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Obsessive Compulsive Disorder is a frightening anxiety disorder and before we attempt to look at the types of treatments used and their effectiveness it is important that we have an understanding of the basic theories behind the disorder As its name suggests in obsessive-compulsive disorder OCD the profound sense of anxiety is reflected in obsessions and compulsions Obsessions are recurrent thoughts or images that do not feel voluntarily controlled and are experienced as senseless or repugnant Compulsions are irresistible urges to engage in repetitive behaviours which are performed according to rituals or rules as a way of reducing or preventing the discomfort associated with some future undesirable event As Tallis 1994 has remarked OCD has undergone a dramatic change in status over the last decade Whilst it was once regarded as a rare example of the neuroses it now occupies a central position in clinical psychology and contemporary psychiatry In America OCD is the fourth most common disorder and in the UK an estimated one to one and a half million people suffer from it OCD affects slightly more females than males and it usually begins in early adulthood Frequently the obsessive thoughts take the form of violent images such as killing oneself or others However such thoughts can take other forms According to Sanavio 1988 the four most common obsessional characteristics are impaired control over mental processes such as repetitive thoughts of the death of a loved one concern over losing control over motor behaviours such as killing someone contamination being contaminated by for example germs and checking behaviours such as concern over whether a door has been locked Whatever form they take such thoughts cannot be resisted and provide no joy to the sufferer Often a compulsion arises from an obsession A person for example who persistently worries about contamination by germs may develop complex rituals for avoiding contamination and these may be repeated until the person is satisfied that cleanliness has been
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