Individuals suffering from Obsessive Compulsive Disorder (OCD) often experience debilitating symptoms that cause significant impairment in overall functioning and can drastically diminish one's quality of life. OCD affects individuals of all ages and is characterized by patterns of recurrent, unwanted, and intrusive thoughts, images, or urges (referred to as obsessions) which cause intense levels of emotional distress and lead to engagement in ritualized behaviors (referred to as compulsions) in order to neutralize or rid oneself of the obsession. This vicious cycle of obsessions and compulsions is often experienced as outside one's control and can cause people to feel powerless to change. Without effective treatment, this cycle is likely to continue uninterrupted. 

The 2013 APA Practice Guidelines for the Treatment of Patients with Obsessive Compulsive Disorder recommends a specific form of Cognitive Behavior Therapy (CBT) called Exposure and Response Prevention (ERP) treatment.  Among available treatments, ERP is considered to be the "gold-standard" and first-line approach, demonstrating the strongest evidence-base in supporting its use in the treatment of OCD.

Obsessions

Contamination 

  • Germs or Diseases (i.e. HIV),

  • Dirt

  • Bodily fluids and excretions

  • Environmental contaminants                      (i.e. asbestos, radiation, lead)

  • Household chemicals

           (i.e. cleaners, solvents)

Losing Control

  • Fear of acting on an impulse to harm oneself or others

  • Fear of blurting out insults or obscenities

  • Fear of having violent thoughts or images​

Unwanted Sexual Thoughts

  • Forbidden sexual thoughts or images (i.e. involving children or incest)

  • Obsessions about homosexuality or fears related to uncertainty about one's sexual identity.

  • Obsessions about aggressive sexual behavior towards others

Scrupulosity (Religious or Moral Obsessions) 

  • Concern with offending God, or concern about blasphemy

  • Excessive concern with morality or what is "right/wrong"

Perfectionism

  • Preoccupation with order, arrangement, or symmetry

  • Overwhelming sense of needing some things to feel "just right" 

  • Concern about a need to know or remember

  • Inability to decide whether to keep or to discard belongings

  • Fear of losing things or forgetting information

Harm

  • Fear of harming others or being responsible for something terrible happening

             (i.e. causing fire or accident)

Mental Compulsions

  • Mental review of events to prevent harm 

  • Praying to prevent harm

  • Counting while performing a task to end on a “good,” “right,” or “safe” number

Other Compulsions

  • Rearranging things until it “feels right”

  • Confessing or asking for reassurance

Repeating

  • Rereading or rewriting

  • Repeating routine activities (i.e: going in or out doors, getting up or down from chairs)

  • Repeating body movements (example: tapping, touching, blinking)

  • Repeating activities in “multiples” (examples: doing a task three times because three is a “good,” “right,” “safe” number)

Washing & Cleaning

  • Washing hands excessively or in a certain way

  • Excessive showering, bathing, tooth-brushing, or grooming routines

  • Cleaning household items or other objects excessively

Checking

  • Checking that you did not/will not harm others or yourself

  • Checking that nothing terrible happened

  • Checking that you did not make a mistake

  • Checking some parts of your physical condition or body

Compulsions

Helpful Resources:

International OCD Foundation
Anxiety and Depression Association of America
Parents Guide- Obsessive Compulsive Foundation of Metropolitan Chicago