People who have obsessive-compulsive disorder (OCD) have obsessions, compulsions or both which are time-consuming, distressing and/or impair their functioning.
Obsessions are recurrent, intrusive thoughts, images or impulses that generally cause anxiety or distress. Some common obsessions among people who have OCD involve becoming contaminated by germs or substances, harming others in some fashion, or being harmed themselves.
Compulsions are repetitive behaviors or mental operations that the individual feels driven to perform in response to an obsession or according to rigid rules. They are aimed at reducing anxiety/distress or preventing a dreaded occurrence, but cannot realistically do so or are clearly excessive.
The most researched and established therapy for OCD is cognitive-behavioral therapy that employs a method called exposure/response-prevention (ERP). The therapist and client make a list of stimuli related to the client’s main obsessions that usually range from mildly to severely disturbing to the client. In subsequent sessions the client is exposed for a prolonged time to an item from this list but is not allowed to employ the compulsion that is usually used to reduce the discomfort from the obsession. Instead, by the process of habituation during the passage of time, the discomfort declines without the use of a compulsion.
For example, a client who compulsively washes his/her hands might be asked to touch or hold something s/he irrationally regards as “dirty,” but would not wash his/her hands. The ERP tasks are repeated at home and during therapy sessions until the discomfort provoked by the items on the list is reduced, and the client is able to tolerate the discomfort without engaging in a compulsive ritual.
I was trained in this approach to treating OCD by Edna Foa, Ph.D., one of the principal researchers and trainers in this area, and have used it successfully with child and adult clients with many different obsessions and compulsions.