QUESTION MAN
OCD equally affects men, women and children of all races, cultures and  socio-economic backgrounds.
 With the correct understanding tools and techniques, OCD is a treatable and manageble condition.

Clinical Definition of OCD

The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) provides clinicians with official definitions of and criteria for diagnosing mental disorders and dysfunctions.  Although not all experts agree on the definitions and criteria set forth in the DSM-5, it is considered the "gold standard" by most mental health professionals in the United States.
DSM-5 Diagnostic Criteria for Obsessive-Compulsive Disorder (300.3)

A.    Presence of obsessions, compulsions, or both:
Obsessions are defined by (1) and (2):
1. Recurrent and persistent thoughts, urges, or impulses that are experienced, at some time during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress.
2.The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action (i.e., by performing a compulsion).
Compulsions are defined by (1) and (2):
1. Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly.

2.The behaviors or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation; however, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent, or are clearly excessive.
Note: Young children may not be able to articulate the aims of these behaviors or mental acts.
B. The obsessions or compulsions are time-consuming (e.g., take more than 1 hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

C. The obsessive-compulsive symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.

D. The disturbance is not better explained by the symptoms of another mental disorder (e.g., excessive worries, as in generalized anxiety disorder; preoccupation with appearance, as in body dysmorphic disorder; difficulty discarding or parting with possessions, as in hoarding disorder; hair pulling, as in trichotillomania [hair-pulling disorder]; skin picking, as in excoriation [skin-picking] disorder; stereotypies, as in stereotypic movement disorder; ritualized eating behavior, as in eating disorders; preoccupation with substances or gambling, as in substance-related and addictive disorders; preoccupation with having an illness, as in illness anxiety disorder; sexual urges or fantasies, as in paraphilic disorders; impulses, as in disruptive, impulse-control, and conduct disorders; guilty ruminations, as in major depressive disorder; thought insertion or delusional preoccupations, as in schizophrenia spectrum and other psychotic disorders; or repetitive patterns of behavior, as in autism spectrum disorder).

 

Types of Obsessions

A list of common obsessions included in OCD, please note the list is not all-inclusive as we are all unique individuals and will experience the condition differently.
It is possible to have a combination of the following list or just one. Plus there are several variations of the below. This is merely a guideline to help you to know the extent of OCD and how others with obsessions affect them.
In terms of OCD it is not about the content of the obsession it is about the process.

External Contamination

  •  Germs/disease (examples: Ebola, HIV, STD’s)
  •  Environmental contaminants (examples: pollution, smoke, asbestos, radiation)
  •  Household chemicals (examples: cleaners, solvents, paint, perfumes)
  •  Dirt, (examples: human and animal excrement, sewerage)
  •  Body fluids (examples: urine, saliva, poo)
  •  Pests (examples, fleas, lice, mice, cockroaches, flies etc.)

Internal Contamination

  •  Thoughts/ ideas (Example: Thinking something is tantamount to doing something)
  •  ‘Bad’ Words
  •  Lucky and unlucky numbers, colours, people.

Losing Control

  •  Fear of acting on a thought/urge/impulse/idea
  •  Fear of harming self or others
  •  Fear of losing one’s mind
  •  Fear of images and ideas that may have happened or could happen
  •  Fear of stealing things
  •  Fear of telling lies
  •  Fear of offending people

Harm

  • Overinflated responsibility to make sure potential hazards won’t happen (Example: checking ovens, doors, gas taps, driving- hit and run, medicine, cleaning, knives, tools, glass etc)

Perfectionism

  •  Everything has to look right or feel just right
  •  Symmetry and exactness
  •  Excessive tidiness (That never feels right)
  •  Have to remember exactly
  •  Have to recall an event exactly
  •  Writing, typing has to be exact
  •  Personal items have to be cherished and cleaned excessively

Disturbing Sexual thoughts

  •  Fear of being gay or transgender
  •  Fear of being a paedophile
  •  Fear of acting on a perverse sexual thought
  •  Fear that you have committed a sexual crime
  •  Sexual thoughts that involve incest and children
  •  Sexual thoughts against your sexual orientation and others

Relationship OCD

  •  Fear you no longer love your partner
  •  Fear your partner doesn’t love you or is being unfaithful
  •  Fear you are in the wrong relationship
  •  Fear your relationship is tainted or not perfect


Religious and scrupulosity OCD

  •  Fear of going to hell
  •  Fear of doing something morally unacceptable
  •  Fear of blasphemy
  •  Fear of having intrusive sexual ideas, images towards Jesus, Mary or any other religious figure
  •  Fear of blurting out insanities whilst in church or any other religious environment

 

Common Examples of Compulsions in OCD

As OCD is a complex and intricate disorder the sufferer can experience variables of the following or even different types of ritualistic behaviours not listed below.

Checking

  •  Checking that you did not/will not harm others
  •  Checking that you did not/will not harm yourself
  •  Checking that nothing terrible happened
  •  Checking that you did not make a mistake
  •  Checking parts of your body for signs of illness and or disease

Washing and Cleaning

  •  Washing hands excessively or in a certain way
  •  Excessive showering, bathing, tooth-brushing, grooming ,or toilet routines
  •  Excessive house work

Repeating

  •   Repeating routine activities (examples: going in or out thresholds, going in and out of cupboards, cars,    repeated walking and sitting)
  •   Repeating body movements (example: sniffing, tapping, touching, blinking, making noises )
  •   Repeating activities in “multiples” (examples: doing a task four times because three is a “good,” “right,” “safe” number)

Mental Compulsions

  •  Mental review of events to prevent harm (to oneself others, to prevent terrible consequences)
  •  Praying to prevent harm (to oneself others, to prevent terrible consequences)
  •  Counting while performing a task to end on a “good,” “right,” or “safe” number
  •  “Cancelling” or “Undoing” (example: replacing a “bad” word with a “good” word to cancel it out)
  •  Ruminating about a situation you have just experienced in fear that something went wrong.
  • Revisiting your memory to try and work out ideas and fears from the past.

Symmetry and exactness

  •  Things have to match, line up, be numbered, and face the right way.
  •  Certain items of clothing can only be worn at certain times.
  •  Things have to be done in a certain order or routine.

Other compulsions 

  • Reassurance seeking on the same subject matter over and over.
  • Avoidance which would trigger an obsessive fear.
  • Rumination. Focusing on the obsession to try and find the answer.

All compulsions are performed to relieve, neutralise or get rid of the obsession.
However this is always counterproductive as it gives more meaning and significance to the problem. Behaving in an obsessive way makes you more obsessive. The intention of therapy is to learn coping skills and understanding to reverse the problem.