OCD is the term for when someone is stuck in a cycle of obsessions and compulsions. These compel the individual to engage in certain activities and behaviours, despite adverse consequences.

Checklist For OCD

Do you have unpleasant thoughts or images in your mind such as:

• Concerns about dirt, germs, chemicals, radiation and illness?
• Strong concern about keeping items in perfect order or arranged exactly?
• Images of death or other horrors?
• Personally unacceptable sexual thoughts?

Have you worried a great deal about terrible things happening, such as:

• Fire, burglary, or flooding the house?
• Accidentally injuring someone or letting your car roll down the hill?
• Spreading illness?
• Losing something valuable?
• Harm coming to a loved one because you were not careful enough?
• An urge to physically harm a loved one, friends or a stranger?

Have you felt driven to perform certain acts over and over, such as:

• Excessive or ritualised washing, cleaning, or grooming?
• Checking light switches, taps, the stove, door locks, or emergency brake?
• Counting, arranging and excessive organising?
• Collecting useless objects or inspecting the rubbish before it is thrown out?
• Repeating routine actions until it feels right?
• Need to touch objects or people?
• Unnecessary re-reading/re-writing; re-opening envelopes before mailing?
• Self-examining for signs of illness?
• Avoiding colours/numbers/names?
• Needing to “confess” or repeatedly asking for reassurance?

There are four clusters of OCD. The first covers aspects such as excessive washing, cleaning and religious rituals. It includes, for instance, fear of catching a disease from touching things in public. The second relates to ordering, counting and symmetry. The third involves hoarding behaviour. And the fourth involves checking rituals — returning repeatedly to make sure a door is locked, for example.

OCD is no longer viewed as an anxiety disorder but an impulse disorder in the same category as addiction. There is a resemblance between addiction and the main symptoms of OCD, such as the desire to repeatedly engage in the activity despite diminishing rewards and an increase in unwanted side effects. Another symptom is the frequent desire to stop or cut down and feeling powerless. The behaviour reduces the user’s ability to engage in regular activities, social events, work and family life. Even though they are aware it causes psychological or physical problems, they continue.

Since OCD is an addictive process, we believe one should deal with it in a similar way to other behavioural non-substance addictions, such as gambling. OCD makes people feel better in the short term (by diverting their mind to a pattern so they do not have to worry about whatever is concerning them). However in the long term, it causes significant problems, just like other addictions. The solution is to focus on the underlying emotional pain and once one has dealt with that, the urge to "act out"  will lift. Some people are able to do this by themselves, however most need a therapist experienced with OCD and addiction models.

Zahava Bloom is clinical manager at Reflections Bespoke Therapy, bespoketherapy.co.uk