OCD is known as obsessive-compulsive disorder. It has two components. Obsessions are thoughts, and compulsions are behaviours. Compulsions follow obsessions. Compulsions do not exist on their own. They follow obsessions. First, there is an intrusive thought. This is an obsessive thought. A trigger usually brings this on. However, the trigger is not the cause of the discomfort. The obsessional thought, which is in the form of doubt or repeated “what if” questions, is the cause of the anxiety and discomfort.
There are three components of an obsession: Trigger, Intrusive thought, and Discomfort due to anxiety.
For example, the trigger is a door. When a person, Mr X, looks at a door, he gets triggered. He immediately remembers his door at home, which he had locked, and came out. He then gets an intrusive doubt about whether he had really locked the door; what if there was dirt inside the lock, leading it to be unlocked? Then he starts getting discomfort that thieves may break in and steal all the belongings. They may even destroy or take away his laptop. He will be broke as he has to replace the goods. This leads to him going back home to check the locks. He is not satisfied by just checking it once. He has to check it repeatedly 5 to 6 times.
Now, let’s think of the sequence of obsessive thoughts and compulsions. We can see that it is first a Trigger (internal or external), then an intrusive thought, followed by discomfort/anxiety, and then a compulsion (mental or behavioural).
For now, if you have any intrusive thoughts, you can journal identifying the triggers, the thoughts, discomfort and the compulsions.
How can you identify triggers?
Write down the situation, thoughts, images, and memories you want to avoid.
What are the situations that cause you to experience thoughts with doubts?
What are the situations where you are compelled to perform rituals?
When do you seek reassurance?
How can you identify obsessional thoughts?
Recognise the thoughts that keep entering your mind that you want to resist or avoid.
Recognise the thoughts that make you anxious about acting the way you want to avoid.
Recognise sticky thoughts.
Discomfort
Note down the feelings of anxiety and discomfort that you feel with the intrusive thoughts.
Compulsive rituals
Identify any repetitive pattern that you have to perform to reduce the discomfort.
What neutralising thoughts do you use?
It is easy to believe that rituals will completely take away the discomfort of obsessive thoughts. But this is not true. Compulsive rituals (mental and behavioural rituals) will provide short-term anxiety relief. However, over a period of time, it will serve to make the thoughts followed by rituals stronger.
The same pattern will be observed in avoidance and reassurance of obsessive thoughts.
The aim of this blog is for you to understand the sequence of obsessive thoughts.
The pattern starts with triggers, followed by thoughts, discomfort and then compulsion. Avoidance and reassurance also serve to act like compulsions.
In the next few weeks, you can maintain a log of your symptoms to identify the sequence of patterns.
