Advanced Therapy Partnership





There can be very few of us who have never got into the car to go somewhere, paused and thought “Did I really lock the door” or “Did I really turn the kettle off”. Then, you got out of the car and went to check.  Sure enough, everything was OK, and you drove off feeling quite comfortable. 

Imagine if, however, you got back into the car, paused, and went to check again.  Then you got back into the car, drove a few yards, stopped and went back to check yet again.   That´s a short description of obsessive compulsive behaviour.  What a terrible position to be in – it´s easy to see how this sort of behaviour could seriously interfere with one´s normal enjoyment of life.   

Like many emotional states, OCD (we´ll call it that from now on), is simply a normal protective mechanism taken to an extreme. To check that the kettle is off is merely sensible, but to do it three or four times in the space of minutes is to say the least unusual. 

There are two common strands observable in OCD, and these are: 

    1. Repetitive behaviours (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the person feels driven to perform in response to an obsession, or according to self-imposed rules that must be applied rigidly
    2. The behaviours or mental processes are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviours or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive.

The sufferer is aware that the behaviour is bizarre, although naturally, we cannot expect this to be the case in young children.  OCD can start at any age, but for the most part, it begins to show itself between the ages of 10 and 24. The gender prevalence of OCD is equal in males and females. However, childhood-onset OCD is more common in males and more likely to be linked genetically with attention deficit hyperactivity disorder (ADHD) and Tourettes syndrome.

What causes OCD? Fact is, nobody really knows.  A family history of similar complaints is sometimes found, and it has been suggested that OCD can be triggered by infection with bacteria of the streptococcus family. Because treatment with SSRI drugs (usually used in the treatment of depression) have been effective in treating OCD, there is also a suggestion that it may have to do with the balance of the neuro-transmitter serotonin in the brain.  The jury is, though, still out. 

So what can be done about it?  The best approach is usually twofold – prescription by a GP of a suitable medication if necessary, together with the use of Cognitive Behavioural Therapy.  CBT utilises techniques of exposure and response prevention, meaning exposure to symptom triggers of gradually increasing intensity, with use of cognitive and relaxation techniques including hypnosis (if the therapist is suitably qualified) to suppress the obsessive or compulsive response.  Response is usually quite fast, and treatment is effective.