Obsession

What is Obsession?

The DSM-5 (p. 237) diagnoses obsessions as the following:

1. Recurrent and persistent thoughts, urges , or images that are experienced, at some time during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress.
2. The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action (i.e., by performing a compulsion).

Persons who are obsessive have recurrent and persistent, intrusive and unwanted, unjustified, and anxiety-evoking thoughts.

In severe cases (known as obsessive-compulsion disorder Opens in new window) attempts to resist or dispel obsessive thoughts are difficult and typically lead to compulsion by repeatedly performing some behavior.

For example an obsessive patient might be unable to stop imagining a break-in at his house, which causes great anxiety; to quell the thought, the person repeatedly and compulsively checks the locks to doors of the house or repeats a particular thought.

An obsession can involve diverse subjects. Typical obsessions include:

• fears of being contaminated by germs or poison,
• fears of causing harm to oneself or others by not being careful enough, and
• fears of doing something unacceptable.

Others include a discomfort with asymmetry or with discarding objects, as well as a range of superstitious fears or magical thoughts.

Often a person’s obsessive thoughts are in direct contradiction to his or her value system (e.g., a highly religious woman fears she will commit blasphemy; a loving father fears he will his child) and are perceived as being outside his or her control.

Compulsions Opens in new window are also known as rituals, and may be either overt acts (such as repeatedly checking that a stove has been turned off) or mental acts (such as silently repeating a prayer).

Typical compulsions include excessive or ritualized washing/cleaning and repeated checking, occurring in 53% and 50% of cases, respectively (Ball, Baer, & Otto, 1996). Other rituals include counting; mental rituals such as repeating words, phrases, or prayers; seeking reassurance; hoarding objects; and insisting that things be put in a specific order or pattern.