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Obsessive Compulsive Disorder

Just the Thought: Sexual Obsessions OCD

Pedophiles. Their names are littered throughout newspaper headlines. You know the stories; you’ve heard them all before. The teachers fired for having sexual relationships with their students. That middle-aged man that looked at your little sister a little too fondly, while you both were taking the bus home. I already know what you’re thinking because I’m thinking it as well. They are punished and shamed from society for good reason.

Now that we’ve established the roles of pedophiles in our society, picture this: An average individual with no pedophilic tendencies, deeply fearing that they may be a pedophile, simply because the thought popped into their head one day and never left since. These people suffer from sexual obsessions OCD, which is a lesser known form of obsessive-compulsive disorder (OCD). They fear engaging in inappropriate sexual behavior such as, incest, rape, pedophilic tendencies, as well as homosexual tendencies. This fear prevails although, “there has been no sexual arousal, sexual fantasies, or sexual behaviors that would support this” (Weg, 2011). The victims of this dark form of OCD includes children and adolescents. A child for example, “might be plagued with worrying that he might commit rape. He might have zero desire to actually commit rape, but the possibility that he might is terrifying to him” (Ehmke). These unfounded thoughts circle their minds until they utterly consume them.

Sexual obsessions OCD extend beyond the mind however, affecting the individual’s behavior as well. For example, this person may remain distant and avoid physical contact with others. They avoid “touching others because [they are] worried it might be sexually inappropriate” (Ehmke). Other symptoms include the inability to focus, extreme anxiety and shame. Additionally, these individuals may compulsively seek reassurance. For example, “they might try to ‘test’ themselves when looking at pictures to “prove” whether or not their obsession reflects an actual desire. Others might go in the opposite direction and strenuously avoid looking at pictures or going to places where people might be physically exposed, like the beach” (Ehmke). In addition, parents may hear repeated questions like, “this doesn’t mean I’m gay, right?” (Ehmke). The answers to these “questions” and “tests” are not exactly effective and so, children still fall victim to these “unwanted and intrusive thoughts that are deeply distressing” (Ehmke).

People with sexual obsessions OCD can experience varying degrees of intensity. For example, in an online forum, a woman named Rose Bretecher, shares her story of having these obsessive sexual thoughts as an adolescent. She feared that she “may have committed a pedophilic act in [her] past without realising” (Bretecher, 2018). Although these thoughts were baseless, they continued to impede on her everyday life. She engaged in various rituals to subdue her sexual obsessions OCD. “I prayed repetitively; I tried to shout them out of my head; I tried to distract myself with reading and running and drinking. Nothing worked” (Bretecher, 2018). She feared that she’d “be punished for [her] sins”, even though they were nonexistent (Bretecher, 2018). It is important to note the difference between pedophiles and people who suffer from this form of OCD, thinking they are pedophiles. According to Dr. Bubrick, “pedophiles actively seek out situations to be alone with children and like those experiences, whereas someone with OCD who has those obsessions will feel extreme guilt and shame [and] avoid those situations and feel horrible about themselves just for having the thought.”

The inappropriate sexual behavior involved with sexual obsessions OCD is not limited to pedophilic tendencies. Some individuals fear being homosexuals. Lauren Townsend, a writer on the OCD Stories forum, for example, feared having an abnormal sexuality before entering high school. She reflects, “my mind made me feel like a pervert on a daily basis, telling me I was dirty and weird and abnormal. (Townsend, 2016). This did not last quite long, however, as she “realized that being gay really didn’t matter to [her]” (Townsend, 2016). However, the longevity of her OCD could have increased if, rather than fearing homosexuality, she feared sexual behavior less accepted by society such as, incest or pedophilia.

Finally, individuals with sexual obsessions OCD are not necessarily pedophilic, gay, or engage in incest; however, they see themselves through a hypersexual lens. Consequently, the smallest actions can trigger their dark thoughts, resulting in toxic social isolation. Lastly, many individuals may associate these behaviors with uncertainty about sexual identity, as opposed to OCD and so, these individuals typically suffer in silence.

References:

Bretecher, R. (n.d.). My OCD story: Living with intrusive sexual thoughts by @RoseBretecher. Retrieved from https://www.ocdaction.org.uk/community/personal-stories/my-ocd-story-living-intrusive-sexual-thoughts-rosebretecher

Ehmke, R. (2018, April 10). Sexual Obsessions and OCD. Retrieved from https://childmind.org/article/ocd-sexual-obsessions/

Townsend, L. (n.d.). OCD: The Monster In My Mind. Retrieved from https://theocdstories.com/intrusive-thoughts/ocd-the-monster-in-my-mind/

Weg, A. H. (2011, July 16 ). The Many Flavors of OCD. Retrieved from https://www.psychologytoday.com/us/blog/living-ocd/201107/the-many-flavors-ocd

Categories
Obsessive Compulsive Disorder

Mind Over Matter: Hit-and-Run OCD

Imagine you are driving to the grocery store on a lazy Sunday afternoon, when your mind begins to wander. A few thoughts cross your mind and a couple of moments pass by. Suddenly, you snap back into reality completely stunned, wondering how you haven’t crashed the car. The traffic lights, the stop signs, the other cars – disregarding any of these could have led to a disaster. You pass a bicyclist on your right and think, I could have hit someone. You think about this for a few minutes and then drop the idea. Certain people however, cannot simply drop it.

