Obsessive-compulsive disorder (OCD) is a mental health issue impacting 1-2% of Canadians. According to the World Health Organization, it is the fourth most common mental illness. Depending on how severe the obsessions and compulsions are, it can result in serious impacts on day to day functioning. In a mild case, you may lose an hour a day to your symptoms. In a more serious case, you may spend an entire day consumed by obsessive thoughts and compulsive rituals. Because of its time-consuming nature, OCD will often interfere with jobs and schooling. Similarly, social relationships can become strained as significant people in your life become concerned with your symptoms.

The idea of an obsession in pop culture differs from the definition of an obsession you might experience if you were diagnosed with OCD. In pop culture, being “obsessed” with something usually means spending a lot of time engaging in or thinking about something that you get pleasure from. For example, being obsessed with video games, a favorite food, a new song you heard, or rock climbing. Even though you are obsessing over these things in an everyday sense, you can still meet up with friends for a drink, get to bed on time, be an attentive partner, and be productive at work. What we mean when we talk about an obsession as an OCD symptom is quite different — it is something unwanted that happens repeatedly and feels like it is outside of your control. An obsession as a symptom of OCD would be unwanted thoughts that stop you from being able to pay attention to other things that are important to you, like your family members. Common obsessions include:

Contamination from: body fluids (urine, feces), germs or diseases (bacteria, herpes, HIV), environmental contaminants (asbestos, radiation), household chemicals (cleaners, solvents), dirt.

Unwanted sexual thoughts: forbidden or perverse sexual thoughts or images, forbidden or perverse sexual impulses about others, obsessions about sexual orientation (own or of others), sexual obsessions that involve children or incest, obsessions about aggressive sexual behavior toward others.

Losing control: fear of acting on impulse to harm oneself, fear of acting on impulse to harm others, fear of violent or horrific images in one’s mind, fear of blurting out obscenities or insults, fear of stealing things.

Harm: fear of being responsible for something terrible happening (fire, burglary), fear of harming other people by not being careful enough (dropping something on the ground that might cause someone to trip and fall and hurt themselves)

Obsessions related to perfectionism: concern about evenness or exactness, concern with a need to know or remember, fear of losing or forgetting important things when throwing things out, inability to decide whether to keep or discard things, fear of losing things.

Religious obsessions: concern with offending a religious figure or blaspheming, excessive concern with right/wrong or morality.

Other obsessions: concern with getting a physical illness or disease, not through contamination (cancer), superstitious ideas about lucky/unlucky numbers or certain colours.

The obsessions people experience in OCD are unwanted and intrusive thoughts, images or urges that trigger an intense level of distress.

A compulsion is also something that we don’t always represent accurately. Often we think about rituals people have or any repetitive behavior as being a compulsion. Yet, everyone engages in these sorts of things — having a bedtime routine is a ritual. Lifting weights is repetitive behavior. We need to look at what someone is trying to do (the function of the behavior) and when, where and how the behavior happens (the context). If your job is housekeeping at a hotel, spending 8 hours a day cleaning is normal. On the other hand, needing to clean your home for 8 hours a day after a friend comes over, the behavior is problematic. You might have “compulsive” behaviors that you engage in because you are a stickler for details — in this case, it’s a personality trait that you might actually like. The major difference for people with OCD is that they feel driven to do compulsive behavior and would rather not have to do those very time consuming and sometimes embarrassing things. A classic example is hand washing: for someone with OCD who has an obsession with being contaminated, handwashing might take hours out of the day and result in pain, damaged hands and burns from prolonged exposure to hot water. For someone with OCD, they engage in behavior that seems out of context and seemingly without a function. However, they must do these things to escape or reduce the distress and anxiety their obsessions cause.

At Shift, we not only focus on the obsessive-compulsive disorder symptoms, but we uncover the root causes of the disorder. We use a two-pronged approach: First, we introduce cognitive behavioral therapy (CBT), which focuses on better managing symptoms and interrupting the link between the obsession and compulsive behavior. Second, we focus on reprocessing techniques, which create an environment in which we can help you work through not only the obsession itself but experiences over your life that may have reinforced the obsession. Studies of cognitive behavioral therapy (CBT) and reprocessing techniques for OCD show excellent outcomes. In addition to this, we work with all of our clients in a proactive, self-empowering and egalitarian manner. We want to get to the root of the issue as quickly as possible, and give you tools to work through it so you can get back to living your custom built reality! Give us a shout and book in today.

James Murch

Registered Psychologist at Shift Psychological
My speciality areas are substance use issues, obsessive-compulsive disorders (including trichotillomania and excoriation), self-harm behaviours, eating disorders, phobias, anxiety and panic, anger issues, obesity, mood disorders, and personality disorders. I also have extensive experience working with psychosis and bipolar disorder.
James Murch