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Obsessions:
Obsessions can come in the form of involuntary thoughts, images
or impulses. Common obsessions include, but are not limited to:
fears about dirt, germs and contamination. Fear of acting out violent
or aggressive thoughts or impulses. Unreasonable fears of harming
others, especially loved ones. Abhorrent blasphemous or sexual thoughts.
Inordinate concern with order, arrangement or symmetry. Inability
to discard useless or worn out possessions. Fears that things are
not safe, especially household appliances. The main features of
obsessions are that they are automatic, frequent, upsetting or distressing,
and difficult to control or get rid of.
 Compulsions:
Just as with obsessions, there are
many types of compulsion. It is common for people to carry out a
compulsion in order to reduce the anxiety they feel from an obsession.
Common compulsions include excessive washing and cleaning, checking,
repetitive actions such as touching, counting, arranging and ordering.
Hoarding, ritualistic behaviours that lessen the chances of provoking
an obsession (e.g. putting all sharp objects out of sight). Acts
which reduce obsessional fears (e.g. wearing only certain colours).
Compulsions can be observable actions, for example washing, but
they can also be mental rituals such as repeating words or phrases,
counting, or saying a prayer. Again, not all types of compulsion
are listed here. The main features of compulsions are they are repetitive
and stereotyped actions that the person feels forced to perform.
People can have compulsions without having obsessional thoughts
but, very often, these two occur together. Carrying out a compulsion
reduces the person's anxiety and makes the urge to perform the compulsion
again stronger each time.
Is OCD a form of madness?
No. A person can have some or all of these symptoms. Almost everybody
experiences the type of thoughts that people with OCD have (e.g.
double checking the front door or the gas). However, most people
are able to dismiss these thoughts. People with OCD cannot ignore
unpleasant thoughts and pay undue attention to them. This means
that the thoughts become more frequent and distressing and, over
time, they can affect all areas of a person's life; often their
job and their family and social life. A person with OCD can, however,
appear to function perfectly normally despite being greatly distressed.
This makes it possible for sufferers to hide their OCD (because
of this, OCD has often been called the 'secretive disorder').
It is important to remember that severity of OCD differs markedly
between people but each person's distress is very real. People
with OCD are not 'mad' or dangerous and do not carry out their
unpleasant thoughts. Most people with OCD know that their thoughts
are excessive or irrational but the anxiety they feel makes the
thoughts difficult to ignore.
Is OCD common?
Today, it is realised that OCD is much more common than was previously
thought. Prevalence estimates suggest that between 2 to 3% of
the UK population has OCD. One reason why the prevalence of OCD
has been underestimated in the past is that people with OCD are
often afraid to seek help. They worry that other people with think
they are mad, or often do not know that their disorder is a recognised
condition with effective treatments. Young people also suffer
from OCD. In fact, many adults with OCD had symptoms in childhood.
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What causes OCD?
The cause of OCD is not known exactly but it is likely to result from
a combination of factors and the causes for one person may be different
from another. OCD can run in families and, in some cases, may be associated
with an underlying biochemical imbalance in the brain. Psychological
factors such as susceptibility to stress or exposure to a emotionally
traumatic experience are also likely to be involved. The good news
is that, for the majority, OCD can be effectively controlled and treated.
Can OCD be treated?
Yes. For most people, professional treatment is the most effective
means of dealing with OCD. This usually means working with a psychiatrist
or a psychologist. In addition to professional help, self-help groups,
books, leaflets and the internet are useful ways of coping with
OCD. The more you know about OCD, the better equipped you will be
to deal with it. There are also several drugs which have proved
very effective.
Can young people
get OCD too?
Yes. Children and adolescents’ problems are very similar to
those of adults, and in fact, many adults say they had their first
OCD symptoms as children. Most young children have a phase of ordinary
rituals, such as wanting special toys at bedtime, or not treading
on cracks in the pavement. This is not a cause for worry, and is
not OCD. If the parents are concerned because the rituals upset
the child, take up a lot of time and interfere with the child’s
everyday life (e.g. school, friends etc) it would be worth asking
the GP for advice, and if necessary seeing a specialist child psychologist
or psychiatrist. The treatments for childhood OCD are also similar
to the treatments used in adults. Therapists will work closely with
the child’s family to help everyone learn the techniques for
fighting OCD.
What can relatives
and friends do to help?
Caring relatives and friends can help a great deal. The following
are guidelines:
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Acknowledge the
OCD and learn about it. |
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Remember that OCD symptoms are
part of a treatable disorder, they are not personality traits
and cannot be dealt with as such. |
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Do not regard OCD as the sufferer’s
‘fault’, and do not believe that you or anyone else
may have caused it. |
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Be supportive to the sufferer
in the decision to seek professional help and, and in the determination
to recover. |
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Encourage the sufferer to persist
with treatment and show appreciation of any improvement however
small. |
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Temper your support with recognition
that symptoms may wax and wane and that each sufferer needs
to overcome their problems at their own pace, even though it
may be a lengthy process. |
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Allow the sufferer to explain
their problems to you, recognise that this will help them to
feel less isolated and ashamed of their condition. |
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While supporting the sufferer
try not to support the obsessions and/or compulsions, rather
encourage the sufferer to fight against them. |
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Sufferers are often aware of
the humorous aspect of the behaviours and this awareness can
be harnessed to help them to distance themselves from the condition. |
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At home sufferers should be
encouraged to maintain as normal a life-style as possible, families
should try not to adapt their ways of doing things to accommodate
sufferers obsessions and rituals. |
The following advice sheet was prepared by The Priory
Hospital in Roehampton.
How to help your
relative or friend with OCD
Source: OCD Action
2002
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Telephone:
+44 (0) 207 226 4000 - Fax: +44 (0) 207 288
0828 
