Did I turn off the burners on the stove? Shut off the coffee pot? Lock the front door? These are some of the questions many of us ask ourselves in the car after we have left the house. We have these questions run through our minds a few times and then they fade out. Some people perform a checking routine to make sure that a window is locked, a door is shut so they can leave the house knowing that everything is fine. Many individuals never think about these matters; it would never enter their conscious thought.
Obsessive compulsive disorder is characterized by obsessive thoughts and compulsive actions related to germs, cleaning, counting, checking and re-checking, and hoarding. An obsession is a persistent series of disturbing thoughts that intrude on the mind and seem to have a life of their own. The subject of these thoughts has to do with extreme concern and fear that harm will come to oneself or others due to some form of contamination or forgetting to perform an everyday action like locking a door or checking to see if an appliance is off. Obsessive thoughts are followed by compulsions in an attempt to alleviate the severe psychological pain of this persistent thinking pattern. These are a series of repetitive behaviors like washing and re-washing of hands, re-arranging objects so they are lined up perfectly, checking and re-checking to make sure that any possible harm to oneself or others has been avoided or eliminated.
Many people who do not understand this disorder or do not suffer from it have a difficult time understanding why someone would continue these rituals. It is such a waste of valuable time. It doesn’t make sense. Once you have locked a door, you move on and forget about it. It all seems remote and far-fetched to those who have not experienced these painful thoughts and rituals first-hand. Obsessive thoughts and compulsive actions are psychologically very painful and intrusive. Some sufferers are so distressed by this disorder that they are unable to sleep or think about anything else. They are immobilized. The compulsive behavior appears to lessen the obsessive thinking. But this is very temporary. The thoughts quickly return, followed by the persistent rituals and the cycle is renewed and appears to have no end point. Those who tell the person suffering from this disorder to just «get a grip» or «get over it» have no understanding of the intricacies of this disorder.
The origins of this disorder are still being studied. Recently, there is strong scientific agreement that obsessive compulsive disorder has neurobiological roots. The brain chemistry of individuals with OCD is different from those who do not suffer from this disorder.
Current treatments for OCD include behavioral therapy and more specifically, exposure therapy. Under the instruction and guidance of a trained psychotherapist the client is gradually exposed to those objects or situations he most fears. The client must be highly motivated to participate in this therapy and feel that he is control of his decisions. In subtle gradations the client learns that he can tolerate exposure to the feared objects or situations. For example, he slowly learns through touching objects that he believes are contaminated, that they are not harmful and that he does not have to wash his hands if he comes in contact with them.
Those who have more resistant OCD have benefited from taking serotonin re-uptake medications. The gradual and judicious increase in serotonin has a beneficial effect upon the obsessive-compulsive cycle. Many clients do well with a combination of medication and behavioral therapy.
The attitude of the individual suffering from OCD and some added activities can be helpful:
1. Find a therapist who has solid clinical training and experience in working with OCD clients and who understands and cares about alleviating their emotional pain.
2. Don’t be ashamed. This is not your fault. Shame causes further distress and anxiety.
3. Be empathic with yourself.
4. Joining a support group and being able to speak freely about your problem can be comforting and
5. Cardiovascular exercise at the proper level can break up obsessive thoughts.
6. Gentle hatha yoga, using relaxation breathing through the nose, calms the nervous system,
lowers the heart rate, and quiets the mind.
Linda Martinez-Lewi Ph.D.