As most of us know, obsessive-compulsive disorder is comprised of obsessions, (thoughts, images or impulses that recur and feel outside of the person’s control), and compulsions (repetitive behaviors or thoughts engaged in with the intention of negating obsessions). What many people don’t realize, however, is that the thoughts that become obsessions in those with OCD are typically no different from the thoughts that most of us experience.
While these thoughts might be more vivid and intense in those with OCD, the real difference lies in our reactions to these thoughts. Most people without OCD will have an uncomfortable thought come into their heads (perhaps a fear of hurting a loved one, for example) acknowledge it (“what a crazy thought”) and then just let it pass. End of story.
Not those with OCD, however. They attach meaning to the thought (“I must really want to hurt my loved one if I have this thought”) and a vicious cycle begins. I go into more detail here about how those with OCD perceive these thoughts and react to them. Also, if you are not familiar with the cognitive distortion known as thought-action fusion, I highly recommend reading this post.
My son Dan was a highly sensitive child, and has grown into a sensitive adult. In this article, there is discussion of research that concludes those with OCD are more sensitive than others, at least in regard to moral dilemmas. In my own experience with people with OCD, they often describe themselves as highly sensitive.
So are those with obsessive-compulsive disorder more affected by unwanted thoughts than those without the disorder because they are more sensitive people, or because they have OCD? Which comes first? Is being highly sensitive a factor in developing OCD, or does having OCD make one more sensitive?
And maybe the most important question of all – does it matter?
In my opinion, probably not much. While it is part of our nature to seek answers, to solve the puzzle so to speak, I don’t think it really matters which comes first. What matters is we recognize that those with OCD are often quite sensitive, and if this becomes an issue in treatment, interactions with others, or in any other way, it should be addressed.
The good news, as I’ve said before, is that we don’t have to completely understand OCD to successfully treat it. Whether you’re highly sensitive or not, if you have obsessive-compulsive disorder, exposure and response prevention (ERP) therapy is the way to go.