|Suffolk Cogntive-Behavioral PLLC
Director: Mark Sisti, PhD
Anxiety disorders are the most common problem seen by psychologists and psychiatrists. Recent national surveys have indicated that a startling 25% of the population reported having symptoms severe enough to warrant the diagnosis for an anxiety disorder at some point in their lives. Most people have some degree of obsessive or compulsive characteristics in their thinking and behavior. When these characteristics begin to interfere with occupational and/or social functioning and cause excessive anxiety or guilt, it can be called obsessive-compulsive disorder (OCD).
How Common is OCD
It is estimated that somewhere between 2 to 3 percent of the people in the U.S. will suffer from OCD at some point in their lives, that’s approximately 2 million people! OCD occurs equally among all racial, economic, and geographic groups. Often the symptoms star in late adolescence or early twenties, though they can begin in childhood. OCD in children is common though the symptoms may be more obvious to the family than to child. The severity of symptoms usually wax and wane over the course of time, depending on may factors including general stress, life changes, other illnesses, fatigue, menstrual cycles, etc.
The primary emotion associated with OCD is anxiety. In this sense OCD is very similar to the other anxiety disorders. Anxiety can interfere with sleep, disturb appetite, make it difficult to concentrate, create muscle tension soreness and fatigue. At its worst fear and anxiety can escalate into panic, a sense that something terrible is about to happen at any moment, accompanied by a variety of physical sensations, racing heart, shaking, trouble breathing, etc. Another common disturbing emotion for OCD suffers is excessive guilt. Obsessive guilt is often caused by obsessions regarding exaggerated responsibility. If the obsessive anxiety and guilt does not improve they can lead to additional emotional difficulties such as irritability and depression.
Obsessions are basically irrational worrisome thoughts. These unwanted thoughts can include disturbing ideas, images, words and beliefs. While the OCD sufferer knows (at least on some level) that these though are senseless and irrational, they cannot help thinking about them. Often obsessive thoughts are similar to worries that might cross any ones mind, but since the average person does not usually fear their own thoughts just, they are able to dismiss them as just passing irrational ideas. Some OCD sufferers have mostly obsessions and few if any compulsions (repetitive behaviors), this conditions is sometimes referred to as ‘pure obsessing’. Many obsessive thoughts are based on an underlying need to be perfect. This is perhaps the most general characteristic of obsessive thinking, “I must be perfectly; clean, organized, moral, successful, safe, considerate, symmetrical, certain, etc” (absolute thinking). Other common types of obsessions include; scrupulosity (exaggerated and rigid sense of right and wrong, excessive religiousness, morals), unrealistic standards of responsibility often regarding the welfare and safety of others (e.g. fire, illness, contamination) and an exaggerated need to be in control (fearing that one is loosing control of one thoughts, feelings, urges and actions).
The simplest way to define a compulsion is as an excessive or irrational behavior. The behavioral symptoms of OCD include an almost irresistible urge to either avoid some feared place or thing and/or to perform some repetitive action. As with obsessions the person knows, at least on some level, that this behavior is excessive or senseless, but they feel unable to resist the urge. These excessive behaviors are called compulsions, also sometimes referred to as rituals. Obsessions (the fearful thoughts) and compulsions (the excessive behaviors) form a vicious cycle. The OCD sufferer often begins these compulsive habits as a way of getting rid of the obsessive worries and anxiety. For example, one of the most common obsessions is thinking excessively about contamination (dirt, germs, chemicals, etc.). When a person with OCD starts to obsess about contamination they get anxious. They feel that they cannot make the anxiety or the obsessions go away unless they give into the compulsion to get uncontaminated (wash or avoid the contamination). The problem with dealing with obsessions and anxiety in this compulsive way is that while giving into the compulsion makes them feel somewhat calmer for that moment , it doesn’t last.