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Obsessive Compulsive Disorder


I remember, once when I was a child, I was playing with my brother and a few of his friends and the game of ball got so aggressive that one of my brother’s friends shoved me on the ground. My left knee was heavily bruised and bruised. I started crying, no bawling actually. Not only because my knee was hurting, but more than that because I felt an imbalance. I felt like there was a void, numbness on the right knee. I felt an inexplicably strong need to restore this balance. So I got up and intentionally fell, only to hurt my right knee and that’s when I felt better. When I started school, I entered my classroom and saw the teacher’s table. A 4-year-old me got so upset right at the doorstep and not because I missed my parents but because there were textbooks and markers kept only on the right side of the table. My parents had to come to pick me up and God knows how long it took for them to calm me down. Even right now I can see as I sit in a cafe typing this article that the coffee cups are aesthetically kept asymmetrically and I do not like that at all! There multiple such “habits” as I would call them then, like eating only specific food combinations, wanting a balance in just about everything and even the slightest imbalance would almost completely stop my functions and I would need to restore the balance.


Seeing how much even the slightest imbalance was making me feel, my parents took me to my paediatrician who further referred me to a therapist. That’s when, at the age of 7, I was diagnosed with obsessive-compulsive disorder or OCD. OCD is one of those terms that people like to throw around very casually without realising the gravity of the disorder and how much it can affect someone’s daily functioning. OCD is one of the many anxiety disorders which is common among all genders, races, ethnicities and is characterized by obsessions that are typically followed by compulsions. Obsessions are intrusive and often nonsensical thoughts, images and urges that are extremely disturbing and that one tries to avoid. They are often followed by a feeling of losing control, disgust, fear and wanting to do things in a specific way. Compulsions on the other hand are those actions and behaviours that one performs to eliminate the distress caused by the obsessions and provide relief. Obsessions and “being obsessed” is completely different. Obsessions are time-consuming and entirely hamper daily activities. Believe me, it can get extremely frustrating. Being obsessed, as we millennials and GenZ tend to use about a song we heard, a book we read, a movie we watched or a dish we tried does not hamper our mundane activities because things are not “Just right”.


Some of the most common obsessions include four types i.e Fear of germs or contamination, Unwanted forbidden or taboo thoughts involving sex, religion, or harm, Aggressive thoughts towards others or self, Having things symmetrical or in a perfect order. Compulsions are those that are engaged into, to control and get rid of the distress caused by these obsessions. These can include Excessive cleaning and/or handwashing, Ordering and arranging things in a particular, precise way, Repeatedly checking on things, such as repeatedly checking to see if the door is locked or that the oven is off Compulsive counting. Compulsions are far more distressing than habits as one can’t control these compulsive thoughts and does them as they feel a strong need to perform. They spend a significant amount performing these behaviours and they often cause distress in the individual’s life.


The specific cause of the disorder has unfortunately not been identified. Research suggests that neurochemical imbalances particularly an imbalance in serotonin levels can be one of the causes of OCD. Research also suggests that OCD tends to run in the family, i.e it can be inherited. The treatment plan for the disorder can be pharmacological treatment, psychotherapy and often a combination of both. OCD is often comorbid with other mental illnesses like anxiety, depression and body dysmorphic disorder, thus making treatment even more complicated. Serotonin reuptake inhibitors (SRIs), which include selective serotonin reuptake inhibitors (SSRIs) are used to help reduce the symptoms of OCD.

  • Encourage the individual to seek professional help: It may be difficult for individuals to seek professional help but it is important to treat the disorder for better functioning. The treatment may be challenging where they may get frustrated, agitated and anxious during the process. The support of the family during these times will most likely be very helpful.

