Obsessive Compulsive Disorder (OCD): What is it and how does it manifest?

Not all mental disorders are based on an abnormal perception of reality. Some, like the Obsessive Compulsive Disorder (OCD), They are not expressed through the way information from the surrounding world is interpreted, but through actions that arise from the subject’s own: calls repetitive behaviors, O compulsions, Which harm people’s quality of life by producing unpleasant sensations and limiting their degree of freedom.

However, talking about this type of behavior only tells half the story. The other half are intrusive thoughts, which are closely related to compulsions. From a psychological point of view, we can say that intrusive thoughts (or obsessions) and compulsions are the two main mechanisms by which obsessive-compulsive disorder is articulated. But … how do they activate these two pieces?

Obsessive-compulsive disorder: intrusive thoughts and compulsions

Obsessive-compulsive disorder is often viewed, in many ways, as an impairment related to anxiety disorders, And is therefore characterized by being associated with a sense of fear, anxiety and continued stress of a magnitude that is a problem for daily living and has a negative impact on the quality of life of the person in virtually all areas in which it is located. development.

In the specific case of obsessive-compulsive disorder, the driving force behind these anxiety attacks is the obsession-compulsion cycle. Obsessions arise spontaneously, regardless of the person’s will, and become so frequent that they become overwhelming. These are recurring mental images or thoughts that disturb the person and do not come out of their head, causing them to desperately seek strategies to stop focusing their attention on it.

In addition to creating anxiety, these intrusive thoughts trigger a series of repetitive behaviors aimed at reducing anxiety caused by obsessions: it’s about compulsions.

Compulsions are a kind of ritual that must always be performed in the same way, and if not, the person starts over the chain of actions that compose them. It is very difficult to resist the urge to perform these compulsions, and at the same time, the more they are performed, the more they depend on them.

Thus, OCD is characterized by being a disorder that combines the symptoms of anxiety and those of problems with controlling one’s own impulses. Its two-phase structure makes the attempt to remedy the situation part of the problem, providing temporary relief but serving to strengthen the association between obsession and compulsion and vice versa.

OCD is also characterized by repetitive behaviors

However, far from being useful, repetitive behaviors are in reality compulsions, that is to say stereotypical behaviors that are beyond the person’s controlJust like thoughts, negative effects try to mitigate. This is why the diagnostic picture of obsessive-compulsive disorder includes not only intrusive thoughts, but also the stereotypical actions that follow them.

As a result of repetition, obsessions and compulsions take control of a person’s life, just as pathological gambling takes over the daily life of the player. The obsession-compulsion cycle keeps anxiety at bay because the person with obsessive-compulsive disorder anticipates intrusive thoughts and stereotypical behaviors and knows that they are out of their control. In this way, we enter a loop of action and reaction which becomes more and more difficult to undo.

The most common compulsions in OCD

Compulsions associated with OCD cover a virtually endless and unattainable range of possibilities., And also its variety grows as technological changes are introduced into our lives.

However, some compulsions are much more common than others. What are the most common behaviors among those who suffer from this disorder?

1. Need to clean

These compulsions are usually related to obsessions that have something to do with the idea of ​​filth or rot, literal or metaphorical. People with this type of compulsions hands can be cleaned too often, Or do the same with objects or other parts of the body. It’s all part of a desperate and urgent attempt to get rid of the filth that pervades what should be pure.

It is one of the most common variants of obsessive-compulsive disorder, and it can lead to skin damage due to erosion.

  • Learn more: “Obsession with cleanliness, causes and symptoms”

2. Need to order

For some reason, the person with this type of compulsion for obsessive-compulsive disorder you feel like you have to sort several itemsEither for the intrinsic value of being in a place with things packed together or for making a good impression. This type of constraint has been linked to the classical laws of Gestalt, because according to this psychological current, we notice a feeling of tension or a slight discomfort if what we perceive does not form a meaningful and well-defined whole. In this sense, a disorderly environment would create discomfort by presenting difficulties in being perceived as a perfectly defined whole: a study room, a dining room, etc.

Thus, obsessive-compulsive disorder would occur when this feeling of discomfort is so magnified that it harms a person’s level of well-being and quality of life, forcing them to take control so as not to feel bad.

3. Compulsions linked to accumulation

In this type of obsessive-compulsive disorder, the person need to save all kinds of items according to their possible use in the future, Although by pure statistics it is very unlikely that you will live in a situation in which each of the accumulated things can be used.

