OCD Compulsions: Identifying, Understanding and Dealing with Them

Obsessive Compulsions and OCD

OCD sufferer

The Diagnostic and Statistical Manual of Mental Disorders, or DSM, lists the symptoms of obsessive compulsive disorder as thoughts, impulses or behaviors that are persistent, unwelcome, irrational, and cause stress and disturbance in the sufferer's day-to-day activities. OCD doesn't mean "liking things to be tidy" or "never missing an episode of your favorite show": it means that you spend an hour or more of most days being inconvenienced by an irrational need to think or act in a certain way.

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Examples of OCD Compulsions

Handwashing is a common OCD behavior

If we could see inside the heads of OCD sufferers, we'd find that the way the disorder structures their thinking is quite uniform – even though the manifestations of those thoughts can be very different. Some sufferers are compelled to "hoard," collecting items such as newspapers, product wrappers or junk mail. Similar to this are OCD compulsions that manifest themselves in repetitive behaviors: walking in and out of rooms, turning the light on and off for example. Some sufferers have a set number of times an action must be performed; others can't say any further than that an action must "feel right" before they can abandon it. The other major OCD compulsion is cleanliness: some, but by no means all, OCD sufferers are compelled to wash, bathe or wipe themselves or their environments far beyond the bounds of good hygiene.

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Coping Strategies

Talking your symptoms over can help

When dealing with OCD compulsions and symptoms, the first thing is to accept that they are just that: symptoms of an inconvenient, but surmountable, mental illness. This places them in the appropriate context for finding a coping strategy and makes talking about them easier to do – a vital step that demands courage to undertake.

Some sufferers find it helpful to research the subject of their obsessive thoughts: sufferers who form intrusive thoughts of a religious nature, for instance, may not want to relegate their entire spiritual life to the realm of "medical disorders," and may wish to talk with a priest to find an appropriate amount of daily prayer or ritual.

Other sufferers prefer to "go cold turkey": they simply refuse to engage in the behaviors demanded by the compulsion. This brave step can be beneficial, but be aware that it will most likely cause anxiety symptoms: these cannot physically harm you, no matter how uncomfortable they may be.

Some sufferers prefer to find a halfway point between these strategies, gradually reducing their behaviours in small increments. It can also be helpful to find an acceptable level for the compulsions to function at: if your compulsions interrupt your work-day, a first step might be resolving to only allow compulsive behaviors in the home, for instance.

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Managing Expectations

Counselling BT

It may be a long time before you are entirely rid of OCD compulsions, if ever. The goal is management, not eradication. Don't be dispirited to find that you can't simply make the compulsions go away overnight. The first step is reducing them to a manageable level, so as to start getting your life back.

OCD compulsions don't exist in a vacuum: they generally emanate from some past or present feelings of weakness, loss of control or guilt. When you are ready, examining your own life for sources of stress, guilt or anxiety may reveal the deeper cause of your symptoms, allowing you to confront them on a deeper level and even find a positive dimension to the role of the disorder in your mental life.

Some sufferers, for instance, find that a compulsion to repeat behaviors stems from feelings of powerlessness in their professional or personal relationships. If compulsions can be reduced to a manageable level, the true source of these feelings can be addressed, allowing the sufferer not just to reduce their compulsions, but to take powerful steps toward further improving their life.

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References/Further Reading

The Fear Book (Amazon link), Cheri Huber, Keep it Simple Books, 1995

The OCD Workbook (Amazon Link), Bruce M Hyman, PhD, New Harbinger Publications, 2010

"It'll Be Ok:" How I Kept OCD From Ruining My Life (Amazon Link), Shannon Shy, AuthorHouse, 2009