Obsessive Compulsive disorder

Obsessive Compulsive Disorder (OCD) is an anxiety disorder which causes the individual to experience both obsessions and compulsions. Most people will experience some form of obsession e.g. worrying about having left an appliance on or whether you have locked the front door and compulsions e.g. not walking under ladders. However, in most cases these symptoms won’t interfere with daily life.

When symptoms being to interfere with your day-to-day life, relationships, work or physical health then it is time to seek professional help.

Obsessions are thoughts, pictures, urges or doubts which appear in your mind and are uncontrollable. They make you feel anxious, disgusted or even just uncomfortable. They can take different forms, such as:

Fear of causing harm or not preventing harm

  • Worrying you have already hurt someone by not being careful
  • Worrying you are going to hurt someone by losing control

Intrusive thoughts, images and impulses

  • Violent intrusive thoughts or images of yourself doing something disturbing
  • Religious or blasphemous thoughts
  • Intrusive thoughts about your relationship
  • Sexual intrusive thoughts or images which are inappropriate

Fear of contamination

  • Worrying about being contaminated by dirt or germs and that you are spreading it
  • Worrying you might get a disease
  • Mental contamination where you feel internally unclean

Fears and worries related to symmetry and order

  • Worrying something bad will happen is everything is “right”, in order, symmetrical or clean

Purely obsessional

Some people may experience obsessions where they experience disturbing intrusive thoughts or images, but show no signs of compulsions. In most cases, however, people will experience compulsions but will be unaware of them as they may be internal. Mental compulsions can include; checking how you feel, checking bodily sensations, checking how you feel about what you are thinking, repeating phrases or numbers in your head or checking if you still have a thought.

There are four main types of compulsion:


  • Washing of hands and body
  • Cleaning
  • Touching things in a particular way or order
  • Arranging objects


  • Repeatedly asking those around you to tell you everything is OK


  • Checking doors and windows
  • Checking for contamination
  • Checking your body
  • Checking your memory
  • Checking your route to work to make sure you didn’t cause an accident

Correcting thoughts

  • Repeating a word, name or phrase
  • Counting to a certain number
  • Replacing thoughts or images with another


NICE guidelines (2005) suggest that when deciding on the most appropriate treatment history, severity and the level of impact on the individual’s life should be taken into account. Guidelines suggest that Cognitive Behavioural Therapy (CBT), Exposure and Response Prevention (ERP) and medication are appropriate treatments.

Cognitive Behavioural Therapy (CBT) – CBT is a therapy which examines the relationship between thoughts and behaviours which create and maintain the cycle of obsessions and compulsions. CBT works for OCD by challenging the cognitions (thoughts or obsessions) that you are having and rationalising these into more realistic thoughts, therefore reducing your level of anxiety. It will also usually involve behaviour experiments, where you may be asked to resist completing compulsive actions and monitor your levels of anxiety in the same way you would in Exposure and Response Prevention (ERP).

Exposure and Response Prevention (ERP) – ERP is a type of CBT which involves you confronting your obsessions and resisting compulsions. The practitioner will support you in putting yourself into situations where you will feel anxious. You will then be encouraged to resist the urge to complete your compulsion ad tolerate the levels of anxiety. Overtime, the levels of anxiety experienced in these situations will reduce through the process of habituation.

Medication – a psychiatrist or GP will be able to prescribe medication depending on the symptoms you are experiencing at the time, the severity of the symptoms, past experiences, physical health and how likely you are to consistently take your medication. Medications available for the treatment of OCD include; antidepressants, tranquillisers and beta-blockers.