Thursday, August 22, 2013

What Defines an Obsession?

It never ceases to amaze, amuse, frustrate, and sadden me when someone seems to want to have obsessive-compulsive disorder. Why is it so popular? What is it about the psychological disorder that seems so "cool" that everyone wants to claim a piece of it? Perhaps the media attention makes it not only more acceptable for those individuals who actually suffer from this anxiety disorder, but also makes it attractive to everyone else.

Obsessive-compulsive disorder is a very real anxiety disorder that can be diagnosed by a trained psychiatrist or clinical psychologist. It has two major components, obsessions and compulsions (thus its nomenclature).

Obsession: recurring thought (or thoughts) that a person cannot seem to rid themselves of, despite their best efforts and desires to do so. This word gets thrown around a lot, especially by people who are fans of things or celebrities or people accusing others of spending too much time thinking about a particular subject (or person). A true obsession, in the clinical sense, is an intruding thought that a person does not will into existence. This thought usually revolves around some form of anxiety--worry, fear, concern, etc.--that underlies a person's life. The obsession invades their thoughts until it becomes difficult to deal with anything else in life. Enter the compulsion.

Compulsion: irrational, ritualistic behavior (or behaviors) in which a person engages in order to eliminate or keep at bay the obsessive thoughts. The key here is irrational. People can be organized and ritualistic in a logical sense. It becomes a compulsion if they feel they cannot help themselves, if avoiding the behavior seems to lead to an increase in anxiety levels. It is also clinically maladaptive if the compulsive behavior hampers a person's ability to eat, sleep, work, play, or interact socially with others. Compulsive behavior is NOT merely being overly conscientious.

Conscientiousness: the care a person gives to organization and thoughtfulness of others. Individuals who rate high on this personality trait tend to be organized, reliable, neat, ambitious, and dependable. High conscientiousness is not necessarily a sign of a clinical obsessive compulsive disorder. Nor does it make a person more susceptible to develop such a disorder. Neuroticism is the personality trait more likely to be a potential predictor of such a phenomenon, though any research that might have been conducted in this area has not been conclusive.

For those individuals who do suffer from a legitimate obsessive-compulsive disorder, they typically fall into one (or sometimes more) of the following 4 categories:

Obsessions and checking. This classification of OCD involves obsessive thoughts primarily focused on lack of self-confidence in one's memory and their concern for safety. As a result, the disordered compulsive behavior tries to alleviate these thoughts. For example, you may have a person who gets up several times during the night to make sure they locked their doors or turned off their stove.

Symmetry and order. The obsessive thoughts of this classification typically, though not always, revolve around a person's desire/need/conditioning to create strict order because chaos is too much for them to handle. These individuals tend to be extremely strict in their personal routines, sometimes (but not always) expecting others to adhere to the same strictures. They also make extreme efforts to organize their personal possessions in a way that makes sense to themselves, though it may seem illogical to others. The symmetry is so important to them that any deviation creates extreme anxiety and fear of invading chaos. Yes, it may sound like they are "fun to mess with," but that is a very inhumane way to treat these individuals.

Cleaning and washing. This is quite possibly the most commonly illustrated or known form of OCD, thanks in part to cases such as Howard Hughes. For these individuals, the obsessive thoughts usually involve the fear of invading germs and the concern that they will be seen as unclean. It can have religious or cultural roots, as well as parental influences. It can also be an extreme reaction to an adverse experience at some point in a person's earlier life. Regardless, this category of OCD usually finds the individual spending an excessive amount of their time cleaning themselves and their environment. Things do not necessarily have to be organized as long as they are sanitary. There have been extreme cases in which individuals have been hospitalized because they washed their hands and arms so much they scrubbed off almost all the layers of skin. Other extreme cases have been reported of an individual suffering adverse side effects from overuse of cleaning chemicals.

Hoarding. Perhaps the form of OCD that has gotten the most attention in recent years, thanks to so many "reality" shows, is hoarding. The obsessive thoughts of this category typically come from a concern that a person will not have what they need when they need it. The obsession may also be a desire to "fill a hole" somewhere with particular possessions instead of social interaction. With these thoughts invading a person's mind, the compulsive acts tend to be collecting, purchasing, and refusing to get rid of items. Do not confuse hoarding with collecting. There can be a healthy amount of obtaining certain items and displaying them without going overboard. Hoarding oftentimes starts off innocently enough, as well. For example, perhaps a person goes on vacation and forgets their sunglasses, so they buy a new pair. They then leave that pair in their luggage and find they need a pair in their car for driving, so they purchase another pair. With enough forgetting and purchasing, it could become a conditioned response in which the person buys a pair of sunglasses almost every time they enter a store because they are afraid that they will not have them when they are needed.

It is possible for an individual to suffer from multiple forms of obsessive-compulsive disorder. Perhaps a person has obsessions about chaos and germs, as well as a fear of not having the supplies on hand to combat these. In this case, you have a hoarding symmetrical washer who collects, and organizes, cleaning supplies and spends the rest of their time cleaning their environment, with little time left for the regular functions of a psychologically healthy lifestyle.

OCD is not a "fad", nor is it a cool badge to wear to make you special. It is a true anxiety disorder that hampers an individual's ability to live a healthy, happy, productive life. It can be treated with various methods, depending upon the roots of the disorder and the category from which a person suffers.