What is OCD?
Obsessive compulsive disorder (OCD) is a common mental health condition where a person has obsessive thoughts and compulsive behaviours. It can affect men, women and children. Some people experience symptoms early, often around puberty, but it usually starts during early adulthood.
In OCD, the word obsession relates to recurrent thoughts, images, impulses or doubts that create awareness of the potential for danger which the person believes they can cause or prevent.
Compulsions are actions, behaviours or reactions that people do as a result of an obsession. They’re intended to prevent the danger the obsession has created awareness of and diminish responsibility for its occurrence or undo or neutralise things which may have already happened. Common compulsive behaviours in OCD include:
– Excessive double-checking of things, such as locks, appliances, and switches
– Repeatedly checking in on loved ones to make sure they’re safe
– Counting, tapping, repeating certain words, or doing other inexplicable things to reduce anxiety
– Spending a lot of time washing or cleaning
OCD can be distressing and significantly interfere with your life. Sometimes it’s joked about – ‘oh that’s so OCD’ of you!’ But living with OCD is no joke. It’s one of the most debilitating anxiety disorders I work with.
Can CBT Help?
CBT can be life-changing for people with OCD. Unfortunately, by the time someone seeks therapy for the condition, they have usually been struggling with symptoms for about 20 years. There are many reasons for this. Some people don’t believe therapy can help or are worried they’ll be asked to face their fears and would like to avoid this.
As OCD usually develops over time, people tend to learn highly effective strategies for managing their symptoms. However, any reduction in anxiety is temporary and the solutions often become the problem, e.g. checking, avoiding, getting reassurance, counting etc. Eventually, these coping behaviours can consume large amounts of time and have a huge impact on someone’s life.
CBT helps increase cognitive flexibility. This means instead of having a fixed mindset and black and white thinking styles, you become more curious about your thoughts. You understand thoughts are not facts and that you are not your thoughts. This awareness helps you give different meanings to thoughts as they arise.
For example, if you think ‘that surface is contaminated with germs’ you would know it is just a thought. There might be another possibility, for example that it’s not contaminated. You would then be able to consider the evidence for and against each thought.
When we alter our thinking, it alters how we feel and what we do. Over time, you will learn to tolerate and work with anxiety differently. You’ll be able to look at your actions and behaviour and explore whether or not they are helping the situation or maintaining it.
OCD & COVID-19
OCD has many different guises. One common presentation is people having worries around germs, contamination or health. Given we’re in the midst of global pandemic, you might be wondering whether I’ve witnessed a rise in people contacting me about CBT for OCD. I haven’t, and this worries me.
I believe many people who might have been having issues before will now be experiencing a real daily struggle. The increase in anxiety we’ve all experienced due to COVID-19 is likely to have had a huge impact on people already struggling with an anxiety problem like OCD.
How to Manage OCD During a Pandemic
A good first step is to keep the information you consume around the pandemic to a minimum. Taking in too much can cause more distress. At the same time, make sure you’re not neglecting the basics of good mental health – exercise, sleep and a healthy diet.
As I’ve said, CBT can make a huge difference, but it’s important to work with a BABCP accredited therapist as they will have been effectively trained. Waiting times on the NHS for CBT can be as long as 12 months, so I’d recommend asking your GP to refer you as soon as possible. You can also self-refer through your local primary care mental health team.
In the meantime, journaling is an excellent tool to help you understand your OCD. Try noting down thoughts, triggers, patterns, fears, belief systems and the rituals or actions you use to manage the condition. Writing down your experiences creates more objectivity, so you can begin to question what is going on.
Another benefit of starting to write about your OCD is that it can slow the process down. Instead of the OCD playing out as if you’re on autopilot, you’ll become more aware of what you’re doing. Awareness is always the first step to change. If you go on to work with a CBT therapist, you’ll be asked to keep a record of your experiences, so it’s a useful thing to do early on.
Journaling Prompts for OCD
– What triggers your OCD? What thoughts do you have? What are your worries, fears or beliefs and what are you doing to manage this
– How do you cope? If you can, consider a recent time where OCD has caused you a problem and write out what happened.
– Do you experience physical symptoms of anxiety? What does it feel like?
– Are there times when your OCD is manageable? What are your strengths in managing your condition?
Any changes you make to work with your OCD should be done in a graded way. Again, it can be useful to write down your experiences. If you are going to reduce a ritual, write down what you are doing now and where you hope to get to. Write down the steps you can take in between. Do you have any worries about altering this ritual? If you do, write them down and test them out. Are there other possibilities? What is the evidence for and against?
Keep Going & Don’t Give Up
OCD is treatable and you can recover. It may take time, especially if it’s been around for a while. The aim of CBT is for you to become your own therapist so you can play a central role in your recovery. I’ve seen many people who have been living with OCD for a long time transform their lives through therapy. Keep going with the small changes and in the end, you will experience big rewards.
Useful Links
- Obsessive Compulsive Disorder {OCD} – Is it Time to Seek Professional Help?
- How to Manage Stress and Anxiety During a Pandemic
- How to Choose a CBT Therapist