Once the idea of a hit and run enters their mind, they begin to believe that they’ve partaken in one, thereby confusing their imagination with reality. These individuals struggle with a form of obsessive-compulsive disorder (OCD) called hit and run OCD. Hit and run OCD is different from other driving phobias, due to the obsessive rituals performed afterward. According to licensed psychologist, Steven Seay “people with OCD may engage in a variety of physical or mental checking behaviors when driving. They may make excessive use of mirrors or visual checks to make sure that they haven’t hit someone or caused an accident” (Seay, 2012). A person with this form of OCD would return to the scene of the “crime” as a form of reassurance. On the other hand, they may avoid the trigger area altogether.

These behaviors do not end on the road however, as these individuals check newspapers and other forms of media in order to ensure no one was hurt. These behaviors are rooted in the fact that “the person begins to doubt themselves and question whether or not they checked enough [times] or perhaps they missed something” (Seay, 2012). Their uncertainty of this one occurrence tends to negatively disrupt their life for a significant period of time. Interestingly enough, “people with [this form of OCD]  tend not to focus so much on whether they actually killed somebody, but more on whether or not they will be caught, punished, and publicly humiliated”(Weg, 2011). In other words, they fear having to deal with the immense consequences, both physical and emotional, of a hit and run.

An online testimonial shares the story of a woman named Katie who suffers from hit and run OCD. She recalls her experience with the disorder beginning as she was driving next to a bicyclist, which provoked the idea of a hit and run. With the thought in her head, her anxiety began to rise. She felt the urge to turn around to ensure that the bicyclist was unharmed, but she knew that she didn’t hit him. “I refused to turn around. I mean, after all wouldn’t I know if I hit someone?” (The OCD Stories, 2017 ). Nevertheless, her sinister thoughts persisted, weaving a tale that was contrary to the reality of the situation. Katie later inspected her vehicle for damage, trying to dissuade the voice in her head, but instead found a new scratch on her car. It was most likely a coincidence, as drivers rarely inspect their car for damage unless prompted to. However, Katie’s obsessive behaviors emerged. She ruminated on the scenario trying to find proof of her innocence. She constantly checked the news waiting for someone to report a hit and run. These behaviors overwhelmed her for an entire month as she lived in fear of the possibility of the police knocking on her door at any minute.

Lastly, as with many other forms of OCD, these repetitive behaviors persevere until the individual is led to utter exhaustion and distress. The thoughts associated with hit and run OCD can waste minutes, or even up to hours, of a person’s day, as they search for reassurance. Many people don’t realize they have a disorder and so they struggle in silence. The battle between logic and the obsessive thoughts persists until the individual is unsure what to believe in anymore.

References

Houston OCD Program. (2014, March 12). Hit-and-Run OCD. Retrieved from https://houstonocdprogram.org/hit-and-run-ocd/

The OCD Stories. (2017, July 11). It started as a thought of hit and run [Blog Post]. Retrieved from https://theocdstories.com/ocd/it-started-as-a-thought-of-hit-and-run/

Seay, S. J. (2012, February 18). Hit and Run OCD. Retrieved from http://www.steveseay.com/hit-and-run-ocd/

Weg, A. H. (2011, July 16 ). The Many Flavors of OCD. Retrieved from https://www.psychologytoday.com/us/blog/living-ocd/201107/the-many-flavors-ocd

 

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Obsessive Compulsive Disorder

Effects of OCD on Romantic Relationships

“When you have Obsessive Compulsive Disorder, you don’t really get quiet moments.” These were the words spoken by Neil Hilborn, whose poem OCD, went viral. Accumulating over thirteen million views,  the slam poet describes his struggles with the disorder and his love life. He includes his struggles of repeating tasks several times, such as giving kisses, turning on/off the lights, and locking the door, until he finds it perfect. His story is concluded with his love interest leaving him due to her lack of patience with his condition.  

The National Institute of Mental Health describes OCD as a chronic disorder in which an individual may suffer recurrent thoughts and behaviors. Obsessions are characterized as repeated urges and images. Common symptoms of these thoughts include fear of contamination and/or having things symmetrical/in order (NIH). Compulsions are characterized as repetitive behaviors that serve as a response to an obsession. Common compulsions include arranging things in a particular way, repeatedly checking on things, and excessive cleaning (NIH). Although it is normal for individuals to be organized or double check things, individuals with OCD simply can’t control their thoughts or behaviors. Thus, these symptoms can pose as an obstacle for maintaining a love life.

