In our most recent blog, Laura described what the obsessional part of Obsessive Compulsive Disorder (OCD) is like. She noted that obsessions are worrisome thoughts, images, or urges that pop into peoples’ heads and trigger massive feelings of anxiety, distress, or discomfort. On the other hand, compulsions are the things people do in order to reduce those unpleasant feelings. You could say that people feel compelled to engage in their compulsions, almost as if they have no choice at all in carrying them out. Compulsions take a wide variety of forms but include:

• Checking doors, locks, or appliances
• Rituals such as getting dressed in a precise sequence
• Hand washing
• Asking parents if they still love you
• Asking partners if you look OK
• Arranging items, clothes, or carpet fringe in precise patterns
• Repeating certain phrases
• Counting ceiling tiles or stairs

Maybe you’re wondering what makes these ordinary looking behaviors compulsions. Most people do lots of these things don’t they? Yes they do. But two issues make them compulsions rather than ordinary behaviors. First, they are engaged in for the sole purpose of providing some temporary relief from one’s disturbing obsessions. Second, they are engaged in frequently, as in very frequently. It’s not uncommon for people to engage in compulsions for hours each day. Thus, they distract people from getting on with their lives.

Yet people don’t give up their compulsions easily. That’s because compulsions provide so much relief. Here are just a few of the benefits people feel for a short while after engaging in their compulsions:

• Anxiety reduction
• Reduced urges
• Reassurance from others
• Increased sense of well being
• Lessened discomfort
• Greater certainty

The problem is that the relief is always fleeting. After engaging in compulsions, folks feel better for minutes or sometimes even hours. But the distressing obsessions always return. And thus, the urge to engage in compulsions continues.

The good news is that OCD doesn’t have to ruin your life. Very effective treatments exist. We’ve noted Exposure and Response Prevention (ERP) before, and we will again. Over and over if we must because the message is so important. We almost feel compelled to talk about ERP a lot because it works so well. Furthermore, a disturbingly small percentage of people with OCD receive this treatment by a professional who is experienced and competent in administering it. And ERP often works well enough so that the use of medication can be avoided in many cases. We’ll talk a lot more about ERP, how it’s done, and pitfalls to avoid in future blogs.

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Prof.Lakshman (April 19, 2009)

From Psych Central's website:
PsychCentral (April 19, 2009)

Jennifer Laviano (April 19, 2009)

    Last reviewed: 19 Apr 2009