The person who suffers from OCD, is continually plagued by anxieties. And though their fears are often rooted in reality they are usually extreme and irrational. They also interfere with the person’s daily life, are highly disruptive and strain relationships.
OCD has five categories of obsession. These are:
· Washers (people who are terrified of contamination)
· Checkers (people who are afraid that something terrible could happen – because they forgot to take some action)
· Doubters and sinners (people who are afraid of being less than perfect – and are “waiting” to be caught and punished for their errors)
· Counters and arrangers (people who have an obsession with order and symmetry. They are often very superstitious, too)
· Hoarders (people who can’t throw anything away). Thus, they compulsively store items that they’ll never use. Examples of the kinds of things they hoard include old newspapers, receipts or medicine bottles.
Other common thought obsessions include sexually explicit or violent thoughts, or the fear of harming yourself or other people. Other common compulsive behaviours include repeatedly checking on people you love to make sure they are alive and safe; or counting, tapping or doing senseless things to try and relieve their anxiety.
With respect to possible causes:
· Research indicates that close relatives of an OCD suffer are up to 50% more likely to develop OCD than someone with no family history.
· There is also a link between OCD and insufficient levels of serotonin. Furthermore, brain imaging techniques have shown that people with OCD have unusually high levels of activity in 3 areas of the brain …
(i) The caudate nucleus – which acts as a filter for thoughts coming from different areas of the brain. This is also the area which manages habitual and repetitive behaviours.
(ii) The prefrontal orbital cortex - Damage or low activity here is linked to feeling uninhibited, having poor judgment, and feeling intense guilt.
(iii) The cingulate gyrus - This area of the brain is believed to stimulate the emotional response to obsessive thinking. It also instructs us to perform compulsions – as a means of relieving anxiety.
In terms of psychological causes, behaviour theory proposes that OCD sufferers associate certain objects or situations with fear. Thus, they learn to avoid those fear-invoking stimuli by perform certain rituals. Cognitive therapists argue that whereas the majority of people can simply shrug off worries that pop into their mind, OCD sufferers cannot do not this. Instead, they ruminate on their fears.
Treatment does not usually focus on medications – although sometimes antidepressants will be combined with counselling. CBT is believed to be the most effective form of treatment. Srategies include helping the client to anticipate obsessive and compulsive urges – and then to take concrete steps to bring them under control. For example, if a client’s compulsive behaviour takes the form of repeatedly checking to see that their doors are locked, they could be encouraged to remove the keys after locking the door, and then put them in their pocket (where they’re easy to find).