Hooked on hand sanitizer? Anxiety and distress over recurrent thoughts? Quirks like this can usually be chalked up to personality or preference; but in some cases, they may point to a more serious issue: obsessive-compulsive disorder (OCD), a condition marked by obsessive or intrusive thoughts and compulsive behaviors.
Here are some of the more common traits of OCD and ways this can effect someone’s thoughts and actions.
Compulsive hand-washing or hand sanitizer use is so prevalent in OCD that "washers" has become a widely accepted category of OCD patients. The urge commonly stems from a fear of germs (the most common obsession seen in OCD), but it also can be rooted in fears of making others sick or of being impure or immoral.
People with OCD who fall into the "washers" category also tend to clean compulsively. As with hand-washing; housecleaning is often a way of easing germaphobia or feelings of impurity. Although cleaning can help chase these obsessive thoughts away; the relief does not last, and the urge to clean is often even stronger the next time.
So-called checking behaviors—returning three, four, or even 20 times to make sure the oven is off or the front door is locked—are the most common compulsions associated with OCD, affecting nearly 30% of people with the disorder. Like other compulsive behaviors, checking can be driven by a variety of obsessions, ranging from a fear of getting hurt to deep-seated feelings of irresponsibility.
Some people with OCD perform tasks according to a certain numeric pattern or count to themselves as they do everyday things (such as climbing stairs or cleaning). These behaviors may be driven by superstitions. For instance, a belief that the number seven is good may lead someone to feel that they'll hurt themselves or someone else if they don't take seven steps at a time. Sometimes this counting behavior is also a maladaptive coping mechanism to help feel more physically balanced or “in alignment.”
People with OCD can take organizing to the level of perfectionism. It has to feel just right, look just right, be symmetrical, and be the right number [of items]. This fussiness is often driven by obsessions about order and symmetry.
Fears of violence
Everybody has fleeting thoughts about the possibility of being affected by violence or other misfortunes. The more we try to avoid thoughts like this, the more they pop into our heads, research shows. This appears to be especially true for people with OCD. Individuals with OCD may be trying harder to suppress these thoughts, or they may react more intensely to them because they deem them as unacceptable.
Unwanted sexual thoughts
Just like violent thoughts, recurring unwanted thoughts about inappropriate or taboo sexual behavior frequently occur in OCD.
Dwelling on relationships
People with OCD are known to obsessively dissect their relationships with friends, coworkers, romantic partners, and family members. For example, they may dwell at length on whether an offhand comment at work alienated a coworker, or whether a small misunderstanding ruined a romantic relationship. This mind-set may reflect an exaggerated sense of responsibility and difficulty accepting uncertainty.
One way people with OCD try to soothe their anxiety is by asking for opinions of their friends and family. If they're concerned they embarrassed themselves at a party, for instance, they may repeatedly ask a friend to replay the incident. Asking friends to weigh in ("Does my house seem dirty to you?") can also be a strategy for avoiding compulsive behaviors.
Hating your looks
Body dysmorphic disorder (BDD) is a condition related to OCD in which people fixate on a part of their body they consider abnormal or unattractive—often their nose, skin, or hair. (Unlike eating disorders, BDD doesn't involve a focus on weight or diet changes.) The obsessive thoughts associated with BDD are very similar to those seen in OCD. Many people with BDD also have OCD and worry about the cleanliness of their body in addition to how it looks.
OCD will not go away by itself, so it is important to seek treatment. The most effective approach to treating OCD combines cognitive behavioral therapy and medical evaluation. If you find that you or someone you care about is struggling with OCD, please contact us at the Village Counseling Center. One of our professional therapists is ready to help you.
Cognitive behavioral therapy: The goal of cognitive behavioral therapy is to teach people with OCD to confront their fears and reduce anxiety without performing the ritual behaviors (called exposure therapy or exposure and response prevention therapy). Therapy also focuses on reducing the exaggerated or catastrophic thinking that often occurs in people with OCD.