Exploring Obsessive Compulsive Disorder: Online Resource
Our free online course explores what OCD is, what it isn’t, what it’s like to live with, how to manage living with it and how therapy and medication may play a role in this.
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Real life experience
I first experienced obsessive, intrusive thoughts as a university student. In the beginning they manifested themselves only occasionally, for example, once when I was a passenger in a car I had a fear of suddenly yanking the steering wheel in the direction of oncoming traffic. While these thoughts were not pleasant they generally only occurred in ‘fleeting’ moments – for example, after I had completed the car journey the thoughts vanished, and so they didn’t have a particularly major impact on my life.
However on one occasion when I was doing the washing up I suddenly felt an urge to stab my housemate with a knife I had been cleaning at the time. This time the thought affected me considerably – I thought that I had to be evil to hold such thoughts about harming my friends. These thoughts quickly evolved – whereas previously I only held them while I was around knives, they started to involve other forms of violent acts both to myself and other people. There was no way I could escape these thoughts; I could avoid holding heavy objects or knives, but I still thought that if I wanted to I could hit someone with my fists or spit on them. The thoughts became a constant and ever-present factor in my life.
On no occasion did I want to act on these thoughts; they were just based around a ‘what if’ situation. I imagined that all it would take would be for one small loss of control to make my worst nightmares come true. I wasn’t able to enjoy a holiday with my dad because of these fears – from shouting out something inappropriate on the plane, to randomly assaulting someone in the street – these thoughts became almost constant.
I went to my GP and told her about my concerns, and was given an appointment with a psychiatrist who gave me the diagnosis of “OCD with primarily obsessional features”. This is a form of OCD known as “Pure O” which has fewer observable ‘compulsions’ than “classic” OCD. For example, while traditional OCD may involve compulsive activities like hand-washing, counting and checking, pure OCD compulsions and rituals are less common and are mostly mental in nature, for example, they may involve excessive rumination and avoidance of certain situations.
While I was prescribed some antidepressants, self-help guidebooks on OCD were the most helpful to me. These books explained that to have such intrusive thoughts is not the mark of an ‘evil’ person. The revulsion one experiences to such thoughts is a sign that they are a caring and moral person – after all, a ‘serial killer’ would not find such thoughts of harming others to be distressing. The typical person who is distressed by intrusive thoughts would not act on these thoughts because it would be completely contrary to his or her character.
Challenging obsessions, compulsions, and other intrusive thoughts is best done through Cognitive Behavioural Therapy (CBT). In the case of Pure ‘O’ OCD, this can be done through repeated exposure to the intrusive thoughts or scenario in a method called “Imaginal Exposure”. For example, if somebody had a fear, say, of causing violence to a loved one, then in this method they would write a story graphically describing them committing their worst fear with the worst possible outcome. They would then read or listen to a recording of this scenario many times each day. While this may seem counterintuitive, it has been shown that to face your fears head on rather than try to avoid them completely will, over time, reduce the ‘shock factor’ of any intrusive thoughts much in the same way that watching a horror film again and again will gradually reduce the fear it produces in us.
While this form of therapy has not ‘cured’ my intrusive thoughts, I now find them much easier to manage on a day to day basis. My fears have once again been relegated to a position of being annoying, fleeting moments rather than something that interferes with my life wherever I go.
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