Obsessive Compulsive Disorder (OCD)
The essential features of Obsessive-Compulsive Disorder are recurrent obsessions or compulsions that are extremely time consuming, cause distress or significant impairment. The person suffering from OCD will be able to recognise that the obsessions or compulsions are excessive or unreasonable. The most common obsessions according to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) are;
- Repeated thoughts about contamination (e.g., becoming contaminated by shaking hands with another person),
- Repeated doubts (e.g., wondering whether one has performed some act such as having hurt someone in a traffic accident, or having left a door unlocked).
- A need to have things in a particular order (e.g., intense distress when objects are disordered or asymmetrical).
- Aggressive or horrific impulses (e.g., to hurt one's child, or a member of the family, or to shout an obscenity in church).
- Sexual imagery (e.g., a recurrent pornographic image).
These can obviously be extremely distressing and often cause extremely high levels of distress with people sometimes believing they should be locked up for others safety. There is often in people with OCD a concept of 'Though-Action fusion'. (Adrian Wells). People often believe that thinking a thought is as bad as an action, or that having the thought will lead to taking action based on the thought. In fact people who worry so much about acting on their thoughts are the least likely to act on them. Research has also shown that intrusive thoughts such as the type experienced in people with OCD are extremely common. The person without OCD however can easily dismiss them where as for the person with OCD they become highly threatening and distressing.