Obsessive-compulsive disorder is characterized by intensive obsessions and/or compulsions which patients experience and which absolutely interfere with workings of their minds and lives. Obsessions are commonly known as worries, fears, thoughts, or feelings that one cannot stop thinking about. Hearing musical passages, counting numbers, or repeating words over and over again may be other avenues of the anxiety’s expression.
A compulsion, on the other hand, is a ritual that one performs to undo the fear that one experiences from the obsession. For example, if someone becomes intensely fearful of being dirty, then she might have the compulsion of washing her hands. If someone becomes fearful that he will set the apartment on fire, so he will combat the fear by repeatedly returning to the apartment to check the stove, etc., only to then do it all over again.
Obsessive-compulsive disorder is not to be confused with an obsessive personality style found in someone who likes things to be arranged in a particular way or to be in control of any given project. Obsessive-compulsive disorder is a much higher level of private obsession and/or compulsion, which impairs someone’s life. In addition to impairing function, it can disintegrate a family structure inasmuch as family members become hostage to the patient’s symptoms. For example, if a patient insists that food be washed in a particular way, hours and hours can be spent with the preparation of a meal. Obsessive-compulsive disorder is generally treatable or at least manageable with the right kind of medication.
However, understanding the context in which symptoms arise can also provide huge therapeutic relief. Patients often report experiencing the heightening of their obsessive-compulsive symptoms just as they feel an overwhelming flood of rage. So, it makes sense to consider the obsession as a method to distract the person from the very rage that he so feels and fears.
Likewise, a connection between sexual urges and obsessive-compulsive preoccupation with the perceived dangerous consequences of acting on these sexual urges occurs time and again. Understanding these links can deepen both psychotherapeutic engagement and benefit.
Rick’s comments:
My OCD rituals mostly revolve around attempts to keep myself safe despite actions that I take that are self-destructive and dangerous. If I eat a very sugary dessert even though I am a diabetic, I might repeat the phrase “I’ll try to do better” every time I stand up or sit down. Do I really believe that this will keep me safe?
No. Then again, a baseball pitcher who makes certain that he doesn’t step on the white lines as he runs off the field doesn’t really believe that this will make his curve ball better; he does it as an attempt to gain additional control over his situation, to gain an edge beyond what his talent provides. Since it is easy for the player to avoid touching the lines, there is no risk of failing to fulfill this ritual and thus losing his “advantage” over the hitter.
This is not OCD—it’s a simple, doable ritual which does not intrude on the player’s ability to function. What, however, if the white-lines skipping was only the beginning? What if the pitcher, in order to feel in control or safe, has to always throw curveballs to left-handed hitters, fastballs down the middle of the plate to right-handed hitters and only high pitches from the fifth inning on while the thought “I must not give up a home run” swirls endlessly around in his mind and he must avoid looking at the shortstop and left fielder during even innings.
This is how OCD can intrude on, even ravage, a life, and it’s what people coping with OCD, including me, go through on a day-to-day basis. That’s why it’s good to know—very good to know—that it is treatable.
Compulsion
a behavior, such as washing one’s hands multiple times an hour, in response to an obsessive thought.