In obsessive-compulsive disorder (OCD), the main features seen are:

Obsessional thoughts.
Compulsive behaviours.
These usually occur together.

i). Obsessional thoughts.

The term obsessional thought describes a situation where the person repeatedly notices that anxious or upsetting thoughts pop into mind again and again and again.

A milder form of this experience is quite common in society. Many people occasionally have the experience of noticing that a tune or piece of music seems to get ‘stuck' and goes round and round in their mind for a time before eventually disappearing.

In most cases this is seen as either "okay" (the person just hums along) or slightly annoying and frustrating. Eventually it stops.

The big difference in obsessive-compulsive disorder is that the thought continues to go round and round for a very long time in spite of efforts by the person to stop thinking it.

Because the thoughts are so distressing, the person becomes overly aware of them, and tries hard not to think the upsetting thought.

Key point: Common obsessional thoughts can include a fear of hurting or damaging others in some way, or of causing harm through not having done something. The person is worried that something really bad will happen as a result.

They may know rationally that no such harm is really likely to occur, yet in spite of this, the worrying fears dominate their thinking and intrude into mind. Sometimes obsessive thinking results in the person becoming crippled by doubt about a particular issue.

They go round and round trying to answer the question to the very last detail, yet find it impossible to reach a conclusion.

ii). Compulsive actions.

Because obsessive thoughts are so scary and upsetting, the person with obsessive-compulsive disorder may try to avoid them or prevent harm occurring as a result.

This can involve:

a). Trying hard to avoid thinking the obsessional thoughts in the first place.

b). Carrying out mental rituals such as thinking particular words, phrases or prayers in order to make the thoughts feel "right" or "safe".

c). Carrying out activities or behaviours to prevent or reverse the harmful consequence occurring. For example, repeatedly checking that the light switches are off again and again. Other examples are cleaning the house or washing themselves to an excessive extent.

d). Avoiding any situations that they fear may cause things to get worse.

These actions might in moderation be seen as sensible and appropriate (e.g. checking the door is locked once at night before going to bed is a quite sensible and reasonable thing to do); however in obsessive-compulsive disorder things gets completely out of hand.

The compulsions can dominate and lead to an increasingly restricted life.

Obsessive-compulsive checklist.

Obsessive thinking:

Q. Do I have thoughts, memories, impulses, images or ideas that seem to go round and round in my mind?

Q. Are these thoughts unpleasant and/or upsetting to me?

Q. Do I think that I am guilty and overly responsible for bad things occurring?

Q. Have I become overly sensitive to these thoughts/fears?

Q. Am I downplaying my own ability to overcome these problems?

Q. Do I dwell on things I have (or could have) done that might result in harm to others?

Q. Do I fear I might lose control and do something that will harm or upset others?

Q. Do I worry that things I haven't done properly might result in harm to others?

Q. Do I have doubts and go over the same questions again and again with no chance of ever finding a solution?
 
Compulsions:

Q. Do I recurrently carry out mental rituals such as counting or deliberately thinking "good" thoughts/saying prayers to make things feel "right"?

Q. Do I compulsively check, clean or do things a set number of times or in exactly the "correct" order so as to make things "right"?

If you have answered Yes to several of these questions, then you may have obsessive-compulsive disorder. Talk to your health care practitioner about this.

If you have answered Yes to several of these questions, then you may have obsessive-compulsive disorder. Talk to your health care practitioner about this.

Next step: To find out more, you can read the workbook Understanding obsessive-compulsive symptoms (OCD) in the book Overcoming Anxiety: A Five Areas Approach.

References – books by Dr. Williams:

Overcoming Depression: A Five Areas Approach

Overcoming Anxiety: A Five Areas Approach

I'm not supposed to feel like this: A Christian self-help approach to depression and anxiety

article source: Living Life to The Full site