All About OCD: What It Is, Who It Affects, and How It Can Be Treated

Have you ever felt that something in your environment was not quite right?

Maybe you’ve been lying in bed at night and started to wonder if you locked the front door after coming home or turned off the oven after cooking dinner. Perhaps you’ve felt a bit dirty after engaging in a physical activity and decided to wash your hands or take a shower. Or maybe you’ve noticed that your home has become disordered and spent a few hours tidying up.

If you’ve ever experienced a situation like one of these, then you know that they generally produce a mild amount of anxiety. This anxiety usually isn’t too troubling. It draws our attention to some situation that might be unsafe for us, and it motivates us to fix the unsafe situation. Then, having served its purpose, the anxiety subsides.

However, sometimes a person can have a very strong, exaggerated anxiety response to everyday situations like the ones we’ve described. This is precisely what people who have obsessive-compulsive disorder, also known as OCD, experience on a daily basis.

OCD is an anxiety disorder characterized by intrusive thoughts that cause anxiety and repetitive behaviors that a person performs to reduce this anxiety. It’s estimated that 1 in 100 adults and 1 in 200 children live with OCD in the United States. However, the ongoing COVID-19 pandemic has worsened the symptoms of many people living with OCD, which makes this disorder especially important to discuss right now.

In this blog post, we’ll explain the basics of obsessive-compulsive disorder, including how it works, who is susceptible to it, and how it can be treated. We’ll also include some thoughts and insights about OCD from our Chief Clinical Officer, Robb Enlow. We hope this information will help you know what you can do if you or someone you know is suffering from obsessive-compulsive disorder.

What Is OCD?

As we explained above, OCD is a disorder characterized by intrusive anxiety and behaviors that help to manage that anxiety. However, we can deepen our understanding of OCD by breaking down its name.

Robb explains, “Obsessive-compulsive disorder is a condition that involves a pattern of unwanted, unhelpful thinking that is driven by anxiety, called an obsession. For many, that obsession also involves a burdensome behavior that attempts to reduce the anxiety in repeated and time-consuming ways, called a compulsion.”

Most people have troubling thoughts and feelings of anxiety from time to time. However, people who have OCD tend to feel anxious much more frequently and for reasons that seem unnecessary or excessive to others. Both obsessions and obsessive-compulsive patterns become very difficult to stop and interfere with the person’s ability to function and feel internally safe,” Robb adds.

Many people who have OCD first experience symptoms in childhood, with most being diagnosed by age 19. The disorder tends to be equally prevalent among women and men and across different races and ethnicities. Although the causes of OCD are still unknown, it does appear to have a genetic component, as individuals with a parent or sibling who has OCD are more likely of developing OCD themselves.

What Does OCD Look Like?

OCD can be easier to understand if we also look at some of the ways it commonly presents itself. Specific obsessions and compulsions vary from person to person, but they do tend to fall into some commonly identifiable categories.

For example, some common obsessions among people with OCD include:

  • Fear of germs, dirt, illness, or contamination
  • A desire for items to be arranged in a specific way, such as symmetrically or at right angles
  • A desire for actions to be performed in a certain predetermined order
  • Fear of lacking a certain item when it is needed
  • Aggressive thoughts or urges to harm oneself or others
  • Unwanted and unpleasant sexual thoughts and urges

Some common compulsive behaviors in response to these obsessions include:

  • Excessive cleaning, bathing, or handwashing
  • Arranging and ordering items in a very precise way
  • Repeatedly “checking” things, such as checking to see that the door is locked or the oven is turned off
  • Counting and re-counting objects or actions
  • Hoarding items
  • “Mental checking” for intrusive, unwanted thoughts

As we mentioned above, the COVID-19 pandemic has only worsened obsessions and compulsions for some people with OCD, especially those whose anxiety revolves around sickness and contamination. Robb explains,

“At its core, OCD is about anxiety and one’s sense of safety, wellbeing, and balance, as problematic thought and behavior patterns organize safety for the individual in a world that is perceived as having dangers. COVID presents the world with legitimate dangers that make it imperative for us all to stay safe and healthy. For example, an individual with OCD who is concerned about germs and contamination repeatedly washes their hands; to them, COVID now gives something ‘legitimate’ to obsess about, and they increase handwashing behavior to attempt to relieve the distress. We all have been told to hand wash more frequently, but the individual with OCD perceives the impact with amplified distress, as there is no doubt to the dangers of COVID contamination. And for many, increased safety behaviors and rituals actually maintain that distressing anxiety instead of quenching it.”

How Can OCD Be Treated?

Obsessive-compulsive disorder can greatly impact an individual’s quality of life, and there is currently no cure for the condition. However, there are several forms of treatment that can help a person manage their troubling thoughts and behaviors.

“OCD can be treated with behavioral, cognitive, and sometimes medication-based treatments,” Robb explains. “Successful treatments allow individuals the ability to examine their thoughts and behaviors in a safe environment.”