OCD can cause hindrance in one’s romantic relationship. One example of this includes the challenges of feeling ashamed of your symptoms. One may feel the need to conceal the nature of their disorder in order to prevent rejection. This can lead to an avoidance in intimate contact with others. Another difficulty includes the interference in sexual relations. For example, an individual who experiences obsessions with contamination may find it difficult to engage in sexual contact, which may cause them to be sexually avoidant and not satisfied (Kelly, 2018). It’s important to know that not every individual with OCD functions the same. However, there are many ways to cope.     

The initial way of coping includes treating the symptoms. Reviewing a plan with a physician, psychologist, or mental health professional in order to ensure the best possible treatment can be helpful. Psychotherapy is also a useful outline for dealing with poor social skills and lack of self-confidence. Joining a support group can be a good source of social support. Above all, it is vital to get your partner involved in understanding your symptoms. Even without OCD, having open and honest communication is an important framework for all relationships.

References:

Kelly, Owen (2018). OCD and romantic Relationships. Retrieved by https://www.verywell.com/ocd-and-romantic-relationships-2510557

National Institute of Mental Health (2016). Obsessive-Compulsive Disorder . Retrieved by https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml

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Obsessive Compulsive Disorder

Peace in Calamity

You made sure multiple times to unplug your steam iron but now you’re in your Chemistry lab, unable to focus on your lab report for the past half an hour because you can’t seem to be sure if you really did unplug it and if it would cause the entire building to burn down. You’re having thoughts about walking back to the dormitory and seeing everything aflame. Police cars, ambulance, fire trucks and people crying all over because you forgot to unplug that iron. How will you ever live past being responsible for the lives of all those unsuspecting students? Jail is waiting for you and you’ll have to give up all your dreams of getting into grad school. What would your family and friends think? How would you console the parents of these students? This is the thought process of those enduring symptoms related to the checking form of Obsessive Compulsive Disorder (OCD).

OCD is different from person to person and is considered a chronic disease. If diagnosis of this mental illness in itself wasn’t difficult enough due to the existence of the numerous variations (ruminations, contamination, checking, hoarding, etc.), finding the right treatment also becomes problematic. Presently, OCD can be treated through a combination of means, but there is not necessarily a cure. If proper treatments are employed, a chance for recovery over time is definitely possible. A lot of different medications and treatment methods have been tested and were found ineffective and the research is still ongoing. According to Stanford Medicine: Clozapine, carbamazepine, lithium, clonidine, stimulants, ECT, sleep deprivation, and bright light therapy are not effective.

So then, what actually works? Medications such as selective and non-selective Serotonin Reuptake Inhibitors (SRIs), antidepressants, neuroleptics and other psychiatric ones are now commonly being used. Clinical psychologists or psychiatrists may prescribe more than one medication to effectively control OCD symptoms. Side effects are common with any form of medications but the risk for self-harm and suicide is higher with psychiatric meds. Although it’s reported that about 50% of patients respond well with solely behavior therapy, there are still many who have to take medication in conjunction with other forms of behavior therapy as well.

Some patients have tried forms of therapy which include: support groups, cognitive behavioral therapy (CBT), aversion therapy, psychoeducation, rational emotive behavior therapy, Exposure-response prevention (ERP), psychotherapy, systematic desensitization, group psychotherapy, and etc (Mayo Clinic). Out of these, many claim that ERP has been the most effective. Exposure-response prevention is a type of Cognitive Behavior Therapy (CBT) which has the patient face his or her fear without allowing them to perform their rituals (compulsions). It is effective for many, but not for all.

The ERP exposures may be applied in two ways; in real life (in vivo) or in imagination (imaginal). To better illustrate this form of treatment, in vivo ERP for someone experiencing concerns related to contamination would consist of having the patient shake hands with someone and having them resist the compulsions related to hand washing. Imaginal ERP for the same would involve having the patient imagine scenarios where they would shake hands and resist washing their hands. These procedures are followed through a structured manual and even if they don’t necessarily decrease the resulting distress, they are said to increase the tolerance towards the patient’s fears. It is then overtime repeated until the patient’s rituals in response to the fear decreases.

Although it isn’t discussed enough, OCD is one of the most debilitating mental illnesses. For similar reasons, it is often underdiagnosed and therefore, access to specialized treatment is also very limited. Everything related to treatment becomes even more difficult when there are chances of comorbidity with OCD and other forms of mental illnesses. For example, the relationship between obsessional ruminations and depression is particularly close: a diagnosis of obsessive-compulsive disorder should be preferred only if ruminations arise or persist in the absence of a depressive disorder. This makes it strenuous for those who are experiencing a variety of these symptoms. Research revolving more effective treatment is still at large and an ongoing effort. Hopefully, the search leads to giving these patients a peace of mind in their tumultuous times.

