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Obsessive-Compulsive Disorder
Understanding and Treating Intrusive Thoughts and Compulsions
Obsessive-Compulsive Disorder (OCD) is a mental health condition characterized by intrusive thoughts (obsessions) and repetitive behaviors (compulsions) performed to reduce anxiety. OCD can interfere with daily life, work, and relationships, but evidence-based treatments like Cognitive Behavioral Therapy (CBT) and medication can significantly improve symptoms and quality of life.
OBSESSISIONS
Unwanted, intrusive thoughts, images, or urges that are usually repetitive, difficult to control, cause significant distress and feel inconsistent with the person’s values or intentions.
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Fear of germs, dirt, bodily fluids, chemicals, or illness despite reassurance
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Persistent doubts about whether something was done correctly (e.g., doors locked, appliances turned off)
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Fear of harming oneself or others, despite having no desire to act on them
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Unwanted sexual thoughts or images that are distressing or inappropriate to the person’s values
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Excessive concern about sinning, morality, offending God, or being “bad”
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Intense discomfort when things feel uneven, misaligned, or “not just right”
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Persistent doubts about one’s feelings, partner, or relationship (“Do I really love them?”)
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Intolerance of uncertainty, needing to be 100% sure or perfect before moving on
COMPULSIONS
Repetitive behaviors or mental acts performed in response to obsessions or rigid rules.
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Excessive handwashing, showering, or cleaning
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Repeated checking (locks, switches, appliances, messages)
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Ordering or arranging items until they feel “just right”
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Repeating actions (walking, touching, rereading) a certain number of times
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Avoidance of people, places, or objects that trigger obsessions
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Seeking reassurance from others or professionals
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Hoarding or difficulty discarding items (in some cases)
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Counting, praying, or repeating phrases silently
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Neutralising thoughts (e.g., replacing a “bad” thought with a “good” one)
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Mental checking (e.g., scanning feelings, intentions, or memories)
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Analysing or reasoning to prove the obsession is untrue
Common Symptoms of OCD
Interventions That Help
EXPOSURE AND RESPONSE PREVENTION (ERP)
The gold standard approach is Exposure and Response Prevention (ERP), which is a specialised form of Cognitive Behavioral Therapy (CBT). It targets the behavioural patterns that maintain OCD, helping individuals face feared thoughts or situations while learning to resist compulsive responses:
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Exposure: Gradually and intentionally facing triggers, such as touching something perceived as dirty
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Response Prevention: Learning to resist performing compulsive rituals, like not immediately washing hands
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Outcome: Reduces the anxiety linked to obsessions and weakens the connection between obsession and compulsion over time
MEDICATION
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Selective Serotonin Reuptake Inhibitors (SSRIs): Antidepressants commonly prescribed for OCD
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Mechanism: Increase serotonin levels in the brain to help reduce obsessions and compulsions
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Effectiveness: Full benefits may take up to 12 weeks; combining ERP and SSRIs often produces the best results
Key Takeaway
With the right combination of therapy and medication, individuals with OCD can learn to manage intrusive thoughts, reduce compulsive behaviors, and regain control over their daily life.