From some schools of psychodynamic currents, like classical Freudian psychoanalysis, this tends to be related to Freud’s psychosexual theory. However, current clinical psychology relies on budgets and a philosophy of research and intervention that has nothing to do with psychoanalysis.

4- Verification compulsions

Another typical example of obsessive-compulsive disorder is that of a person who you have to constantly make sure that everything is working as it should to the point of doing the same thing several times a day. This is a case of compulsion to check, based on the need to avoid future accidents and, more specifically, to completely stop thoughts and imaginary scenes of accidents that might occur and stop causing harm. ‘discomfort. These thoughts appear unintentionally and lead to various checks aimed at reducing the risk of them occurring, which in turn becomes a hard habit to change.

Causes of obsessive-compulsive disorder

As with many psychiatric syndromes, little is known about the precise biological mechanisms by which some people experience obsessive-compulsive disorder. This is not surprising because to remedy this, in addition to studying the complicated functioning of the human brain, it is necessary to address the context in which the person has developed, their habits and living conditions, etc. In short, OCD must be understood from a biopsychosocial perspective.

Textbooks such as the DSM-IV describe all of the symptoms that characterize this anxiety disorder, but beyond the diagnostic criteria, there is no theoretical model supported by a broad scientific consensus that explains its causes in detail. New neuroscience research, coupled with the use of new technologies to study how the brain works, will help uncover the causes of OCD.

The relationship between this psychological phenomenon and the perfectionism

Many people assume that obsessive-compulsive disorder is related to perfectionism, because in compulsions a chain of steps is always followed exactly as completely as possible. No, however, everything seems to indicate that OCD is not so much linked to this scruple as to its absence. For example, while people with obsessive-compulsive personality disorder score very high in responsibility (with the exception of the Big Five model created by psychologists Paul Costa and Robert McCrae), those with obsessive-compulsive disorder typically score very low on this trait.

This indicates that in OCD there is an intention to pathologically compensate for the tendency to chaotic and spontaneous behavior that occurs in other aspects of life, i.e. to go from very unscrupulous to most of the time, obsessing over her for a few minutes.

Relationship to body dysmorphic disorder

Obsessive-Compulsive Disorder has certain symptomatic features that overlap with those of Body Dysmorphic Disorder, a psychological disorder also based on perceptual rigidity, And in which the person is very concerned that the aesthetics of his body does not come out of very demarcated canons. Therefore, its comorbidity is high: where one is diagnosed, it is very possible that the other is also present.

If they occur at the same time, it is important to treat these two disorders as separate entities, as they affect different aspects of patients’ lives and also express themselves through other situations.

Treatment of this psychopathology

The treatment of OCD combines resources ranging from the field of psychiatry to psychological therapy. In the first of these forms of intervention, we mainly use anti-anxiety drugs and antidepressants such as SSRIsAnd with regard to psychotherapy, forms of intervention such as systematic desensitization and controlled exposure are used, in which the person is trained to resist the anxiety without reinforcing it by anxious thoughts and realization of the anxiety. compulsion.

Bibliographical references:

  • Doron, G,; Derby, D., Szepsenwol. O. and Talmor. D. (2012). Contaminated love: exploration of relationship-centered obsessive-compulsive symptoms in two nonclinical cohorts. Journal of Obsessive-Compulsive and Related Disorders 1 (1): pages 16 to 24.
  • Colesa, ME; Frostb, RO; Heimberga, RG; Rhéaumec J. (2003). “Not Just Appropriate Experiences”: perfectionism, obsessive-compulsive traits, and general psychopathology. Behavioral research and therapy 41 (6): pages 681-700
  • Rhéaume, J .; Freeston, MH; Dugas, MJ; Letarte, H .; Ladouceur, R. (1995). Perfectionism, responsibility and obsessive-compulsive symptoms. Behavioral research and therapy 33 (7): pages 785 to 794.
  • Kaplan, Alicia; Eric Hollander. (2003). A review of pharmacological treatments for obsessive-compulsive disorder. psychiatryonline.org.
  • Sanjaya Saxena, MD; Arthur L. Brody, MD; Karron M. Maidment, registered nurse; Hsiao-Ming Wu, physician; Lewis R. Baxter, Jr, MD (2001). Brain metabolism in major depression and obsessive-compulsive disorder that occur separately and simultaneously. Society of Biological Psychiatry.

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