Obsessive-Compulsive Disorder

Obsessive-Compulsive Disorder 1

Written by  Jac Tichbon
Psychologist & Clinical Psychology Registrar

Obsessive-compulsive disorder (OCD) is a psychological disorder that can impact both children and adults. Amongst children, it may be more common in boys than girls. OCD consists of repetitive, intrusive thoughts such as fears of contamination, the need for symmetry or completeness, distressing images or thoughts of potential harm to others. These obsessions are accompanied by some very unpleasant anxiety. To reduce or calm these anxious obsessions, people with OCD “neutralise” them with another thought or action (compulsion). This might appear as repetitive behaviours like washing, checking or counting.

There are effective treatments available for OCD, with psychological therapy suggested as the go to treatment in combination or separate from medication. Psychological treatment is especially useful for treating as OCD, as it aims to reduce the reliance on the compulsion being used to “calm” the obsession, as reliance on this behaviour to cope or stay safe can maintain the obsessive-compulsive cycle. This is achieved through what is called a “graded exposure hierarchy”. In a safe and manageable way, people are exposed to the anxious obsession. . Naturally, someone might want to run away as soon as the word “exposure” is mentioned in the therapy room because it can be scary and anxiety inducing. However, these feelings of anxiety are why exposure therapy can be so effective.

Through graded exposure, people are slowly and safely introduced to the most manageable exposure first. During the exposure, while feeling anxious, the person purposefully does not engage in their compulsion, until their anxiety goes down on its own. This is called “habituation”. With habituation, a safe interaction with the anxious stimulus creates a new type of learning in the brain that can alter future interactions with that stimulus. This process is continued with more and more difficult exposures until the person learns they don’t need their compulsion to feel safe or less anxious, as they have had numerous “safe” interactions without the compulsion. This could be enhanced by doing exposures in different contexts, like in different spaces or different times of the day, creating more and more safe interactions that reduce the initial anxious response.

With the help of a psychologist, these strategies can be implemented to successfully treat and manage OCD in both children and adults.