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Understanding & Overcoming OCD

Understanding your struggle: the intricacies of OCD

Have you ever thought, Am I a bit OCD? What is OCD? Obsessive Compulsive Disorder (OCD) isn’t just a tendency towards neatness or dislike of germs, neither is it a fleeting worry. OCD is an anxiety disorder that can hijack your mind with intrusive thoughts, leading to distress and compulsive behaviours in an attempt to ‘fix’ these distressing thoughts. This compulsive and obsessive thought and behaviour interaction can be so distressing that at least 1 in 3 people with OCD also suffer with depression.

Fast facts about oCD

  • Approximately 1 in 50 people will experience OCD as some point in their lives.
  • OCD usually shows up between 18 and 24 years of age.
  • 80% of people with OCD don’t get better without professional help.

What is an intrusive thought?

An intrusive thought is an unwelcome and, at times, distressing idea, image, or impulse that can pop into your mind involuntarily and repeatedly. These thoughts often go against your values or beliefs which is why they can cause discomfort or anxiety. For example, you might suddenly imagine causing harm to a loved one, even though you have no intention of doing so.

Other common intrusive thoughts often include fears about contamination, such as worrying about germs after touch a handrail, or they may be thoughts or images of graphic violence or sexual acts that are out of character for you.

Despite their disturbing nature, intrusive thoughts are really common and experienced by most people at some point in their lives. And they are easily dismissed as being just a random thought. People with OCD often grapple with the same intrusive thoughts as everyone else. For instance, nearly 50% of people in one study admitted they felt the urge to harm a family member. These thoughts – whether about germs, harming others, being careless, and more – are surprisingly universal.

However, for people with conditions such as OCD, these thoughts can take on so much meaning that they become persistent and intrusive and lead to significant distress that interferes with their daily lives.

Why do normal intrusions turn into obsessions?

Here’s where it gets tricky. While many of us might have random thoughts, like swerving into oncoming traffic, most people can easily brush these off as meaningless. But for someone with OCD, these thoughts can trigger deeper beliefs. For instance, the idea of swerving into traffic might lead them to believe they genuinely want to harm themselves or others. This conviction might result in initiating behaviours to prevent such harm, like giving up driving all together.

How is Our Biology Involved?

OCD is not merely a biproduct of anxious thoughts; our neurobiology plays a part. The part of our brains called the caudate nucleus is linked to our inability to stop obsessing and trying to ‘fix it’ with compulsive behaviours.

What makes someone have OCD?

There is evidence that OCD can tend to run in families. However, stress or trauma can be a trigger for OCD in otherwise normal brains. Pregnancy or childbirth can also trigger OCD.

So if our biology is involved, can OCD be overcome? Yes! There are lots of examples of the ways we can train our brains – learning a new language, learning to drive, overcoming fear, adjusting to grief.

Breaking Free from the oCD trap

Understanding the connections between thoughts, feelings, and behaviours is essential in navigating the OCD labyrinth. The way we feel is fuelled by how we think and behave. We are able examine our thoughts and behaviours and how we think about them (this is called metacognition) and we can make sure we have a balanced view of them.

But if your view of a situation is unbalanced (which is often the case in OCD and other anxiety disorders), your emotional and behavioural reaction to these situations may also be unbalanced or inappropriate.

Herein lies the problem with OCD: compulsive behaviours give instant relief from anxiety but the next time you find yourself anxious, you need more relief. This cycle escalates to the point that you never ‘sit with’ your anxiety and so never find out what would happen if you don’t act on your compulsions. So your brain never learns that compulsions are not necessary because you are simply feeling anxious about a thought and not a true danger.

This cycle of obsessive thoughts leading to compulsive behaviours can be likened to a trap. Cognitive Behavioural Therapy (CBT) serves as a key to unlocking this trap. By challenging your unbalanced views of situations, you can achieve a more balanced emotional response.

the mechanics of CBT for OCD: How does it all work?

CBT targets the distorted thought patterns and resulting compulsive behaviours. Together with your therapist, you can work to identify and challenge these distorted thoughts. This can help you to develop healthier perspectives.

The process involves:

  • Thought recognition: CBT helps you to recognise unhelpful thoughts and understand that they are a product of your OCD and not a reflection of reality. This understanding is the first vital step towards regaining control.
  • Cognitive restructuring: Once these thoughts have been spotted, your therapist will help guide you in challenging and restructuring these. This involves working on replacing irrational beliefs with more rational and balanced ones.
  • Exposure: CBT often incorporates exposing you to triggers without engaging in your compulsive behaviours. This gradual exposure helps you to desensitise to your triggers for anxiety and break the cycle of avoidance.
  • Coping strategies: With your therapist, you’ll learn effective coping strategies to manage anxiety without resorting to compulsive behaviour. These strategies will empower you to tolerate uncertainty and triggering situations without the need for ritualistic behaviours.

Real-world experience

Consider Noah’s example: Having successfully managed worries about harming people in the past, Noah’s anxiety resurfaced during the COVID-19 pandemic. He became fearful of infecting others and adopted the compulsive behaviour of holding his breath when he was around people. CBT empowered Noah to break free from this cycle by gradually reducing his need to hold his breath and, over time, he was able to breath normally around people and his anxiety reduced significantly.

Delve deeper: recommended resources

Delve deeper into the intricacies of CBT for OCD with ‘Overcoming Obsessive Thoughts’ by Christine Purdon and David A Clark. This insightful resource provides valuable perspectives on tackling obsessive thoughts and finding resilience in the face of OCD challenges.

Katie D’Ath is a CBT therapist who specialises in treating OCD and produces videos on YouTube to help people understand OCD as well as the treatment techniques used to help people overcome OCD.

Navigating obstacles to getting Treatment

OCD often generate feelings of shame and embarrassment, contributing to undiagnosed and untreated symptoms. Approximately 1 in 50 of us face the challenge of OCD, so you are not alone. If intrusive thoughts and compulsive behaviours are disrupting your daily life or causing you distress, it’s crucial to reach out for help.

Here at CBT Networks, Dr Sian Thrasher is specialised in treating anxiety disorders and specifically OCD. If you would like to know more about CBT can help you or a loved one struggling with OCD symptoms, you can contact us here.

If OCD is impacting your life, consider reaching out for support. Our consultant psychologist, Dr Sian Thrasher, offers a free 15-minute telephone consultation specifically for you to discuss CBT and treatment options.

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