I. Definition of obsessive compulsive disorder
We all have quirks that take up small bits of the day. Very often,
people wrestling with an obsessive compulsive disorder invest hours of their
day avoiding these concerns. People with an obsessive compulsive
disorder (OCD) have an intolerance and rejection of a mental experience
that generates a tremendous amount of agitation and anxiety over losing
control of ones mind. “It seems as if that one aspect of OCD is and
overactive conscience” (Article on Scrupulosity).
The definition of obsessive compulsive disorder is an anxiety disorder
that is characterized by repetitive, irrational, intrusive thoughts, impulses or
images and irresistible impulses to engage repeatedly in some acts
Individuals with an obsessive compulsive disorder do not want or
enjoy the obsessive thoughts or time-consuming compulsions. They think
of them as excessive and feel as if they interfere with daily functions. The
reason for this caution and avoidance of details is simple: many people with
OCD are troubled by very explicit, offensive, and socially horrifying,
The most common and well-studied branch of OCD involves the OC
where the undoing response generally involves some overt behavior. The
presence of dirt evokes a sense of threat and an incredible inspiration to
reduce contamination. Most commonly the escape ritual involves a cleaning
response. The next common form of OCD involves checking. The
overwhelming impulse to recheck remains until the person experiences a
reduction in tension despite the realizations that the item is secure. A less
common form of OCD includes hoarding, which is the excessive saving of
typically worthless items. Ordering is a subcatagory where persons feel
compelled to place items in a designated spot or order. This person fears a
sense of being overwhelmed and impending anarchy if items are not placed
exactly as they are arbitrarily determined. Another form of OCD is
perfectionism, in which persons feel compelled to habitually check for
potential mistakes or errors that might reveal their own faults or might
jeopardize the person’s stature at work.
The next branch discussed will be the purely obsession OC. The
objective in this classification involves the escape or avoidance throughout
“excessive mental behavior” of noxious and unwanted thoughts. Persons
with the Pure-O classification also can experience what seems to them to be
threatening ideation involving the potential that they might do harm to
others or that merely the idea of having the threatening thought suggests
something evil or depraved about their identify, capability of selfworth.
Superstitiousness might take a great significance in OCD.
The last branch involves a somewhat more complex and difficult to
that form OCD, and that is responsibility OC (hyperscupulosity). Here, the
person’s concern is not for themselves, but directed toward the well-being
of others. Typically, significant others are thought of as the predominant
focus on which to prevent harm from comeing. More obscure forms of
OCD involve body dysmorphia. Body dysmorphia is a condition where a
person becomes excessively focused on some body part, which they
perceive to be grossly disformed. Another sub-classification of OCD
involves an olfactory obsession in which persons are entrenched in the idea
that some part of their body is emitting a noxious aroma. This form of OCD
involves a preoccupation with the potential of having some physical
malady, typically cancer or some life threatening disease. This condition in
referred to as hypocondriasis (Weinberg).
Those with OCD can have either obsessions or compulsions or both.
About twenty percent have wither obsessions or compulsions. The other
eighty percent have both. Obsessions are unwanted thoughts that are
recurrent and persistent impulses, or images that cause extreme anxiety or
distress. They are not simply excessive worries about real-life problems.
Of course, we all have comforting little rituals. Obsessions may start as
early as ages 3 or 4 and the conditions are more common in boys than in
girls until mid-adolescence. True obsessions are far, more common in
children than ever imagined in the past: at least half of adults with OCD
report onset of symptoms during childhood, and many more during
adolescence. Obsession is a term that is misunderstood very often. An
example of this would be that, “my brother is obsessed with his new shoes.”
Obsessions intrude into consciousness despite efforts to avoid these
thoughts. Some typical obsessions include:
*fear of something wrong with one’s body
*Fear one has not done something “just right”
*excessive concern about germs, contamination, or “dirty substances”
*fear of things not being lined up “right” or turned off
While these are some of the more common obsessions, there are many
more, and it is not uncommon to discover clients who are having a variety
of different obsessions which gravely interfere with their ability to
concentrate on anything else (Schwartz).
Compulsions are behaviors employed, over and over to try to get rid
of the obsessive thoughts by some ritual, repetitive action. These are often
carried to considerable extremes. Children with OCD do not announce they
have obsessions or compulsions; rather, they throw “tizzy fits.” Adults with
OCD may have difficulty getting to work on time due to having to return
home to check the phone cord alignment. Some typical obsessions include:
*Excessive washing of hands or other body parts
*inseistnece on unusual attention to details of hair, clothing,
*checking, re-checking, going back to check again, then again
These are some of the common compulsions. Excessive washing is a
compulsion that attempts to ward off the fear of contamination. Checking
and re-checking is a compulsion that OCD sufferers develop to try to put to
rest their anxiety something is not turned off, lined up right, straight, or that
they might have done something wrong, hurt someone, etc. (Weinberg).
Social workers, counselors, physchologist have said that there is not a
determined cause for OCD. There are many different reasons for having
OCD. IT could be linked as a genetic disorder. This is also called
“neurological misfiring,” a sort of hiccup, in the caudate nucleus buried
deep within the basal ganglia, the primitive brain that serves as a sort of
relay station between oursenses, motor functions I the cortex. OCD may
also involve elevated levels of activity in the frontal lobes and parts of the
basal ganglia. This increased activity may account for the repetitive
obsessions ore merely reflect them; the frontal lobes are involved in
planning and thinking, an important component of obsessive compulsive
People with OCD are so well aware that their ideas and behaviors are
so odd, they often go to considerable lengths to conceal these symptoms.
Almost all adolescence and adults with OCD are teribly afraid of being
labeled “crazy,” and this is the case since their self-perception of the
thoughts and behaviors linked with OCD seem so very bizarre to them.
Even relatively young children are often secretive about their obsessions,
and as they grow older try to conceal their compulsions from their family,
friends, and fellow school children.
There are two specific tactics clinicians should consider using to help
clients be more comfortable in revealing these symptoms:
1) use of an OCD-specific initial evaluation/intake questionnaire.
2) “a casual, relaxed form of communication in which the clinician
mentions how new research has discovered many features
about the biological basis for OCD, and how many people are
now begin helped over obsessions and compulsions by use of
newer medication and/or behavioral treatment” (Schwartz).
No expert in this field has yet to fully understand why perfectly nice,
harmless and socially well-adjusted people develop such horrifying
obsessions. They do know the content is completely disconnected from
experience and conscious, routine behavior, it is in effect a wild and crazy
bit of the “id,” the most basic element of the personality; it is the source of
the instincts and operates on the pleasure principle, popping into conflict
with the “ego,” the element of the mind that operates according to the reality
principle and serves to satisfy the id and the superego (Science News).
However, people with OCD bear no personal responsibility for the content
of these obsessions, and digging into them deeply and drawing conclusions
about them is a tactic that scares countless OCD clients away from any
willingness to participate in further treatment of any kind (Forde).
“Article on Scrupulosity.” Margo, Writing on Scrupulosity 1:1.
Forde, David R., Ph.D. “Obsessive-Compulsive Disorder in the
Community: An epidemiological Survey with Clinical Reappraisal.” Am J.
Psychiatry 8 Aug. 1997: 154:8
“Science News.” Gene may Further Obsessions, Compulsions. 3 May
Schwartz, Jeffrey M., MD Brain Lock: Free Yourself from Obsessive
Compulsive Behavior. New York: Harper Collins, 1996.
Weinberg, George. Compulsions and the Fear that drives them: Invincible
Masters. New York: Grove Press, 1993.