Obsessions

Recurrent thoughts, images or urges that can't seem to be shaken off can often be the cause of excessive distress, anxiety or guilt.

Whether it's feeling contaminated from germs, dirt, disease, radiation or something else, the sufferer can often feel compelled to go through excessive cleansing rituals.

A fear of somehow causing accident, injury or misfortune can cause the sufferer to create repetitive rituals that have to be repeated a set number of times (often in multiples) in order to neutralise the threat. A belief that doors have been left unlocked, windows left open or the gas tap left turned on can lead to compulsive checking.

Obsessions can also be concerned with violence, murder, blasphemy or sex, indeed, many sufferers find it difficult to put the nature or process of their obsession into words.

Sufferers will often go to great lengths to avoid situations or activities believed to put them 'at risk'.

Compulsions

These are the actions or rituals which sufferers repeat in order to avoid or reduce discomfort or prevent some feared event occurring. I've mentioned some rituals above and other common ones include:

• Excessive house cleaning
• Repeatedly seeking reassurance that a feared event will not happen
• Counting or repeated touching of objects to prevent disaster
• Arranging or ordering of objects or activities in a particular way
• Repeated questioning of or confessing to others
• Hoarding

Sometimes obsessive thoughts may require rituals to be performed in the mind. Like externalised rituals these ruminations may serve to neutralise unpleasant thoughts or images. A phrase may have to be repeated mentally in order to prevent a specific catastrophe occurring.

OCD sufferers can often feel demoralised or ashamed by their symptoms and behaviours created as reactions to them, and may even become clinically depressed.

There are several recognised conditions which fall within the spectrum of OCD. These include:

• Trichotillomania - the urge to pluck hair or eyebrows
• Hypochondriasis - fear of suffering serious illness
• Body Dismorphic Disorder - a preoccupation with being ugly or having a defect in one's personal appearance
• Tourette's syndrome - involuntary vocal or motor ticks.

Psychological explanations for OCD are often based around feelings of responsibility and an over-inflated sense of personal influence. Biological explanations emphasise a genetic predisposition to anxiety with onset being triggered by stressful life events.

Please be assured that no matter what you may think or feel about your condition you will be heard and treated with respect and of course, in confidence.