Obsessive Compulsive Disorder (OCD)

Affordable OCD Treatment In Singapore

Obsessive-Compulsive Disorder (OCD) affects 1 in every 28 Singaporean (Chandra, 2019). It is considered a common health condition and we seek to spread awareness on the importance of OCD Treatment in Singapore.

OCD is a chronic mental condition that causes persistent unwanted thoughts called (obsessions) or the desire to repeat something continuously (compulsions). People with OCD can have either or both obsessions and compulsions. Compulsive behaviours are performed to stop obsessive thoughts. This vicious cycle of obsessive thoughts and compulsions can become very strenuous for individuals suffering from OCD, as the person can spend hours a day repeating the compulsive behaviour. This in turn interferes with daily activities and lowers their quality of life and well-being. Individuals diagnosed with OCD may exhibit different symptoms and behaviours. Some of the most common OCD themes are:

Signs and Symptoms of OCD

Common Obsession themes:

• Cleanliness- fear of dirt and contamination by germs
• Religion – fear of thinking sinful or evil thoughts.
• Aggressive thoughts- fear of causing harm to others.
• Sexual- thoughts about strangers, friends, and family in a sexual way.
• Hoarding
• Rigid rules- fear of making mistakes,
• Need for order, symmetry, and exactness.

 Common Compulsions:

• Repeated cleaning and washing.
• Repeated checking- doorknobs, locks, phones etc. certain body parts, mistakes.
• Repeating certain routines like walking in a specific way or in a specific direction.
• Counting and recounting
• Ordering and rearranging
• Performing mental rituals like praying
• Continuously asking for reassurance.
• Collecting and hoarding items which are not of any value.
• Eating rituals
• Performing a task, a certain number of times.

 These OCD symptoms can have a detrimental impact on people’s lives and can affect relationships with family and friends. People with OCD may often experience aversive emotions such as anxiety, fear and disgust in response to obsessive thoughts and get agitated or irritable if the compulsive behaviours are not performed to avoid these thoughts.

Most people who have been diagnosed with OCD, may also exhibit at least one of these comorbid conditions:

• Anxiety Disorders- panic attacks, phobias, PTSD
• Mood Disorders- Major Depressive Disorder, Bipolar Disorder.
• Impulse Control Disorder
• Substance Use Disorder

Seeking OCD Treatment in Singapore

According to the findings from the Singapore Mental Health Study, 3 out of every 100 adults suffer from OCD. Despite the prevalence of OCD, only one out of ten people with OCD seek treatment with most taking an average of nine years to do so. The Singapore culture strives for perfectionism and excellence. Many adopt an achievement-oriented mindset which highlights the need for control over things. This leaves OCD going undiscovered and many mistake it as merely a personal trait characterized by a strong urge for controlling things. Without seeking help, people with OCD tend to struggle with feelings of self-criticism, anxiety, shame, guilt, anger, worry and fear.

Types of Treatment for OCD in Singapore

Typically, OCD is treated with medication, psychological therapy, or a combination of both. The following are two primary forms of psychological therapies with proven efficacy for individuals with OCD.

Exposure and Response Prevention Therapy (ERP)

ERP is a form of Cognitive Behavioural Therapy (CBT) that has been clinically validated in its efficacy in treating OCD. ERP aims to expose individuals to thoughts, images, objects, or situations that make them feel anxious and develop obsessive thoughts, The goal is to encourage them to make a choice not to engage in the compulsive behaviour once the anxiety and obsessive thoughts have been triggered. ERP is carried out in a safe environment with the guidance of a therapist.

For example, if someone were to have an obsessive fear of contamination, he might be exposed to touching objects and encouraged to let go of the obsessive thoughts of wanting to wash his hands. Through gradual exposure, starting from the least anxiety-provoking situation, the individual can slowly build tolerance for distress which eventually enables him or her to resist the compulsions as well as re-evaluate the anxiety that they feel.

The severity of obsessions and associated anxiety are tracked with a series of questionnaires called Subjective Units of Discomfort (SUDS), which monitors the individual’s progress with OCD.

Acceptance and Commitment Therapy (ACT)

ACT is typically used in conjunction with ERP to treat individuals with OCD. Incorporating acceptance and mindfulness practices, the goal of ACT is to help individuals accept thoughts and feelings that may arise and develop healthy relationships with those experiences. ACT also encourages them to increase awareness about their thinking and feeling patterns and develop psychological flexibility in how they respond to their obsessive urges and thoughts, and how they choose to act on their compulsions.

Unlike ERP which primarily focuses on eliminating the obsession or compulsion, ACT involves accepting those obsessions or compulsions and holding them at a psychological distance away from the self, while deliberately engaging in behaviours that are consistent with our personal values.

ACT involves six core principles:

ACT abides by 6 core principles:

1. Acceptance
    • Embracing unwanted or unpleasant emotions, thoughts, urges without attempts to change their frequency or form
    • Observing the thoughts surfacing every now and then
2. Cognitive Defusion
    • Learn to observe our thoughts, feelings, and emotions in a non-attached manner 
    • Learn to change the way one interacts with these thoughts and reducing the undesirable functions resulting from them
3. Contact with the Present Moment 
    • Focus on the present moment and being fully aware with the here-and-now experience with openness, interest, and receptiveness
4. The Observing Self
    • Separating oneself from the thoughts, feelings, and internal experiences that we have 
    • Being aware of these thoughts and experiences in a non-judgemental way
    • Understanding that they are not the essence of who we are
5. Values
    • Clarifying what is meaningful and important to us, and what motivates us to make an impact in our lives. This helps us understand what gives us a greater sense of purpose to lead a fulfilling life
6. Committed Action
    • Setting goals that are aligned with personal values and act on them
    • Commit to those goals and be consistent 

Get Help Now

There is no cure for OCD, however it can be managed effectively with proper medication and psychotherapy. Counselling can help in reducing the frequency and intensity of OCD symptoms. Therapy helps in working with the client in understanding their behaviour causing extreme discomfort to reduce the physical impact and exploring the underlying thought process. It also helps in finding the appropriate coping strategies that can help in managing the disorder. Behaviour therapy (exposure-response prevention) and cognitive therapies are effective in treating OCD. Highly motivated people, who are willing to put in the effort and commitment required shows good results in therapy. Involvement of family is also an important factor that contributes to the management of OCD.

Before it gets worst, let us help you process and validate your feelings, identify triggers, stressors, past grievances, and contributing factors that may have put you in distress. We will explore effective coping skills, and life management skills or solutions that will help you excel better to meet your daily life demands and responsibilities effectively.

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This article uses material from WebMD and other useful references for obsessive compulsive disorder (OCD). The article is for use of reference and information only, for specific diagnoses and treatment, please reach out to our licensed and/or certified professionals.