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OCD
Please find references for this content at bottom of the page.

What is OCD?

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  • OCD is a brain-based mental health disorder that involves obsessions and compulsions

  • An Obsession is: An unwanted, intrusive thought, feeling, sensation, or urge that is repetitive and induces a significant degree of anxiety, uncertainty, doubt, or disgust

  • Compulsions are both physical and mental behaviors that are done to reduce or remove anxiety, uncertainty, or another form of discomfort

  • These obsessions and compulsions are exhausting and can significantly impair daily functioning and quality of life

How does someone end up with OCD

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  • Research suggests that biological factors make someone vulnerable to developing problems with anxiety and fear, while learning and environmental factors dictate the particular obsessions and rituals a person may have.

  • It is not precisely known what combination of factors causes any individual to develop OCD.

  • There is no one to blame for the development of OCD.  Having OCD is no one’s fault. There is no way to control for someone’s biological makeup.

  • Studies have not supported the chemical imbalance theory that OCD is due to an imbalance in a neurotransmitter, Serotonin.  Most experts now agree that this serotonin theory is incorrect.

  • Many researchers have labeled OCD as a genetic disorder, but no one has found an “OCD gene.”

  • Rather than viewing OCD as a genetically predetermined and permanent brain disease, you can see it as something you could change.

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Abramowitz, J.S.  Getting over OCD: A 10 step workbook for taking back your life (second edition).  New York:  The Guilford Press  (2018). 

Dr. Jonathan s. Abramowitz is a professor of psychology and neuroscience, research professor of psychiatry, and director of the Anxiety and Stress Disorders Clinic at the University of North Carolina, Chapel Hill.  Dr. Abramowitz also conducts award-winning research on OCD and other anxiety and stress-related disorders. 

Prevalence of OCD: 

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  • Approximately 2.3% of adults experience clinically diagnosable OCD at some point in their life.  

  • This translates to approximately 1 in every 40 people, or over 6 million adults in the United States alone.

  • Although OCD can begin at any age, most people develop OCD in their late teens or early 20s (More research is needed here because so many people can trace their OCD to even younger than the teenage years)

Did you know there are at least 16 OCD subtypes?

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  1. Contamination OCD:  The fear and uncertainty that germs, chemicals, and other contaminants will make one sick or even terminally ill.  Contamination OCD also includes obsessions of repulsion and disgust

  2. Symmetry OCD:  The anxiety and discomfort that objects are not lined up correctly, are asymmetrical, or are not in a particular pattern

  3. Sexual Orientation OCD:  Fear and uncertainly surrounding one’s sexual orientation.  Obsessions can become focused on any sexual orientation.  A person of any sexual orientation can struggle with the uncertaininty of having or developing a different orientation.  Obsessions surrounding one’s GENDER IDENTITY are also common.

  4.  Just Right OCD:  The fear and discomfort related to experiencing a “Not right” feeling.  This subtype of OCD can be “fixed” (with the individual always feeling that things need to be a precise and particular way), or ever-changing (with the individual’s feelings of “rightness” changing, depending on what feels “right” at the moment). 

  5. Harm OCD:  The fear and uncertainty around whether one could or did, accidentally or intentionally hurt others or oneself. 

  6. Pedophilia OCD (commonly known as POCD):  The fear and uncertainty related to being or becoming a pedophile.  Common POCD obsessions include fears related to possibly being aroused by or attracted to a minor or the fear of intentionally or unintentionally having performed a sexual behavior with a minor in the past or doing so in the future.

  7. Perinatal OCD:  The uncertainty and fear of harming one’s newborn baby or child, either physically or sexually.  Perinatal OCD is a subtype of OCD that can be experienced by both female and male primary caretakers, not just the person who delivers the baby. 

  8. Scrupulosity or Moral OCD:  The fear and uncertainty about possibly offending one’s religious figure (such as God), possibly performing a behavior that doesn’t align with one’s morals or religion, or the fear of not achieving a desired afterlife. 

