OBSESSIVE COMPULSIVE DISORDER
There can be very few of us who have never got into the car
to go somewhere, paused and thought “Did I really lock the door” or “Did I
really turn the kettle off”. Then, you got out of the car and went to check.
Sure enough, everything was OK, and you drove off feeling quite comfortable.
Imagine if, however, you got back into the car, paused, and
went to check again. Then you got back into the car, drove a few yards,
stopped and went back to check yet again. That´s a short description
of obsessive compulsive behaviour. What a terrible position to be in –
it´s easy to see how this sort of behaviour could seriously interfere with one´s
normal enjoyment of life.
Like many emotional states, OCD (we´ll call it that from now
on), is simply a normal protective mechanism taken to an extreme. To check that
the kettle is off is merely sensible, but to do it three or four times in the
space of minutes is to say the least unusual.
There are two common strands observable in OCD, and these
are:
- Repetitive behaviours (e.g., hand washing, ordering, checking) or mental
acts (e.g., praying, counting, repeating words silently) that the person
feels driven to perform in response to an obsession, or according to
self-imposed rules that must be applied rigidly
- The behaviours or mental processes are aimed at preventing or reducing
distress or preventing some dreaded event or situation; however, these
behaviours or mental acts either are not connected in a realistic way
with what they are designed to neutralize or prevent or are clearly
excessive.
The sufferer is aware that the behaviour is bizarre, although
naturally, we cannot expect this to be the case in young children. OCD can
start at any age, but for the most part, it begins to show itself between the
ages of 10 and 24. The gender prevalence of OCD is equal in males and females.
However, childhood-onset OCD is more common in males and more likely to be
linked genetically with attention deficit hyperactivity disorder (ADHD) and
Tourettes syndrome.
What causes OCD? Fact is, nobody really knows. A family
history of similar complaints is sometimes found, and it has been suggested that
OCD can be triggered by infection with bacteria of the streptococcus family.
Because treatment with SSRI drugs (usually used in the treatment of depression)
have been effective in treating OCD, there is also a suggestion that it may have
to do with the balance of the neuro-transmitter serotonin in the brain.
The jury is, though, still out.
So what
can be done about it? The best approach is usually twofold – prescription
by a GP of a suitable medication if necessary, together with the use of
Cognitive Behavioural Therapy. CBT utilises techniques of exposure and
response prevention, meaning exposure to symptom triggers of gradually
increasing intensity, with use of cognitive and relaxation techniques including
hypnosis (if the therapist is suitably qualified) to suppress the obsessive or
compulsive response. Response is usually quite fast, and treatment is
effective.
