This is a guest post by Alegra Kastens, a licensed Marriage and Family Therapist who founded the Center for OCD, Anxiety, and Eating Disorders.
Obsessive Compulsive Disorder (OCD) is a debilitating mental health condition that can impair a person’s functioning across a variety of domains: socially, emotionally, physically, relationally, and more. Basic, day-to-day tasks, such as driving and showering, can be time-consuming and painful because of obsessions and compulsions. The impact of OCD on five such activities is explored below.
When intrusive thoughts are popping up during reading, and perhaps even racing through your mind while you attempt to take in what is on the page, it can be difficult to concentrate. Imagine a radio blasting metal music at the highest volume while you’re trying to focus on a book. This is what reading can be like for people with OCD, but the metal music isn’t a neutral stimulus. Instead, it’s the scariest unwanted thoughts popping up repeatedly, accompanied by heightened anxiety and discomfort. Sitting in silence with a book, or at any point in time, can be uncomfortable for people with OCD who are afraid of their own brain. The silence leaves room for scary thoughts and images to arise. Reading can be laborious for those with “need to know,” “just right,” and/or perfectionistic obsessions who feel they must understand every word “perfectly” or read something in the “right way” before moving on. Books are full of potential triggers and some people compulsively avoid reading because of it.
OCD obsessions can manifest as a fear of hitting someone or something and not knowing it (nicknamed “hit-and-run OCD”), snapping and driving off the road (nicknamed “suicidal OCD” or “homicidal OCD”), hitting someone or something on purpose (nicknamed “harm OCD”), etc. These obsessions can lead to an avoidance of driving at certain times of the day, in certain places, or altogether. Those who do continue to drive often run late because they compulsively turn their car around again and again to check and make sure they have not hit someone or something. As with reading, driving is a time where we are alone with our thoughts and feelings. This can be triggering for people with OCD who dislike quiet time without as many distractions.
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Excessive sanitization in the shower is a compulsion people with OCD may carry out. While it’s common for those with contamination obsessions, excessive showering can be present with any obsessional theme. Folks with sexual or blasphemous obsessions might shower excessively to cleanse themselves of “dirty thoughts.” People with “just right” obsessions might have to repeat certain actions in the shower again and again until an internal sense of “rightness” is achieved. Those with symmetry obsessions might have to touch every body part symmetrically while showering, keeping them in the shower much longer than desired. Folks with contamination obsessions might shower for hours a day to get rid of any physical or emotional contamination. In addition to being time-consuming, compulsive sanitization in the shower can be physically painful. Intense washing can damage the skin.
The kitchen can present numerous triggers for the OCD sufferer: knives, uncooked meat, dirty dishes, etc. Cooking involves sharp objects like butcher knives and vegetable peelers, which can be scary for those with harm and/or suicidal obsessions who fear that they could snap and stab others or hurt themselves. Handling uncooked meat can be challenging for those with contamination obsessions who fear getting ill, with disgust obsessions who have difficulty tolerating raw meat, and with hyper-responsibility obsessions who fear getting others sick from their cooking. With cooking comes cleaning, and washing the dishes can be difficult for people with contamination and disgust obsessions who are afraid to touch dirty or “contaminated” dishes.
5. Skincare Routines
Morning and nightly skincare routines are more popular than ever. Thanks, TikTok! What is self-care for those without OCD can feel like torture for those with it, not because of the skincare routine itself, but the ways in which OCD can hijack it. If a step of the skincare routine doesn’t feel “right”, those with “just right” obsessions—looming thoughts and feelings of something not feeling “right” or “complete”—might feel the urge to redo that step again and again until the internal feeling of “rightness” or “completeness” is achieved. Unwanted intrusive thoughts of a violent, sexual, or blasphemous nature are common with OCD. Those who struggle with emotional contamination might feel compelled to redo a skincare step when an unwanted thought arises so that the skincare routine is clean, pure, and not contaminated. Magical thinking, a cognitive distortion characterized by the belief that thoughts or actions have the power to influence the world and make something happen when they are not related to the world in a realistic way, can plague people with OCD. With skincare routines, it might show up as: if I don’t do skincare in this order, something bad will happen. While the order of the skincare routine doesn’t impact what happens in the world, it can feel true for the person with OCD. Doing just one skincare step might be uncomfortable, while doing the entire routine might not be possible every time. This can lead to an avoidance of skincare altogether.
These are just a few ways that OCD can impact your everyday life. If you are struggling to get by, there is hope. Exposure and Response Prevention (ERP), an evidence-based treatment for OCD, can help you get your life back. By exposing yourself to feared stimuli—like only doing one skincare routine step—and practicing response prevention—such as cutting out compulsions like re-doing a behavior repetitively or excessively sanitizing—you can get your time and life back.
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Cognitive therapy to address errors in reasoning can also be beneficial, such as Metacognitive Therapy to look at how we are thinking about our thinking. For example, does a person believe that having a thought makes it true? Challenging that black-and-white thinking and learning that thoughts are not inherently facts is a cognitive tool that can help a person reframe their thoughts. Inference-based Cognitive Behavioral Therapy (ICBT) is an evidence-based treatment for OCD that is primarily cognitive. It works to resolve inferential confusion (confusing imagination with reality) and obsessional doubt.
If you’re struggling with OCD and your symptoms are getting in the way of your daily tasks, NOCD can help. Our licensed therapists deeply understand OCD and are specialty-trained in treating OCD with ERP. You can book a free 15-minute call with our team to get started with OCD treatment.