Part of therapy is helping people truly understand their own struggles. They may recognize that they have anxiety, stress, or even depression. But they may not truly understand it – from the mechanism of action to the process of prevention and treatment.
Obsessive Compulsive Disorder, or “OCD,” is an example of a disorder and struggle that many people *think* they understand, but they may not quite recognize what’s occurring. With OCD, a better understanding of what they’re struggling with is actually a part of treatment, because the distress caused by the “obsessions” is directly related to misunderstanding one’s own thoughts.
Quick Recap of OCD
Obsessive Compulsive Disorder refers to a condition where a person has upsetting, persistent, recurring thoughts that cause them to feel extreme distress. These thoughts are “intrusive,” which means that they occur all the time, with or without warning, and in situations where nothing should be able to trigger it.
Obsessions can be any distress inducing thought. Examples include, but are not limited to:
- Contamination fears – Germs, chemicals, bodily fluids
- Responsibility fears – Causing harm to others through negligence or inaction
- Order and symmetry – Things needing to be “just right” to avoid distress
- Moral or religious concerns – Fear of committing immoral acts or offending one’s beliefs
- Unwanted sexual or violent thoughts – Disturbing ideas that are inconsistent with the person’s values
We’re going to talk more about them in a moment, but the key here is that the thought itself is occurring against a person’s will, and causes them extreme stress each time it occurs.
Some people respond to these obsessions with a behavior that seems to reduce their distress temporarily. For example, a person that feels extreme distress about contamination (like germs) may get relief from a washing hands (a behavior). Over time, they may perform this behavior over and over again. This is the “Compulsions” part of OCD. We’ll talk more about these at a later date. For now, we want to explain more about obsessions.
“Obsession” is Not the Way We Think of It
In casual conversation, “obsession” means something very different. We are “obsessed” with the partner we love. We are “obsessed” with the cheese pizza at a new pizza place. We are “obsessed” with our baby niece. We use the term almost like it’s a good thing, referring to something we desire.
What confuses a lot of people in the context of OCD is that the word “obsessions” can frequently mean the exact opposite. These are thoughts we don’t want. They can, critically, be inconsistent with who we are.
For example, in the context of OCD, some people have obsessions that include a fear that they want or desire to commit a violent act against someone else. They may have an intrusive thought of physical assault, sexual assault, or even murder. They may imagine that they’ll hurt children.
When these thoughts are intrusive, the person may think that it reflects on their desires. That is not the case. The reason that these thoughts cause distress is specifically because they are *not* something we want and not who we are. But they intrude nonetheless, which is what makes them so upsetting, and why people with OCD can have very severe reactions and behaviors.
Obsessions and Shame
Similarly, because a person worries that these obsessions reflect on their desires, they are more likely to experience shame, lower self-esteem, and more. This can also lead to feelings of inadequacy, further distress, and make it harder to cope with the stress you have. For reasons that are not always clear, the more we experience these negative sensations, the more the intrusive thoughts can come.
Looking at Obsessions as a Symptom, Not a Reflection of Character
Obsessions are not a choice, and they are not moral failings. They are a neurological symptom – one that can be treated. Recognizing obsessions as involuntary and unwanted is a key step in addressing them without shame. With proper treatment, many people with OCD find that their obsessions lose their intensity and their impact over time, even if the thoughts occasionally still occur.
If you would like more help understanding OCD, including obsessions, compulsions, and the distress they cause, and you’re ready to start with treatment, please reach out to Nassau Counseling Services, today.
