Obsessions are thoughts, images or urges that do not go away. They are unwanted and cause a great distress.
A person with OCD is experiencing repetitive, intrusive and unwanted thoughts that cause distress. An example of intrusive thoughts are thoughts of contamination. This is when a person fears coming into contact with germs and that germs will cause them harm in any way, make them sick. At times a person obsesses that either themselves or other people may die as a result of them transferring germs onto them or onto objects around them. The obsessions are like intrusive voices in a person's mind that tell them that they might get sick if they touch the door knob or use the public toilet. It can be hard to talk yourself out of the OCD type of obsession. The likelihood of serious illness and death from touching the door knob might be minimal but a person with OCD thinks that they cannot take that chance.
Everyone has strange, unusual or even disturbing thoughts that pop up from time to time. Most people will not be bothered by these thoughts. For a person with OCD these thoughts are very distressing and interferes with their activities.
Contamination obsessions revolve around fear of getting sick and eventually dying from germs. A person with OCD might also experience obsessions about the safety of their home and people around them. Obsessive thoughts tell a person that if they don’t check the front door someone will burglarize their house. They might worry that if they don’t keep the windows locked someone will come and take their children away (even if they live on the second floor). These obsessions are centred around safety of their home and people inside their house.
Another type of obsessive thoughts are symmetry obsessions. A person who experiences symmetry obsessions becomes fixated on position and arrangements of objects around them. It makes them feel uncomfortable when items are not arranged in a certain way. Even though we call these obsessions symmetry obsessions they evolve around the broader idea of ‘sameness’. A person often obsesses about having the same experience of doing something in comparison to the experience they had in the past. The intrusive thoughts they might experience: ‘Did I enjoy it? ‘Did it feel the same as last time when I did that?'
A person with OCD might experience obsessions about having harmed someone without knowing or obsession that they may harm someone. A person has thoughts that they may lose control and impulsively harm someone. Unwanted sexual thoughts and religious obsessions are also one of the themes of intrusive thoughts. Religious thoughts are centred around the fear of offending God or breaking the moral compass. Some people experience intrusive sexual thoughts focused on others or thoughts about their own sexual orientation.
Obsessions are not only in the form of thoughts but also images and urges. A person with OCD usually has few types of obsessions. Moreover, obsession themes can also change over time. A person with OCD feels they have to take action, whether it is mental or in the form of doing something, to prevent a disaster from becoming reality. Despite realisation that their fears are often not rational they cannot talk themselves out of it and have to act on their compulsions. In the next article in the OCD series we will explain what compulsions are.
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