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The main symptoms of OCD are:

  • Obsessional thoughts – ideas, images, or impulses that enter the mind and are almost invariably distressing. Sufferers often try, unsuccessfully, to resist them. They are recognized as his or her own thoughts, even though they are involuntary and unpleasant. Obsessions may involve:
    • Health
    • Germs and contamination
    • Having done (or being likely to do) something dangerous
    • Sexual thoughts or images experienced as unpleasant
    • A feeling that things are “not right” or of being unsafe
  • Compulsive acts or rituals – repeated behaviours that the sufferer feels they must carry out to prevent the feared event occurring. They are neither enjoyable nor useful tasks:
    • Excessive cleaning
    • Washing
    • Checking
    • Repeating acts
    • Mental behaviours (e.g. counting or saying prayers)

A variety of causes of OCD have been proposed:

  • Genetic – it is thought that some people may be pre-disposed, possibly through family inheritance, to suffering OCD.
  • Brain chemistry – there is some evidence that miscommunication between different brain areas can result in feelings of fear and anxiety without the presence of any threat. There is also some evidence of a reduction in serotonin, a chemical associated with regulating anxiety.
  • Life events – OCD is not necessarily caused by life events. However, difficult or unpleasant situations may trigger episodes.
  • Psychological – intrusive thoughts that occur in OCD are common. It is thought that sufferers of OCD are especially disturbed by these thoughts and thus become anxious. Carrying out the compulsive behaviour reduces anxiety, but only for a brief period of time. This creates a vicious circle because it reinforces the idea that the obsessions are themselves dangerous.
  • Cognitive Behavioural Therapy – CBT helps people to evaluate intrusive thoughts (and their fears about such thoughts). They then to learn to inhibit their compulsions and to tolerate the anxiety this causes. This is known as exposure and response prevention. Over time, the anxiety is likely to reduce.
  • Medication – some anti-depressant medications have been shown to be effective. This is likely due to their action on serotonin.

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