OCD in Adults

Obsessive Themes:

OCD in adultsAdults with OCD tend to have obsessive thoughts that are in direct contrast to their values and moral codes which explains why many people with OCD often do not seek treatment until years after being diagnosed. Many obsessions center on:

  • Pathological doubts (doubts that a shadow or a pothole on the road might have been a person, or that twigs, cracks or shadows on the ground might be syringes or other potentially dangerous objects).
  • Violent (violent images involving family or doubts that you may be responsible for hurting strangers as you pass them by)
  • Sexual obsessions (fears of deviant behaviours, paedophilia, being unfaithful or suitability of one's partner). Most people with this type of OCD respond to their thoughts by reminding themselves that they would never do such a thing, and by trying to avoid situations where the thoughts are likely to occur)
  • Religious/moral questions (profane thoughts combining religion and sex.)

Compulsive Behaviours:

  • Avoidance: for example a person with sexual obsessions may avoid certain situations or people. Unfortunately the social isolation only feeds the anxiety.
  • Counting specific things (such as footsteps) or in specific ways (for instance, by intervals of two) and doing other repetitive actions
  • Washing
  • Ordering and arranging: making sure certain items are in a straight line, repeatedly checking that their parked car is have been locked before leaving it, constantly organizing in a certain way
  • Checking: turn lights on and off,  keeping doors closed at all times,
  • Touching and tapping: touching objects a certain number of times before exiting a room or tapping an appliance to reassure self that it is off.
  • Excessive reassurance seeking


The only well-established psychological treatment for OCD is exposure-based Cognitive Behavioural Therapy (CBT). CBT is a psychotherapeutic approach that you can use to identify, challenge and overcome your dysfunctional thoughts, behaviours and emotions. The benefit of CBT is that you can change the way you think so that you feel and act better, even if the situation hasn't changed.

How successful are the standard treatments?

Over the past 15 years, a sizable evidence base has been established for the use of CBT to treats adults with OCD. A recent review of 12 adult outcome studies revealed immediate post treatment response rates of 83%, with gains maintained over follow-up (Storch, Mariaskin and Murphy, 2009).

How do I find the right therapist for me?

Many people are reluctant to disclose the nature of their OCD because they feel embarrassed. It is critical that you are treated by a clinical psychologist who specialises in the treatment of OCD, but also in the treatment of adults. It is important to ask your psychologist if they:

  • Specialise in OCD
  • Are a member of the APS College of Clinical Psychologists
  • Have a PhD specialising in OCD
  • Have a proven publication history researching OCD.

Disclaimer: The information on this page is very general and should not be seen as diagnosis or treatment advice. You should consult a psychologist or other qualified health professional for advice on your specific problems and the best form of treatment for you.

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