therapy and treatment


obsessive-compulsive disorder (OCD)

OCD is estimated to affect between 1 and 4% of the population and is characterised by unwanted thoughts, images and/or urges. These intrusions provoke high levels of anxiety and can become very distressing. To control these unpleasant feelings and thoughts, people engage with compulsions, often including behaviours that seem irrational like washing hands continuously, counting to certain numbers, ordering items in a certain way, following strict routines, checking windows and doors are locked several times, avoiding particular situations etc. Fortunately, psychological treatments available for OCD are very effective.

common OCD symptoms

Each person who experiences OCD describes something different. However, the symptoms people experience can often have similar themes. Below are some common features of OCD.

You may worry that you or others are contaminated (or are at high risk of being contaminated) by germs, faeces, urine, dirt, chemicals or some other harmful agent. As a result, you may need to wash your hands repeatedly, avoid touching certain things and/or stay away from people. Often people with these kinds of worries are more concerned about the harm they may cause other people than themselves. These kinds of concerns are particularly prevalent at the moment, with the onset of the coronavirus pandemic raising people's fear of contamination in general.

An intrusive thought is an unwanted thought that causes distress. They can often be difficult to eliminate. The content of these thoughts may include issues related to sexual acts, violence, deliberately causing harm to others or something else the person finds unacceptable. It may also include doubts that you have hurt someone by accident, for example knocking someone over in a car. Intrusive thoughts can be graphic images that shock and disgust you. As a result you may need to seek reassurance that your thoughts have no basis in reality and work very hard not to have them, through distracting yourself with other things.

This type of OCD involves a compulsion to arrange and order things/objects/possessions in a certain way. People who have experienced this problem often describe not being able to stop these compulsions until it feels 'just right'. As a result, routines associated with compulsions can become very time consuming, leading to isolation and loneliness, as well as a general inability to carry out life tasks, such as attending work.

People who repeatedly check things (doors, windows, cooker, plug sockets, light switches etc) are usually concerned that something bad might happen as a result of their own negligence (house fire, burglary, harm to someone, lost or stolen items etc). These checking behaviours often have to be carried out over and over again, for a considerable amount of time. The impact of these behaviours can be devastating and lead to real issues, including problems being on time, engaging with relationships and holding down work.

treatment for OCD

Although completely treatable, people who experience OCD have often lived with their symptoms for a number of years before seeking help. For this and other reasons, the beliefs and rituals that drive their problems can be difficult to shift. This can make therapeutic sessions in the home and community more relevant, enhancing the effectiveness of the techniques we us.

The evidence-base (research and results of clinical trials) recommend a course of Cognitive Behavioural Therapy combined with Exposure Response Prevention (a technique designed to help people face their fears) for the treatment of OCD. For most people this will be sufficient. However, those experiencing particularly stubborn symptoms may need a more specialised approach involving more than one therapist.

At NOSA we will take time to asses your individual needs and work in collaboration with you to recommend a treatment package that best meets your goals.