OCD involves the presence of either obsessions, compulsions, or both. Obsessions are unwanted, unpleasant thoughts, images, or impulses/urges that lead to feelings of anxiety, guilt, and/or shame, and compulsions are deliberate behaviours or mental rituals performed to prevent something ‘bad’ from happening or to reduce feelings of anxiety.
Common OCD presentations can include:
- Fear of contamination and excessive washing/cleaning compulsions
- Repetitive doubting and compulsive checking (e.g., Is X open/unlocked/on? and checking locks, stoves, appliances, checking that no harm has come to one’s self or others)
- Superstitious rituals (e.g., touching or tapping objects a certain number of times, avoiding specific numbers, colours, people or places out of a fear that something “bad” will happen)
- Unwanted and intrusive thoughts, images, or urges of a sexual, aggressive, or blasphemous nature (e.g., unwanted urge to drive into traffic, unwanted thought of touching someone inappropriately)
- Ordering and arranging compulsions (a need to have things placed in a certain way either to avoid something “bad” happening or in order for things to “feel just right”)
Most people will occasionally engage in superstitious behaviours or double-check things such as doors and the stove. In OCD, however, obsessions and compulsions are time-consuming and distressing, and interfere with the person’s enjoyment of life. Many people with OCD feel shame about their behaviour and might conceal it from others either by hiding their compulsions or not telling others about the distressing unwanted thoughts they experience.