For example, cognitive behavior therapy (or CBT) is one of the most common forms of treatment for OCD. This type of therapy helps a person learn to recognize their obsessive thoughts and resolve their anxiety without engaging in a compulsive behavior. A specialized type of CBT called Exposure and Response Prevention may also be used, which involves controlled exposure to situations that trigger compulsions in order to help a person become desensitized to these triggers.

“Learning cognitive-behavioral strategies, such as thought-stopping techniques and grounding techniques, helps many people gain control of patterns that seem to run against their will,” Robb adds. “Other treatments, such as Internal Family Systems, involve exploring how the mind and body seek safety by developing patterns of functioning intended to safeguard their self from underlying exiled feelings.”

If cognitive and behavioral therapies are not effective at reducing symptoms, a person might also be prescribed medication. Certain medications known as serotonin reuptake inhibitors (SRIs) and selective serotonin reuptake inhibitors (SSRIs) can help reduce the intensity of obsessive thoughts and compulsive urges. In very specific cases, antipsychotic medications have also been shown to help certain people.

Finally, in cases where traditional therapies and medications do not achieve the desired results, several “add-on” treatments may be considered. One of these is transcranial magnetic stimulation (or TMS), which uses magnetic fields to stimulate specific nerve cells in the brain.

Although it is less common than other mental health disorders like depression and generalized anxiety, obsessive-compulsive disorder still affects the lives of 3–4 million people in the United States alone. Although this disorder is long-lasting and can greatly impact a person’s quality of life, it is also treatable through therapy and medication. With the appropriate treatment, and individual with OCD can learn to live a full and rewarding life despite their challenges with obsessive thoughts and compulsive behaviors.

If you would like to speak to a mental health professional about receiving treatment for OCD, we invite you to call us at (888) 714-1927. With the right help, you or your loved one can recover from OCD and take back control of your life.

HOPE for Youth Who Engage in Harmful Sexual Behavior: Understanding the Problem

Children tend to hold a special place in our hearts and minds.

In an objective sense, children are simply young human beings, but they are also so much more than that. Often, children represent the best parts of humanity. They are curious and creative. They are honest and welcoming toward others. And in the eyes of many, they seem innocent and pure. They remind us how good people can be before they are corrupted by harmful emotions, desires, and outside influences.

It is perhaps for these reasons that sexuality and sexual development are carefully scrutinized among children and teens. Society tends to have strong opinions regarding which expressions of sexuality are acceptable at which ages, and youth who engage in sexual behavior “too soon” are often heavily stigmatized.

These social pressures can be useful for guiding youth through their developing sexuality, which comes with risks they may be too young to understand. However, severe stigma can be detrimental if it prevents youth from receiving help for sexual development issues.

In particular, some children and teens suffer from a tendency to engage in harmful sexual behaviors. These behaviors may be subconsciously learned from a variety of sources, and they can be highly damaging to the youth, their peers, and their loved ones. However, these behaviors can be corrected, and youth can learn to express their sexuality in healthy, age-appropriate ways if they receive help from behavioral health care professionals.

Cummins Behavioral Health will soon begin offering a program designed specifically for youth who engage in harmful sexual behavior. The program, called “Healing for Optimal living through Protective factors and Education” (or HOPE), will help youth understand what constitutes healthy sexual behavior and change their actions accordingly. This sort of intervention can drastically change the course of an individual’s life, leading them away from destructive behaviors and toward healthier, safer ways of living.

Ashlee Prewitt, our Director of Specialty Programs, is the driving force behind our new HOPE program. In this blog post, she explains more about harmful sexual behaviors among youth, including what drives them, how they get started, and why stigma is dangerous to a youth’s treatment and recovery.

Ashlee Prewitt
Ashlee Prewitt, LMHC, CSAYC, Director of Specialty Programs at Cummins Behavioral Health

Defining Harmful Sexual Behavior and “Reactive” Sexual Behavior

The first step in understanding and correcting harmful sexual behavior is knowing what this behavior looks like.

First, we should clarify what makes this behavior harmful. In the simplest sense, harmful behavior is behavior that has negative ramifications for the person performing the behavior, another person or persons who become involved in the behavior, or both. The negative ramifications could include physical harm, emotional or psychological harm, or even legal consequences. Even if the negative effects are relatively mild, a behavior can still be harmful if it impedes a person’s daily functioning in some way.

“These behaviors are sexual in nature, and what it comes down to is: there is an inadequate adjustment or inappropriate response to the environment or stimuli that manifests sexually,” Ashlee explains. “This could be sending naked pictures of themselves to peers. This could be excessive pornography viewing. And it can go all the way up to hands-on offenses like sexual molestation and assault.”

It’s important to note that some of these harmful behaviors may be what are called “reactive behaviors.” This means that the behavior occurs in response to an event or stimulus without much conscious thought. For example, think about the decision you make to take a drink of water when you feel thirsty, or your decision to say “excuse me” after sneezing.