References:

The Different Types of Obsessive-Compulsive Disorder. Retrieved October 09, 2017, from www.ocduk.org/types-ocd

My experience of Postpartum OCD (2013, October 13). Retrieved October 09, 2017, from http://www.ocduk.org/my-postpartum-ocd

Obsessive-compulsive disorder (OCD). (2016, September 17). Retrieved October 09, 2017, from http://www.mayoclinic.org/diseases-conditions/obsessive-compulsive-disorder/diagnosis-treatment/treatment/txc-20245962

Behavior Therapy. (n.d.). Retrieved October 09, 2017, from http://ocd.stanford.edu/treatment/psychotherapy.html

Gillihan, S. J., Williams, M. T., Malcoun, E., Yadin, E., & Foa, E. B. (2012, May 30). Common Pitfalls in Exposure and Response Prevention (EX/RP) for OCD. Retrieved October 09, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3423997/

 

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Obsessive Compulsive Disorder

Game of Thoughts

We have all heard about Obsessive Compulsive Disorder (OCD) in one form or another. Even if we don’t know much about the symptoms or the common types of OCD, we have still used the term or heard someone use it before. In general, it is a psychological anxiety disorder which is characterized by repetitive, uncontrollable and unwanted thoughts followed by rituals performed by the person in order to alleviate the resulting anxiety.

Most of the OCDs discussed or depicted, are those that result in common physically visible actions/rituals (compulsions). Such compulsions are the ones related to washing your hands too many times or having things kept extremely tidy and in order. Hoarding is also another form of OCD, although less discussed, it has surfaced more often in the mainstream media and amongst the public. The types of OCD that usually emerge in movies and shows are those that result in compulsions. The OCDs with obsessions alone are rarely shown.

“I was obsessed with the number eight. I’d count eight times … I’d look on both sides of me eight times. I’d make sure nobody was following me down the street, I touched different parts of my bed before I went to sleep, I’d imagine a murder, and I’d imagine that same murder eight times.”

Lena Dunham, someone diagnosed with OCD, had directed and acted in the HBO series, “Girls” showcasing her condition. In her interview with the Rolling Stone, she stated the aforementioned to help place a mental picture of her suffering. These forms of OCD are usually referred to as rumination or intrusive thoughts. It is also referred to as “Pure-Obsessions” or “Pure-O”.

“I’ve had maybe ten obsessive thoughts since we arrived at the green. Would I push her pram into the traffic as we crossed from the car park? What if I hit her with a cricket bat, there all out propped on the porch. I open the broadsheet newspaper we bought to peruse and the story of a poisoned Russian spy escalates thoughts that I might have Münchhausen by Proxy and be on the verge of making my child sick with salt. The word ‘Poison’ is repeating in My head like my own mind is torturing me with the word and it kinda is.” 

To further illustrate this condition, the above mentioned is the thoughts of an anonymous woman, on the OCD UK platform, who has been dealing with postpartum OCD for several years. OCD can take on numerous forms and, excluding the ones currently diagnosed, many other forms exist as well. Within OCD, ruminations may take the form of ideas, mental images, or impulses. Ruminations by itself also have many of its own forms as well; ranging from intrusive thoughts about symmetry/orderliness, relationships, body-focused obsessions, sexual thoughts, magical thinking, religious to those that are related to avoidance, trigger, and violence.

Due to unfamiliarity and improper diagnosis, these impulses exhibited within an individual are not immediately recognized under OCD and they could easily be misdiagnosed for a completely different mental illness. One thing that’s a given with OCD is that it causes distress for the individual. Individuals struggling with OCD find their thoughts unnecessary and with that, we can try to distinguish OCD from Obsessive Compulsive Personality Disorder (OCPD) since those with OCPD don’t actually think that their behaviors and/actions are unnecessary. However, in comparison to the symptoms of other mental illnesses, it may not be as clearly distinguishable.

These seemingly never-ending thoughts consume a person’s time, energy, control, and disrupt their day-to-day activities. In essence, the person is forced to enter long battles multiple times during the day and face their worst fears that are manifested by their own mind.

References:

Suval, L. (2013, April 27). Obsessive-Compulsive Disorder in the Media. Retrieved September 30, 2017, from https://psychcentral.com/blog/archives/2013/04/28/obsessive-compulsive-disorder-in-the-media/

The Different Types of Obsessive-Compulsive Disorder. Retrieved September 30, 2017, from www.ocduk.org/types-ocd

My experience of Postpartum OCD (2013, October 13). Retrieved September 30, 2017, from http://www.ocduk.org/my-postpartum-ocd

What do patients do with their obsessive thoughts? (1998, June 15). Retrieved September 30, 2017, from http://www.sciencedirect.com/science/article/pii/S0005796796000940

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Obsessive Compulsive Disorder

When Motherly Love Becomes Too Much: Postpartum OCD

In recent years, concern of and research into mental health of the postpartum period (the time span following the birth of a child) has increased. “Pregnancy throws your mood-regulating system into the air. This is a biochemical experience and a major life transition,” says Liz Torres, a psychologist at McLean Hospital (Restivo, 2012). The two postpartum illnesses garnering the most attention include postpartum depression and postpartum psychosis. As these illnesses are becoming more well-known to the public, the focus has increased on postpartum anxiety disorders, including postpartum obsessive-compulsive disorder (OCD).

