As I'm backing out of my driveway to go to work and the garage door's closing, I think to myself, "Did I turn off all the burners on the gas stove? I'd better go back inside and check or the house could burn down." So I open the garage, disarm the alarm system and go check the stove. "Whew." All the burners are off and I feel a physical, emotional and mental relief flooding over me.
But as I'm backing out of the garage again the thought returns to me, "What if I accidentally bumped one of the burners and the stove is back on?" And I feel the worry and tension rising again so I go back inside, repeating the same process. Of course, the burners are all off and relief washes over me again. But as I'm backing my car out again...So you get the idea. Sometimes it can take OCD sufferers hours to get out of the house.
What happens is that OCD, or Obsessive Compulsive Disorder, is an anxiety disorder and by checking the burners and finding them all off I get relief or reward. And any behavior, such as checking, that's rewarded is reinforced. It's like teaching a dog to do a trick by giving it a treat each time it does what you want.
A couple of simple definitions: Obsessions are repetitive thoughts or images that are distressing, frightening and often shame producing; they're almost never, if ever, pleasant. Attempts to dismiss them are usually unsuccessful. Compulsions on the other hand are actions, behaviors or rituals that are hard to resist and attempts to control the worry. Such as checking the burners.
We're all a little OCD (I won't tell you mine) and sometimes we even laugh them off as funny little quirks. But it's when they become disruptive or interfere with normal functioning that there's a problem and we need to learn how to manage or overcome the thoughts or behaviors. And once symptoms begin they usually become more persistent over time. Interestingly, as a therapist I often see clients who come in with a different problem and in the course of therapy will mention, almost as an afterthought, some OCD behavior they do. "Oh yeah, it drives me crazy if my socks aren't lined up from light to dark colors in the drawer and stacked exactly six inches high."
So what causes OCD and who gets it? Well, even though we know a lot about treating it, we really don't know much about its causes with any certainty. Some studies suggest that OCD has a biological basis possibly caused by abnormalities in brain neurotransmitters. Maybe it's genetic and runs in families. If a parent and offspring both have OCD there's no conclusive way to determine if it's truly genetic or learned behavior by a child imitating the parent.
Studies of life histories are not revealing as no particular childhood events distinguish OCD sufferers from others. A person's psychological makeup can often influence the persistence of obsessions or compulsions but is not their cause.
It's often the case in medicine and psychology that we know more about how to treat a problem than what causes it. And that's OK. We can come up with better tools and strategies to manage and diminish OCD symptoms (as well as a lot of other problems too) and never figure out the cause. But as long as things get better that's what's important. Next time I'll talk about some of these powerful and effective techniques. See you then.
Next Time: BREAKING FREE FROM OCD (Part Two)