Obsessions are experienced as a fear that something has happened, is happening, or may happen.
This fear elicits anxiety, which is defined as an emotional and physiological dysregulation response to a perceived or actual threat. Compulsions are learned behavioral or mental responses that are used to provide temporary relief from the anxiety associated with the fear. While there is some variability in the presence, theme, or dominance of either the obsessions or the compulsions, the following four steps or stages typify the experience of Obsessive-Compulsive Disorder.
While we all may occasionally obsess about something or do something compulsively, the frequency, intensity, intrusiveness of the obsessions and compulsions, and the strength of the conditioned relationship between the two are some of the key factors in determining a diagnosis of Obsessive-Compulsive Disorder.
Common obsessions can include a fear of contamination, of having harmed other people, of losing control, or of succumbing to violent urges. Obsessions can also include having intrusive unwanted sexual thoughts, excessive religious or moral doubts, of thoughts related to having things “just so” or “just right.”
Repetitive behaviors (e.g. hand washing, ordering, checking) or mental acts (e.g. praying, counting, repeating worlds silently) that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly. The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation. However, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive. The person attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action (for instance, by performing a compulsion).