Let's Learn About OCD
Before we move on, we have one more anxiety cycle to talk about- The OCD cycle.
Note: OCD is a bit different than other types of “anxiety”. Every kid in this program will most likely have anxiety. But not all of you will have OCD. The information here will only be needed by a few of you!
Obsessive Compulsive Disorder, or OCD, is often misunderstood. It is common for people to think that OCD is just a quirky trait or a preference for staying clean and organized- but this is not what OCD is! OCD involves a cycle that repeats over and over. This cycle can impact many areas of life, and it uses up a lot of time and energy. Here are the steps in the OCD cycle: (View as PDF)
Step #1: Triggers
It all begins with a trigger that brings up an intrusive thought. Intrusive thoughts are upsetting or unwanted ideas, doubts, images, or feelings that pop into someone’s head. A trigger can be almost anything – a person, a situation, a place, or a feeling in your body.
Step #2: Obsessions
It’s normal to have intrusive thoughts! We all experience doubts or unwanted ideas at times. Intrusive thoughts only become a problem once they turn into something called obsessions. Obsessions are intrusive or unwanted thoughts that come up over and over again. For someone with OCD, intrusive thoughts carry a lot more meaning- this makes them feel very threatening, scary, urgent, or important. For most people, intrusive thoughts are just temporary ideas, but in OCD, they turn into something much bigger. When someone gets stuck in the OCD cycle, their intrusive thoughts start to recur and turn into obsessions.
Step #3: Emotions
In OCD, obsessions can bring up a lot of really uncomfortable emotions such as fear, shame, anxiety, or disgust. Another common emotion in OCD is feeling like things are not correct or not just right. This is called having a “not-just-right” experience. For example, when cleaning his room, George has a constant feeling that his bookshelf is not organized just right. This feeling upsets and bugs George a lot.
Step #4: Compulsions
Emotions such as distress, fear, or disgust caused by obsessions can lead to actions called compulsions. Compulsions can be any action someone with OCD uses to try and get rid of these feelings or to stop bad things from happening. Compulsions are usually physical actions, such as washing your hands or checking on your pet over and over, but they can sometimes be in your head too. For example, you might try to block out scary thoughts or replace your “bad” thoughts with “good” ones. You may adjust your thoughts like this over and over again, even if it does not seem to work for very long.
Compulsions are a specific type of quick fix. Compulsions happen much more often than other kinds of quick fixes, and they also tend to come along with the strongest urges. For example, George has a very strong urge to keep organizing his bookshelf, not because he enjoys organizing, but to try and get rid of the upsetting feeling that it is not organized correctly.
Step #5: Temporary Relief
Compulsions provide a short break from upsetting emotions and thoughts, but they also keep the OCD cycle going. When using compulsions, someone with OCD will feel temporary relief, so it makes sense why they would keep using compulsions to try and feel better. But the next time an upsetting thought comes up, they feel like they must repeat the compulsion over and over again to get rid of the uncomfortable thought or feeling. Compulsions end up stopping someone from learning that their unwanted thoughts or doubts do not have to be a big deal. They don’t get to find out that they can face these thoughts and emotions when they give themselves a chance!
You’ll notice that the OCD cycle looks almost exactly like the other two anxiety cycles we have shown you so far. This is because the OCD cycle is a specific version of these other cycles. One difference is that the OCD cycle tends to be faster. Someone can move through the steps in the OCD cycle pretty quickly. This means that the OCD cycle can repeat itself a whole lot of times in just one day.
If you have OCD, or if you feel like you might be dealing with some obsessions or compulsions, then take some time to fill out the Understanding Your OCD worksheet.
Then, take a look at this chart to see some common obsessions and compulsions that can show up in OCD. But keep in mind- there are many other types that are not on this list:
| OCD Type | Common Obsession | Common Compulsion |
| Harm | You are afraid that you might hurt yourself or someone / something else | You may be extra careful that you don’t accidentally hurt yourself or others (Ex. Hiding knives or sharp things) |
| Contamination | You are afraid that germs or harmful substances will hurt or kill you or others | You may wash your hands or surfaces in a specific way or for a specific amount of time |
| Bad Thoughts / Rumination | You can’t stop going over unpleasant thoughts in your head | You might ask people to reassure you that your unpleasant thoughts are wrong or try to avoid thinking about upsetting topics |
| Order & Symmetry | You need things to feel “even” or equal and if they aren’t you are fearful for some reason | You may count your movements or try to do things equally on the right and the left |
| Somatic | You have a fear around normal things your body does, like blinking, swallowing, or breathing | You may count normal bodily functions or check that you are still completing them (Ex. Making sure you are still breathing / breathing correctly) |
| Magical Thinking | You think that your actions are connected to unrelated things that happen to you and other people | You may do certain things the same way every day to make sure that unrelated bad things do not happen to yourself or other people |
| Health | You are afraid that you already have or will develop a serious health issue | You may look up health conditions on the internet and feel convinced you have a condition |
| Other | Obsessions can be about almost any topic that is important to you | Compulsions can be almost any action |
Do any of the thoughts or behaviors on this list seem familiar to you? Are any of these thoughts or behaviors similar to the ones you wrote down on your worksheet? If so, take a quick mental note of this!
OCD can be hard to understand, and it can be even harder to know if it is something you are dealing with or not. If what you have learned about OCD confuses you, or if it seems like OCD is something you could be dealing with, please talk about this with your therapist the next time you meet with them! You can also talk about these things with your parent.