Reactive behaviors are behaviors that are learned, one way or another, as the normal response to certain environmental triggers. Many harmful sexual behaviors can be reactive in nature, meaning that the youth may not even realize they’re doing something wrong. Ashlee explains,

“If something is an immediate trigger, it is going to change a person’s thought patterns. Both intrigue and emotionality are going to be escalated, and so now, because of that escalation, something is going to happen. It’s kind of a cause and effect situation. In this case, triggers could be being sexually aroused, either because of puberty or through an external stimuli, such as seeing other people engaged in public displays of affection. That can absolutely trigger an increased sexual urge, which makes the youth want to do something to satisfy that sexual urge. That may be sending nude pictures. That may be excessive porn watching. That may be touching a peer or a younger sibling in a sexual way.”

How Harmful Sexual Behaviors Get Started

As we’ve said, most youth who engage in these harmful behaviors don’t realize they are harmful at all. On the contrary, their experience has led them to believe that these behaviors are normal. How is it that this happens?

In some cases, a history of trauma or abuse may be to blame. “Sexual abuse, neglect, and physical abuse are risk factors to starting the pathway to engage in some of these behaviors,” Ashlee says. “Youth may see these maladaptive patterns within their abuser, and if they’re not taught how to handle emotions, or sexual urges, or the trauma that they’ve experienced, they may be one decision away from engaging in these unhealthy behaviors.”

If a child has been the victim of sexual abuse in particular, they might develop a skewed perception of love, intimacy and sexuality. “That is the groundwork, that is the example, whether it’s, ‘I have been sexually abused, and now, in my brain, this is how I show love,’ or, ‘In my brain, this is how I have power and control,’ “ Ashlee explains.

However, past trauma is not the only factor that can lead youth to engage in harmful sexual behavior. For example, Ashlee notes that there can also be a variety of societal influences. “I would love to say that society doesn’t play a part in it, but it does,” she says. “Sex and sexual behaviors are often reinforced, so youth get the idea that this is normal, everybody else is doing it. So until there is that moment of, ‘Oh, no, I can’t actually do this, this is not OK,’ there are times where they operate under that impression.”

Ashlee also points out that these behaviors, although inappropriate and ultimately harmful, are usually undertaken in an attempt to fulfill the youth’s basic needs. Although we condemn the behavior, we must also recognize that the youth is simply misguided, not malicious. Ashlee explains,

“We do a lot of education around the five basic needs and how behavior is a response to try to meet the five basic needs that every human has. The five basic needs come from a psychiatrist named William Glasser, and they are love and belonging, power and control, fun, freedom, and survival. And the idea is that all behavior comes from a desire to meet those needs. So with these individuals, they’re seeking to meet those needs through that sexual component. Let’s take love and belonging for example. They want to feel that connection to other people, so they engage in behaviors that society, or porn viewing, or whatever it may be has shown them, ‘This is how we connect with people.’ So they seek it out in a way that is not beneficial or healthy.”

How Stigma Prevents Youth from Getting Help

Earlier, we mentioned that stigma can be a problem for youth who engage in harmful sexual behaviors.

On the one hand, this stigma is somewhat understandable. After all, behavior that is harmful toward other people is never acceptable, and it’s difficult to reconcile the innocence of youth with harmful sexual behavior. “People don’t want to go there, because I’m looking at a child, and how can I handle this child hurting another child and still see them the same way?” Ashlee says.

Parents or guardians of youth may also seek to minimize these behaviors so as not to feel guilty or at fault for bad parenting. “There’s the stigma of, ‘My kid engaged in sexually harmful reactive behaviors. I’m a horrible parent. Let me just ignore it so that I don’t have to deal with it.’ Or, you know, the ‘boys will be boys’ mentality, or, ‘Oh, they’re just kids, they don’t know what they’re doing,’ “ Ashlee explains.

However, seeking to ignore these problem behaviors always causes more harm than good, because youth are unlikely to change their behavior by themselves. Therefore, they will likely continue to cause harm to themselves and others for far longer than is necessary. “When we minimize it, we hurt the population, and we hurt the people who need help,” Ashlee says.

The good news is that these behaviors can be corrected with treatment from mental health professionals. “When treatment is followed, these kids have about a 4% recidivism rate, meaning they don’t re-engage in these behaviors after they go through treatment,” Ashlee says.

It can be difficult to admit when a child or teen under our care has a behavioral problem, especially when it’s in an area as stigmatized as harmful sexual behavior. However, ignoring the issue only causes more harm. Youth deserve help overcoming these behavioral challenges, and with the proper treatment, they can learn to express their sexuality in ways that are healthy for both themselves and their peers.

In part two of our blog series on our new “HOPE” program, we dive deeper into the treatment itself, explaining what it entails and how it works. Click here to read more!