Obsessive-Compulsive Disorder (OCD)

Obsessive-Compulsive Disorder (OCD) is a type of an anxiety disorder where an individual may experience unreasonable thoughts or fears (obsessions) that result in repetitive behaviors (compulsions). OCD centers around a theme, such as fear of contamination or germs, which results in compulsions such as repetitive or excessive hand washing. The ritual behavior usually temporarily alleviates the anxiety/stress caused by the obsession. Although someone suffering from OCD, may be aware of the obsession is unreasonable or unrealistic, it is quite difficult to stop the repetitive behavior.


There are a variety of different symptoms for both the obsessions and the compulsions. The following are examples of possible obsessive and compulsive symptoms.

Obsession Symptoms:

  • Fear of contamination or dirt by germs

  • Having things orderly and symmetrical

  • Aggressive or horrific impulses

  • Sexual images or thoughts

  • Doubts that you've locked the door or turned off the stove

  • Impulses to shout obscenities in inappropriate situations

  • Avoidance of situations that can trigger obsessions, such as shaking hands

  • Fear of causing harm to another

  • Fear of making a mistake

  • Fear of being embarrassed or behaving in a socially unacceptable manner

  • Excessive doubt and the need for constant reassurance

Compulsive Symptoms:

  • Washing and cleaning

  • Refusing to shake hands or touch doorknobs

  • Counting

  • Checking

  • Constantly arranging things in a certain way

  • Demanding reassurance

  • Performing the same action repeatedly

  • Orderliness

  • Eating foods in a specific order

  • Being stuck on words, images or thoughts, usually disturbing, that won't go away and can interfere with sleep

Who Gets OCD?

OCD affects over 2 million American adults each year and the lifetime prevalence of OCD is approximately 1.6% of the population (Kessler, Berglund, et al 2005). The exact cause of OCD is not known, however, it is believed that a combination of genetics, environment, trauma, and/or stress can result in OCD. Individuals are more likely to develop OCD if they have family members with OCD or any other anxiety disorder. Individuals under a lot of stress can also develop OCD. Lastly, it is believed that trauma to the brain or an imbalance in brain chemistry can also cause OCD.

How Does Thinking Affect OCD?

Studies indicate most people have thoughts similar to people with OCD, however people OCD become much more upset and focused on these thoughts, leading to distress. These thoughts are interpreted as dangerous or valid rather than harmless, random thoughts passing through one’s awareness. Once the thoughts or images are interpreted as dangerous, someone with OCD may become preoccupied with them.

How Does Behavior Affect OCD?

People with OCD will try to reduce the distress cause by the obsessions by engaging in some behavior or thought process to reduce the distress. As mentioned earlier, this could be washing, counting, arranging things in a specific way, etc. This reduces the distress in the short term, however it inevitably returns with the next obsessive thought. The compulsions also reinforce the belief that someone needs to engage in the compulsive behavior to feel better. In some variations of OCD the compulsion is not a behavior, but rather a mental ritual or obsessive rumination.

How Does CBT Help?

Individuals with OCD believe that if they don’t act on their obsessions by doing their ritual behaviors/compulsions, they will become more anxious, “go crazy,” or they will experience some other feared outcome. The therapist will provide you with techniques that can help alleviate your anxious thoughts without having to rely on your compulsions. CBT helps individuals control their anxiety by not relying on their compulsions. In treatment, your therapist may help you learn some relaxation techniques or ways to control your obsessive thoughts. Further, your therapist may guide you in facing your fears until they are eliminated. This involves exposing you to the obsession while refraining from the compulsion until the anxiety goes down.  Facing your fears can alleviate the need to partake in your compulsions. CBT treatment for OCD last for about 20 sessions (more if your symptoms are severe) and 80% of patients who complete CBT treatment for OCD have been able to overcome their compulsions. Obsessive thoughts or anxiety may still persist after treatment but patients are better equipped in dealing with their anxious thoughts.To learn more about treatment or to set up an appointment, contact Dr. Fazzari today.