Obsessive Compulsive Disorder – More common than you think An REBT/CBT approach

Obsessive–Compulsive Disorder (OCD) is a serious anxiety-related condition where a person experiences frequent intrusive and unwelcome obsessional thoughts, often followed by repetitive compulsions, impulses or urges.

The illness affects as many as 12 in every 1000 people (1.2% of the population) from young children to adults, regardless of gender or social or cultural background. In fact, it can be so debilitating and disabling that the World Health Organisation (WHO) has actually ranked OCD in the top ten of the most disabling illnesses of any kind, in terms of lost earnings and diminished quality of life.

Based on current estimates for the UK population, there are potentially around 741,504 people living with OCD at any one time.   But it is worth noting that a disproportionately high number, 50% of all these cases, will fall into the severe category, with less than a quarter being classed as mild cases.
In general, OCD sufferers experience obsessions which take the form of persistent and uncontrollable thoughts, images, impulses, worries, fears or doubts. They are often intrusive, unwanted, disturbing, significantly interfere with the ability to function on a day-to-day basis as they are incredibly difficult to ignore. People with OCD often realise that their obsessional thoughts are irrational, but they believe the only way to relieve the anxiety caused by them is to perform compulsive behaviours, often to prevent perceived harm happening to themselves or, more often than not, to a loved one.

Compulsions are repetitive physical behaviours and actions or mental thought rituals that are performed over and over again in an attempt to relieve the anxiety caused by the obsessional thoughts.  Avoidance of places or situations to prevent triggering these obsessive thoughts is also considered to be a compulsion. But unfortunately, any relief that the compulsive behaviours provide is only temporary and short lived, and often reinforces the original obsession, creating a gradual worsening cycle of the OCD.
Common obsessions and compulsions include:

  • Feeling unclean or contaminated and being afraid of germs
  • Wanting to keep washing your hands or other things
  • Thinking something is bad is going to happen to you
  • Thinking something bad is going to happen to someone you love
  • Feeling that you might hurt someone – even though this is the last thing you want to do
  • Thinking violent/sexual thoughts or that you will say something awful out loud
  • Counting things endlessly in your head
  • Checking things (like doors, taps and light switches) over and over again
  • Putting things in a particular order and arranging objects
  • Being scared about throwing things away

For many people with OCD there is often an over inflated sense of responsibility to prevent harm and an over-estimation about the perceived threat that an intrusive thought signifies. It is these factors that help drive the compulsive behaviours, because the person with OCD often feels ultimately responsible for trying to prevent bad things happening.

OCD is diagnosed when the obsessions and compulsions:
Consume excessive amounts of time (approximately an hour or more)
Cause significant distress and anguish
Interfere with daily functioning at home, school or work, including social activities and family life and relationships.

OCD sufferers tend to have a need for certainty but it is not clear whether biological deficiencies create this ‘need’ and/or block individuals from interrupting and giving up this ‘need’, when they see that it is not doing them any good. Albert Ellis holds the view that both biological and psychological make up play a part.

Looking at Ellis’s ABC Model, we can see how this can be applied to OCD



A = You leave home and have the thought ‘Did I lock the door?’ and you believe
B = ‘I MUST be 100% certain and have absolutely no doubt that I locked the door, I can’t stand it not being 100% sure and free of doubt.
C = Anxiety/Panic (Unhealthy negative emotion)

On the other hand if you think healthily at
B = ‘I’d like to be 100% certain but I don’t have to be, I can stand uncertainty. I have checked once already. It’s frustrating to have a doubt but I can stand it.
C = Concern (healthy negative emotion)

Since unhealthy beliefs are usually about life’s adversities and handicaps e.g.” I hate failing and therefore I must not fail”, and because OCD itself is a handicap, sufferers usually have a severe problems about their OCD and their other life problems.

  • Due to social disapproval and due to their own disapproval, OCD sufferers frequently put themselves down, depress themselves and make themselves anxious about other failures and disapprovals. Such self damning stems from unhealthy beliefs such as ‘I must not be as disapproved of as I am; I’m no good for bringing on this disapproval. If I can’t function better than I do, I am a worthless person’.
  • OCD sufferers tend to have regular self damning and low frustrations tolerance about other challenges and hassles in their lives.

REBT/CBT teaches how thoughts, feelings and actions are connected. The most important part of REBT/CBT is learning how to stop carrying our compulsions even when you feel anxious. Using REBT/CBT, clients can increase their frustration tolerance and be more ready to accept themselves and the good news about OCD is that it does respond well to treatment.

REBT (Rational Emotive Behaviour Therapy) was developed by Albert Ellis. It is an evidence based, trans-diagnostic and philosophic CBT model.

OCD Awareness Week October 9 – 15, 2014

Our next workshop for members of The National Hypnotherapy Society and The National Counselling Society is on the 15th November in Sheffield. To book please contact: Email support@nationalhypnotherapysociety.org or

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