If you think about Obsessive-Compulsive Disorder Perhaps the image of the maniac Melvin Udall dodging tiles in Couldn’t be better (As good as it gets).
The great Jack Nicholson appears in the film obsessed with order and neatness, perfectly lining up his house slippers, or being unable to go to bed without having locked the four door locks several times. These rituals are just a small example of the multiple manias that the novelist presents, his life being articulated around them.
Obsessive-compulsive disorder, popularly known as OCD by its acronym, is a disorder characterized by obsessive thoughts and compulsive actions such as cleaning, checking, ordering or accumulating excessively.
Obsessions are thoughts, images or impulses repetitive and unwanted sounds that cause anxiety and discomfort to people with OCD. Obsessions occur invasively, regardless of the person’s will, and become so frequent and disabling that they can completely dominate the life of someone who suffers from OCD.
The person who has these obsessive thoughts tries to ignore or suppress them. To do this, he carries out compulsions or compulsive rituals, which have the objective of neutralizing the obsessions and their feared consequences.
Compulsions are like motor or cognitive behaviors (praying, counting numbers) repetitive tasks that are carried out according to certain rules, in a stereotypical way. The purpose of these behaviors or thoughts is to prevent or reduce distress, or avoid a feared situation or event.
Among the most common obsessions in OCD we find, among others, those related to dirt and contamination, order and verification.
1. Pollution Ideas
One of the most common types of obsessions are contamination obsessions. These are characterized by a exaggerated fear of dirtgerms, getting infected or contracting a disease.
Many times the fear in these patients may be of feeling dirty, and they may spend a large amount of time washing. These ideas can be focused on another person as well, such as fearing that a loved one will get sick or die from an infection or germs.
2. Need for verification or pathological doubt
The obsession of these individuals consists of constantly check that they have not had an oversight that makes them responsible for the feared negative consequences, for example causing a fire by forgetting to turn off the stove, leaving the tap running, or not locking the door when leaving the house.
Excessive doubt and the need to check commonly lead to checking rituals.
3. Need for order or symmetry
In this case the concern is arrange or order things “perfectly”performing certain activities in an exact, symmetrical or balanced manner, such as parking correctly or organizing clothes meticulously.
The thought that is at the base of the obsessive idea is: “It is absolutely essential that everything is organized and in its place.”
4. Aggressive and sexual obsessions
These individuals present excessive fears of harm others or committing an unacceptable sexual act such as thinking about stabbing a loved one, fantasizing about sexually abusing someone, or an exaggerated fear of being homosexual.
Many are horrified by their obsessions and do not tell others about them out of shame, mistakenly believing that thinking something objectionable is equivalent to doing it.
5. Religious obsessions
The excessive fear in this case is based on commit sins, blasphemenot praying enough, fear of going to hell or not being forgiven, etc. The behaviors or compulsions they perform to eliminate their anxiety may be praying repeatedly or going to church numerous times.
Most frequent compulsions or rituals
Below we describe the rituals most commonly described in cases of OCD. Many of these types of compulsion are directly related to the obsessions described above.
1. Cleaning
Washing is the most common compulsion associated with pollution obsession. People with these types of compulsions may clean their hands too frequently, as did Melvin Udall, who washed his hands three times in a row every time he returned home and used different new soaps that he then threw away.
Other examples are: brushing your teeth excessively, avoiding using public bathrooms, or thoroughly cleaning your home for fear of germs. This behavior typically occurs after contact or proximity to the contaminated object.
2. Of order or symmetry
The ritual seeks to alleviate a fear that If something is not done, a misfortune will occur.or mitigate the unpleasant feeling that things are not as they should be. These compulsive actions are derived from the need for symmetry or order.
Some examples would be avoiding stepping on black tiles, arranging things according to certain predetermined criteria, etc.
Individuals are characterized by insistently repeating phrases or behaviorsout of the belief that this will prevent the feared catastrophe from occurring. They may always want to follow certain routines, such as always eating at the same table in the same cafeteria, or always going to work the same way.
4. Accumulation
In this type of OCD the person has the need to save all types of items taking into account its possible usefulness in the future. They can accumulate a large amount of unnecessary things such as old newspapers, empty bottles or cardboard boxes.
5. Check
They focus on prevent the occurrence of possible catastrophes. They are associated with pathological doubt and the need for verification.
In general, those who perform these rituals tend to use the reassurance strategy, asking nearby people things like “Have you seen me put out the fire?” or “Have I closed the door at home?”
6. Mental compulsions
They are thoughts or mental acts that, like observable behaviors, are carried out to neutralize or reduce the anxiety caused by the obsession. It is common repeat words, phrases or numbers in order to relieve distress.
Mental compulsions are frequently confused with obsessions because they are covert rather than motor behaviors; The fundamental difference is that obsessions generate anxiety and compulsions reduce or prevent it.
