For most of us OCD or Obsessive Compulsive Disorder may seem strange, silly or even scary, but for the 2 to 3% of the population who suffer from the debilitating effects it can be a nightmare.

For OCD sufferers, their behaviour distresses and exhausts them, they find the obsessions uncontrollable and the compulsions difficult or impossible to resist. The all-pervasive, controlling nature of OCD seriously affects the person’s life, work, school, family and relationships. When they’re going through an OCD episode, many say they feel their stomach tighten, feel light headed or experience a racing heart, all the symptoms of being in a highly anxious state which OCD is associated with.

Imagine if you felt you couldn’t get your hands clean and you washed them so much it damaged your skin. Or every time you touched a door handle you had to wash your hands. What if you felt a compulsion to check every lock or power point in your house over and over even though you just checked it?

With OCD, your behaviour is so excessive and ritualised the obsessive and compulsive thinking and behaviour takes over your life. It can be so debilitating it affects your wellbeing. From the outside, you may not even know someone has OCD because they become masters of disguising their behaviour as they usually feel intense shame and try to hide it.

The Many Manifestations of OCD

Reported obsessions and compulsions run from the more common need for cleanliness to highly unusual behaviours including; superstitious fears like never stepping on a crack in the pavement, morbid fear of losing things, counting, excessive list making, fear of hurting oneself or others, hoarding, always fearing you have a terrible illness when you don’t, constantly rearranging things like furniture, clothes in the wardrobe, or desk items.

Other OCD behaviours from a long list include;

• Excessive or ritualized showering, bathing, toothbrushing grooming, or toilet routine.
• Fear of losing things.
• Needing to know or remember (e.g. if they hear parts of some information, the person needs to hear the rest) or fear of saying certain things.
• Being controlled by lucky or unlucky numbers or colours.
• Excessive concern with body parts or aspect of appearance (not weight related).
• Intrusive (non-violent) images (i.e. cartoons, faces, clouds).
• Need to repeat routine activities like jogging, in/out of a door, or up/down from a chair.
• Ritualized eating behaviours.

How Does Normal Thinking Turn Into OCD?

We all have anxious thoughts from time to time and it helps us get things done or keeps us safe. For example, if you thought you may have left water boiling on the stove you will check it to make sure things are safe. The problem is, once the thoughts become recurring or obsessive it can create behavioural patterns that are unhealthy and that can cause daily functioning to become difficult.

For the person with OCD these compulsions or rituals are often performed in the hope of stopping their obsessive thoughts or eliminating them all together. Performing these compulsions provides only temporary relief and will perpetuate the problem – yet not completing them, increases anxiety in the short term. The time spent carrying out the compulsions can be very disabling.

OCD is thought to develop as a result of a combination of genetic and environmental factors. A number of factors may increase the risk of developing OCD. These include:

• Learned behaviours, whether through an event you have experienced or from watching others including parents as you are growing up.
• Genetic disposition, family history, anxiety disorders can run in families.
• Biological factors like experiencing high constant anxiety or stress which research has shown to change the brain’s chemicals.
• Personality traits, thinking style.

The Good News is OCD is Very Treatable

If you or someone you know displays any of these OCD behaviours to the point it is affecting yours or their well-being, psychological therapies like Cognitive Behaviour Therapy or CBT have widespread successful outcomes. It’s generally delivered individually but group sessions can be conducted if person with OCD gives permission. CBT is a structured psychological treatment, that understands a person’s way of thinking and acting and how it can affect the way they feel. In CBT, a person works with a professional to look at the patterns of thinking and acting which are causing them to become anxious or which are preventing them from any improvement when getting help.

Once these patterns are recognised, the person can consciously and dilberately make changes. For some OCD sufferers the brain can maintain a healthy chemical balance to control compulsions and obsessions through the use of different medications. Support groups provide an environment where people with OCD and their families can meet to give and receive support. Information is provided, along with self-help and coping strategies.

Other than talking to a doctor here are some tips about dealing with OCD –

Many people trying to overcome OCD keep a diary of the frequency, intensity and types of unwelcome thoughts (obsessions they are advised to resist). They also start to limit the completion of rituals (compulsions) as much as possible, practise letting go and putting things into perspective, trying to reduce their stress in general.

They can practise relaxation techniques such as breathing and muscle relaxation. Relaxation techniques can provide quick relief from anxiety and, if practised regularly, can also reduce anxiety and stress in general. They have to make time for pleasurable activities and importantly maintain a healthy lifestyle, have adequate sleep, get regular exercise, eat a well-balanced diet and reduce alcohol and other stimulants, such as caffeine to reduce the anxiety.

If you know someone with OCD some tips on how you can help –

• Don’t argue with the person, don’t try to stop the person from participating or collude in what seems to you like illogical behaviour. Often the person realises it is illogical, but still feels compelled to act in this way.
• Encourage the person to take action and seek help.
• Acknowledge that the person has a disorder and is not just being difficult; the anxiety is a very real and distressing experience.
• Don’t involve yourself in the person’s compulsions. Helping a person with OCD to carry out the compulsions only makes it more difficult for the person to recover.

Importantly if you’re dealing with or caring for someone with OCD, find emotional support for yourself. You may need to seek out support too. Support groups, counselling, or educational sessions may be of help for those who are caring for someone with this condition.

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Janice Killey

Janice has a wealth of experience and training. She holds a Diploma of Education, Bachelor of Arts (Psychology), Master of Arts (Counselling), Diploma of Clinical Hypnotherapy (ASH) and is a Registered Psychologist at Psychologists Southern Sydney. She’s also a member of the Australian Psychological Society.