‘Obsession’ means a person is thinking thoughts that he does not want. They are involuntary. They are intrusive thoughts. They are unwanted thoughts. The thoughts are usually repetitive in nature and are resisted by the person. These can be thoughts, images or impulses. They can be about violence, of a sexual nature or, about seeking reassurance and safety. The cognitions can be about fears of disaster, avoiding something, or seeking reassurance.
‘Compulsion’ is a type of behaviour that is irrational and excessive. There is a certain order in the behaviours. There are external compulsions that can be observed by others. There are also internal compulsions which others cannot see, like counting, or saying sentences over and over again.
Example-
Washing hands repeatedly.
Some people with OCD have obsessions without compulsions.
Having a Disorder usually means that people have lost control over their lives and can not function in society. In the case of OCD, people are so affected by their behaviours and thoughts that they can no longer work or develop meaningful relationships for example.
Treatment
Again CBT is very effective for challenging people’s thoughts and behaviours in the cycle of OCD.
Treatment may involve:
- Medication
- Behavioural Therapy
- Exposure Response Prevention (ERP), which is where a client is asked not to do the compulsions to learn that the distress, will decrease by itself.
- Cognitively challenge the irrational obsessive thoughts. Thoughts can be challenged about how probable they are, or where responsibility lies. People are generally advised not to avoid thoughts but to confront them for example, by writing them down.
- Family members need to be involved and trained to understand the OCD cycle.
- After treatment relapse prevention is advised as OCD tendencies can re-emerge if the client comes under stress.
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