FREE ESSAY ON OBSESSIVE COMPULSIVE DISORDER

OBSESSIVE COMPULSIVE DISORDER

Obsessive Compulsive Disorder- pg. 1
Introduction and Thesis
Introduction
When I was young, I used to constantly hum one solitary note every few seconds or minutes
throughout the day. I also used to glide the tips of my fingers right behind my ear just
so I could be assured that my hair was in place. It was almost impossible to avoid. I was
continually asked the question, "why do you do that," from my classmates and friends. It
was sometimes embarrassing. Then one day, my "habit" disappeared.
Today, my cousin R.J. coughs for no reason every minute. My friend Brian V. constantly
picks his rear end, only when driving, thinking he's playing it off. I'm always told that
I pray more than once before eating my meal. My response is, "I did?" There are many
people who have odd or common habits. But there are those who are endlessly encircled by
rituals and anxious thoughts called obsessive-compulsive disorder.
Obsessive-compulsive disorder (or OCD) is characterized by anxious thoughts or rituals
you feel you cannot control. If you have OCD, as it is called, you may be plagued by
persistent, unwelcome thoughts or images, or by the urgent need to engage in certain
rituals. You may be obsessed with germs or dirt, so you wash your hands over and over.
You may be filled with doubt and feel the need to check things repeatedly. You might be
preoccupied by thoughts of violence and fear that you will harm people close to you. You
may spend long periods of time touching things or counting. You may be preoccupied by
order or symmetry. You may have persistent thoughts of performing sexual acts that are
repugnant to you. Or you may be troubled by thoughts that are against your religious
beliefs. 
Obsessive Compulsive Disorder- pg. 2
The disturbing thoughts or images are called obsessions, and the rituals that are
performed to try to prevent or dispel them are called compulsions. There is no pleasure
in carrying out the rituals you are drawn to, only temporary relief from the discomfort
caused by the obsession.
Thesis
Obsessive-compulsive disorder is an anxiety problem in which people are in severe
emotional pain or they are unable to function because of obsessions and compulsions.
Richard, a married man with three children has this disorder. In this essay, I will
determine the cause of his ordeal and the treatment needed to be utilized based on the
numerous information collected from various resources.
Symptoms of Obsessive-Compulsive Disorder
Signs and symptoms frequently associated with obsessive compulsive tendencies or
obsessive compulsive disorder can have a variety of symptoms.
Symptoms
Obsessions
These are unwanted ideas or impulses that repeatedly well up in the mind of the person
with OCD. Persistent fears that harm may come to self or a loved one, an unreasonable
concern with becoming contaminated, or an excessive need to do things correctly or
perfectly, are common. Again and again, the individual experiences a disturbing thought,
such as, My hands may be contaminated -- I must wash them; I may have left the gas on; or
I am going to injure 
Obsessive Compulsive Disorder- pg. 3
my child. These thoughts are intrusive, unpleasant, and produce a high degree of anxiety.
Sometimes the obsessions are of a violent or a sexual nature, or concern illness.
Compulsions
The most common of these are washing and checking. Other compulsive behaviors include
counting (often while performing another compulsive action such as hand washing),
repeating, hoarding, and endlessly rearranging objects in an effort to keep them in
precise alignment with each other. Mental problems, such as mentally repeating phrases,
listmaking or checking are also common. These behaviors generally are intended to ward
off harm to the person with OCD or others. Some people with OCD have regimented rituals
while others have rituals that are complex and changing. Performing rituals may give the
person with OCD some relief from anxiety, but it is only temporary. 
Insight
People with OCD show a range of insight into the senselessness of their obsessions.
Often, especially when they are not actually having an obsession, they can recognize that
their obsessions and compulsions are unrealistic. At other times they may be unsure about
their fears or even believe strongly in their validity. 
Resistance
Most people with OCD struggle to banish their unwanted, obsessive thoughts and to prevent
themselves from engaging in compulsive behaviors. Many are able to keep their
obsessive-compulsive symptoms under control during the hours when they are at work or
attending school. But over the months or years, resistance may weaken, and when this
happens, 
Obsessive Compulsive Disorder- pg. 4
OCD may become so severe that time-consuming rituals take over the sufferers' lives,
making it impossible for them to continue activities outside their homes. 
Shame and Secrecy
OCD sufferers often attempt to hide their disorder rather than seek help. Often they are
successful in concealing their obsessive-compulsive symptoms from friends and coworkers.
An unfortunate consequence of this secrecy is that people with OCD usually do not receive
professional help until years after the onset of their disease. By that time, they may
have learned to work their lives -- and family members' lives -- around the rituals. 
Taking "Forever" To Get Things Done
Sometimes because of compulsions, it can take "forever to get things done. It may be
necessary to check the back door seven times before leaving the house, to get in and out
of the car three times before starting it, to walk backwards in a room, to touch all of
the drawer knobs in the bathroom before washing, and so forth.
Long-Lasting Symptoms
OCD tends to last for years, even decades. The symptoms may become less severe from time
to time, and there may be long intervals when the symptoms are mild, but for most
individuals with OCD, the symptoms are chronic. 
