Obsessional Compulsive Disorder (OCD) is regarded as a common anxiety disorder estimated
to affect between 0.05 and 3% of the general population. In its more severe forms
it is an extremely debilitating disorder affecting the sufferer in all aspects of
The age of onset varies but is generally between 6 – 15 years for males and 20 –
29 years for females.
Obsessions are persistent intrusive thoughts, impulses, ideas or images which are
perceived as inappropriate and cause marked anxiety, distress and/or discomfort.
These obsessions are 'ego-dystonic' which refers to the nature of the intrusions
as being not within the person's own control and alien to their usual pattern of
The most common obsessions are related to repetitive intrusive thoughts regarding
contamination of self or others, doubts, aggressive and/or horrific impulses and
sexual thoughts and/or imagery.
These intrusions are not simply excessive worries about real-life problems, nor are
they likely to be related to a real-life problem (see Generalised Anxiety Disorder).
Also the sufferer usually attempts to block or control these intrusions or to replace
(neutralise) them with some other thought or behaviour.
The Cognitive Behavioural Therapist will work with the sufferer to discover the maintaining
factors of the presenting problem and collaboratively construct an idiosyncratic
formulation of the problem.
Following this an individual treatment regimen will be constructed and guided by
Depending on the presentation and formulation, a number of techniques will be employed,
such as the well-established and evaluated Exposure & Response Prevention (ER/P),
which has been shown to produce positive results in up to 70% or more of patients,
to a combination of cognitive techniques including; Verbal Reattribution, Detached
Mindfulness, Challenging of Fundamental Beliefs and Appraisals regarding responsibility
(however one must take care that
this does not become assimilated into the repertoire of safety behaviours), Thought
Action/Event Diffusion and Behavioural Experimentation.
Those who improve with treatment are typically able to maintain their gains at follow
ups of between 1 to 5 years.