CHAPTER VI - OBSESSIVE-COMPULSIVE DISORDER
Let us focus now a little bit on OCD: obsessive-compulsive disorder. Among young people today, one in 200 suffer form OCD. This is significant because this disorder can disrupt academic and social functioning. OCD is more common in children and adolescents. OCD is a neuro-psychiatric disorder that can be cured with medication called serotonin reuptake inhibitor (SRI) and cognitive behavioral therapy.5 It is a pervasive condition that causes individuals to over examine their thoughts, spoken words, actions, activities and relationships. In this over examination they always find what they have done is inadequate and not good enough. This mental examination process is repeated over and over through out the day, and as a result, it creates a dangerous level of tension. They become very stressed, are never satisfied with themselves, and are rarely happy. They repeat their activity with an intensity bordering desperation; let me give you few examples:
- Running fifteen miles a day in rain or sun.
- Working 12 hours a day, six or seven days a week feeling they are getting nowhere.
- Shopping endlessly and buying more items than they need.
- Showering for two hours a day changing clothes repeatedly, yet never feeling clean.
- Searching day in and day out for items they never get around to use, or for clothes they forget to wear.
Why do they engage in these types of activities?
Because, all these activities that they repeat called rituals are self-soothing devices used to fill an emotional emptiness caused by under parenting or trauma from early childhood. These activities are pacifiers and they tend in the mind to replace the loving trusted authoritative parent that was missing, weakened or depleted. The child turns inward and depends on his or her own invented behaviors. This dependency becomes a ritual, obsessive compulsive, and as it proliferated the child moves in total isolation, unable to reach out to anyone. We have to separate obsessions from compulsion. Obsessions bring recurrent thoughts and impulses and are capable of producing tremendous anxiety and feelings of discomfort such as disgust, guilt, and other compulsions that are repetitive behaviors or mental actions that the person feels driven to perform as a response to an obsession. They do it in a way to try to reduce distress and prevent some dreaded event or situation. They do not know the danger sign.
There is magic in repetition, because it brings familiarity and familiarity is the opposite of the unknown. Once abused, there is an enormous tendency to be abused repeatedly. When a baby is distressed they suck a bottle or their thumb to relieve the anxiety. Repetition is familiar and familiar is predictable and predicable is safe. When some rituals are not sufficient anymore and there is still a lot of anxiety, the children have to find new rituals and convince themselves to do more and more rituals.
Let me give you the structure of obsessive-compulsive disorder:
- Continuous anxiety state due to biological, hereditary or environmental causes.
- Concern that parents are unable to make one feel better.
- Development of a sense of hopelessness about depending on others for comfort, support and guidance.
- Emotionally turned inward, feeling disconnected from others.
- Inventing secrete rituals (pseudo solutions) for resolution of emotional distress.
- Discarding emotional accessibility due to intense belief in rituals and preoccupation (obsession) with carrying them out.
Since these rituals must be repeated to head off more anxiety they are compulsive and since the person must over think each ritual in order to make certain it is performed properly, thinking becomes obsessive. This combination of thought and behavior is called obsessive-compulsive disorder, OCD.
Let me give you the typical OCD symptoms that I placed in a paradigm:
COMMON OBSESSIONS |
Go with |
COMMON COMPULSIONS |
Contamination themes
| |
Washing |
Harm to self or others
| |
Repeating |
Aggressive themes
| |
Checking |
Sexual themes
| |
Touching |
Scrupulosity religiosity
| |
Counting |
Forbidden thoughts
| |
Ordering, arranging |
Symmetry urges
| |
Hoarding |
Need to talk, ask confess
| |
Praying |
My concern is that because of all the cultural changes in our society, we have entered an obsessional age and unless major cultural changes take place we are going to witness a growth in the number of people suffering from OCD and they are going to be more and more isolated.
It should be noted, that Anorexia and Bulimia are very serious and are part of OCD behaviors. It is an eating disorder I wrote about earlier in this paper. It is very important to be sensitive to this trauma. Freud understood from his neurological background that when there is trauma there is a disconnect between feelings and thoughts. Therapy is important because it integrates the two.
From my personal findings, people try to remember more or to let go. Otherwise there is the repetition compulsion, the pressure and the pain.
Sexual abuse is rape and rape is never so easy to define. From the act itself to the content and duration of its aftermath the crime is so steeped in taboos and misconceptions that it remains almost as daunting for its mysteriousness as for its brutality.
5 Levenkron, S. (1991) Obsessive-Compulsive Disorders. New York: Warner Books
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