Obsessive thoughts and compulsive behaviours (OCD)
‘I can’t stop thinking about things that freak me out’
On one level, we know these obsessions aren’t a reflection of reality. We tell ourselves not to worry. But, the obsessions persist and pester. They build in our heads until we yearn for reassurance the way a junkie yearns for a fix. Then we take this reassurance any way we can.”JJ Keeler. ‘I hardly ever wash my hands: The other side of OCD’
‘You’re so OCD,’ I overheard someone saying this the other day, to describe a friend who was very organised and tidy, and who likes to peg his washing with matching coloured pegs. This use of the term OCD makes it sound like OCD is a form of extreme and quirky tidiness and organisation. In reality, OCD is a much more complex, distressing and pervasive problem.There are usually two aspects of OCD – obsessive thoughts and compulsive behaviours.Obsessive thoughts aren’t ‘obsessions’. They are not the kinds of thoughts that you enjoy thinking. Rather they are scary, distressing, horrible thoughts, thoughts that upset you and frighten you but that you can’t stop from coming into your head. Often they are scary because you think that they might be true, that thinking them makes them happen, or that thinking that way makes you a bad person.
Compulsive behaviours are a response to feelings of worry and anxiety. They are a way of feeling better, of minimising the chance of something bad happening. Usually you feel better after you have done the behaviour, but it becomes a vicious cycle because you have to keep doing the behaviour to keep your anxiety at bay. The behaviour can be a physical action or even a deliberate thought.
One of the things that makes OCD so complicated is the many and varied ways that anxiety can play out. Here are some examples:
- obsessive thoughts about germs and contamination, leading to compulsions such as excessive hand washing
- obsessive thoughts about mistakes, leading to compulsive checking of your work or perfectionism
- obsessive thoughts about being robbed or attacked, leading to compulsive checking of locks and alarms
- obsessive thoughts about harming others, leading to compulsive avoidance of people and objects that you fear you might use to harm them
- obsessive thoughts about things not being ‘right’, leading to a compulsive need for symmetry, tapping, use of lucky numbers
- obsessive thoughts about being unacceptable in some way (e.g. ‘Am I a child abuser?’) leading to compulsive mental rituals (e.g. repeating ‘The Lord’s Prayer’ in your mind).
- obsessive thoughts about being wasteful, leading to a fear of throwing things away, a compulsive need to retain and hoard objects.
The kinds of obsessive thoughts people have can vary widely, and the way they use compulsive behaviours to feel better can also vary. What makes this even more complex is that your experience of OCD can change over time. It’s the ultimate shape shifter – you can conquer your obsessions over one topic, only to wake up the next day obsessing over something new. If you experience severe OCD, it can be difficult to function in the world because your need to manage your anxiety using compulsions stops you from doing important things. This can sometimes mean that you need to rely on others (such as family members) more than you would like to help you manage day to day.
Things you can do
- Recognize what is happening and talk it thorough with someone you trust. The more embarrassed and secretive you are about your obsessive thoughts, the more power they have over you. Often talking it through with someone can help you to regain perspective.
- Learn as much as you can about thoughts and how the brain works. In fact, thoughts are just thoughts. We all have a myriad of thoughts, ranging from pleasant to unpleasant, and often we are not in control of what thought pops into our heads. Teach yourself that you can cope with having these distressing thoughts, and that you can let them come and go without reacting to them or pushing them away.
- Challenge yourself to gradually reduce your compulsions and see what happens. The rule of thumb is to try doing the opposite of what the obsessive thought is telling you. It is often useful to enlist the help of a friend or family member, to help encourage and support you.
- Talk to a psychologist. We have a range of strategies and techniques that can help.