Richard's Story
The Anxiety
Shortly after awakening on a Tuesday morning about six months ago, Richard, a married man
with three children, had the unbidden thought, "today is the day I will die." He felt a
chill 
Obsessive Compulsive Disorder- pg. 5
go through his body, and he tried to counter the frightening idea by thinking, "that's
silly. I'm in perfect health. I don't do dangerous work. I'm a careful driver." However,
in a short time, the unbidden thought returned. He was shaving, and he watched his hand
tremble as he rinsed his razor in the warm water. "Today is the day I will die." His
heart began to pound and he broke out in a cold sweat. Then he voluntarily thought,
"Superman, Batman, and Tarzan will protect me." He felt an almost immediate decrease in
his anxiety. Three more times that day, he had the unbidden thought that he would die,
and each time he controlled his anxiety by invoking the names of the three superheroes.
As indicated above, this happened six months ago, and it has repeated itself two to seven
times a day since. 
Sound Reasoning
Richard's strange thought is an obsession, a persistent, invasive idea that is perceived
to be illogical by either the subject who holds the thought, or an outside observer
(Frank J. Bruno Ph.D. Psychological Symptoms 1994). (This assumes that the subject is
willing to discuss the thought with someone else, which is often not the case.)
Obsessions are common mental phenomena in both neurotic disorders and in schizophrenia.
This essay will focus on the disorder that Richard has which is focus on neurotic
process. An additional feature of obsessions in neurotic conditions is that they have a
content suggesting the possibility of some danger, loss, or risk. Consequently, they
induce anxiety.
Other than Richard's obsession, here are some additional examples. "I'm going to lose all
my friends." "I have a wart on my nose that's getting bigger and bigger." "Every man
wants to rape me." "I'm ugly." "You can get AIDS from touching contaminated objects such
as 
Obsessive Compulsive Disorder- pg. 6
doorknobs." Maybe I forgot to lock the door and unplug the iron." " My partner secretly
hates me." " An earthquake will destroy my house next week."
Rationalization Blanket
A compulsion is a ritual; tinged with either an irrational or a magical quality, designed
to reduce the anxiety associated with an obsession. In Richard's case, invoking the names
of the three favorite superheroes of his late childhood and early adolescence gave him a
temporary sense of security. He recognizes the silliness of both his obsession and his
compulsion, but he was powerless to prevent the thought and to resist the compulsion. A
compulsion can express itself in the form of either thought or action (Hollander E, Stein
DJ: Obsessive Compulsive Disorders 1997). Richard's took the shape of thought.
The Course of Obsessive-Compulsive Disorder (OCD)
OCD can be relentless. If untreated, OCD is usually chronic and follows a waxing and
waning course. That is, symptoms may get somewhat better for months or even years, only
to get worse again before returning to a lower level of severity. "Only about 5 to 10
percent of OCD sufferers enjoy a spontaneous remission in which all symptoms of OCD go
away for good (Wayne K. Goodman, MD, University of Florida Brain Institute, 1999).
Another 5 to 10 percent experience progressive deterioration in their symptoms." Stress
can make OCD worse, but trying to eliminate all stress is unlikely to quell OCD. In fact,
it is better for most people with OCD to keep busy. Idleness can be the breeding ground
for increased obsessional thinking. Changes in the severity of OCD may be related to
fluctuations in the body's internal chemical environment. Women with OCD often report
that their symptoms become more severe the week before their 
Obsessive Compulsive Disorder- pg. 7
menstrual period. Presumably, this is related to the natural ebb (or reflux) and flow of
hormones that regulate the menstrual cycle. Diet has not been shown to influence OCD
(Hollander E. Stein 1997).
Causes and Explanations 
The Perspective
Classic psychoanalytic theory suggests that obsessions come from repressed id impulses.
The id is the primitive, pleasure, risk taking, biological urge, aggressiveness and
fantasy-oriented agent of the personality (Nat DeAnda Ph.D. Los Medanos College 00).
These impulses are more likely to be present in persons who suffered emotional wounds in
early childhood and who are socialized and lead a comforting, morally conventional life
(Frank J. Bruno, Psychological Symptoms 1994). Put differently, the superego, the moral
component of personality, sets moral guideline, which limit the flexibility of the ego
(Wood and Wood, The World of Psychology, Third Edition, 1999), but does not allow the
expression of the id impulses in either consciousness or action. Richard is trapped in a
loveless marriage. Being a traditional man dedicated to the social conventions of his
family and culture, the thought of leaving his wife is morally unacceptable. As a
solution, his id simply wishes to simply do away with his wife and children - the obvious
obstacle to his happiness and to the possibility of a loving relationship. As farfetched
as this sounds to most people, it must be remembered that there are married partners,
both male and female, who actually act out such impulses and kill a spouse as well as
children. In state mental hospitals, there are numerous individuals called " criminally
insane" who have inflicted either death or great bodily injury on their loved ones.
