The Devil Made Me Do It!
Don’t step on a crack or you’ll have to recite one hundred Our Fathers and Hail Marys, wash your hands ten times or until the skin peels off to prevent contamination, go back five times to make sure you’ve turned off the stove’s gas and locked the front door, and, most importantly, blame the devil for the daily rituals and hell on earth suffered by your psyche in order to guarantee some semblance of a normal life. You’ve got to be kidding, you say. No, if you’re one of the more than three million lost souls in the U.S. wrestling with the anxiety disorder known as obsessive-compulsive disorder (OCD), you know that the description above is not far removed from your quotidian reality. In fact, the series of episodes described might even be a best-case scenario, with severe cases bordering on science fiction or the ludicrous, and veterans of the OCD wars resorting to behaviors and idiosyncrasies that only half a century ago would have landed them in state insane asylums or worse. Victims in some cases, for example, have been known to go for extended periods of months without taking a shower, or the opposite extreme of washing so often that they’ve actually denuded their skin and left little time in the day to do other things, in order to compensate for misgivings, perceived errors, or murmured instructions of sulfurous origins exacting penance for sins as innocuous as touching a doorknob or shaking a hand.
But how does this all start? Where in the world do those recurrent, unwanted thoughts and repetitive or ritualistic behaviors come from? The answers to those questions are not immediately forthcoming, in the wake countless lost hours every day, a great deal of distress, and hurdles thrown in the paths of those who just want to get through a simple day in one piece. Without therapy, medication, and the love and support of those most dear, however, that is as unlikely as putting the square peg of one’s sanity into the round hole of what is generally regarded as normal for the human race.
Frankly speaking, diagnosis of OCD brings some relief. When one realizes that checking a locked door repeatedly to assure its closure is a disease, ever bit as real as heart disease or diabetes, then solutions can be sought for one’s fear of uncleanliness and germs, known as mysophobia, or the utter paralysis brought on by that fear. Those suffering from the ravages of OCD are not alone, and television personalities such as Howie Mandel, afflicted since childhood, have done much to increase awareness and outreach on that score. Destigmatizing OCD, mysophobia, and other mental illnesses, and urging people to get professional help, is nonetheless a full-time job, especially in a society that prides itself on looking good, showing no signs of weakness, and keeping up with the Joneses.
So, just how do we tackle the problem? First, you must realize that there are some definitions to be digested, with obsessions being uncontrollable thoughts associated with various fears, and compulsions being the uncontrollable repetitive actions or attempts to ease anxiety. Enormous periods of time can be lost every day by those afflicted with OCD, as they are drawn onto a merry-go-round or endless loop of obsessive and compulsive behaviors. Fear of contamination, fear of harm or danger, fear of discarding objects, fear of imperfection, and fear of disorder and superstitions are just a few of the obsessions that inundate fragile minds ill-equipped to break the chain. Fear of contamination seeks its champion in repeated handwashing, excessive cleaning, and avoidance behaviors that border on going out of one’s way to bypass the imaginary. When checking a door or gas or electric burner becomes a full-time job, then we know that OCD has won the day. Hoarding behavior, or a fear of discarding objects ranging from newspapers and canned foods to sales receipts and plastic containers, is a sign that all is not well in Oz, and that something bad will happen in the Emerald City if those objects are thrown away. Near and dear to many of us, if not to our teenagers who leave their homework undone, their beds unmade, and their appearance unkempt, is a fear of imperfection that drains hours from our day, as we strive to make the perfect bed, groom ourselves as if to walk the “red carpet,” or print notes, lists, or diaries so impeccably that we leave calluses and blisters on our fingers and a disdain for all that requires transcription of the written or spoken word. In OCD, a perceived failure to be perfect inevitably results in our punishment or catastrophe, and, while we are cognizant of the irrationality of our obsessions and compulsions, we are absolutely powerless to halt their onslaught. If that were not all, order and symmetry, the perfect number, and colors, if not pleasing to the mind, at least tacitly accepted by it, round out our, or perhaps only your, foray into the realm of OCD. How many times have you aligned those cans in your cupboard or those books on your shelf? Once or twice? Ok. More than that? Then perhaps a reality check is in order, as you batten down the hatches and prepare for the OCD storm that is sure to follow.
