Obsessive-Compulsive Disorder (OCD) is an anxiety disorder that affects approximately 2.5% of the populations in both the U.S. and the U.K. It is a two-part disorder, the two parts usually afflicting the sufferer concurrently. In the first part, obsessions twirl uncontrollably in the sufferer’s mind, frightful images, overpowering impulses, and a frequent state of near-panic being among the hallmarks of the obsessive part of this mental illness. Affected individuals then use compulsive, ritualized behaviors –the second part- to control the obsessive thoughts. In the end though, it’s this crippling disorder that does all the controlling. The disorder is frequently hereditary and can come in conjunction with eating disorders, other anxiety or mood disorders, attention deficit–hyperactivity disorder (ADHD), and eating disorders. It afflicts both genders equally and frequently shows up in childhood or early adulthood.
Obsessions and compulsions
Obsessive thought-patterns occur when the brain gets stuck on a frightful image or urge like a needle on a broken record. For example, someone may have an intense fear of contamination, a frequent obsession with OCD sufferers. Germs or contamination-related anxieties may trigger in them a frenzied anguish. To counter this, sufferers may resort to the compulsive ritual of scrubbing their hands repeatedly until they are chapped and raw, although no matter how many times they wash their hands, the frightful thoughts of germs and illnesses keep recurring –more forceful and demanding each time.
The different levels of the disorder
The majority of OCD sufferers realize that they are in fact imagining the risks involved in their obsessive machinations -and that the rituals they devise to alleviate their fears are anything but effective. And yet they remain relentless in their pursuit of their compulsive behaviors. Unlike individuals suffering from a psychotic disease, OCD sufferers do not lose touch with the real world. They may even think of themselves as being strange, which frequently gets them to enact their fantasies in secret in an attempt to avoid embarrassment, particularly when they are in business.
Famous People with OCD
Many people with OCD carry on successful lives, at least in their respective trades. It is thought that Michelangelo, Charles Darwin and Albert Einstein were afflicted with OCD. Howard Hughes, billionaire, movie producer and famous aviator, was constantly washing his hands and keeping his distance from hand shaking. He also compulsively counted and laid out his peas symmetrically before eating them. New York real estate mogul Donald Trump shares some of the germ-related phobias of Hughes. Michael Jackson seemed to have a parallel disorder known as Body Dimorphic Disorder (BDD) which often leads to plastic surgery. It is thought that Michael Jackson had 30 different surgeries done on his face and body.
Symptoms of obsessive behavior
Superstitious fallacies: Lucky or unlucky signs or occurrences are almost always prevalent in sufferers, even when their main obsessions are in another direction (thus odd or even becomes critical, 20 steps are good, 21 terrifying and to be avoided). Touching or tapping objects is a part of this obsession.
Symmetry: The peas have to be lined in some precise order. More frequently, the shirts, or shoes, or canisters in the pantry (Jack Nicholson in the movie “As Good As It Gets” was portrayed as always having his pantry in exact order, all the cans facing in the same direction). Intense stress can result when objects aren’t orderly.
Fear of contamination: cleaning, washing, sanitizing and a fear of catching germs or illnesses are the hallmark of this particular obsession. In addition, environmental contaminants, such as household cleaning materials are to be treated cautiously.
Obsessions of a sexual nature: Unwanted and inappropriate sexual images conjure up severe stress, as does fear of molesting a child, even though the sufferer has no desire to do so.
Images involving violence: The unfounded fear of having caused a fire or big mishap, and the unfounded fear of actually acting out a stabbing or robbery. In the same vein, a common obsession is one of having slammed someone while driving.
Checking and miscellaneous: Doubts that doors were, lights and stove turned off, arranging, double-checking, counting, hoarding, list making, fears of having hurt someone, and other intrusive thoughts that take you away from the more urgent tasks of the day.
Symptoms of compulsive behavior
- Compulsive behavior is invariably regimented, playing out per strictly observed, self-imposed guidelines. It is best described as sets of ritualized and repetitive activities that are conjured up to provide a break from the stresses and anxieties produced by agitated, obsessive images. There is usually a stark dichotomy between the madness of the thoughts and the precision of the actions.
- A significant part of OCD’s definition is that sufferers know well that the compulsive behaviors they undertake will not realistically yield the intended result, i.e. to relieve the pain caused by the obsessive thought patterns.
- And yet, there seems to be a cycle to OCD that provides the sufferer with a reward, for there is a small compensatory reprieve at the end of each set of behaviors. Thus, a ritual that rewards the sufferer –even in the smallest and most temporary of ways- is followed by another cycle of obsessive images which prompts the renewal of the ritual in order to cash in on the small reward –and this can go on for many years, getting more warped with time.
Two or more of the ritualized compulsions (including frequent washers, counters, hoarders, double-checkers, symmetrical arrangers and many more) can thus be tried at different times, and a sufferer may use more than one ritualized behavior to suppress aggressive thoughts at any one time. A good example would have someone who sanitizes everything for fear of germs also exhibit superstition and shut the bedside lamp exactly 15 times before going to bed for fear of bad things happening at night.
In order to adequately understand OCD, one has to imagine the intensity of the pain that the obsessive thoughts can invoke. When OCD sufferers are caught in the distress of twirling thoughts in their heads, they may well try anything for relief.
Part 2 will deal with diagnosing OCD,
and part 3 with psychotherapy and pharmacological treatments.
About Mike Takieddine, the author:
Mine has been a privileged life, first for having traveled all over as son of a diplomatic family, then for having had the opportunity to study at Oxford, and finally for a gratifying career in business, in geriatric home care, and in writing. I look forward to using this wonderful medium to discuss the various aspects of life that are of interest to my readers.