Obsessive compulsive disorder and psychodynamic psychotherapy

Obsessive compulsive disorder (OCD) is a mental health condition consisting of obsessions and compulsions that have a significant impact on a person's life. 

Understanding obsessions and compulsions

Obsessions

Obsessions are unwanted and intrusive thoughts, images, or impulses that repeatedly and persistently intrude into a person’s mind. These thoughts are often distressing and generate anxiety and discomfort. Common examples of obsessions include fear of contamination, worry about order and symmetry, fear of unintentionally harming others, or concern about catastrophic events that might occur.

Compulsions

Compulsions are repetitive behaviours (e.g. washing hands, ordering, checking) or mental acts (e.g. praying, counting, repeating words mentally) that the person feels compelled to perform in response to an obsession or to respond to internal rules which they believe must be rigidly applied. Although compulsions are attempts to manage the anxiety stemming from obsessions, they end up creating a vicious cycle. The act of performing compulsions can temporarily alleviate anxiety, but ultimately, it only serves to reinforce the obsessions, leading to an increase in anxiety and a strong dependence on compulsions to feel better. 

The impact on daily life

Obsessions and compulsions in OCD can cause significant suffering and substantial interference in everyday life, relationships, work activities, and social interactions. In some cases, the person may recognise that the obsessions are products of their own mind and that the compulsions are unreasonable, but feels unable to resist them and bound to carry them out.

4 self-care ways to reduce compulsive behaviours

1. Lead a healthy lifestyle

For example, getting enough good quality sleep, eating healthy food and getting regular exercise. Meditation, yoga and massages can also help ease the stress and reduce anxiety.

2. Mindfulness

Mindfulness can help develop greater awareness of one's thoughts and emotions, which can reduce the meaning and power given to the obsessive thoughts. 

3. Social support

Maintaining positive social relationships and engaging in recreational activities can help with overall good mental health.

4. Self-compassion

Learning to be kind and compassionate with oneself is essential to counteract self-criticism and excessive perfectionism. Practising self-kindness can help reduce guilt and improve self-esteem.

OCD diagnosis and treatment

The first step to getting help for OCD is to speak to the GP who may also refer the patient to a specialist mental health team.

The treatment for OCD varies depending on the cases and their severity and can include psychological therapy, medication, or a combination of both. Medications such as selective serotonin reuptake inhibitors (SSRIs) are prescribed by a doctor (GP or psychiatrist) to help regulate mood and reduce obsessive-compulsive symptoms.

How psychodynamic psychotherapy can help treat OCD

• Gaining greater awareness of one's internal world: Psychodynamic psychotherapy encourages the exploration and understanding of the person's unconscious thoughts, feelings and desires, helping them develop better self-awareness.
• Developing self-acceptance: Through the therapeutic process, the individual can confront and integrate parts of themselves that may have been repressed or considered unacceptable.
• Reducing excessive sense of responsibility and perfectionism: Psychodynamic psychotherapy can help the person better understand the origins of their sense of responsibility and perfectionism and address it in a more balanced way.
• Exploring and understanding interpersonal relationships: Psychodynamic psychotherapy examines unresolved conflicts and symptoms that come from past dysfunctional relationships.
• Understanding one's life history: Psychodynamic psychotherapy aims to explore the subject's past and childhood experiences to better understand the roots of their current disorders.
• General improvement in the person's life: Although psychodynamic psychotherapy cannot guarantee the complete disappearance of symptoms, it can lead to significant improvement in the individual's quality of life, increasing their confidence, reducing feelings of alienation, and enhancing their capacity for personal fulfilment.

When a team approach is needed, I work in conjunction with GPs, psychiatrists and other professionals to best support my client.