Obsessive Compulsive Disorder (OCD)

Obsessive Compulsive Disorder (OCD) is a mental health disorder marked by unwanted, sudden thoughts (intrusive) that cause discomfort or stress and lead to an action (compulsion) to soothe those uncomfortable feelings. These thoughts and behaviors will typically be repetitive; the same types of thoughts will occur causing anxiety, then the same types of behaviors will be used to relieve their anxiety. 

An example of an OCD chain of events could be an intrusive thought while driving like, “What if I swerve off the road right now?” This causes feelings of anxiety and additional thoughts of, “Am I suicidal? Why would I think like that? Am I a horrible person, or a danger to myself/others?” In order to make that thought chain stop and make the anxiety dissipate, you check your speed repetitively. Your eyes move to the speedometer every several seconds. You reposition your hands repeatedly. You repeat a different thought to yourself to distract your brain. Finally, the anxiety fades and you return to baseline until the next intrusive thought presents itself. 

Of course, OCD can be different for every person. Obsessive and Compulsive Disorder includes a broad range of obsessions and compulsions that can change overtime. The pattern of OCD will always entail an intrusive thought, followed by anxiety/stress/negative emotions, and then usually a compulsive behavior (or cognitive strategy) used to relieve anxiety. 

OCD is time-consuming and those impacted will spend an hour or more per day dealing with obsessive thinking and related compulsions. 

OCD can affect adults, adolescents, and children. Children may have a harder time wading through their thoughts and emotions as effectively as an adult might. OCD in a child could look like a little one who is expressing discomfort or concerns around germs, frequent (unprompted) hand-washing or repetitively reciting words or counting. Or it can be demonstrated as an effort spent keeping things particularly orderly (matchbox cars lined up end-to-end in a straight line), only sleeping with one type of blanket or pillow, or having to check things repeatedly (bathroom faucet, door locks, etc).

OCD can also impact work or school performance. For example: a child might take a long amount of time to complete homework due to perfectionism and the urge to complete repetitive compulsions until their anxiety is reduced (examples of compulsions could be excessive rereading, rewriting, or checking math calculations on homework). The child might avoid turning in homework because it's not "perfect" or a child may struggle to finish an exam on time due to the urge to check answers repetitively. OCD might also look like procrastination or avoidance due to things not being “just right." It might be difficult to break a child out of their cycle of thoughts and behaviors. For children with OCD, an Exposure and Response Prevention (ERP) therapist can work with classroom teachers to provide guidance on how best manage a student's OCD in the classroom. 

OCD can cause stress on the family system. For example, parents can unknowingly keep a child stuck in OCD behaviors by making accommodations or adjustments for OCD (letting the child check homework repetitively or giving them space to engage in rituals). If these rituals are interrupted, a child with OCD might experience intense emotions and have outbursts or tantrums. It might seem unbearable for the child to not complete the OCD behaviors and rituals. When a child is in ERP treatment, a therapist may recommend scheduling parent support sessions to provide guidance and psychoeducation on how to limit accommodations and help their child overcome OCD. 

Exposure and Response Prevention is the gold standard treatment for OCD in children, adolescents, and adults. Exposure and Response Prevention is offered by several therapists with advanced training at Colorado CBT. Click here to read more about Exposure and Response Prevention. 

To find Colorado CBT therapists, in the Denver, Colorado area, who can treat OCD through Exposure and Response Prevention, click here.