Have you ever noticed that many prestigious hotels do not have a 13th floor: After the 12th comes the 14th floor! This is an example of a “superstition”; many healthy individuals have vague superstitions, which they know are “silly”, but nevertheless they still prefer not to transgress.
Superstition and Obsessive-Compulsive Disorder (OCD) are not related, but superstitions and how we respond to them have something of the nature of OCD.
The manifestations of OCD are peculiar: Patients are usually intelligent people who are not deluded, but who experience unwelcome thoughts which they know are their own, and often find themselves doing odd things such as touching objects unnecessarily, and unable to complete their daily activities on time.
What are Obsessions and Compulsions – What is an Obsessive Compulsive Disorder?
Obsessions are persistent, intrusive ideas, thoughts, impulses, or images that are experienced as inappropriate and that cause anxiety or distress. Importantly, the individual recognises that the obsessions/events are the product of his/her own mind and not imposed from outside.
The most common obsessions are repeated thoughts about contamination (e.g., becoming contaminated by shaking hands); repeated doubts (e.g., worrying about having left a door unlocked, or a stove switched on); a need to have things in a particular order (e.g., intense distress when objects are out of order); aggressive or horrific impulses (e.g., to hurt one’s child or shout an obscenity in church); and sexual imagery.
Obsessions are “ego-dystonic”, meaning they are experienced as stressful and the individual is unable to control them. These symptoms often result in self-doubt and contribute to social and/or occupational dysfunction. Moreover, sufferers are often reluctant to disclose their symptoms, and there is frequently a 5 to 10 year delay before individuals finally seek some form of counselling intervention.
Compulsions are repetitive behaviours and the individual feels driven to perform the compulsion: The individual with obsessions about contamination may wash his/her hands until the skin is damaged; individuals distressed by unwanted blasphemous thoughts may find relief in counting or saying prayers.
In many respects regarding OCD, the person feels compelled to perform according to rules that must be applied rigidly.
Sometimes compulsive behaviour may not be connected in any realistic way with what it is designed to neutralize. For example, a person might find himself/herself repeatedly touching the back of a chair to reduce anxiety raised by the thought that he/she might swallow a knife or pick it up and stab the other person in the room.
In OCD, anxiety may exist at several levels. Anxiety may be an inherent part of the obsession/thought (I fear that I might impulsively throw the baby out of the window if I get too close to the window), or it could be a consequence of the loss of autonomy (becoming distressed at not being able to control one’s own thoughts). In any case, anxiety accompanies OCD: The greater the anxiety, the greater the OCD manifestations.
The onset of symptoms may be gradual or sudden, but often will begin – or become noticeable – after a stressful event such as pregnancy/childbirth, or a severe motor vehicle accident, or an assault, and so on. Generally once started, the course of OCD is chronic but will fluctuate with changing circumstances and stress levels. If left untreated, it is seldom that the OCD disappears. Rather, progressive deterioration can occur.
The obsessions or compulsions cause marked distress, are time consuming (can often take up more than an hour each day), and tend to progressively interfere with the person’s normal routine, occupational (or academic) functioning, or usual social activities and relationships. Additionally, indecision is frequently a feature of OCD.
OCD is often associated (co-morbid) with other emotional difficulties (particularly depression and anxiety), and contributes to alcohol dependence and drug dependence as well as eating disorders in many instances.
Hoarding can also be part of this disorder which is best understood as experiencing a difficulty discarding possessions regardless of their actual value, and the perceived need to save the items. Consequently, the person’s living space might become congested.
OCD and Obsessive-Compulsive Personality Disorder (OCPD) sound similar, but the clinical manifestations are different: OCPD is not marked by the presence of obsessions or compulsions but is characterised by a pervasive pattern of preoccupation with orderliness, perfection and control.
Here is a symptom checklist
If you answer YES to several of these questions, you might wish to consider seeking counselling and/or psychotherapy with a registered Clinical or Counselling Psychologist.
- Do you often have repetitive, intrusive, and unwanted thoughts that make you anxious, and you feel that you cannot stop these thoughts no matter how hard you try?;
- Do you wash your hands or shower more often or for longer periods of time than most other people?;
- Do you excessively clean objects (e.g., clothes, towels, bed sheets, household items, your car interior, etc)?;
- Do you repeatedly visually check to be sure you have properly performed a just-completed task (e.g., looking to be sure you have locked a door, signed the register, perform a re-count? and so on;
- Do you often repeat routine behaviours (e.g., locking doors, turning off light switches or the stove)?;
- Do you frequently ask others for reassurance that tasks have been properly completed (e.g., “Did I lock the door?”)?;
- Do you unnecessarily arrange, order, or tidy the contents of your desk, closet, cabinets, bookshelves, etc, to make them symmetrical or “just right” or unnecessarily straighten common household objects such as window blinds or rugs?;
- Do you repeatedly count mundane items that do not really merit counting (e.g., ceiling or floor tiles, lights, cars etc)?;
- Do you have great difficulty discarding things that have no practical value and that most other people would consider rubbish (e.g., old newspapers, clothing you have worn for years, empty food containers)?;
- Do you repeatedly ask others for reassurance that you have not done something “wrong”, “bad”, or “harmful”?;
- Do you worry excessively about speaking or acting in a manner that you think is harmful, violent, sexually inappropriate, immoral, or sacrilegious?;
- Do you repeatedly ruminate unwanted thoughts in an effort to prove to yourself that you will not act in a manner that you think is harmful, violent, sexually inappropriate, immoral, or sacrilegious?;
- Do you recite prayers or certain phrases in an effort to rid yourself of unwanted thoughts or to ensure that nothing bad happens?;
- Do you sometimes repeat a route, and /or a daily activity to ensure that you did not harm someone (e.g., driving back to a certain place in the road to reassure yourself that you did not run over a pedestrian)?
For further information please contact:
Professor Christopher R. Stones (Clinical Psychologist and Behavioural Management Specialist)
Phone: 011-801-5616 (Reception) OR 083-222-9666
NHC Health Centre
Cnr Christiaan de Wet Road & Dolfyn Street
(opposite Eagle Canyon Auto)