Written by Dr. Andrea Potthoff, Ph.D., L.P.
Obsessive-Compulsive Disorder (OCD) is one of the most misused labels for psychological symptoms. Most of us have heard someone (or even ourselves) refer to their behavior as “OCD” when talking about things like excessive cleaning, a preference for symmetry, or a quirky desire for order. These behaviors may in fact be part of OCD, but on their own they do not constitute a diagnosis. And unfortunately, misusing this diagnostic label contributes to the misinformation about OCD and undermines the experience of those truly struggling with OCD. Knowing more about the diagnosis can help illuminate whether your symptoms are actually OCD.
A diagnosis of OCD includes the presence of obsessions and/or compulsions, some of which may look like excessive cleaning and organizing, while others may not. An obsession is a thought that pops up repeatedly, is distressing, and feels as if you are not in control of it. Some examples are, “I will get sick if I don’t wash my hands,” “I cannot be sure that the door is locked,” and “Maybe I hit someone with my car as I drove to work today.” Although it is not often talked about, some people experience obsessions as intrusive images they see in their mind’s eye. These are often gruesome, violent, sexual, or inappropriate in nature.
A compulsion is then a behavior or mental ritual that you use to temporarily relieve the obsession. For the examples above, this might mean washing your hands repeatedly, going back to check that the door is locked several times, or getting back in your car and retracing your drive to work to make sure no one was injured. Some people, especially adults, begin to use mental compulsions that are not overtly noticeable. This may include things like saying a certain word in your head or repeating things a certain number of times to yourself. The problem with compulsions is that they help in the moment, but tend to increase the power of the obsession or anxiety in the future.
There are several effective treatments for OCD. Certain medications are used to treatment OCD and a specific therapy, known as Exposure and Response Prevention (EXP or EX-RP), has also demonstrated a high degree of effectiveness in treating OCD.
Misusing the term “OCD” creates several problems. First, we undermine the experience of those people actually struggling with OCD. Second, we contribute to the misinformation about the disorder which may cause a delay in diagnosis and treatment. When you are tempted to misuse the term “OCD,” consider other ways to describe your behavior. That might sound something like, “my preference for things to be just so,” “it bothers me when things are messy or disorganized,” or “I can be kind of rigid.” The people in your life with OCD will certainly appreciate this change.
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