Compulsions 

        Compulsions are repeated behaviors (such as repeated hand washing) that seem impossible to stop or control. They are characterized by uncontrollable thoughts or impulses to perform an act, often repetitively. Compulsions are often thought to be due to an unconscious mechanism to avoid unacceptable ideas or desires which arouse anxiety. If the compulsive act is prevented; the anxiety is felt, often intensely. Compulsions are often associated with obsessive thoughts.

Obsessive-Compulsive Disorder

        I couldn’t do anything without rituals. They transcended every aspect of my life. Counting was big for me. When I set my alarm at night, I had to set it to a number the wouldn’t add up to a “bad” number. If my sister was 33 and I was 24, I couldn’t leave the TV on Channel 33 or 24. I would wash my hair three times as opposed to once because three was a good luck number and one wasn’t. It took me longer to read because I’d count the lines in a paragraph. When writing a term paper, I couldn’t have a certain number of words on a line if it added up to a bad number. I was always worried that if I didn't'’ do something, my parents were going to die. Or I would worry about harming my parents, which was completely irrational. I couldn’t wear anything that said Boston because my parents were from Boston. I could write the word "death” because I was worried that something bad would happen.

        Getting dressed in the morning was tough because I had a routine, and if I deviated from that routine, I’d have to get dressed again. I knew the rituals didn’t make sense, but I couldn’t seem to overcome them until I had therapy.


        Obsessive-compulsive disorder is characterized by anxious thoughts or rituals you feel you can’t control. If you have OCD, as it’s 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. 

        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.

        A lot of healthy people can identify with having some of the symptoms of OCD, such as checking the stove several times before leaving the house But the disorder is diagnosed only when such activities consume at least an hour a day, are very distressing, and interfere with daily life.

        Depression or other anxiety disorders may accompany OCD. Some people with OCD have eating disorders. In addition, they may avoid situations in which they might have to confront their obsessions. Or they may try unsuccessfully to use alcohol or drugs to calm themselves. If OCD grows severe enough it can keep someone from holding down a job or from carrying out normal responsibilities at home, but more often it doesn’t develop to those extremes.

        Fortunately there are medications and behavioral treatments that can benefit people with OCD. A combination of the two treatments is often helpful for most patients. Some individuals respond best to one therapy, some to another. Two antidepressant medications that have been found effective in treating OCD are clomipramine and fluoxetine. A number of others are showing promise, however, and may help.

Click to Return to the Topics Index


 

Assessment/Admissions - 410-938-3800 - 24 Hours / 365 Days
Main Switchboard - 443-364-5500