Obsessive Compulsive Disorder- pg. 8
OCD Works as a Cycle
The purpose of the compulsion, or ritual, is straightforward. It reduces the anxiety
associated with the obsession via the power of magic. If the underlying conflict remains,
the obsessions and compulsions repeat themselves (Baer L, Jenike MA, Personality
Disorders in OCD, 1992)
Treatments and Professional Help
Although the exact cause of OCD is not known, recent medical research has shown that
biological factors are involved. As with panic disorders and depression, OCD may be
caused by an imbalance of chemical messengers such as serotonin, in the brain. Serotonin
deficiency is associated with anxiety, depression and suicide (Wood and Wood, The World
of Psychology, 1999).
The important thing to remember is that there is help available. Here are some ways in
which the professions of psychiatry and clinical psychology can help.
Psychodynamic Approach
Taking the psychodynamic approach, a therapist can help Richard attain deeper
understanding of an obsession that he can attain on his own. An obsession is structured
somewhat like a dream. It's manifest content must often masks a latent content (i.e. a
forbidden wish). The manifest content must be decoded in order for its meaning to be
revealed. A therapist can help Richard overcome his resistance by methods such as free
associations on his part to various aspects of the obsession.
Obsessive Compulsive Disorder- pg. 9
Drug Therapy
Drug therapy is medication prescribed by a doctor to relieve the symptoms of an illness.
Most recently, certain antidepressant medications in the selective serotonin reuptake
inhibitors class (SSRI's), paroxetine HCL, and tricyclic antidepressants have been found
to be effective for controlling symptoms of OCD (Albert Rothenburg, MD, The Psychiatric
Clinic of North America 1998)
Cognitive-Behavior Therapy
Cognitive behavior therapy can help Richard reduce the anxiety associated with obsessions
and reduce and eliminate compulsions. Techniques of cognitive-behavior therapy usually
include facing the very situations that are most feared (this is called exposure),
without resulting into compulsive rituals (this is called response prevention). Other
cognitive-behavioral techniques to address specific obsessions or compulsions are
sometimes used.
Humanistic Approach
Taking a humanistic approach, a therapist may offer Richard emotional support. Humanistic
therapists encourage personal growth and seek to teach clients how to fulfill their
potential and to take responsibility for their behavior and for what they become in life
(Wood and Wood, The World of Psychology, 1999).
Conclusion
In this essay, I have included a plethora of information from various sources which
pertain to the obsessive-compulsive disorder. Obsessions or compulsions cause emotional
pain, take up a lot of time, or strongly disrupt the person's normal routine of work,
school, or social 
Obsessive Compulsive Disorder- pg. 10
life. Obsessions are thoughts, impulses or images that come to mind over and over again,
and that seem foolish to the person and can cause a lot of anxiety or distress.
Compulsions are attempts to reduce anxiety or prevent some feared event or situation by
carrying out certain acts over and over and over again. Common compulsions are, hand
washing, putting things in order, checking things, praying counting, and repeating words
softly. Some or all the time, the person with OCD feels that the obsessions and
compulsions are foolish and excessive - yet the person usually cannot avoid them for long
without great effort. 
Observation
From extensive pondering, I have formed a solution concerning Richard's case. You have to
take in consideration that it is not Richard, represented by his whole personality, who
wants to inflict injury on his loved ones. Rather, it is his id, a primitive part of his
personality. He is nowhere near acting out his hostile impulses. Instead, they are
blocked - repressed into the unconscious realm. However, his ego, the conscious agent of
the personality, senses danger to his loved ones. This danger signal is converted, for
the purposes of censorship and protection against the id's wishes, into hostility
directed against the self. In other words, the unconscious logic is, "There is danger to
my wife and children. The source of this danger is me. Therefore I must die for their
safety." The unconscious obsession is, Today is the day I will die." And the unconscious
mental processes are blocked from view.
Although not given much information on the case study, in my opinion, hypothetically, I
believe the condition that Richard is in is genetic, and probably obtained it from one of
his parents. Research evidence points to a biological basis for obsessive compulsive
disorder in some people, and several twin and family studies suggest that a genetic
factor may be involved 
Obsessive Compulsive Disorder- pg. 11
(Rassmussen and Eisen, 1990). Given that Richard repeatedly says that he is going to die,
this tells me that he shows some signs of carelessness. And carelessness is an indication
that someone is suffering from depression. A sign of depression in Richard can also
indicate that his serotonin levels are abnormal. If I were Richard's doctor or
psychiatrist, I would prescribe to him antidepressant medication, which increases the
availability of serotonin in the synapses (Murphy and Pigott 1990) so his mood and
impulsivity can be controlled. 
Recommendations for Future Study 
In more recent years, it had become generally known that the incident of OCD is much
higher than previously thought (Hollander E. Stein DJ, Obsessive Compulsive Disorder, NY
1997). There are approximately five million Americans who suffer from this condition.
Future study should focus more on decreasing this number to a minimum. Medication should
works for all OCD patients, not just some. 
In my opinion the most successful treatments of OCD involves cognitive-behavioral
therapy, humanistic therapy, and family guidance. There is no need to endure chronic,
mental, and emotional suffering. If someone has OCD, they should be assured that there
are ways out. The professions of psychiatry and clinical psychology will always be there
to offer help so that those with OCD can live a more a contented and "time well spent"
life.