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Obsessive-Compulsive Disorder
If you have ever had the experience of not being able to get a catchy, repetitious jingle out of your mind, or of needing to go back and make sure you have locked all the doors even though you are sure you have, you should have a sense of what it is like to have an obsessive-compulsive disorder (OCD). Here, a person’s profound sense of anxiety is reflected in persistent, unwanted, and unshakable thoughts and/or irresistible, habitual repeated actions. Although the approximately 2.5 percent of Americans who have this disorder usually know that their obsessive thoughts or compulsive actions are irrational, they still cannot block out their thoughts or keep themselves from performing the repetitious act, often an extreme number of times. It also appears that women are almost twice as vulnerable as men for OCD, even though in men compulsive urges are more common than in women (Mancini et al., 1999). That is, men are more likely to be "checkers" and women are more likely to be "cleaners." There is one report of a woman who washed her hands over 500 times per day (Davison & Neale, 1990). (The hand-washing compulsion that Lady Macbeth acquired after helping her husband murder the king of Scotland is one of the most common compulsions reported.) The senseless, repetitious behavior seems to ward off a flood of overwhelming anxiety that would result if the compulsive acts were terminated.
In the classic manifestation of this disorder, obsessive thoughts lead to compulsive actions. The following case illustrates this connection:
Shirley K., a twenty-three-year-old housewife, came to the clinic with a complaint of frequent attacks of headaches and dizziness. During the preceding three months she had been disturbed by recurring thoughts that she might harm her two-year-old son, Saul, either by stabbing or choking him (the obsessive thought). She constantly had to go into his room, touch the baby, and feel him breathe in order to reassure herself that Saul was still alive (the compulsive act) otherwise she became unbearably anxious. If she read a report in the daily paper of the murder of a child, she would become agitated, since this reinforced her fear that she too might act on her impulse. Shirley turned to the interviewer and asked, with desperation, whether this meant that she was going crazy. (Goldstein & Palmer, 1975, p. 155)
In the case just described, it appears that by constantly checking on her son’s well-being this woman was able to relieve temporarily the anxiety caused by her thoughts about harming her son. Most people who manifest this disorder demonstrate the components of both obsessions and compulsions. However, about 15 percent of cases experience only obsessive thoughts that are not accompanied by compulsive acts (March et al., 1989).
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