Obsessive-Compulsive Disorder (OCD)

Obsessive-Compulsive Disorder (OCD) is the experience of obsessions, leading to compulsions. Obsessions are unwanted repeated and intrusive thoughts, urges, or worries that cause mental discomfort. The presence of these obsessions leads to compulsions, which are repeated actions or activities carried out with the aim of reducing the anxiety caused by the obsessions.

Overview

Obsessive-Compulsive Disorder (OCD) is the experience of obsessions, leading to compulsions. Obsessions are unwanted repeated and intrusive thoughts, urges, or worries that cause mental discomfort. The presence of these obsessions leads to compulsions, which are repeated actions or activities carried out with the aim of reducing the anxiety caused by the obsessions.

Causes & Symptoms

Causes of OCD

There is no one exact cause of OCD, but the below factors are theorised to contribute to the development of OCD:

  • A lack of the brain chemical Serotonin.
  • Genetic predisposition, shown in family history of anxiety disorders.
  • Brain activation abnormalities.
  • Experience of trauma, including abuse, neglect and bullying.
  • Recent key or stressful life event.
  • Compulsions can be learnt from parents or carers.
  • High personal standards.
  • Neat and meticulous personality.
  • Anxious temperament.
  • Perceived high level of responsibility.

 

Obsessive-Compulsive Disorder Symptoms

Symptoms of OCD come in two key parts: Obsessions and Compulsions.

What is obsession in OCD?

Obsessions are unwanted thoughts, images, urges or worries that repeatedly appear in the mind. They are intrusive and not controlled and interfere with your thoughts. These obsessions can cause fear, discomfort, anxiety, and sometimes disgust. People sometimes feel that they cannot share their obsessions as they feel like they are wrong to experience. It is important to remember that obsessions do not reflect your personality.

Examples of Obsessions:

  • Fears of initiating or failing to stop harm:
    • For example, worrying you have harmed someone by not being careful enough
  • Intrusive thoughts, images and impulses:
    • Violent thoughts or images
    • Religious or blasphemous thoughts
    • Relationship intrusive thoughts that often appear as doubts about a relationship
    • Sexually intrusive thoughts or images
  • Fears of contamination:
    • Physical contamination (e.g. by germs) or mental contamination (e.g. ‘internal uncleanliness')
  • Associated with order or symmetry:
    • For example you might have a fear that something bad will happen if everything isn't 'right'

People may experience more than one of the types of obsession.

 

What is compulsion in OCD?

Compulsions are repetitive actions or activities that you do to reduce the anxiety caused by the obsessions. Often these behaviours can be time consuming and get in the way of day-to-day life and functionality.

These compulsions can be physical actions, mental rituals or involve a specific number. Sometimes people rationally know that it does not make ‘sense’ to carry out the compulsion but feel scared to not.

Examples of Compulsions:

  • Rituals
    • Arranging objects in a specific way
    • Frequently washing your hands, body or surroundings
    • Touching things in a particular order or at a certain time
  • Checking  
    • Ensuring repeatedly that all doors and windows are locked
    • Checking your body for signs of response to thoughts or for contamination
  • Correcting thoughts   
    • For example, counting to a certain number
    • Repeating a word, name or phrase
    • Drawing out a certain shape
    • Replacing an intrusive thought with a different image
  • Reassurance
    • For example, repetitively asking people if everything is alright

Treatments

The treatments and support we provide

We provide a very comprehensive and holistic range of interventions and support. This means we are able to find the mechanisms for recovery, which will be different for each patient. Everyone will have a highly personalised treatment programme. 

The programme is reviewed every week by the patient’s multi-disciplinary team (MDT), encompassing the different professionals involved in their care. Our MDT consists of: consultant psychiatrist, psychotherapist/psychologist, family therapist and occupational therapist. The MDT is at the centre of our approach, ensuring all the progress made across the programme is understood, built upon and applied. Our model provides consistency and continuity. 

Individual programmes are tailor-made to each patient’s needs and progress. The following provides a guide to the typical building blocks of our day treatment programmes, all of which include a number of weekly 1:1 sessions with members of the MDT.

  Full-day Programme Half-Day Programme
Days  Monday to Friday Monday to Friday
Hours 7 - 8 hours per day 4 - 5 hours per day
Programme length Up to 4 weeks Up to 4 weeks
Detailed group therapy 5 - 6 sessions 3 - 4 sessions
Daily meals Lunch/snacks Lunch/snacks

We provide the following therapies and interventions. These may be delivered on a 1:1 or group basis by members of the MDT.

Psycho-education Cognitive behaviour therapy (CBT) Mindfulness
Relapse prevention Self-esteem / resilience  Movement
Peer Led Support Dialectical Behaviour Therapy (DBT) Food preparation / cooking
Applied relaxation Art / drama Interpersonal therapy
Social issues Family therapy Schema

Treatments are available at the following locations

Schoen Clinic Chelsea

Our Address
Schoen Clinic
Centre for Mental Health Chelsea
13a Radnor Walk
Chelsea
London SW3 4BP
General Telephone Enquiries
0203 146 2300
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Dr James Woolley

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Dr Samantha Cobb

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Dr Niraj Arora

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Dr Werner Kierski

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