Obsessive-Compulsive Disorder

What is Obsessive-Compulsive Disorder (OCD)?

Obsessive-compulsive disorder (OCD) is a psychological condition characterized by two interrelated components: obsessions and compulsions.

What are Obsessions?

Obsessions are repetitive, intrusive thoughts, images, or urges that cause distress and anxiety. They are often accompanied by feelings of stress, worry, disgust, or doubt. While many people with OCD recognize that their obsessive thoughts, urges, or images are excessive or irrational, they often struggle to control or alleviate the distress caused by these obsessions. As a result, they may turn to compulsions to cope with these distressing feelings.

What are Compulsions?

Compulsions are repetitive actions or mental activities performed to alleviate or eliminate the significant stress and discomfort caused by obsessions.

What are Common Obsessions and Compulsions?

Contamination or Dirtiness Obsession and Cleaning Compulsion

Individuals with this obsession believe that their body, clothes, or environment have been contaminated by bodily fluids (such as blood, urine, or feces), infectious diseases (like Herpes or HIV), animals (such as insects), environmental pollutants (such as asbestos, radiation, or toxic waste), or domestic chemicals (like detergents or solvents). This belief leads to excessive anxiety or disgust, causing them to engage in continuous cleaning behaviours.

Kişiler bu zararlı ve bulaşıcı etmenlerin taşıyıcısı haline geldiklerini düşündüklerinden bunları başkalarına bulaştırmaktan da korkabilirler.

Obsessional Doubt and Checking Compulsion

This occurs when an individual constantly doubts their actions and worries that they may have forgotten or overlooked something, causing excessive anxiety about potential mistakes that could lead to accidents or disasters. To alleviate this anxiety, they may repeatedly check objects they are concerned about, such as verifying multiple times that a window, door, or stove is closed, the door is locked, or the iron is unplugged. Some may even take photos of these objects to confirm that they have been properly checked.

Symmetry/Order Obsessions and Compulsions

Symmetry obsession, also known as an obsession with order and symmetry, is a type of obsession where an individual becomes excessively focused on the appearance or placement of objects. This is associated with the need for objects to be perfectly aligned, symmetrical, or orderly. If anything is not in a predetermined order, it can cause anxiety or intense stress in individuals. To eliminate these distressing feelings, a person may exhibit compulsive behaviours related to symmetry, such as arranging, correcting, sorting, and aligning items.

Examples of symmetry obsessions include arranging objects to face the same direction or be positioned in a specific way, organizing items according to a particular order (e.g., from smallest to largest or by color), or placing objects in a specific location (e.g., at a certain spot or alignment).

Sexual Obsessions and Compulsions

Sexual obsessions involve unwanted, intrusive sexual thoughts and images that are inconsistent with a person's values or are considered "unacceptable" from a moral perspective.

Common obsessions in sexual OCD include:

• The fear of being a pedophile or anxiety about such a possibility (often parents fear having sexual interest in their own children).
• The fear of feeling sexual attraction towards God, religious figures, inanimate objects, animals, or close relatives (siblings, parents, etc.).
• Doubts about one’s sexual orientation and concern about it (e.g., a heterosexual person fears they might be homosexual, or vice versa). This includes a hidden fear of being homosexual (or heterosexual).
• The fear of committing violence during sexual intercourse.
• The fear of performing a repulsive sexual act.

Common Compulsions in Sexual Obsessive-Compulsive Disorder:

When experiencing these types of obsessions, individuals develop compulsions to alleviate the anxiety stemming from these intrusive thoughts. Common compulsions in this disorder include:

• Avoiding situations where they might encounter obsessive thoughts or interact with such situations.
• Attempting to replace unacceptable sexual thoughts with acceptable ones through mental rituals.
• Avoiding sexual intercourse with partners to prevent harm.
• Mentally reviewing past sexual behaviours repeatedly to check for signs of deviance or immorality.
• Monitoring genital arousal when encountering or interacting with obsessive topics.

Religious Obsessions

Religious obsessions may involve involuntary thoughts, urges, or images that are considered sinful, or they may manifest as a fear of committing a sin.

Some common religious concerns include:

• Constantly doubting whether one has sinned unintentionally or unknowingly or violated moral rules.
• Frequently having blasphemous thoughts or images targeting religion.
• Worrying about performing a religious practice fully and correctly.
• A constant state of fear and anxiety about being punished.

In societies where Islam is predominant, common religious obsessions include themes such as doubts about whether the ablution (wudu) or ritual bathing (ghusl) was broken or not performed correctly, concerns about the validity of prayers or making mistakes during prayer, and fears that worship is not performed completely.

General compulsions often involve excessively praying, performing ablution, or praying until it is flawless, repeatedly reciting religious texts such as verses or surahs, seeking reassurance from religious leaders to feel safe, and excessively asking for forgiveness.

Repetition and Counting Compulsions

This involves repeating certain physical or mental actions a specific number of times (e.g., rinsing a plate four times, saying "goodbye" three times before hanging up the phone, mentally repeating a word or prayer three times) or counting certain objects (e.g., cars, license plates, sidewalk tiles) due to the anxiety that their day will not go well if they do not perform these actions or count these items a certain number of times.