An In-depth Exploration of OCD's Causes

The OCD and Anxiety Podcast by Robert James Coaching. Music.

Hello and welcome to The OCD and Anxiety Podcast where we explore how to have a more positive relationship with anxiety disorders disorders, taking back control so that you can start living the life you choose and not the one chosen by your fears. Music. Hello and welcome to episode 392. I hope that you're doing very well today. If you are though struggling with OCD or anxiety, then you can get a free session with me to get that.

You you can head over to my website robertjamescoaching.com and there you can book in for that free session and send me a message and let me know about what you're struggling with. In today's podcast, I'm going to be talking specifically about the causes of OCD.

I think this is a really important area because when we understand about the causes, it can actually help us to be more hopeful about the potential things that we can do to actually make OCD better, to manage it better to overcome it to to kind of deal with it to learn how to accept anxiety all of these things i think the more that we understand about it the better off we we tend to be so i really hope that you enjoy this one if you would like to support

the podcast more you can follow and like on instagram my instagram handle is at robjamescoachinguk and also you can now find the the podcast on youtube so you can follow and like there too so yeah many thanks guys i really hope that you enjoy this one and if you have any questions at all do please let me know yo.

I'll be starting off today by looking at biological factors. The first area is brain structures. In recent times, researchers using powerful brain scanning techniques such as fMRI have led us to believe that OCD can be explained by observable differences in the brain, chemical imbalances and inherited defects. However, despite this research confirming that there are measurable differences in the brain structures of people struggling with OCD when compared to someone who is not.

It is hard to say if these differences are inherited and related to genes or if they are a consequence of a person with OCD thinking in a very specific way over an extended period of time. The brain imaging studies initially showed that the OCD brain has more oxygenated blood flows to certain areas than that of people in a control group with the cortical and basal ganglia region standing out.

However a later meta-analysis of studies actually found that the only consistent differences in brain structures between people struggling with OCD and the control group were were to be found in the orbital gyrus and the head of the caudate nucleus. These particular areas of the brain become activated when someone is worrying, as is actually often the case in OCD, of course. And therefore, it is not surprising that there are structural differences in the brains of people with OCD.

The next area we're going to look at is genetic factors. Again, in recent times, there has been a plethora of interest in trying to find a genetic risk factor for OCD with efforts focusing on finding a specific gene. These researchers point to the fact that people struggling with OCD often have a family, a person in the family who actually struggles with the disorder as well.

In fact, a 2001 meta-analysis study claimed that if you have OCD, then you are up to four times more likely to have a family member with OCD. Studies on twins have also found that zygotic twins have a high concordance rate, meaning that if one twin has OCD, then the other is significantly more likely to have it as well. However, sometimes identical twins who, of course, share the same DNA, do not both end up with OCD.

With researchers struggling to find a specific gene for OCD, some caution is perhaps called for. Not all people who have OCD have people in their family who also suffer with it and in addition there are many learnt and environmental variables that might contribute to OCD.

The next area is chemical imbalance. In modern times many disorders have been attributed to a chemical imbalance in the brain and in OCD serotonin is often implicated. Serotonin is a neurotransmitter responsible for sending chemical messages in the brain and is involved in regulating anxiety, mood, sleep and more.

The initial belief of researchers was that there was too little serotonin in the brains of people with OCD and by increasing serotonin they could relieve symptoms but there is actually little evidence to suggest this is actually correct.

That being said it does seem that serotonin is playing a role in OCD with the use of SSRI medications relapse is often seen after their withdrawal especially if no behavior therapy is given meaning that serotonin could be playing a role in the maintenance of OCD even if it is not the specific cause.

Now we're going to be looking at psychological factors and the first area we're going to be discussing is behavioral theory. An early promising area of treatment for OCD came from behavioral theory. In the early 1970s researchers started taking what they already knew from the successful treatment of phobias through the use of exposure to specific fears and started to apply this to OCD.

OCD is different from phobias though in that it is characterized by compulsive and ritualistic and avoidant behavior a type of treatment was then developed that involved exposing an individual to their fear and then supporting them to not act out their compulsions and to instead sit with their discomfort and habituate to it this approach is now referred to as exposure and response Prevention, or ERP, and is known as the golden standard treatment for OCD.

The researchers base this approach on their belief that the obsessional thoughts that characterize OCD have over time become associated with anxiety and that that has actually failed to extinguish. By sitting with the discomfort that an obsession produces and waiting long enough, the urge to perform the ritualistic behavior eventually begins to spontaneously subside.

An important add-on to to erp is demonstrated through the cycle of ocd namely that obsessions give birth to anxiety which causes the individual to to act compulsively which tends to lead to more obsessions however when compulsions are delayed or stopped and the individual is encouraged to wait and to feel the difficult emotions the anxiety begins to actually decrease and over time this can lead to the extinction of anxiety associated with a particular obsession.

