What happens In OCD?
The most common symptoms of OCD are described below. To make things clearer, some of the technical words often used in talking about OCD are explained.
Obsession or obsessional thought or rumination: These words are all used to describe the original fear or unpleasant thought. Mrs A's fears about cancer, Mr B's worries about some disaster and Mrs C's thoughts about harming are all examples of obsessions. Obsessions can be divided into three common forms. They may be simple thoughts, in words, such as "I might get cancer", they may be mental pictures, for example an image of something terrible happening; or they can consist of impulses, such as an actual urge to harm someone.People are often afraid that one day they will act on these urges (for example Mrs C's fears of harming her children). Infact, long experience with OCD tells us that these urges are rarely if ever carried out.
The most common areas in obsessions are dirt and disease, violence, other kinds of harm coming to people, and sex. Because the thoughts are unpleasant or frightening, they make the person with OCD feel very uncomfortable or anxious. Most often the discomfort aroused by the obsessions leads the person to do something to try to feel better. These actions ("rituals") are described below. However, there are also some people who have obsessions without obvious rituals.
Compulsion or ritual: This term is used to mean the action which the person with OCD feels compelled to carry out. Rituals are divided into two kinds. First, there are actual actions which somebody watching would be able to see. Mrs A's washing and Mr a's checking are examples of this. In fact, washing and checking are the two most commend kinds of obsessional ritual, though there are many others. Often, as with Mrs A, the sufferer's family also become involved in ritual activity.The other kind of ritual is a mental action, such as Mm C's "good thoughts". Obviously no-one else can know about this unless she tells them.
Reassurance: Another way in which many people with OCD try to reduce their discomfort is to ask others, such as their family or doctor, for reassurance about their fears. Mrs A's demand for details of her family's movements is an example of reassurance-seeking. Sometimes people spend time trying to reassure themselves. For example Mrs A might go over her day in her mind. Trying to be sure she had not touched anyone dangerous'.
Avoidance: Often the worries are 'triggered' by certain situations or people, such as touching people for Mrs A. The-person with OCD then tries to avoid such situations in an attempt to reduce their fears. Mrs A's avoidance of going out is an example of this. This can be one of the most crippling symptoms of OCD. Life becomes more and more limited by the situations which must be avoided.
