Obsessive-compulsive disorder, also known as OCD, has many forms and is a spectrum of anxiety disorders. Obsessive-compulsive disorder is characterised primarily by intrusive chains of thoughts, known as obsessions. An obsession is any form of intrusive thought that the sufferer cannot get rid of, demands his or her full attention, returns with unbearable persistence, exhausts him or her and causes considerable psychological suffering. The sufferer finds short-term relief from this unpleasant condition in what is known as compulsion, a compulsive, repetitive behaviour or thought ritual.

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Typical examples are obsessive thoughts such as "I left the stove on, we'll burn out", "I didn't wash my hands, I'll get an infection". The relief compulsion is then represented by returning home and repeatedly checking the apartment or repeatedly performing personal hygiene tasks.

Another example might be the nagging idea of hurting someone, hurting your child, running over someone on purpose in a car, or sexually assaulting someone. The relieving compulsion then takes the form, for example, of a thought ritual such as chanting, counting down, repeating certain cognitive stereotypes, focusing on walking only on certain tiles, and so on. Paradoxically, people suffering from these intrusive thoughts are usually very moral, non-aggressive and empathetic in their personal lives. These horrific scenarios play out only in their thoughts.

Anxious clients suffering from obsessive-compulsive disorder (OCD) have insight that their thoughts are illogical, ineffective, and do not match their actual needs. Yet they are unable to get rid of them of their own volition. The compulsions become more frequent and intense, taking over the life of the sufferer and gradually tying up his or her freedom in life.

If left untreated, OCD leads to the sufferer's compulsions becoming completely automatic, sometimes losing sight of the illogicality of their behaviour. He becomes captive to his rituals, which often leads to his illness taking him out of normal life. Understandably, people suffering from obsessive-compulsive disorder seek relief from intrusive thoughts in alcohol or addictive substances.

The degree of their psychological suffering is often unimaginable for a healthy person. Drinking is, of course, only a short-term relief and exacerbates the course of obsessive-compulsive disorder. It should be remembered that anxiety sufferers are also at greater risk of addiction than the general population. If OCD is accompanied by problems with risky drinking, it is a good idea to combine psychotherapy with elements of a Controlled Consumption Programme.

The most typical examples of compulsions are repetitive control activities (locking the apartment, car, checking electrical appliances, food safety, checking whether I have hurt someone, repeated hand washing, exaggerated hygiene and cleaning rituals, ritualized accumulation of certain objects, counting objects, repeating certain incantations, and many others.)

The treatment of obsessive-compulsive disorder rests on several pillars, the most basic of which is psychotherapy, which addresses the causes of the disorder. In practice, cognitive behavioural therapy, or the various modifications of this method, which are ACT therapy and other variants of CBT, work best. Supplementing psychotherapeutic treatment with elements of Mindfulness, i.e. targeted mindfulness work, is very effective and provides very rapid relief. Training in breathing and muscle strategies is also very helpful for the individual.

If the obsessive-compulsive disorder is at a severe stage, or if it is associated with depression, it is possible to support the psychotherapeutic process with gentle medication. Long-term use of drugs containing benzodiazepines is definitely not recommended. Although these drugs may bring momentary relief, in the long term they are addictive and worsen the course of the illness. Third- and fourth-generation antidepressants are effective pharmacotherapies in this respect.