OCD is an anxiety disorder.  Obsessions are repetitive thoughts or images, accompanied by anxiety or distressed feelings. Compulsions are actions or thoughts meant to relieve the anxiety.  Obsessions come in varying forms such as doubting, guilt, fear of ‘bad’ things happening to a loved one or oneself.  Although most people realize the obsessions are not objectively true, they cannot resist doing the compulsion to get relief.

Sex, fear of harming others, morbid thoughts, contamination, religious obsessions, body image, perfectionistic obsessions, superstitious types of obsessions, obsessions about sexual orientation, doubting, guilt, looming danger or imminent harm, numbers and their power to cause negative consequences, any thought may be an obsession if the person obsesses about the thought, and ‘bad’ words or curse words.

Cleaning, washing, hand-washing, checking (and re-checking), need for perfection, counting compulsions, touching or tapping compulsions, praying compulsions (prayer is positive, compulsive praying may not be positive), compulsions involving physical appearance such as Body Dysmorphic Disorder (excessive concern about and preoccupied by a perceived defect in one’s physical features), compulsions involving rules family members must engage in such as keeping things in a certain order or cleaned in a certain way, hoarding/collecting, and mental compulsions (pure obsessions are rare. When it seems there are pure obsessions, there are very often mental compulsions present or very subtle compulsions).

Repeating compulsions could involve re-reading or re-writing, routines and body movements, or repeating a certain number of times (safe numbers). Reassurance and Enabling – asking for or seeking reassurance is a compulsion.  Giving reassurance is an enabling compulsion.  Those who supply reassurance must learn to stop, but not necessarily all at once.  This is built into the treatment plan.

The “Just Right” Phenomenon
An action is repeated until it feels “just right”.  An example of this is when a person must repeat a simple step forward with a foot, over and over, until it feels “just right”.

Co-Morbid conditions (often seen with OCD)
These conditions include Depression, Anxiety, Phobias, ADD or ADHD, Body Dysmorphic Disorder, Bipolar Disorder, eating disorders, and other anxiety disorders.

When evaluating a person who suffers from OCD, it is necessary to identify and treat any co-morbid condition.  Treating these other disorders improves the likelihood of success in the treatment of OCD.