Obsessive-compulsive disorder (OCD)
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.