Fear of bacteria may be centered on foodstuffs (e.g. meat or eggs), bacteria in the environment or fear of blood, mucous, urine and feces. The latter will often cause extreme discomfort during the use of public toilets.
To avoid contagion, long and elaborate washing rituals (hands, body, surroundings) may be used. A fear of chemicals may be seen in connection with the use of strong cleaning agents or during laboratory work. There may also be a fear of the environmental pollution in the air or in poisonous waste.
A fear of losing things, or that things will break. For example, checking through a purse to make sure that wallet, keys, cell phone, etc. have not been lost or stolen. The fear of breaking something may relate to the more valuable items in the home, such as the television, stereo equipment and computer.
A need to collect things, or difficulty in discarding. The items that are collected may in the eyes of others seem to be without any great value. They might be old school projects, bus tickets, newspapers and magazines, old letters or official notifications.
A strong impulse to count things/thoughts/words. The numbers often take on “magical” significance, and there may be a tendency to act in accordance with lucky or unlucky numbers.
Sexual or religious obsessions. These thoughts can give rise to many speculations about morally correct thoughts and behavior. Religious obsessions can include a fear of thinking blasphemous thoughts, especially while in church. Sexual obsessions can be highly unpleasant, and they are never related to feelings of pleasure.
A strong impulse in favor of repetitive rituals. Apart from checking the stove, front door, electrical installations, water faucets etc. due to a fear of damage, there can also be repetitive behavior for the sake of repetition. A person may thus repeatedly turn lights on and off, turn the volume up and down, or place a glass on a table again and again.
Others will have an impulse to reread or rewrite. Repetitive rituals may be driven by ”magical rules” for preventing or avoiding something unpleasant. Repetitions may also be seen at “crossings”; when moving from the street to the sidewalk, for example, or from room to room, the “crossing movement” may be repeated.
A need for order and symmetry. This symptom is especially prominent in relation to compulsions where items in the home must be arranged in a special way or a certain order. There may be a need to scratch the right arm if the left arm has just been scratched (symmetry), or to sort the clothes in the closet or on the clothesline by color (order). To classify this as OCD, it must be unpleasant to see disorder or asymmetry in the areas where one normally wants to see symmetry and order. Compulsions are driven either by something feeling right or by magical thinking in which something could go wrong if one does not obey the “rules of conduct”.
Somatic obsessions and compulsions. Obsessions relating to the body will in many cases result in anxiety with regard to illness and a checking of the body for tenderness and asymmetry. A doctor will rarely be consulted due to a fear that a serious illness will be discovered.
Treatment of OCD
At Rigshospitalet, I worked together with the Anxiety Clinic’s medical specialists to develop a treatment program for people with OCD. It is based on the cognitive and behavioral therapy treatment method. Most patients here were offered OCD treatment in the form of group therapy. This type of OCD treatment has in follow-up proven to be both effective and long-acting for a great many of our patients. The treatment program at Ulrichsen’s Clinic in Copenhagen will follow many of the same principles and methods used at Rigshospitalet. Most of those who come to Ulrichsen’s Clinic ask for individual psychotherapy, but an OCD group will be established if desired by those who seek help here.
If needed, Ulrichsen’s Clinic can also offer OCD treatment in the form of support for the behavior therapy portion of the treatment. This will be provided by a psychology student who has been trained in the treatment method. You are welcome to call us at 38 28 88 72 or send us a message on pboks.dk to learn more about our OCD treatment.
We gladly accept patients from Copenhagen and all of northern Zealand.
This chapter was written by licensed psychologist Michelle Ulrichsen.