Although there have been no large-scale studies on mothers with postpartum OCD, small-scale studies have shown a higher than expected percentage of women experiencing symptoms of OCD around the time of giving birth. Postpartum OCD is rare and affects approximately 3% of childbearing women (Abramowitz, 2014). The obsessions usually relate to the child and include fear the baby will be unhealthy, the mother will drop the baby, or the baby will die in their sleep. To prevent these events, they may compulsively pray, check up on their baby, avoid contact with their child, or ask others to affirm they will not harm their child.

Most new mothers worry about the wellbeing of their child. Thus, new mothers with OCD are unlikely to misinterpret this worry as more than just “motherly instincts” or being cautious. For example, a mother may constantly worry about dropping their child and will see this as something which can potentially happen and will be extra careful as a result. Those with postpartum OCD may interpret this as an unconscious desire to intentionally harm the infant and may take precautions to avoid this by staying away from their baby (Angeles, 2016).

Some experts suspect the cause of postpartum OCD is associated with a surge of hormones released by the brain during pregnancy and birth. A history of stress in the marriage or a difficult delivery can all contribute to the condition. While a family history of anxiety or mood disorders places women at greater risk of developing postpartum OCD, the condition can also occur in women who had no prior risks of OCD.

Becoming a parent is a major change in one’s life, causing a mix of emotions including happiness, anxiousness, excitement, and worry. Liz Torres says one of her main concerns with postpartum OCD is that women feel too embarrassed to talk about it. “A lot of women will tell [physicians] of their OCD thoughts. The problem is that women don’t tell each other about it.” Dr. Lee Cohen, director of the Perinatal and Reproductive Psychiatry Clinical Research Program at Massachusetts General Hospital in Boston, extends the reasoning for women’s silence on the issue: “Unfortunately, women are very reluctant to reveal those symptoms because they’re fearful that [child welfare] is going to be at their door taking their baby away. So this is a disorder in which patients suffer in silence.”

It is common for women, especially new parents, to fear their child may get hurt. It is important that we identify the problem afflicting women with postpartum OCD and get them the help they need. It is also important to assure them that their feelings of concern are natural so they feel free to open up and discuss their thoughts. Jerilynn Ross, president and CEO of the Anxiety Disorders Association of America, has advice to those who know someone struggling with postpartum OCD: “If she’s having those feelings at all, she should talk to a professional. If, for no other reason, to tell [the women] that it’s OK.”(Restivo, 2012).

References:

Abramowitz, J. (2014, November 18). Beyond the Blues: Postpartum OCD. Retrieved April 22, 2017, from https://iocdf.org/expert-opinions/postpartum-ocd/

Angeles, O. C. (2016). Perinatal / Postpartum OCD – Symptoms And Treatment. Retrieved April 23, 2017, from http://ocdla.com/postpartum-ocd

McGrath, P. (2013, July 10). Postpartum OCD. Retrieved April 23, 2017, from https://www.psychologytoday.com/blog/dont-try-harder-try-different/201307/postpartum-ocd

Restivo, J. (2002, January 23). Postpartum Obsessive Compulsive Disorder. Retrieved April 23, 2017, from http://abcnews.go.com/Health/story?id=117022&page=1

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Obsessive Compulsive Disorder

Less is More? The Problem with Obsessive Compulsive Decluttering

Let’s do a thought experiment. You’re visiting a neighbor’s home for the first time. You enter through the ornately designed front door, pass the neat rows of shoes, and head into the living room. The first thing you notice about the room is how tidy it is. The floor is almost empty, spotless and glistening. There are a few books and pens on his desk, placed neatly in front of the table’s chair. The small chair in the center of the room appears to be brand new. You don’t see any lamps in the room and ask why. “Less is more,” he replies. As you leave, your neighbor begins to toss his pens and books into the garbage. He breaks down his chair and chucks it into the trash as well. The next day, he goes out and buys a new pen, more books, a new lamp, and another chair from the market. When you ask why, he says, almost to himself, “I would rather throw something out and buy it again than keep it.” You conclude your neighbor may have obsessive-compulsive decluttering, the polar opposite of hoarding.

Obsessive-compulsive decluttering is listed as a subtype of obsessive-compulsive disorder. It is an inability to keep possessions and a strong desire to discard one’s belongings (American Psychiatric Association, 2013). Throwing away your belongings or wanting to keep a clean house is something that is considered to be normal and productive. However, those who obsessively declutter find themselves in a cycle of purchasing items, tossing those items away, and rebuying them only to get rid of them shortly afterward (Singer, 2016).

Some of psychologist Vivien Diller’s patients describe it as “this tightness in their chest if they see things that should be thrown out.” This feeling can be eased only by getting rid of the offending objects. Another described it as “a physical sensation as though I’m being crushed when I have too many things around me” (Barbour, 2014).

“Being organized and throwing things out and being efficient is applauded in our society because it is productive. But you take somebody who cannot tolerate mess or cannot sit still without cleaning or throwing things out, and we’re talking about a symptom,” says Diller. The cultural embrace of decluttering can provide a cover for this damaging behavior (Garrett, 2015). This makes it difficult for people to recognize when someone has decluttering disorder.

