Obsessive Compulsive Disorder

Many of us have recurrent thoughts or worries, some people perform repetitive routines that might seem unreasonable; however, because these ideas, thoughts, and habits do not last long and on the whole do not cause distress and dysfunction, they are not classified as obsessions. On the other hand, for individuals with obsessive- compulsive disorder, these worries and concerns resulting in compulsions, can go as far as taking over a person's life. These persistent obsessions can impair a person's ability to function, limit their behavior, and result in them feeling miserable (Holmes, 2001). Moreover, according to the World Health Organization, "OCD is one of the most incapacitating of the anxiety disorders" (Doron et.al. 2007)

Individuals, who are diagnosed with obsessive-compulsive disorder, have either obsessions, compulsions or both. In persons who suffer from obsessive-compulsive disorder, anxiety is caused by the recurrent ideas, thoughts, or impulses, in other words called obsessions. Some common obsessions are of doubt, thoughts of death or violence, fear of becoming ill or of contamination. In contrast, compulsions are repetitive behaviors that the individual performs due to the belief that if they do not do that ritual, something terrible will result (Stein, 2002). It is important to note, that people suffering from obsessive-compulsive disorder, are often aware of the irrationality of their behavior; however, they feel compelled to carry out the compulsion in order to temporarily alleviate the extreme anxiety they are feeling (Holmes, 2001).

An example of an individual with obsessive- compulsive disorder, who is extremely anxious about being contaminated, can be seen from a protagonist of the film Aviator, Howard Hughes. This film is a perfect illustration of obsessive-compulsive disorder becoming self-destructing for the person. The protagonist's extreme fear of being contaminated by germs led to

his inability to leave his home and go out in public. Hughes locks himself inside his home thereby insuring no contact with the outside world. Obsessive-compulsive disorder completely took over his life and left Hughes debilitated due to the lack of treatment. For many years, obsessive-compulsive disorder was considered a rare condition; however, now days it is viewed as one of the prevalent and severely disabling mental disorders.

Studies indicate a lifetime prevalence of 2.5% in adults, affecting males and females at the same ratio, which seems to be the same across different cultures (DSM VI -TR). The disorder may begin in childhood, although it is known to begin its occurrence in early adulthood. Which proposes the question, of what seems to explain the onset of this mental disorder? Or in other words why do some people develop obsessions and/or compulsions that tremendously heighten the anxiety and create a call for its immediate neutralization to avoid a horrible consequence?

The cognitive and the physiological explanations for obsessive-compulsive disorder seem to be most plausible. The cognitive explanation states that compulsions are a result of the incorrect beliefs that something bad will happen to the person unless they carry out the ritual (Riskind & Rector, 2007). The treatment that was found to be very effective for treating obsessive- compulsive disorder, is a procedure called exposure and response prevention, which is a form of cognitive behavioral therapy. This treatment is essentially, exposing a person to a situation in which he/she would feel the need to perform the compulsion and preventing one from carrying it out. One can see why this is a very effective way of changing the incorrect beliefs, this is due to the fact that a patient has an opportunity to see that there are no negative consequences even thought the compulsion was not performed. This form of cognitive behavior therapy exposes the person to the anxiety provoking situation and can result in enlightenment that there is nothing to be afraid of.

Another treatment that produces great results is the use of antidepressant drugs that increase the level of serotonin. For the most severe cases, at times surgery known as cingulotonomy is performed, where small lesions are formed in the nerve tract that connects lower structures in the brain. However, even this operation is about fifty percent effective. What is particularly interesting is a case of man who developed obsessive-compulsive disorder as a result of a brain tumor (Holmes, 2001). This example indicates the validity of the physiological explanation for the incidence of obsessive-compulsive disorder; therefore, a conclusion that can be made is that with proper medication and cognitive behavior therapy, individual's obsessive-compulsive disorder can be more or less stabilized. Furthermore, during the last twenty years, a lot of research has been devoted to gaining "knowledge about cognitive processes in obsessive-compulsive disorder", which might be important implications for treatment (Aardema & O'Connor, 2007).

Aardema and O'Connor (2007) argue that the problem is not the intrusions that the person is experiencing, but that the person places significance on them, evaluates, and appraises these thoughts. Specifically, Aardema and O'Connor state that even though