This was a really important breakthrough as it gave both therapists and their clients hope that if they were able to allow the anxiety to be there rather than constantly pushing it away, then they should be able to overcome it. These behavioral-based approaches set the groundwork for the modern cognitive behavioral approach to treatment.

So the next area we're going to look at is cognitive theory and the rise of cognitive behavioral therapy according to cognitive theorists OCD is about faulty beliefs and unhelpful thinking strategies for example research shows that the majority of people have intrusive thoughts sometimes however people with OCD tend to interpret these thoughts in a a very negative way.

An attempt is made by the therapist to help the person to challenge their thoughts.

A criticism of this approach for OCD is that by encouraging the individual to explore their thoughts more and to reassess them you might actually be aggravating the OCD even more as often overthinking and ruminating are hidden compulsions that fall under a category of OCD that is informally known as pure O. Cognitive behavioral therapy or CBT takes the same premise as cognitive theorists namely that faulty beliefs and interpretations of intrusive thoughts are at the heart of the problem.

CBT has very helpful phrases and approaches such as catastrophic thinking and black and white thinking that help people to see their thoughts more objectively but they also focus on helping the individual to change their behaviours.

The next area we're looking at is mindfulness and acceptance commitment therapy. In recent years more modern approaches to CBT have been researched for OCD and have been found to be very beneficial. One of these is acceptance commitment therapy or ACT which is a blend of CBT and mindfulness-based acceptance approaches.

One of the central premises of this approach is that engaging with the intrusive thoughts at all is actually the problem as it causes you to come out of the present moment and to get lost in your thoughts. People are encouraged to use diffusion techniques to live more in the present and to practice acceptance of anxiety and obsessions.

There is a big behavioral component as people are encouraged to refocus their attention on values and activities rather rather than trying to cognitively problem-solve their way out of their obsessions.

Depression. Another factor to pay attention to is depression. However, whilst depression will likely make OCD symptoms worse, it's not thought to be the cause of OCD, but rather a consequence of it.

Another area is personality. Using the five-factor model of personality, personality researchers have found that individuals with OCD are more likely to have high levels of neuroticism, agreeableness and low levels of extroversion.

Then we move on to the final area which is social factors. So let's start by looking at stress. OCD has been linked to a mix of social influences including stressful life events. Although stress is not thought to cause OCD, if someone has a lot of stress in their life then this could actually trigger OCD but only if they were already predisposed towards the disorder.

Even if the individual is not struggling with particular life stresses just the daily demands of living with OCD can be very stressful.

For example many sufferers may spend more than an hour each day struggling with their obsessions and compulsions making even simple tasks like making breakfast monumentally more difficult than they need to be as they're having to expend so much energy on just kind of performing their various compulsions and you know trying to not get caught up in the obsessions um.

The next area is relationships. OCD can put pressure on relationships due to the fact that the person is putting so much emphasis on managing the disorder they can begin to neglect romantic relationships, family relationships and even friendships. The person may find themselves stuck in their head with their thoughts and disconnected from what is actually going on around them and the resulting relational problems with those close to them may well lead to more stress and feelings of isolation.

Another important idea when it comes to OCD and relationships is that some people believe OCD is a learned behavior. It's something that perhaps if you have parents for example who struggle with OCD themselves or obsessive tendencies could it be that a child who has parents like that is learning the behavior directly from the parents.

This is this kind of nurture idea so rather than OCD being a biological problem where you have something in in your nature that makes you that way your you have specific genes for example that you that you inherit this idea is more the falling under the kind of nurture category that OCD is is more to do with you know difficult experiences that you you have maybe had perhaps you even have some traumatic experiences, maybe when you were younger.

And, you know, that could cause you to, you know, to develop anxiety and maybe in time that could also lead to OCD. Work is another area that is important. Studies have shown that individuals with OCD are more likely to struggle in work settings than even to be unemployed. The urges to attend to the obsessions and resulting compulsions can outstrip the need to complete work tasks on time and to appear professional. So there we go. I really hope that you enjoyed this episode today.

I think it's a really important thing to understand about the causes of OCD. As much as anything, I think it's important because we begin to realize that, you know, OCD really is something that with the right support and the right help, you really can learn how to manage it much more effectively, to habituate to the fear and to the anxiety that you have and to change your experience of OCD.

And so you know with with that in mind I think it's it's really positive and and hopefully helpful so many thanks and if you were to check out the references uh where I got the information for today's podcast you can find that in the show notes and if you have any questions at all do please let me know many thanks just a quick reminder that if you want to get a free session all you need to do to get that is to head over to my website www.robertjamescoaching.com

and there you can leave me a message and we can arrange the free session and now just a quick reminder of my disclaimer any information that you view on my website instagram page facebook group or anywhere else online or any information that you listen to on the podcast is for informational purposes only and is not intended to be a substitute for actual medical or mental health advice from a doctor psychologist or any other medical or mental health. Music.