Obsessive-Compulsive Disorder: What is it? People with OCD suffer a great deal of stress and often feel they are helpless victims. OCD is characterised by frequent and intrusive thoughts or images (obsessions) leading to repeated behaviours (compulsions). Obsessions tend to arise from a person’s own mind and they see these thoughts and images as absurd and pointless. These thoughts can be repulsive and obscene. The person neither wants nor welcomes them and tries desperately to either resist or get rid of these thoughts. This can hinder the sufferer from functioning normally.
Compulsions on the other hand are behaviours or mental acts that are repetitive or excessive. Examples include excessive hand washing, checking windows and doors are locked at home or mental repetition of numbers in a certain order. These symptoms can disrupt a person’s life. Obsessive-Compulsive Disorder Symptoms and Examples O Washing – washing hands for hours – so much so that hands become raw and bruised O Checking – checking locks a few times before leaving the house. O Counting – when a person enters a room, they have this compulsion to count how many tiles there are. O Obsessive thoughts O Thoughts of causing harm to others constantly invades your mind O Thinking that somehow you have caused an accident because you made a lane change O Thinking you ran someone over when you where backing out of your drive way O Being attacked by germs whenever you touch something O Hoarding – keeping useless items such as movie tickets, newspapers, batteries, pens and even tissues.
O Symmetry – shoelaces being symmetrical O Hair being symmetrical O Having the rooms in your house be symmetrical Theories and Explanations According to the National Institute for Mental Health (1999) men and women are equally likely to suffer from OCD, although men tend to show symptoms at an early age. According to Wilkinson, Moore & Moore, (2000) Cleaning compulsions are more common in women, while men are more likely to be checkers. No one can say for certain what causes OCD. At one time researchers speculated that OCD resulted from family attitudes or childhood experiences including harsh discipline by demanding parents. Recent evidence has shown that biological factors may contribute to the development of OCD. There is a tendency for OCD to run in families and many people with OCD also suffer from depression.
The Psychoanalytical View The origins of psychoanalysis and its method of treatment were developed by Sigmund Freud. This school of thought suggests that obsessions and compulsions are symptoms of some deeper problem in the person’s unconscious mind (De Silva & Rach man, 1999). According to the psychoanalytic view certain memories, desires and conflicts are repressed in order to stop the person feeling anxiety. The explanation is that these repressed memories desires or conflicts later manifest themselves as obsessive-compulsive behaviour. The Biological View The biological theory proposes that OCD is caused by a biochemical imbalance in the brain. In particular it proposes that it is caused due to low levels of serotonin in the brain.
People that have a lack of serotonin (a chemical in the brain) may suffer from OCD Turner & Bei del, (1998). Serotonin is a neurotransmitter that is needed for the brain to function. This chemical helps send messages from one cell to another. Low levels of serotonin in the brain can lead to depression, impulsive acts, aggressive behaviour and even suicide. Treatment Behaviour therapy Behaviour therapy refers to the use of Learning Theory in the treatment of psychological disorders. It concentrates on the problem behaviour itself and more on the problem as it is now, and what factors are currently associated with it, rather than its past history.
Learning theory proposes that OCD arises from an initial period of stress, such as the death of a loved one as a result of a contagious disease. Due to this, distress then becomes associated to the idea of disease, and this anxiety is reduced for the person when they thoroughly cleanse after coming into contact with or thinking about dirt. However, the reduced anxiety a person feels when cleaning only reinforces itself as the person is then faced with further concerns about disease. Avoidance of situations triggering obsessional thoughts can also occur.
According to behaviour therapy, faulty learning can be undone, and new learning can be promoted. (Wilkinson, Moore & Moore, 2000) Cognitive behaviour therapy Cognitive Behavioural Therapy (CBT) involves Behaviour Therapy (BT). Behaviour therapy helps change patients behaviour. OCD patients will be involved in something called “exposure.” Basically, they are exposed to the things that they fear.
After a long period of repeated exposures, the anxiety will diminish. Fear will eventually subside until the individual is no longer in fear. “Exposure” has to be combined with response or ritual prevention in order for the CBT to be effective. When you are being exposed to, for example, germs, you will be compelled to wash your hands. Response or ritual prevention will help you to stop doing that compulsion or ritual. CBT also involves cognitive therapy.
Cognitions are thoughts, idea, beliefs and attitudes. Cognitive therapists focus on analysing the patient’s cognitions that are relevant to their problem and help them to modify them. For example, when in contact with germy things, the OCD patient may think, “What if I get Aids?” That thinking will trigger the compulsion to wash their hands. CBT will help to work through those thoughts or eliminate them over time.
Conclusion The exact cause of Obsessive-Compulsive Disorder is not known, but there are a few things that may trigger the disorder. OCD may run in families, but this does not necessarily mean that an OCD patient’s child / children will get the disorder. Stress and anxiety can also be a factor. It may not be a cause of OCD, but it has been known to make OCD symptoms worse. Low levels of serotonin are also another possible explanation. In terms of the treatment for OCD sufferers, current medical research suggests that the two main effective treatments are Cognitive Behavioural Therapy and medication with a serotonin reuptake inhibitor.
During the last twenty years these are the most effective treatments to be found.