Obsessive-Compulsive Disorder (OCD)

What is Obsessive-Compulsive Disorder (OCD)?

Obsessive-Compulsive Disorder (OCD) is a mental health condition in which someone experiences unwanted, intrusive thoughts (obsessions) that they then try to cope with through repetitive behaviours or rituals (compulsions). People with OCD frequently struggle with anxiety, shame, or guilt regarding their intrusive thoughts. Obsessions can vary among individuals with OCD, including fears of contamination, concerns about symmetry or order, or fears of committing moral transgressions. In order to alleviate the distress caused by these intrusive thoughts, people with OCD engage in compulsive behaviours, such as excessive handwashing, checking, counting, or ordering things in a certain way. These behaviours may temporarily relieve distressing thoughts but result in significant dysfunction to the person’s life.

To be diagnosed with OCD, obsessions, compulsions, or both must be present.

Obsessions are defined as:

  1. Recurrent and persistent thoughts, urges, or impulses that the individual experiences as intrusive and unwanted and causes them significant anxiety or distress.

  2. The individual tries to suppress or ignore these thoughts, urges, or images, or attempts to counteract them with other thoughts or actions (i.e., by performing a compulsion).

Compulsions are defined as:

  1. Repetitive behaviours (e.g., hand washing, checking, ordering) or mental acts (e.g., counting, repeating words silently, praying) that the individual performs in response to obsessions or according to rigid rules.

  2. The behaviours or mental acts are aimed at reducing distress or anxiety, or preventing a dreaded event or situation; however, they are excessive or not realistically connected to what they are meant to neutralize or prevent.

The obsessions and compulsions are time-consuming (e.g., often taking more than one hour each day) and cause significant distress and impairment in social and occupational functioning.

How Do We Treat OCD?

OCD can be treated with a form of Cognitive-Behavioural Therapy (CBT) known as Exposure and Response Prevention (ERP). In ERP, individuals gradually confront thoughts, images, or situations that provoke anxiety and obsessions, while resisting the urge to engage in their usual rituals or compulsive behaviour. Through repeated exposure, individuals can habituate to previously triggering stimuli and learn that it is possible for their anxiety to decrease over time without needing to perform compulsions. Mindfulness-based approaches, like Acceptance and Commitment Therapy (ACT), can help individuals become more aware and accepting of their thoughts without responding to them, as can another variant of CBT called Inference-based CBT (iCBT).

The OCD Treatment Team