Perhaps the most commonly misunderstood mental health disorder, in my experience, is obsessive-compulsive disorder, commonly known as OCD.
It’s not uncommon to hear people say something like “I’m OCD about that” when they are talking about their desire to have things in a particular way. But, obsessive-compulsive disorder is much more than just someone’s need to have all chairs in a particular place or a Kleenex box at just the right angle.
People with OCD go through obsessions, which are repetitive thoughts or images that feel uncontrollable. These obsessions are often frightening to the person, so there is a strong desire to avoid or get rid of the thought. This leads to the compulsions, which are actions or thoughts that people have to lower their anxiety from their obsessions.
For example, a person might have the obsessive thought that their hands are dirty because they touched something that might be unclean. They have a compulsion to wash their hands. The purpose of the compulsion might seem to be the desire to get clean, but that’s actually not it. Instead, the goal of the compulsion is to rid the person of the anxiety that they are feeling that their hands might be dirty. OCD often leads to repetitive patterns of behavior as people experience anxiety due to obsessions and feel compelled to do the same thing over and over to lower their anxiety.
The most familiar forms of OCD are those where people engage in either cleaning, avoiding or checking behaviors. Many of us are familiar with depictions of OCD in which a person feels the compulsion to check that their door is locked a certain number of times before they can leave the house. We know about people who count how many times they do a repetitive action due to their uncertainty that they’ve performed it correctly. And we’ve heard of people who feel compelled to wash their hands over and over. However, one of the most common forms of OCD is often one of the ones least often represented in our depictions of the disorder: intrusive thoughts about causing harm.
People with this form of OCD often get stuck on trying to figure out if they want to do the thing that they thought about. For example, have you ever been driving and thought, “What would happen if I just turned my steering wheel and caused myself to wreck into a tree?” Many people have had those types of thoughts, but people with OCD get stuck on trying to decide if they actually want to crash their car.
People with intrusive thought OCD often have thoughts about harming themselves or someone else. Everyone has these types of thoughts, but people with OCD often aren’t able to dismiss the thought as simply a thought and not an actual want.
So what can you do if you or someone you love has OCD?
Remember, people with OCD perform their compulsions out of a desire to reduce the anxiety that they feel from their obsessions. To begin working on managing your OCD, you have to begin working on allowing yourself to sit with the anxiety and not perform the compulsion.
In essence, the compulsion is a form of avoidance; you are avoiding feeling anxious about something being not clean or done incorrectly by doing something to reassure yourself. And when we feel anxiety, we often find ourselves avoiding it because avoidance is a temporary way to reduce the anxiety. Practice not performing your compulsion and instead allowing yourself to experience the anxiety that motivates the compulsions.
- Mischa McCray is a licensed professional counselor and a licensed marriage and family therapist. Send questions or topics you’d like him to discuss to mmccray@wpcgreenwood.org.
