is a diagnosis that is characterized by recurrent obsessions and/or
compulsions that interfere substantially with daily functioning.
Obsessions are "persistent ideas, thoughts, impulses or images
that are experienced as intrusive and inappropriate". These
obsessions tend to cause a great deal of anxiety and distress. Typical
obsessions would include repetitive thoughts about contamination,
causing harm to others, self-doubt (e.g. did I lock the door) or
other unwanted thoughts that people battle to get out of their minds.
Compulsions are "repetitive behaviours or mental acts that
are aimed at preventing or reducing the anxiety or distress".
Typical examples of compulsive behaviour would include hand washing,
ritualistic prayer, checking and counting. Compulsions are often
aimed at either preventing the distress brought on by obsessions
or at preventing the proposed harm associated with them.
For example, an individual with a contamination obsession would
worry a great deal about getting "dirt" or "germs"
on his hands. As a result, he would tend to avoid touching a wide
variety of "contaminated objects" (e.g. door handles,
the floor, towels that have previously been used by themselves,
restaurant cutlery, desks at college). He would tend to then frequently
wash his hands in an attempt to reduce his anxiety associated with
his perceived contamination. This behaviour would cause a great
deal of distress and get in the way of his ability to function,
firstly because of his avoidance and secondly because of the amount
of time that may be taken by his hand washing behaviour.
The treatment of choice for OCD is referred to as prolonged exposure
and response prevention (EX/RP) (Franklin & Foa, 2008). During
exposure therapy, individuals are introduced to the idea of prolonged
exposure to obsessions without the use of the associated compulsive
behaviour as a coping mechanism. During prolonged exposure, individuals
are encouraged to expose themselves to the very thoughts, images,
ideas, situations or other stimuli that they have their obsessions
about. This is done for a prolonged period of time until their anxiety
begins to habituate or starts to come down without the use of the
compulsion. This is a very powerful technique that helps the brain
to rewire its circuitry that is involved with OCD symptoms. As with
most other exposure-based interventions, most people feel a great
deal of anxiety about this before beginning with exposure and a
significant amount of psycho-education and cognitive therapy is
often required before hand.