Although cleanliness and minimalism are looked upon as favorable qualities in society, this does not mean that problems will not arise when these issues are taken to the extreme. People who possess obsessive compulsive decluttering disorder are unable to keep their belongings and will feel anxious by just having “stuff” around. “Any behavior can technically become a problem when it starts having an obsessive and compulsive nature. Even healthy behavior” says Jennifer Baumgartner, a clinical psychologist who has worked with patients suffering from obsessive-compulsive cleaning (Garrett, 2015). Despite being the opposite of hoarding, obsessive-compulsive decluttering is an illness that causes real harm to those who have it.

References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Barbour, H. (2014, February 04). Less is more. Retrieved April 10, 2017, https://helenbarbour.blogspot.com/2014/02/less-is-more.html

Garrett, L. (2015, September 07). The Opposite of Hoarding. Retrieved April 09, 2017, https://www.theatlantic.com/health/archive/2015/09/ocd-obsessive-compulsive-decluttering-hoarding/401591/

Singer, J. (2016, March 1). Obsessive Decluttering. Retrieved April 09, 2017, https://blogs.psychcentral.com/ocd-reflections/2016/03/obsessive-decluttering/

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Obsessive Compulsive Disorder

Taboo Thoughts: Obsessions in OCD

Quirky, clean, and organized. These are three words that people tend to think when they hear the word “OCD.” Obsessive-compulsive disorder (OCD) is different from other mental illnesses in that it is associated with more “positive” traits than “negative” traits (Loving, 2013). For example, people with depression are sometimes seen as antisocial, dangerous, and weak while people with OCD are seen as humorous, meticulous, and perfectionist. However, there is a hidden side to OCD that many people are unaware of; the extent to which OCD affects a person’s life is often underestimated.

OCD is divided into two components: obsessions and compulsions. Obsessions are recurrent, unwanted, and intrusive thoughts, while compulsions are the mental acts performed in response to the obsession. The focus of obsessions and compulsions vary among individuals. Common types include cleaning, symmetry, taboo thoughts, and harm (American Psychiatric Association, 2013). These obsessions and compulsions can take up several hours of a person’s day and inhibit their ability to function properly. When it comes to taboo classified obsessions, people often feel distressed because they see it as a flaw in their character; they interpret these thoughts as something which may come to fruition. The alarming nature of these thoughts causes a person to perform whatever mental acts possible to prevent it from coming true (Cormier, 2016). OCD can take the things that a person cares about the most and turn it into their worst enemy.

For example, let’s look at the case of John (a pseudonym). John is a devout Christian and family man with a young daughter. Imagine hearing a call that went something like this: “I have an inpatient that worries he might be a pedophile. I think it’s OCD, but he has a young daughter and our social worker wonders if we should make a report to child protective services.”

John had OCD since he was 12. At that age, his obsession was focused around religious and spiritual topics, such as where he would go after he dies. However, as he grew older, his obsession shifted into different areas. He began to fear he was attracted to his sister, that he was gay, and that he was a pedophile. It’s important to understand that John was none of these things. People with this form of OCD are actually the least likely to harm children (Williams, 2012).

Yet, these thoughts made John a disaster waiting to happen. He would avoid his children at any cost out of fear that he may hurt them. John frequently read the Bible, thought of children to affirm the fact that he wasn’t attracted to them, and asked his family and friends to constantly reassure him that he was a good person. John had become so distracted that he was demoted at work and would falsely call in sick. He eventually became so concerned for his children, he attempted suicide.

John’s form of OCD was misunderstood by authorities, who questioned his ability to parent. This is a reasonable assumption. However, this misdirects people with OCD into the disciplinary system instead of the office of a medical professional. People with pedophilic OCD are afraid to talk about their feelings to the community because they may believe they will be misunderstood or that people will see them as malicious.

John managed to slowly heal through cognitive behavioral therapy, a form of talk therapy that focuses on changing a way a person reacts to a situation. Although he had to accept that his obsessions may never completely go away, the therapist provided him with guidance on resisting his compulsions, the driving force of OCD (Thoughts, 2013).

The image of OCD being a cleaning disorder takes away from the suffering that people with OCD actually face. In John’s case, it took away from his peace of mind, his ability to spend time with his daughter, and almost directed him to the legal system instead of the mental health system. Educating ourselves about the realities of OCD is key to extending help to those who may suffer from it.

References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Cormier, Z. (2016, March 26). The Mental lllness Cursing People With Pedophile Illusions. Retrieved March 26, 2017, from http://www.thedailybeast.com/articles/2016/03/26/the-mental-lllness-cursing-people-with-pedophile-illusions.html

Loving, O. (2013, November 08). Obsessive Thoughts: A Darker Side of OCD. Retrieved March 26, 2017, from https://www.theatlantic.com/health/archive/2013/11/obsessive-thoughts-a-darker-side-of-ocd/281260/

Thoughts, I. (2016, July 28). Am I a Monster? An Overview of Features and Treatment for POCD. Retrieved March 26, 2017, from https://www.intrusivethoughts.org/monster-overview-common-features-treatment-pocd/
Williams, M. (2012, December 15). Could I Be a Pedophile? The Worst Kind of OCD. Retrieved March 26, 2017, from https://www.psychologytoday.com/blog/culturally-speaking/201212/could-i-be-pedophile-the-worst-kind-ocd

