possible.
- Explore what would happen if you stopped your compulsions, or tried to ignore your obsessive thoughts. Imagine it, and feel free to test it out. What emotional or mental discomfort arises? Write it down.
- Imagine if you could just stop obsessing and doing things. What would that allow you to do, what would your everyday life be like? Write down the points.
You have now created an overview of important information to understand your problem. You have a description of how it plays out, what discomfort you are trying to push away, and what everyday obsessions/actions are at the expense of. Sometimes clarity and overview can provide a prospect of a way out of the problem. Other times it makes it clear that we need help.
If this is a problem you are struggling with and would like help moving forward, we would like to hear from you. Send us an email or call us and we will find out how we can best help you.