I spend much of my time as a therapist helping people who have Intrusive Thoughts, where a person obsesses over something, often an irrational thought, to the point that it can paralyze them from getting anything meaningful done for hours if not days.

For some, the focus of their thoughts is on some health issue, and most often not an actual physical issue they are dealing with but one they fear might arise. Every ache or pain triggers the fear of something more serious lurking around the corner.

Others find themselves spending vast amounts of their energy avoiding germs, not necessarily because they have had some disease, but they experience this urge, this unexplainable need to wash their hands repeatedly, or to shower multiple times before they feel comfortable enough to move on.

Still others find themselves checking their work over and over for fear that there is something they are missing that could lead to a disaster, failure or rejection.

A person can find himself obsessing over anything and then compulsively needing to carry out some repetitive behavior like checking, reorganizing and repeating some behavior while his day is passing him by. The nature of the thoughts and the resulting rituals know no boundaries, but they can be paralyzing.

If you have not experienced a form of obsessive-compulsive behavior, you may think it odd that others do. Certainly, some individuals who do find themselves trapped in the endless pattern of obsessing and carrying out rituals are the butt of jokes and sitcoms. But the reality is, many people suffer from this anxiety disorder and it is quite emotionally painful.

Having had a turn at obsessive-compulsive behaviors of my own,  I enjoy working with these individuals in therapy, because I understand them. Of course I find them intelligent and truly wanting to find an avenue to control their thoughts and rituals. They are most often driven to find answers. There are most often sensitive, empathetic, adapting and caring people.

But what I also find is that they are people who have experienced emotional  conflicts in their lives, where they are caught between doing what they feel they should, what is expected of them versus doing what they want, what is personally satisfying. It might be a child  experiencing her first taste of rejection at the hands of a new student that she attempted to befriend, only to find the new friend bad-talking her to others. It might be an adolescent experiencing normal sexual urges but also being sensitive to what he has been taught about being responsible and respectful, what is right and wrong. Does he follow his basic urges, does he experiment and take risks ?  It might be a young man raised in a perfectionistic environment where he feels nothing he does is good enough, yet he gives up being a child to do all he can to please his parents' expectations.

Emotional  conflicts often cause much frustration and anger, but the emotions are suppressed for fear of rejection. Suppressed emotions can do harm.

Conflict and conflicting emotions, especially anger, tends to create a sense of not being in control. Anger especially can ramp up ones brain chemistry so the person has strange feelings, even panic attacks. Not feeling in control, and not understanding the emotional turmoil that is brewing below the surface only adds to those feeling of not being in control.

This is when the person may find himself having intrusive thoughts and compulsive behaviors, momentary yet irrational thoughts leading to an urge to carry out some ritual, some compulsive behavior. Carrying out the compulsive behavior may give some relief, create a sense that 'If I do this, I will feel better ", thus creating a temporary sense of control. Then  the compulsive behavior becomes a habit.

When a client is willing to do the work to uncover the emotional conflicts, and also make some changes in how they deal with issues and people in their lives, they can in fact learn to challenge and take control of their intrusive thoughts and compulsive behaviors. The trick is to be able to guide the client to see the true causes and triggers, and offer the needed support while steps are taken to face changes. What these people need most of all is understanding and support. If you know someone with OCD, remember that !

Gene Benedetto, Psychologist
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