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Obsessive Compulsive Disorder

The Kids Aren’t Alright

Children: curious, rambunctious, and innocent. As a child your mind is filled with strange thoughts: believing your parents are aliens, your pet can talk, or there are monsters in your closet. Additional to these thoughts, you probably had a few interesting habits: arranging your food by color, leaving your toys around your parent’s workspace, or avoiding cracks on the street. As you age, you grow out of these thoughts and quirks, reaching the conclusion they’re irrational. But what if you couldn’t? What if these thoughts of monsters felt so real that you couldn’t sleep? What if you wanted to step on that crack but you couldn’t because you were afraid it would make that monster angry? For children with obsessive-compulsive disorder, this may be their reality.

Obsessive-compulsive disorder (OCD) is described by the DSM-5 as the presence of time consuming and irrational obsessions and compulsions (American Psychiatric Association, 2013). Almost half a million children in the United States suffer from OCD. Approximately 25% of those with OCD  developed it before age 14, with 25% of male cases occurring before the age of 10.

Unlike adults, children with OCD may not realize their obsessions and compulsions are excessive or view their symptoms as a disorder which can be treated. A result of their limited vocabulary, it may be difficult for them to communicate the purpose of their compulsions (Kulkarni and Sudarshan, 2015). Children are also more likely to involve other people, usually their parents, as part of their ritual; they have their parent confirm their obsessions and acts are logical or may request their family member’s assistance completing the ritual (American Psychiatric Association, 2013). Parents are confused by their child’s behavior and may perceive it as them being “bratty.” When they are unable to engage their parents in their ritual to dispel their worries, they can become anxious, withdrawn, irritable, or angry.

Routines and rituals are a part of everyday life for a child. They’ll say goodnight before sleeping, follow their class schedule, or eat lunch at a particular time. These repetitive acts help organize a child’s day and are considered normal. Following routines also help children socialize, develop hobbies, or generate stress management tools (Boileau, 2011). However, actions and thoughts stemming from OCD are time consuming and make daily life stressful for children. When in a school environment, children with OCD tend to find it difficult to make friends or take part in extracurriculars because of the amount of time consumed by their compulsions (Strauss, 2016). The Anxiety and Depression Association of America describes how OCD affects children academically:

“Students with OCD may appear to be daydreaming, distracted, disinterested, or even lazy. They may seem unfocused and unable to concentrate. But they are really very busy focusing on their nagging urges or confusing, stressful, and sometimes terrifying OCD thoughts and images. They may also be focused on completing rituals, either overtly or covertly, to relieve their distress.”

Early detection of OCD is crucial to recovery. There are various treatment options available for those with OCD, including support groups and therapy. The International OCD Foundation and the Anxiety and Depression Association of America provide resources, such as help finding the nearest therapy group, opportunities to be involved in the foundation and spread awareness of OCD, and information for family members to educate themselves.

References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Boileau, B. (2011). A review of obsessive-compulsive disorder in children and adolescents. Dialogues in Clinical Neuroscience, 13(4), 401–411.

Dotson, A. (2016, November 03). Tuesday Q&A: Ethan S. Smith. Retrieved February 26, 2017, from https://alisondotson.com/2015/07/28/tuesday-qa-ethan-s-smith/

Kulkarni, H., & Sudarshan, C. Y. (2015). Obsessive Compulsive Disorder in a 4-Year-Old Child. Indian Journal of Psychological Medicine, 37(2), 230–232. http://doi.org/10.4103/0253-7176.155647

Strauss, V. (2016, October 11). What obsessive-compulsive disorder does to a young mind when it grows unchecked. https://www.washingtonpost.com/news/answer-sheet/wp/2016/10/11/what-obsessive-compulsive-disorder-does-to-a-young-mind-when-it-grows-unchecked/?utm_term=.6d509ef1833d

Categories
Obsessive Compulsive Disorder

A False Image: The “Quirkiness” of OCD

“I’m so OCD.” You’ve probably heard this phrase before. It’s what a friend says when they need a synonym for being punctual or when they want everything on their desk — from pens to laptop and books — to be positioned in a specific way. Or maybe you’ve heard it when someone needs a word to describe the intensity of their cleaning habits.

Contrary to popular belief, obsessive-compulsive disorder (OCD) is not an illness of cleanliness or rigidity. Many people with OCD have dysfunctional beliefs, which may include an inflated sense of responsibility, perfectionism, intolerance of uncertainty, or the need to control thoughts. OCD is characterized by the DSM-5 as the presence of obsessions and/or compulsions. Obsessions are recurrent, intrusive, time-consuming, and persistent thoughts, urges, or images. Often, the person will attempt to ignore or suppress these thoughts by focusing on another thought or action. Compulsions are repetitive behaviors or mental actions that a person feels driven to perform in response to an obsession. These compulsions are done with the goal of reducing or preventing anxiety, or preventing something harmful from happening. It differs from being cautious in that compulsions are excessive and do not realistically prevent the obsession (American Psychiatric Association, 2013). According to the National Institute of Mental Health, OCD is present in approximately 1.2% of the population with 50.6% of those inflicted having severe OCD. In the United States alone, 2.2 million are affected (Myrick and Pavelko, 2015).

