(Information for this essay comes from the following sources:”Freedom from Obsessive Compulsive Disorder” by Dr. Jonathan Grayson, Ph.D., “The Road Less Traveled” by Dr. M. Scott Peck M.D. and “Love, Medicine, Miracles by Dr. Bernie S. Siegel. M.D.)
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I have OCD – a frequently misunderstood psychiatric condition. At times, I am reluctant to talk about it. And people often give me advice that hurts me more.
So, what is it like to have OCD?
First, what is OCD?
OCD means Obsessive Compulsive Disorder and is diagnosed as repetitious thoughts and/or actions motivated by fear and anxiety. To reduce the anxiety, we “ritualize” – acting out our compulsions by repeating certain things until it feels right.
Our fears are irrational. They are based on our imagination. They logically make no sense. We may have these fears but, in reality, we are being bluffed by a sensation that deceives and emotionally cripples us.
Let me put you in the mind of an OCD sufferer and what we have to confront. I believe that we all have the following feelings. OCD sufferers have them greater.
Have you ever felt the following: you have left your home, you get half way down the road and you have a sudden thought that causes anxiety: …….Did I turn off the stove? …..Did I turn off the faucets? ……Did I put out my cigarette in the ashtray? Etc…etc.,…Something is troubling you and you can not get in it out of your mind.
You try to reason with your anxiety. You go over and over in your mind, replaying what you did and what you might not have done. No amount of thinking it through brings peace of mind.
You just can not get this “thing” out of your mind.
Somebody tells you just to forget it. But this is futile. You want to forget it. And get it out of your mind. And get on with your life.
Now multiple those feelings about 100, 200, even 1000 times a day. And that’s what OCD sufferers must go through.
We’ve all had these feelings. Fortunately, for most, it is fairly rare. But OCD sufferers have them on a consistent basis.
You wouldn’t tell an alcoholic wanting a drink to forget it. You wouldn’t tell someone suffering with the flu to stop feeling this way. Then why should an OCD sufferer plagued by his anxiety be treated any differently? To tell him to forget his problem is telling him to forget his pain.
For recovery, pain must run its course.
Another feeling we confront: have you ever handed anything in – a report, essay, sent out a letter – you know is right. But something doesn’t “feel right.”You keep checking and checking. Or you’re about to leave your house, you’ve checked half a dozen times. Again, something doesn’t “feel right.” You keep checking. This is part of what an OCD goes through.
We’ve all done this. OCD sufferers just do more of it.
Let’s compare what a non OCD sufferer person and what an OCD sufferer might do in an earlier mentioned situation.
Let’s take the stove, for example. Did he leave it on? A non OCD sufferer might go back and double check and, then, walk away. We’ve all done that.
An OCD sufferer, on the other hand, may go back, check, leave, only to be tormented by something else. He goes back again, checks, leaves, only to be tormented by something else. And so on…and so on….This vicious cycle never seems to end.
Or he may go back, check the stove, only to trigger other areas that need checking because they might have laid dormant in his mind. And keep checking because they, too, don’t feel right.
The more he gives in, the more anxiety he creates and more fears become prey to his OCD. It’s been said that if you give your OCD an inch, it takes a mile.
We all have one or two obsessions/compulsions. Medical officials feel when obsessions/compulsions control one’s life, consuming much of a person’s time, then there is a medical problem.
What’s the difference between obsessions and compulsions? Obsessions are the thoughts or ideas that the sufferer can not get rid of. They cause his anxiety. Compulsions are the physical acts or rituals to neutralize his anxiety.
What I have mentioned here is one small facet of OCD – checking things. There is a host of behaviors that plague OCD sufferers – hand washing, doing things in specific order, avoiding words/phrases to name a few.
The treatment for OCD is medications and CBT or Cognitive Behavior Therapy. CBT is a fancy expression in learning to confront one’s fears.
Cognitive represents the “educational” part of the disorder. It means, among other things, that giving in to one’s OCD makes matters worse. More anxiety is created.
Behavior is the actual confronting of one’s fears. And it’s in 2 parts – “exposure therapy” where the sufferer faces his fears and “response prevention” where he prevents giving into his rituals to neutralize his anxiety. It is never an easy road.
A short word about medications. There are many factors why medications work for some and not for others.
Generally speaking, in medical research, a quarter to a third of patients will show improvement if they “merely believe” they are taking an effective medication even if the pill has no actual ingredient. This is called the placebo effect. But the following must be present:
(1) meaning of illness experience for patient is altered in a positive manner,
(2) patient is supported by caring group and
(3) patient sense of mastery and control over illness is enhanced.
I believe some of these factors are present when OCD meds do have one or more active ingredients.
Other factors to consider for meds to work: those patients who had a higher level of trust and rapport with their doctor. And, finally, patients must want to take meds and believe they will work. This is called the “power of suggestion”. The patient is more likely to work at his recovery.
Why do meds work for some and not others? Meds reduce symptoms in some people and only reducing symptoms by about 30 – 50%. The patient still has to practice CBT. As a matter of fact, meds are not that helpful unless accompanied by CBT.
Several questions:
Question #1:
Is there some biochemical imbalance at play which OCD sufferers are born with? Some research says we are. For the record, the theory is a neotransmitter called serotonin is at play and not enough of this chemical is getting into certain parts of the brain.
Let’s face facts. All emotions are biochemical. But are we born this way? Science says we are. What gives it its severity is learned.
I have trouble with the idea that we are born this way. If we are, are people who are violent born that way as well? Scientists are suggesting that they are. Are other negative behaviors born in us rather than made? Bigotry? Racism? Etc.
By labeling it biochemical, we allow patients not to take responsibility for their recovery. I have met OCD sufferers who say that they can’t help themselves because of this imbalance.
OCD sufferers have trouble giving up on their rituals. They simply can not stop.
But would we feel comfort if a violent person says he can not stop being violent because of some imbalance? We say he had a sense of free choice or free will.
Then, why can’t we say that about OCD sufferers?
Question #2:
Is OCD the real problem or is there something more serious that needs to be addressed – specifically the patient’s entire well being?
Psychiatric medicine does not address the spiritual components of the patient. They address the illness but not the entire needs of the patient. Love, faith, a sense of purpose, humility, values, etc. By neglecting these principles, are doctors not harming the patient?
I have met OCD patients that if cured from their OCD, they’d still be sick and have emotional baggage.
Personally, when I have a sense of purpose, my OCD symptoms are less severe. Without focus, my OCD is worse.
There is also a theory that OCD as well as some symptoms of mental illnesses originate from the subconscious mind and are there to tell the patient his human spirit isn’t maturing.
I know from experience, when my OCD acts up, it is not relieved until I find out what spiritual component is plaguing me. Once I figure out what it is, the anxiety is lifted.
Such a theory is offensive to many doctors as well as patients. Doctors because patients are less likely to need medications. Patients because it means they have to take a more active role, more responsibility in their recovery.