“Habit,” wrote Saint Augustine, “if not resisted, becomes necessity,” and that may well be the infrequent revelation of how much we know, or don’t, about obsessive compulsive disorder, or OCD, a mental health condition that is contemporarily, more frequently clinically diagnosed today, as we begin to understand it?
OCD occurs across all ages, all genders, and can affect so many people in so many different ways, and with varying severity. We can all be ‘guilty’ of locking a door that was already locked, but most of us will put such things behind us immediately, while someone with OCD will think back on it all day, uncertain whether they actually did lock the door or whether they imagined it... again, and again. Can you imagine how exhausting that would be by the end of the day?
According to a colleague, Lyndsey Parker, minor obsessions and compulsions can be ‘just the tip of the iceberg,’ so let’s look at how the medical profession and its ‘men in white coats,’ define OCD.
They say that an obsession may be a thought, image, or urge, usually unwanted, usually about the future, and often unpleasant. These enter one’s mind persistently, automatically causing unease, anxiety, or distaste, but above all, frustration, with the feeling that something is ‘not quite right.’
The most prevalent of these concern germs and contamination, how these can cause harm to themselves and their loved ones, and consequently, are at the root of obsessive diagnoses of fear, exacerbated by the invisibility of germs and viruses.
‘Can you imagine then,’ asked Parker, ‘how traumatic the global pandemic was for those with OCD?’
Compulsions differ slightly in that they are a response to obsessions, being repetitive actions or cognitive activity that will, for a moment, obscure the unpleasantness brought forth by the obsessive thought.
The problem is that the compulsion is not a solution, but is very much a ‘sticking plaster,’ and doesn’t even reduce the anxiety, but feeds the repetitive, cyclical, perpetual, never-ending, the ‘hamster wheel,’ nature of what has become an unwinnable battle with themselves. It doesn’t matter that whatever the topic of the angst rarely, or never eventuates, but that it is there, in their mind.
One sufferer explained OCD as quite simply, losing time... “You lose chunks of your day to obsessive thoughts and actions. You have to finish songs on the radio before you can get out of the car, or leave a shopping centre. You can vacuum the same room, or part of a room, so many times, wash your hair ten times in the shower, or do many more reps at the gym, because you lose count. Also, when your mind isn’t thinking about the future, it’s usually bogged down in the past, the mind obsessing about what did, what may have, or what could have happened. It’s so difficult, under those pressures, to function ‘in the now.’”
Therapeutic interventions include what is known as exposure and response prevention, ERP, which is all about encouraging those with OCD to face their fears, and to find ways to divest themselves of the absolute need to respond, while medication alternatives are used with success by prescribing selective serotonin uptake inhibitors, or SSRIs, which modify the chemical structure within the brain. Though extensive, this treatment can, over an extended period, achieve significant improvement.
The OCD journey must be frustrating, yet for researchers, they seek reward in a profound exploration of the human experience, at times discomfiting, yet who among us would want anxieties that run so deep they subvert their sensitivities and time, in mis-shaping their lives.
The resilience and fortitude of all those who are inflicted with OCD, can literally be visualised as Don Quixote so eloquently professed: “When life itself seems lunacy, who knows where madness lies? Perhaps to be too practical is madness. To surrender dreams — this may be madness. Too much sanity may be madness — and maddest of all: to see life as it is, and not as it should be!”
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