Obsessive-Compulsive Disorder

OCD was classified as an anxiety disorder due to the sometimes,

extreme anxiety that people experience. Certain disorders characterized
by repetitive thoughts and/or behavior, such as OCD.
 Repetitive Behaviors Of Various Types:

SELF-SOOTHING REWARD-SEEKING DISORDERS OF BODY

BEHAVIORS BEHAVIORS APPEARANCE OR
FUNCTION
• Trichotillomania • Hoarding • Dysmorphic disorder
• Dermatillomania • Kleptomania
(BDD)
• Onychophagia • Pyromania
• Oniomania
Obsessions
• Recurrent
• Persistent
• Intrusive
• Unwanted thoughts
• Images
• Impulses that cause marked anxiety and
interfere with interpersonal, social, or
occupational function
 Compulsion
ritualistic or repetitive behaviors or mental acts that a person carries out
continuously in an attempt to neutralize anxiety.

THEME OF RITUALS

• Repetitive hand washing, obsessed with contamination

• Repeated prayers or confessions
• Checking rituals
• Washing and scrubbing until the skin is raw
• Praying or chanting
• Touching, rubbing, or taping
• Exhibiting rigid performance
 Compulsion
ritualistic or repetitive behaviors or mental acts that a person carries out
continuously in an attempt to neutralize anxiety.

FOR EXAMPLE:

• A man who can no longer work because he spends most of his day
aligning and realigning all the items in his apartment
• Or, a woman who feels compelled to wash her hands after touching any
object or person.
ONSET

• Starts in childhood (especially in males, in females it more commonly

begins in 20s)
• Females in their 20s
• Overall distribution between the sexes are equal

Compulsion
Related Disorders
Excoriation disorder, skin-picking, also known as Dermatillomania, is
categorized as self-soothing behavior. The behavior is an attempt of people to
soothe or comfort themselves, not that picking itself is necessary a positive
sensation.

ALTERNATIVE THERAPIES
• Yoga
• Acupuncture
• Biofeedback
 Trichotillomania, chronic hair-pulling, a self-soothing behavior that can
cause distress and functional impairment.
Related Disorders
ONSET

• Common in childhood

OCCURS

• More in females than in males

BDD, a preoccupation with an imagined or slight defect in physical
appearance that causes significant distress for the individual and interferes
with functioning in daily life.
• Elective cosmetic surgery is sought repeatedly to “fix the flaw”
• TX: SSRIs
Related Disorders
Hoarding disorder, progressive debilitating, compulsive disorder only
recently diagnosed on its own.

OCCURS

• Between the ages of 20 to 30

• More in females than in males

TREATMENT
• Medications, CBT
 Onychophagia, chronic nail-biting, is a self-soothing behavior.
Related Disorders
OCCURS

• Childhood with a decrease in behavior by age 18

Kleptomania, compulsive stealing, is a reward-seeking behavior. The

pleasure is not the stolen item, but rather the thrill of stealing and not getting
caught.

ONSET

• Most common in females with frequent comorbid

diagnoses (depression, substance use)
 Oniomania, compulsive buying, is an acquisition type of reward-seeking
behavior.
Related Disorders
ONSET

• 80% of compulsive buyers are females in their early

20s
Body identity integrity disorder, the term given to people who feel
“overcomplete”, or alienated from a part of their body and desire amputation.

• Also known as amputee identity disorder and apotemnophilia or

“amputation love”.
• Describes: feelings of anguih and distress with their intact bodies
and report feeling “naural, like they were intended to be” after an
amputation.
Interventions
• Offer encouragement, support, and compassion.
• Be clear with the client that you believe he or she can change.
• Encourage the client to talk about feelings, obsessions, and rituals in detail.
• Gradually decrease time for the client to carry out ritualistic behaviors.
• Assist the client in using exposure and response prevention behavioral
techniques.
• Encourage the client to use techniques to manage and tolerate anxiety
responses.
• Assist the client in completing daily routine and activities within agreed-upon
time limits.
• Encourage the client to develop and follow a written schedule
Interventions

FOR CLIENTS
FAMILIES
Teach about
• Avoid givingOCD.
advice such as, “Just think of something else.”
Reviewtrying
• Avoid the importance of talkingthat
to fix the problem; openly
neverabout obsessions, compulsions, and
works.
• anxiety.
Be patient with your family member’s discomfort.
•• Emphasize medication compliance as an important part of treatment.
Monitor your own anxiety level, and take a break from the situation if you
• Discuss
need to. necessary behavioral techniques for managing anxiety and decreasing
prominence of obsessions.
• Tolerating anxiety is uncomfortable but not harmful to health or well- being.
Providing Client and Family Education
• It is important for both the client and family to learn about OCD.
• They are often relieved to find the client is not “going crazy” and that the
obsessions are unwanted, rather than a reflection of any “dark side” to the
client’s personality.
• Helping the client and family talk openly about the obsessions, anxiety, and
rituals eliminates the client’s need to keep these things secret and to carry the
guilty burden alone.
• Family members can also give the client needed emotional support when they
are fully informed.
• Teaching about the importance of medication compliance to combat OCD is
essential.
• The client may need to try different medications until his or her response is
satisfactory.
• The chances for improved OCD symptoms are enhanced when the client
takes medication and uses behavioral techniques.
 Community-Based Care Treatment
• involves both medication and CBT, as discussed in “Treatment” section. The
therapist or treatment team can teach the client exposure and response
prevention techniques, but the client will need to continue to practice those
techniques at home in the community over an extended time. Successful
outcomes of treatment require consistent use of the techniques on a daily
basis.
Points to Consider
• When clients experience severe symptoms of OCD, they are usually not able
to change their patterns of thinking and behavior without treatment and
assistance from professionals.
• As with any chronic illness, clients with OCD will have stressful periods that
may increase symptoms and necessitate professional support and assistance.
• It is not beneficial to tell the client that his or her thoughts and rituals
interfere with life or that the ritual actions really have no lasting effect.
Thank you!