  9. Relationship OCD (commonly known as ROCD):  The uncertainty and fear related to knowing if one’s partner is “the one” or if their love for their partner is “pure” or “right.”  Relationship obsessions can also focus on a partner’s specific body part or their partner’s history. For more Information on Relationship OCD Click Here

  10. Emotional Contamination OCD:  The uncertainty and fear that contact with a person, object, or place will alter them psychologically.  Emotional contamination OCD also involves the fear that the contaminated person’s “essence” will be transferred onto the person with OCD. 

  11. Existential OCD:  The fear that uncertainty about the true purpose or meaning of one’s life. 

  12. Obsessing about obsessing:  The uncertainty and fear that one will never be able to stop obsessing or having anxiety and intrusive thoughts.  This OCD subtype also involves the uncertainty related to whether they are engaging in treatment correctly or will recover from OCD.

  13. Sensorimotor or Hyper-Awareness OCD:  The uncertainty and fear that one will never stop noticing a sensation or feeling (breath, eyes, blinking, hads tingling, a specific side of their body or body part, itches, and so on).

  14. Hyper-Responsibility OCD:  The uncertainty and fear of being responsible for a tragic event, other people’s feelings, or well-being. 

  15. Health Anxiety OCD:  The uncertainty and fear of having or developing a severe or terminal illness.  Health anxiety obsessions can also focus on the health of a loved one, such a a child or partner.

  16. Perfectionism:  The uncertainty and fear related to not being perfect.  This doesn’t necessarily mean the person with perfectionism needs everything to be perfect.  Perfectionism can target one are of one’s life or can spread to every aspect of one’s life. 

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References: 

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Abramowitz, J.S.  Getting over OCD: A 10 step workbook for taking back your life (second edition).  New York:  The Guilford Press  (2018). Dr. Jonathan s. Abramowitz is a professor of psychology and neuroscience, research professor of psychiatry, and director of the Anxiety and Stress Disorders Clinic at the University of North Carolina, Chapel Hill.  Dr. Abramowitz also conducts award-winning research on OCD and other anxiety and stress-related disorders. 

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American Psychiatric Associartion: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.  Arlington, VA, American Psychiatric Association, 2013. 

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Hershfield. J.  Overcoming Harm OCD: Mindfulness ad CBT Tools for Coping with Unwanted Violent Thoughts.  Oakland, CA: New Harbinger Publications, Inc.  (2018).

 

Quinlan, K.  The Self-Compassion Workbook for OCD:  Lean into Your fear, Manage Difficult Emotions and Focus on Recovery.  Oakland, CA: New Harbinger Publications Inc (2021). 

 

Ruscio AM, Stein DJ, Chiu WT, Kessler RC. The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication. Mol Psychiatry. 2010 Jan;15(1):53-63. doi: 10.1038/mp.2008.94. Epub 2008 Aug 26. PMID: 18725912; PMCID: PMC2797569.

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What if I Experience OCD and I also have Complex Developmental Trauma/CPTSD

If you experience OCD and you also have complex PTSD/CPTSD/cumulative trauma, then you(s) will require a very specialized approach. Please know that both of these experiences, although highly distressing, are very treatable. You would highly benefit from a trauma-informed therapist that also specializes and is trained in exposure response prevention (ERP) for OCD, which is the gold-standard treatment for OCD. Luckily, I am highly trained in both trauma and OCD. Below you will find a handout with some helpful tips on how to navigate CPTSD and OCD. You can also read further on this website for information on the treatment for OCD and treatment for CPTSD. I will be combining both approaches.

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Navigating CPTSD and OCD Helpful Tips Handout

Read more about treating OCD by clicking this link:  OCD treatment

Read more about treating Complex Trauma (CPTSD) and Dissociation through this link:   CPTSD and Dissociation Treatment 

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