  • Recognize the warning signs: Sometimes it is difficult to identify the symptoms of OCD and personality factors. But there are certain factors that are quite different like spending large amounts of time alone, repetitive behaviours, excessive need for reassurance, taking a long time to complete mundane tasks, exaggerated reaction to small inconveniences, daily routine revolving around a particular task or avoiding something, stress, anxiety and threat felt out of proportion to the threat that the activity may exhibit, unable to function well. Do not give into accommodating behaviours: accommodating behaviours are essentially you as a family is a part of the rituals of the individual. It may be intended to reduce the distress of the individual and complying with the wishes of the individual is the only way out but this may, in turn, maintain OCD. Instead of being an “accomplice” gently withdrawing yourself from being a part of the rituals, repetitive behaviours and compulsions. You should first recognize such behaviours and decide as a family to not be part of it.

  • Don’t make it all about OCD: Do you as a family have started revolving all around the OCD? It can be easy to find your family to have every conversation about OCD. Sometimes it is better to not engage in these conversations and set limits. Maintain a routine that keeps thighs normal and peaceful. Keep some time apart for yourself as an individual and wind down.

  • Communicate: Largely, the individuals suffering from OCD, experience doubts and uncertainty. Understanding the triggers of the person and also realise that any amount of reassurance may not necessarily satisfy us. What we learn through therapy is that life is full of uncertainty and we have to accept it gradually and this therapy, if reflected at home, is also helpful. So avoid giving us lengthy explanations or debate with us. Communicate your boundaries respectfully with us and we might retaliate in the beginning but we will understand gradually. This communication can also include showing your love to the individual suffering from OCD. Sometimes we all need that and especially when we are anxious and having a bad day, especially with OCD. It can get very difficult sometime with our OCD to express our love but know that we love you.

  • Create a conducive environment: This one especially helped me. Create an environment that is respectful, empathetic and encouraging for us. Understand that improvement in every individual occurs at differing rates, so creating “small-wins” is very motivating. My parents practised this with me when I consciously did not try to balance the clothes rack in my mom’s newly furnished wardrobe. My parents were very proud of me and showed me their appreciation.

  • Understand that OCD does not define us: I understand that OCD can be very time consuming and debilitating but it does not define us as a person. It is a part of us. Hence being respectful, compassionate and understanding is really helpful. Try not to ridicule our symptoms but try not to make everything about it either.


Conclusion

I have seen and heard people say “I am so OCD-ic!” “I have to keep things in order, I have OCD” far too many times. There are these individuals who take OCD so lightly and deduce the meaning of the disorder to casual terms. Then there are those individuals who have an immense amount of judgement for those who are suffering from OCD. OCD and habits, OCD and being obsessed are not the same. It is not a choice of any individual but it is a mental illness that can be extremely debilitating. Disregarding anyone’s symptoms and blaming them by saying, “you are just acting up, you are just exaggerating” can even worsen someone’s condition. I, as someone who has OCD, can tell you this, a little bit of compassion and empathy can be very helpful. Instead of debunking the symptoms of the individual, helping them seek help can be “Just Right”!


References

Barlow, D. H., Durand, V. M., Lalumiere, M. L., & Hofmann, S. G. (2021). Abnormal psychology: an integrative approach. Nelson Education Ltd.

U.S. Department of Health and Human Services. Obsessive-Compulsive Disorder. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml#part_145346.

This article on 'Obsessive Compulsive Disorder' has been contributed by Smruti Pusalkar, who is a graduate Psychology student from Fergusson College. She is part of the Global Internship Research Program (GIRP), which is under the leadership and guidance of Anil Thomas. GIRP is an Umang Foundation Trust initiative to encourage young adults across our globe to showcase their research skills in psychology and to present it in creative content expression.


Smruti wishes to develop herself to be a more patient listener and a sharp observer to understand the happenings of the world and grow increasingly empathetic. She is passionate about mental health and well being and plans to pursue a career in this field. She is extremely curious about psychology and wants to spread awareness about mental health problems to help those in need.


Anil is an internationally certified NLP Master Practitioner and Gestalt Therapist. He has conducted NLP Training in Mumbai, and across 6 other countries. The NLP practitioner course is conducted twice every year. To get your NLP certification

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