Most people experience impulsive and distressing thoughts that can be considered symptomatic of OCD (Moulding, et al.). It can be constantly worrying that you forgot to lock your door, believing that your professor is going to give you a surprise quiz, or feeling that your car will break down while you’re driving. This behavior is normal and usually only causes a brief or low level of distress. A person with OCD focuses on their obsessions and compulsions to the point where their daily functioning becomes impaired.

Alison Dotson, author of the memoir Being Me With OCD, has an experience with OCD that exemplifies the misconception of the disorder. Although she began displaying symptoms as a child, she was diagnosed shortly before her 27th birthday. “I suffered in silence for years and years because all I knew about OCD was that people wash their hands too much and always check to make sure the stove is off,” she said in an interview with The Atlantic. When Dotson would mention her diagnosis to her loved ones, they would approach her with a tone of confusion:

“‘Are you sure? I’ve been to your apartment. I mean, it wasn’t messy or anything, but it didn’t seem like you clean compulsively.’ I explained to him that an obsession with germs is only one symptom of OCD and that I mostly just have obsessive thoughts without trying to get rid of them with a corresponding compulsive behavior. (I have since realized that avoiding situations that trigger or make me face the source of my obsessions is a compulsion.) I tried to express to him how my irrational fears can completely take over until I feel like I have no control over my own thoughts or happiness (Dotson, 2014).”

When Dotson’s friend Joe asked for an example of an obsession, she paused:

“No one, not even my psychiatrist, knew the specifics of my deepest fears. Dr. Grant knew in general what I had been struggling with, but he knew how painful it would be for me to detail any of my obsessions with him. He knew enough to comfort me and let me know I wasn’t alone. I chose a ‘safe’ example to share with Joe. ‘When I was little, I had a fear of being burned alive. And it wasn’t just that I was afraid it might happen; I was sure it was going to happen. I would cry in bed at night and ask God why I had to be in a fire. I worried about it constantly.’ I think he sympathized with me, but because what he knew about OCD didn’t match up with what he knew about me, he didn’t seem convinced (Dotson, 2014).”

It speaks volumes that Dotson considered her fear of being burnt alive as a “safe” obsession to reveal to her friends. The image of OCD being a “cleaning disorder” does not accurately portray or represent the severity of its symptoms. Even medical professionals expressed their skepticism towards her diagnosis. After coming down with a painful stomach ache, Dotson went to see a gastroenterologist. While asking her for the names of medications she had been taking, Dotson had mentioned that she was diagnosed with OCD. The doctor then proceeded to reflect the stereotype that is often perpetuated towards OCD:

“Don’t we all?” he said with a note of disgust in his voice. “Psychiatry – that’s like the designer profession to have. Someone comes to you and says, ‘I wash my hands a lot,’ and you diagnose them with OCD. It’s so easy (Dotson, 2014).”

Misuse of the word is common and has skewed our paradigm of the illness itself. People often equate OCD with positive characteristics such as cleanliness and orderliness and while OCD is occasionally related to cleanliness, it does not encompass or describe the illness fully. People with OCD can have obsessions and compulsions that center around religion, sexuality, checking, and the body. While those with illnesses such as depression, schizophrenia, and bipolar disorder are often considered dangerous, those with OCDs often serve as a form of comic relief. Instead of focusing on the amount of anxiety they feel as a result of their illness, their repetitive behaviors are often considered humorous (Pavelko & Myrick, 2015). This complicated and debilitating illness is misrepresented and seen as a quirk rather than the serious illness that it is. Obsessive-compulsive disorder is a chronic mental illness and, like all mental illnesses, affects the lives of those who have it. Limiting our knowledge of this disorder prevents people who may have the disorder from seeking help and minimizes the pain felt by those who have it.

References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Dotson, A. (2014). Being me with OCD: how I learned to obsess less and live my life. Minneapolis, MN: Free Spirit Publishing.

Moulding, R., Coles, M. E., Abramowitz, J. S., Alcolado, G. M., Alonso, P., Belloch, A., & Wong, W. (2014). Part 2. They scare because we care: The relationship between obsessive intrusive thoughts and appraisals and control strategies across 15 cities. Journal Of Obsessive-Compulsive And Related Disorders, 3280-291.

Rachelle L. Pavelko, Jessica Gall Myrick, That’s so OCD: The effects of disease trivialization via social media on user perceptions and impression formation, Computers in Human Behavior, Volume 49, August 2015, Pages 251-258, ISSN 0747-5632,

Tipu, F. (2015, February 22). OCD Is Not a Quirk. Retrieved February 07, 2017, from https://www.theatlantic.com/health/archive/2015/02/ocd-is-a-disorder-not-a-quirk/385562/