Obsessive Compulsive Disorder (OCD) is a condition that has many myths around it. Some use the term for people that are highly organised while others use it for those that are overly concerned with cleanliness. However, to be formally diagnosed one must have persistent, intrusive, unwanted thought and compulsions (repetitive actions or rituals) to neutralise the anxiety these thoughts cause.
I have worked with and have had a very close family member diagnosed with this misunderstood condition. For me the basis of OCD is DOUBT. Doubt of whether one is clean enough and then the compulsion would be to wash to ensure the cleanliness. Doubt if whether one is secure enough and the actions would be checking all the locks over an over again. Doubt that the day will not go well and thus a very specific ritual needs to be followed. Some doubting is normal and is an inbuilt mechanism to ensure that we don’t act in a way that harms ourselves but when does doubting move beyond the realm of normal and towards psychopathology?
OCD is often shrouded in mystery, as sufferers struggle to understand the cause of their disorder. They understand that the behaviour isn’t normal but struggle to control their actions. Already prone to “over-thinking,” many believe that if they can determine what caused their brain to go awry, they can figure out a way to fix it. People with OCD have been known to spend hours ruminating to find “the root of the problem.” Many speak of a stressful time in their life prior to the OCD symptoms being triggered. However, research shows that no one factor can be held accountable for this condition. Just like all other mental disorders, a person must have a genetic predisposition towards the condition and it is possible for life events and trauma to trigger it. Personality and social environment also play a role on how this condition manifests. Changes in the neurochemical serotonin, as well as in the neurochemicals dopamine and glutamate, also play a part in OCD thus medications like the antidepressants known as selective serotonin reuptake inhibitors (SSRIs) improve symptoms for many people.
Interestingly, therapy that focuses on insight and finding the root of the condition has not been found to be effective. A combination of medication and cognitive behavioural therapy (CBT) focusing on exposing one gradually to the anxiety provoking thoughts and situations and assisting one to cope with it has been found to work well. Basically, it comes down to challenging the doubts, reframing the situation and responding mindfully with actions even though they may cause some anxiety initially. Taking the power away from the doubts and focusing on living each moment to its fullest becomes the goal of therapy. As Shakespeare once said,
“Our doubts are traitors and make us lose the good we oft might win, by fearing to attempt.”