What is Obsessive Compulsive Disorder (OCD)?

Learn about OCD and what mental health professionals are doing to help ...

obsessive compulsive disorder

The 1990s movie As Good as It Gets stars Jack Nicholson as a best-selling novelist who has some strange habits, habits that those with one anxiety disorder immediately recognize.

These habits include locking and re-locking each lock on his apartment door five times, turning his light switches on and off five times, heading straight for the bathroom upon entering his apartment where he opens his medicine cabinet to numerous bars of soap, all labels facing the same direction.

He proceeds to wash his hands over and over, using two bars of soap, throwing away each one after rubbing it over his hands.

For those without obsessive-compulsive disorder (OCD), this activity of Nicholson’s character might seem exaggerated for dramatic purposes. However, those who suffer with OCD know well that these behaviors are not extreme.

Compulsions used to try and stop obsessions

The rituals that Nicholson performs are called compulsions, acts used by individuals with OCD to stop or stifle persistent, relentless, and unwanted thoughts.

The hand washing, for example, is an attempt to stop nagging, irrational worries about dirt, germs, bacteria and possible contamination. The rows of soap all lined up in order and all facing the same direction exemplifies excessive anxiety about order and symmetry. And the counting that occurs with the light switches is behavior that the individual feels driven to perform otherwise something bad will happen.

OCD is a type of anxiety disorder. An individual can have OCD exclusively, or it occurs with other mental health disorders, such as depression, or in combination with one of the other anxiety disorders. These disorders are post-traumatic stress disorder (PTSD), social anxiety disorder, panic disorder, generalized anxiety disorder (GAD), and specific phobias.

Examples of compulsions (rituals or routines to stop distressful thoughts)

Compulsions form and become problematic, interfering with other normal activities, in numerous ways. They are repetitive and related to obsessions. So if individuals imagine that they hurt someone in a particular parking lot, for instance, running them over or committing a criminal act, they return to the parking lot again and again.

However there are common compulsions shared by many individuals with OCD, and are recognizable symptoms of the disorder. The following compulsions typify OCD, and were compiled from the Anxiety Disorders Association of America (ADAA) and MayoClinic.com:

  • Spending hours cleaning, including one’s own body, hands, or household items.
  • Counting in certain ways or patterns.
  • Checking and re-checking electrical appliances and the stove to ensure they’re turned off. Also incessantly checking the locks on the house and car doors.
  • Lining up canned goods and boxed items to ensure that everything is symmetrical and faces the same direction.
  • Hoarding or difficulty throwing anything away.
  • Replaying mental rituals, such as continuously reviewing past conversations, perpetual praying, and calling up specific words to stop obsessions.

Examples of obsessions (constant, disagreeable thoughts)

Obsessions are irrational thoughts, having absolutely no foundation or basis in fact. They appear when individuals are trying to focus and concentrate on other thoughts or activities, and they keep individuals in a vicious cycle of obsessive-thought and compulsive rituals. Obsessions prevent individuals from their normal, daily activities, antagonizing and provoking them.

Individuals with OCD often know that obsessive thoughts are irrational, yet they can’t stop them. Compiled from the ADAA and Mayo Clinic websites, here are the most common symptoms of obsessions:

  • Relentlessly worrying about germs and bacteria, often fearing to be touched by others.
  • Excessively preoccupied with order and arrangement of items.
  • Constantly imagining pornographic images.
  • Feeling extreme responsibility and concern for others’ safety.
  • Irrationally doubting yourself or others.
  • Replaying thoughts that you’ve hurt or injured someone.
  • Brooding excessively over getting rid of or throwing away inconsequential items.

Not a rare condition

In recent years, those working in mental health fields have discovered that OCD is not a rare condition as originally thought. According to the National Institute of Mental Health, about 2.2 million Americans have the disorder.

Mental health professionals have also discovered that OCD symptoms starting in childhood begin at about age 10. If symptoms don’t appear until adulthood, it’s usually at around age 21 that individuals first begin noticing OCD’s signature signs.

Untreated OCD significantly impairs an individual’s life. It affects relationships, careers, and educational goals. Suicidal thoughts can also occur and plague an individual, and should be addressed immediately by a mental health professional.

Common treatments for OCD include psychotherapy in the form of cognitive behavioral therapy (see CBT), and medications. (see Anxiety Treatments.)

If helping individuals with OCD or other mental health disorders interests you, consider a career as a mental health professional. These professionals work as either therapists or counselors, requiring a master’s degree in mental health counseling and state licensing.

Schools offering counseling degrees provide helpful information on the requirements for working in this field. Request information about degree programs in mental health counseling or related counseling fields.

How OCD and 9/11 Affected a British Boy

Failing to complete one of his established rituals, a 10-year-old boy with obsessive-compulsive symptoms firmly believed that he caused the terrorist acts of Sept. 11th 2001. The boy also suffers with Tourette’s Syndrome.

London researchers Mary Robertson and Andrea Cavanna reported that the boy sought mental health consultation before the 9/11 attacks, displaying Tourette’s symptoms of various tics and vocal outbursts, and obsessive-compulsive tendencies.

Treating the boy only two weeks after the terrorist attacks, Robertson said he was “tortured,” believing that because he failed to walk on a specific white road marking, he caused the tragedy.

Walking on the road markings was one of his rituals, in addition to needing to touch sharp knives, and put his hand in a teapot’s steam.

The boy’s torturous self-blame is indicative of the type of blame OCD patients experience when they do not perform their daily rituals, according to the London researchers.

Robertson and Cavanna said that medication in combination with explaining to the boy that his missed ritual actually occurred after the events of the terrorist attack helped alleviate his extreme, distressful state. (The time difference between Britain and America was explained to the boy.)