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Birmingham and Solihull Mental health NHS Foundation Trust
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Obsessive-compulsive disorder (OCD)

What is OCD?

Each person who suffers from OCD describes slightly different problems. In general, people with OCD experience obsessions. These are thoughts, pictures or impulses which are usually unpleasant and come into mind when we don’t want them. Many things can trigger these obsessions, and they usually leave the person feeling very anxious, uncomfortable or frightened. The compulsion is the behaviour performed in order to ‘put right’ the obsession. Sometimes the behaviour performed is quite irrational (and the OCD sufferer recognises this) such as counting up in sevens for seven minutes. Sometimes the behaviour is more closely related to the obsessional thought, such as washing hands many times to avoid thoughts of contamination. Most people with OCD know that their compulsions are unreasonable or over the top but they feel unable to control their thoughts or change their behaviour. Many people experience obsessions and compulsions and are able to live with this without problems. People may think about seeking help when their lives are becoming disrupted by these unwanted thoughts and actions.

Signs and symptoms of OCD

Most people who have OCD find that there is a patter in their thoughts, feelings and actions. They feel anxiety or discomfort at having the obsession and relief once they have carried out the compulsive act. This becomes a vicious cycle which strengthens itself and becomes more likely to happen again. In addition to this the person who experiences OCD will often feel guilty and that they must be a terrible person to have such thoughts. This in turn makes the thoughts more likely to return because they are given such negative importance in the person’s mind.

  • Thoughts or images about being contaminated by dangerous substances e.g. germs, dirt, AIDS.


  • Thoughts or images about serious harmful events that will occur because of your carelessness e.g. a gas explosion in the house because the cooker is left on or that you may have knocked someone over in your car. 

  • Thoughts or images that suggest you will harm others, especially those you care for and would never want to harm e.g. that you may hurt your own child, that you may be unfaithful to your partner.


  • Images come into your mind of your loved ones dead.


  • Things in your life are not in the correct order or not symmetrical enough or in the right place e.g. ornaments are out of alignment and you feel distressed by this.


  • Blasphemous or unpleasant thoughts/images and doubts about your faith


  • Check body for signs of contamination.


  • Wash/disinfect frequently.


  • Avoid going to places or touching objects that you fear may contaminate you.


  • Check feared situations/ appliances or journey route many times.

  • Avoid being the last person to leave the house.


  • Avoid responsibility.


  • Seek reassurance regularly from another person that everything is alright.


  • Avoid situations which you feel put you at risk of harming, e.g. hide kitchen knives.

  • Think something to yourself to ‘put right’ the frightening thoughts – neutralizing thoughts.

  • Carry out some task that will neutralize the thought, e.g. counting or saying a special word.

  • Seek reassurance from others.

  • You put things right or make them symmetrical many times until they ‘feel’ right.

  • You avoid contact with things that make you feel like this.


  • You pray, seek forgiveness frequently.


  • Consult religious leader/seek reassurance.