Obsessive Compulsive Disorder

01-Jul-2008


From a CASE STUDY - How far can OCD go?

Mary’s pregnancy was a time of joyous anticipation. If she had moments of anxiety about taking care of a new baby, these times passed quickly. She and her husband proudly brought a beautiful, perfect baby boy home from hospital. Mary bathed and fed the baby, comforted him when he was restless, and became a competent young mother. Then the obsessional thoughts begun. She feared that she might harm her child. Over and over again she imagined herself stubbing the baby. She busied herself around the house, trying to think of other things, but the distressing thoughts persisted. She became terrified to use the kitchen knives or her scissors. She knew that she didn’t want to harm her child. When her thoughts came... anything else in her life, took second place.

WHAT IS OCD

Obsessive-compulsive disorder (ocd) is a strange sickness of ritual and doubt run wild. “Obsession” derives from the latin obsidere, meaning to besiege; at its worst, this illness is truly a siege. When the thoughts and rituals are intense, one’s work and home life disintegrate.


Part of the pain experienced by people with this mental problem is created by their frustration at recognizing the irrationality of excessive nature of their obsessions without being able to eliminate them. Persistent fear of harming self or a loved one as in the above case study, is a common unwanted idea that repeatedly occurs in the mind of a person with ocd. The individual who suffers from ocd becomes trapped in a pattern of repetitive thoughts and behaviors that are senseless and stressing but extremely difficult to overcome. The unwanted intrusive unpleasant thoughts are called obsessions and produce a high degree of anxiety. In response to obsessions most people with ocd resort to repetitive behaviors called compulsion.

 

HISTORY OF OCD


This is a serious disease, much more common than we ever thought. The first clear accounts go back more than 400 years and are found in the theological literature on scrupulosity. This term is derived from the Latin scrupus, whose diminutive form scrupulus means a small sharp stone. Conceptually, a minute weight could tip the scales of a sensitive balance, such as the scales of conscience (Palazziui 1962). Later definitions were similar; for example “a disease, physical and moral which produces a sort of derangement of conscience and causes one to harbor vain fears of having offended God.”

OBSESSIONS

Obsessions are thoughts, images, or impulses that occur over and over again and feel out of your control. The person does not want to have these ideas, finds them disturbing and intrusive and usually recognises that they don’t make sense. People with ocd may worry excessively about dirt and germs and be obsessed with the idea that they are contaminated or may contaminate others. Or they may have obsessive fears of having harmed someone else, even though they usually know this is not realistic. Obsessions are accompanied by uncomfortable feelings such as fear, disgust, doubt, or a sensation that things have to be done in a way that is just so.

COMPULSIONS

People with ocd typically try to make their obsessions go away by performing compulsions. Compulsions are acts the person performs, over and over again, often according to certain rules. People with an obsession about contamination may wash constantly to the point that their hands become raw and inflamed. A person may repeatedly check that she has turned off the stove or iron because of the obsessive fear of burning the house. She may have to count certain objects over and over because of an obsession about losing them. Unlike compulsive drinking or gumbling, ocd compulsions do not give the person pleasure. Rather, the rituals are performed to obtain relief from the discomfort cause by the obsessions.

 

TYPICAL OCD SYMTOMS


When worries, doubts, or superstitious beliefs become so excessive or make no sense at all, than a diagnosis of ocd is made. Ocd usually involves both obsessions and compulsion.

 

Common Obsessions:


Contamination fears of germs, dirt, etc.
Imagining having harmed self or others
Imagining losing control of aggressive urges
Intrusive sexual thoughts or urges
Excessive religious or moral doubt
Forbidden thoughts
A need to have things "just so"
A need to tell, ask, confess

Common Compulsions:

 
Washing
Repeating
Checking
Touching
Counting
Ordering/arranging
Hoarding
Praying

 


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