Imagine a dog barking incessantly outside your home. At first, you try to pacify the dog by feeding it. Indeed, the barking ceases right after you fed it, affording a brief period of calm and quiet. However, the barking soon returns with a vengeance. Once again, you feed the dog, which appeases it but not for long. Over time, you realize that responding to the dog’s barking only makes it bark more.
This analogy illustrates the psychological process underpinning OCD. The barking of the dog represents obsessions, which are recurrent, intrusive and anxious thoughts or urges. Feeding the dog represents compulsions, which are actions undertaken to neutralise the obsessions and anxiety in the short term, but inadvertently perpetuate a vicious cycle which worsens the OCD in the long term.
Eventually, you learn to ignore the barking, and the dog quietens down. It does still bark occasionally, but you have learned to coexist with it, understanding that it’s just noise and does not require a response. If you can tolerate and make space for the barking for a long enough period, the dog might just leave for good and never return.
In this analogy, behavioural therapy (Exposure and Response Prevention, Cognitive Behavioural Therapy) would be like learning skills and techniques to coexist with the barking, to tolerate it without responding to it.
Medications would be akin to ear plugs, which effectively block out some or most (but not all) of the distracting and frustrating noises. Ear plugs do not eliminate the barking completely, but they make it more bearable and enhances the capacity to live with the barking, until the dog goes away because it has learnt that it will not be fed.
OCD can be a chronic and debilitating condition which impacts social and occupational functioning. Untreated OCD can lead to depression, work problems, strained family relationships and a lower quality of life. Seek help early if you suspect that a loved one is suffering from OCD. At Private Space Medical, our psychiatrists and psychologists have vast expertise and experience in guiding OCD sufferers towards recovery.
Dr. Tay Kai Hong
Senior Consultant Psychiatrist
Senior Consultant Psychiatrist