Obsessive Compulsive Disorder

There are many anxiety disorders that make people act irrationally. One of these disorders is Obsessive Compulsive Disorder, also known as the "disease of doubt." (Mueller p.26) This is because the sufferer cannot rely on what is possible or what will happen in any given situation. OCD is different from other anxiety disorders because the individual is focused more on fear and avoidance of specific thoughts or ideas, as opposed to other anxiety disorders. People that have been diagnosed with OCD are suffering from repetitious obsessions (persistent ideas, thoughts and impulses) or compulsions (repetitive behaviors and mental acts) that try and reduce anxiety. Often, rituals are performed. These are repeated actions which the victim displays. For a moment the sufferer feels relief but is not yet satisfied. They feel if they do not continue with the rituals something horrible will happen to them or their loved ones. This person knows these thoughts are illogical, but continues to fear they may be true. Many OCD sufferers feel like they are going insane because they can not control themselves. When trying to avoid these thoughts and actions, a great deal of anxiety rises. The anxieties and obsessions can become so severe that it causes a person distress, change in daily routines, time-consuming situations, and work or social relationship problems. (Gravitz p.44) One case history about a boy at the age of fourteen stated:

"Alan felt impelled to arrange the shoes and hangers in everyone's closets so that they were all exactly one inch apart. At times his father had to drag him bodily out of the closet where he was arranging shoes and bring him to the dinner table so that he could eat with everybody else. He arranged the contents of all the drawers in the house so that the clothes were lined up symmetrical. Magazines and books lying on a table had to be lined up with their edges parallel to the table edge. Alan also arranged furniture in parallel or symmetrical lines; he would jockey the kitchen chairs around until he got them into positions that felt "right" to him."

"When Alan closed a door, he had to check it three times to be sure that it really was closed. In school he tried to write perfectly without mistakes, but if he misspelled a word, he would stop and begin the entire assignment over again. When he closed a door, washed his hands, and brushed his teeth, he had the need to count."

"When he didn't perform these rituals, or when someone in his family would touch something he had arranged Alan would feel unbearably anxious. His behavior led to arguments with other family members." (Sebastian, p.14)

The Diagnostic and Statistical Manual of Mental Disorders (DSM III -R), which lists the standard criteria used to diagnose mental disorders, states that the obsessions of OCD must be "experienced, at least initially, as intrusive and senseless" and that the person affected by them must try to ignore, suppress, or neutralize them. The person affected by the obsessions must also be aware that they are products of his or her own mind and do not come from some "outside source." (Sebastian p.18)

There are many different types of OCD. The most common compulsions as a result of a particular obsession are: checking, cleaning, washing, counting, repeating, and ritualistic thinking. The severity of OCD does range depending on the victim. Some people may concentrate just on compulsions without awareness of any obsessions. Other people can have obsessions without acting on them, but most people with OCD have both components. (Sebastian p.18)

People that have to continuously wash are so afraid of germs, they spend hours washing and sterilizing themselves. They may also insist that the others around them do the same. This obsession can also prevent them from leaving their homes, from having company, and the presumed "need" to keep a "safe" distance from loved ones. These people are called "washers" and "cleaners." This is the most common form of OCD.

The second well-known type of OCD is "checkers." These individuals are so afraid something disastrous will happen from their "careless" actions that they check and check again what they've already done. Typical thoughts might be that they left the stove on and the house will burn down. Checkers will return to the stove over and over again through out the day to make sure it is really off. Another severe action is thinking that they ran someone over while driving. They will retrace their route several times, and then check the car for dents and scratches. Checkers have a difficult time trusting themselves, and must continuously reassure themselves, or have others reassure them, that everything is okay. A case history about a woman named Heidi states:

"Today, Heidi is a successful lawyer living in NYC. But when she was 16 years old, she had a terrible secret that was causing her life to spin out of control.

"I constantly thought I would make a terrible mistake and, because of my carelessness, someone would get hurt." Heidi said. "I thought I might accidentally burn my house down or forget to lock the door, making it easy for a stranger to enter."

Heidi never got more than halfway to school before she had to turn around and go home to make sure she locked the door.

"I would stare at the door for what seemed like hours, checking to make sure it was really locked," recalled Heidi. "On a really bad day, I would miss a whole day of school."

Heidi's behavior disrupted her life. She spent so much of her time checking and rechecking locks, toasters, and ovens that there was little time to participate in activities or have friends. Because of all the school she missed, her grades really suffered. Even when she made it to school on time, she was often too anxious to concentrate on her work.

"The funny thing is that I knew my fears were foolish," said Heidi. "I just couldn't control myself. I was sure I was going crazy." (Mueller, p.26)

Although there are many forms of OCD, there is one last common type. These people are called "orders." These people need to place objects in specific places. If the sufferer sees the object has been moved the slightest bit, it can cause a great distress and even anger in individuals who have this type of OCD. (Gravitz, pp.46-47)

It is really unclear how you develop Obsessive Compulsive Disorder. One article stated "OCD may be caused by a problem in how the brain works. It may also be caused by a chemical change in the body." (CareNotes,