October 03, 2011

Am I OCD or just really particular ?

Am I OCD or just really particular ?

Over the past years, our segments  have tried to educate, raise awareness and expose myths on many mental health and relationship issues.  Although we've covered many topics, we have never talked about Obsessive Compulsive Disorder or OCD.  Today we're going to fix that oversight.

The reason OCD deserves our attention is because many folks worry needlessly about it.  In fact, many emotionally healthy people carry around a secret and embarrassing belief that some repetitious quirk they might have is a sign that they have OCD  and therefore a mental disorder.  Today we are going to discuss what OCD is and talk about how real OCD differs from everyday-normal repetitious thoughts and behaviors.

Normal "life anxiety" and everyday obsessions and compulsions
It is important to understand that, as humans,  our awareness of the reality of chaos and death makes anxiety a fundamental part of life. There are many threats to our sense of safety and security which are outside our control. Obsessive/compulsive tendencies are a response to that sense of threat and are not, in and of themselves, a pathology. In fact a obsessions and compulsions are psychological defense mechanism  to help us keep it "together".

Likewise, obsessions and compulsions aren't necessarily bad.  Most of us have some thoughts which make us uncomfortable and some action which can relieve the stress.  For example, it is good to check that you locked the door or to look both ways before crossing the street.  Paying attention to real potential problems can mean just being careful or precise. (I want my accountant to be a little OCD).  Also there is nothing wrong with having little gestures which help us to feel better when we are stressed.  For example, the basketball player who crosses him/herself before shooting the foul shot.  

What distinguishes the pathological from the "normal" is relative, a matter of degree and sometimes is difficult to determine with absolute certainty.  For example, many people find that cleaning is a way to cope with anxiety. Likewise  straightening up may help us to feel better when we are stressed.  Thus we need to be careful not to use OCD as a pejorative label.  Even religious devotion, from a skeptical eye, may seem obsessive.

When taken to the extreme however these helpful behaviors can become problematic and are signs of an underlying psychological condition.

What is OCD ?
OCD is a type of perceptional/anxiety disorder which is characterized by exaggerated,  persistent, intrusive, unwanted or inappropriate thoughts and behaviors which involve thoughts of irrational threats and magical remedies. There are many different kinds of obsessions and compulsions but here are some common examples:
-- An exaggerated or unreasonable inability to tolerate disorder and a need to straighten up  (Think of Jack Nicholson's character in the film As Good As It Gets) .
-- A fear of germs and a need to wash one's hands over and over.  (Think of the TV character Monk or Howie Mandell)  
-- A fear of poverty and a need to hoard.
-- A sense of being overwhelmed by what to do and a need to make many lists.

What is sometimes not understood is the connection between the unwanted obsession and the compulsive behavior. The thought (the obsession) creates the anxiety and  the act (the compulsion) reduces it ... at least temporarily.  

According to the National Institute for Mental Health, most folks who suffer from OCD inherit or are born with this neurological condition. (It isn't caused by poor parenting. or trauma.) OCD affects about 2% of our population.

Here are some guidelines which can help us to sort out whether our  OCD tendencies are clinically problematic or not:

Tell Tale Signs of the Obsessive Compulsive Disorder

1) Persistence :The state of stress for most folks varies and goes up and down. For one who suffers with OCD, life is in constant turmoil and anxiety.
 
2) Intensity: Anxiety for most people is unpleasant but for those with OCD, the anxiety is intolerable especially if the associated compulsive ritual cannot be performed.  

3) Loss of Ability to Reality Test : For non-OCD anxiety , the irrational connection between the ritual and the relief experience is understood. e.g. If I don't put my left shoe on first instead of my right, I know  won't necessarily have a bad day.  OCD folks can't discern a true threat from a false alarm or understand the magical thinking connected to the ritual.  All anxiety is experienced as an imminent threat which requires the salutary compulsive act.

4). Rigidity: Just can't  stop the thought feeling or behavior.  Most of us are creatures of habit and have regular times and structures  for when and how  we do things. However  from time to time changes are necessary in this routines.  For most these changes are unpleasant or mildly upsetting, for someone with OCD, changes are a crisis. For one with OCD, the order or the ritual is absolutely rigid and can't be changed even if it means experiencing seriously negative consequences .    

5) Interfering:  For most compulsive acts are done when they are practical to do so. For folks with OCD however the behaviors must be done even if normal routines need to be altered to accommodate the acts. The anxiety is so great that it causes serious alterations behavior which can significantly interfere with or disrupt one's life , plans or other important goals.    

For most of us, OCD  is not  a clinical disorder but a dimension of the human personality which helps us cope with stress and uncertainty. Hopefully we have cleared up some misunderstandings, provided some helpful information about OCD and allayed fears that some have about the little thoughts or rituals which help them to feel better. Indeed if your thoughts or acts help you and don't hurt anyone else or interfere with anything  important in your life -- ENJOY.  

If, after hearing this segment, you still have concerns, seek professional help. There are very effective treatments.
 
These comments were prepared by the Rev. Michael Heath, LMHC for Bridge Street 10 3 2011

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