Out of Control
Obsessive compulsive disorder (OCD) is an anxiety disorder in which people have thoughts, feelings, sensations (obsessions) or behaviours that make them feel driven to do something (compulsions).
Take, for example, Mary’s OCD. She came into therapy because she feared sharp objects and imagined herself lying on the floor with a knife or scissors in her chest. At night she was afraid of falling asleep because she worried that she would never wake up. Her OCD revolved around death.
Then there’s Angelo who at age 20 came to therapy with his OCD having taken the form of rubbing his desk constantly and having to put his pen away a dozen times.
Meanwhile, Peter had a fear of germs and contamination and washed his hands constantly. He obeyed certain rituals of touching and counting. His condition also took the form of scrupulosity, a religious form of OCD. Something in his mind told Peter he had cursed at god and that he would hurt him. Or, when he prayed, he has to repeat the prayer many times in case god misheard him.
All these patients were totally cognisant that their fears were irrational. But that is the torture of this disorder. Knowing that their fears aren’t rational didn’t make them any less terrifying.
In treatment, I let them all know that the more they gave in to their compulsions the less control they had over them. The compulsions and the rituals is what keep OCD alive.
This disorder is biologically based with severe psychological consequences. The brain is erroneously signaling that there is something dangerous out there
Reducing the anxiety of these individuals was through antidepressants in conjunction with behavior therapy which included exposure/response prevention where they were exposed many times to the situation that triggered their anxiety symptoms. Eventually, they learned to resist the urge to perform the compulsion.