What can you do when disaster strikes? As always, seek professional help. The weaponry in the armamentarium of the latter ranges from psychotherapy, and, specifically, cognitive behavior therapy (CBT), or retraining thought patterns and routines so that compulsive behaviors to “correct” obsessions are no longer necessary, to medications, with antidepressants that increase serotonin in the brain at the fore. Antidepressants should be prescribed at the lowest possible dosages to control the signs and symptoms of OCD. There are no guarantees, however, and if psychotherapy and drugs don’t work, then the “big guns,” like electroconvulsive therapy (ECT), may need to be called in, to quash an unruly devil.
© 2010, Albert M. Balesh, M.D. All rights reserved.
But how does this all start? Where in the world do those recurrent, unwanted thoughts and repetitive or ritualistic behaviors come from? The answers to those questions are not immediately forthcoming, in the wake countless lost hours every day, a great deal of distress, and hurdles thrown in the paths of those who just want to get through a simple day in one piece. Without therapy, medication, and the love and support of those most dear, however, that is as unlikely as putting the square peg of one’s sanity into the round hole of what is generally regarded as normal for the human race.
Frankly speaking, diagnosis of OCD brings some relief. When one realizes that checking a locked door repeatedly to assure its closure is a disease, ever bit as real as heart disease or diabetes, then solutions can be sought for one’s fear of uncleanliness and germs, known as mysophobia, or the utter paralysis brought on by that fear. Those suffering from the ravages of OCD are not alone, and television personalities such as Howie Mandel, afflicted since childhood, have done much to increase awareness and outreach on that score. Destigmatizing OCD, mysophobia, and other mental illnesses, and urging people to get professional help, is nonetheless a full-time job, especially in a society that prides itself on looking good, showing no signs of weakness, and keeping up with the Joneses.
So, just how do we tackle the problem? First, you must realize that there are some definitions to be digested, with obsessions being uncontrollable thoughts associated with various fears, and compulsions being the uncontrollable repetitive actions or attempts to ease anxiety. Enormous periods of time can be lost every day by those afflicted with OCD, as they are drawn onto a merry-go-round or endless loop of obsessive and compulsive behaviors. Fear of contamination, fear of harm or danger, fear of discarding objects, fear of imperfection, and fear of disorder and superstitions are just a few of the obsessions that inundate fragile minds ill-equipped to break the chain. Fear of contamination seeks its champion in repeated handwashing, excessive cleaning, and avoidance behaviors that border on going out of one’s way to bypass the imaginary. When checking a door or gas or electric burner becomes a full-time job, then we know that OCD has won the day. Hoarding behavior, or a fear of discarding objects ranging from newspapers and canned foods to sales receipts and plastic containers, is a sign that all is not well in Oz, and that something bad will happen in the Emerald City if those objects are thrown away. Near and dear to many of us, if not to our teenagers who leave their homework undone, their beds unmade, and their appearance unkempt, is a fear of imperfection that drains hours from our day, as we strive to make the perfect bed, groom ourselves as if to walk the “red carpet,” or print notes, lists, or diaries so impeccably that we leave calluses and blisters on our fingers and a disdain for all that requires transcription of the written or spoken word. In OCD, a perceived failure to be perfect inevitably results in our punishment or catastrophe, and, while we are cognizant of the irrationality of our obsessions and compulsions, we are absolutely powerless to halt their onslaught. If that were not all, order and symmetry, the perfect number, and colors, if not pleasing to the mind, at least tacitly accepted by it, round out our, or perhaps only your, foray into the realm of OCD. How many times have you aligned those cans in your cupboard or those books on your shelf? Once or twice? Ok. More than that? Then perhaps a reality check is in order, as you batten down the hatches and prepare for the OCD storm that is sure to follow.
What can you do when disaster strikes? As always, seek professional help. The weaponry in the armamentarium of the latter ranges from psychotherapy, and, specifically, cognitive behavior therapy (CBT), or retraining thought patterns and routines so that compulsive behaviors to “correct” obsessions are no longer necessary, to medications, with antidepressants that increase serotonin in the brain at the fore. Antidepressants should be prescribed at the lowest possible dosages to control the signs and symptoms of OCD. There are no guarantees, however, and if psychotherapy and drugs don’t work, then the “big guns,” like electroconvulsive therapy (ECT), may need to be called in, to quash an unruly devil.
© 2010, Albert M. Balesh, M.D. All rights reserved.
posted by Dr. Al at
4/07/2010 08:08:00 AM
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