Obsessieve-compulsieve stoornis (OCD)/en

Definition

The obsessive-compulsive disorder (OCD) is a mental disorder characterized by:

• recurrent, persistent thoughts (obsessions), and/or
• repetitive behaviors or mental acts (compulsions) that are performed to reduce anxiety or tension.

According to the DSM, OCD is a classification based on symptoms. It therefore describes what someone experiences, but does not explain why.

OCD can vary greatly in severity. For some, it takes up a lot of time and hinders daily functioning; for others, the symptoms are milder and more manageable.

Contextual thinking and OCD

OCD can be understood from a contextual thinking perspective as a form of extreme first-degree thinking:

• In the absence of contextual relativization, thoughts remain literal and absolute.
• Without the ability to include nuance or alternative explanations, certain beliefs can get stuck.
• Compulsive behavior is then an attempt to restore control and predictability.

Examples

• Fear of contamination → endless hand washing (fear of contamination).
• Fear of making a mistake → checking again and again (e.g. gas stove or door).
• Persistent belief that the partner is cheating → always checking or seeking confirmation.
• Hypochondria: being convinced that you have a disease, every signal is seen as confirmation; doctors to quacks to 'keep it under control'.

Obsessions vs. compulsions

• Obsessions' are persistent thoughts, images or impulses that evoke fear or tension.
• Compulsions' are the behaviors or mental actions that someone performs to neutralize or reduce the fear of the obsessions.
  But: by performing these compulsions, the obsessions are actually maintained or confirmed. This creates a vicious circle in which the obsessive thoughts keep coming back stronger.

Distribution

OCD is estimated to affect 1 to 2% of the population worldwide. The disorder often occurs together with other conditions, such as depression, anxiety disorders and autism. The first symptoms usually appear in adolescence or early adulthood.

Coping strategies

• Applying structure and predictability.
• Active activities that interrupt worrying.
• Cognitive behavioral therapy (CBT), often in the form of exposure and response prevention (ERP).
• Medication: SSRIs, sometimes antipsychotics in severe forms.
• Contextualizing learning: helping to put thoughts into perspective.

See also

• Very strong first-degree thinking
• Personality disorders
• Overstimulation