OCD Patients

Obsessive-Compulsive Disorder Patients

Soon after obsessive worries begin, OCD patients typically do something to diminish the worry, a compulsive act. If they feel they have been contaminated by germs, they wash themselves; when that doesn't make the worry go away, they wash all their clothing, the floors, and then the walls. If a woman fears she will kill her baby, she wraps the butcher knife in cloth, packs it in a box, locks it in the basement, then locks the door to the basement. The UCLA psychiatrist Jeffrey M. Schwartz describes a man who feared being contaminated by the battery acid spilled in car accidents. Each night he lay in bed listening for sirens that would signal an accident nearby. When he heard them, he would get up, no matter what the hour, put on special running shoes, and drive until he found the site. After the police left, he would scrub the asphalt with a brush for hours, then skulk home and throw out the shoes he had worn.

Obsessive doubters often develop “checking compulsions.” If they doubt they've turned off the stove or locked the door, they go back to check and recheck often a hundred or more times. Because the doubt never goes away, it might take them hours to leave the house.

People who fear that a thud they heard while driving might mean they ran someone over will drive around the block just to make sure there is no corpse in the road. If their obsessional fear is of a dread disease, they will scan and rescan their body for symptoms or make dozens of visits to the doctor. After a while these checking compulsions are ritualized. If they feel they have been dirtied, they must clean themselves in a precise order, putting on gloves to turn on the tap and scrubbing their bodies in a particular sequences ; if they have blasphemous or sexual thoughts, they may invent a ritual was of praying a certain number of times. These rituals are probably related to the magical and superstitious beliefs most obsessionals have. If they have managed to avoid disaster, it is only because they checked themselves in a certain way, and their only hope is to keep checking in the same way each time.

Obsessive-compulsives, so often filled with doubt, may become terrified of making a mistake and start compulsively correcting themselves and others. One woman took hundreds of hours to write brief letters because she felt so unable to find words that didn't feel “mistaken”. Many a Ph.D. Dissertation stalls – not because the author is a perfectionist, but because the doubting writer with OCD can't find words that don't “feel” totally wrong.

When a person tries to resist a compulsion, his tension mounts to a fever pitch. If he acts on it, he gets temporary relief, but this makes it more likely that the obsessive thought and compulsive urge will only be worse when it strikes again.

OCD is very difficult to treat. Medication and behavior therapy are only partially helpful for many people. 

Even some forms of obsessive jealousy, substance abuse, compulsive sexual behaviors, and excessive concern about what others think about us, self-image, the body, and self-esteem can be helped.

(Brain Lock Unlocked. The Brain That Changes Itself by Norman Doidge, M.D., excerpt).