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 May 27 2006, 11:09 AM
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Admin Team
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QUOTE Symptom Clusters of Obsessive Compulsive Disorder
Abstract
Obsessive Compulsive Disorder is an anxiety disorder that can be emotionally, painful and humiliating causing people to isolate themselves from others. There are many types of disorders, but the seven most common OCD are the checkers, washers and cleaners, repeaters, orders, hoarders, thinking ritualizes, worriers and pure obsessionals. The cause of OCD is really not known. There is help for those that suffer with OCD through medication and therapy.
Obsessive Compulsive Order
What is obsession? Obsession has a different meaning for the mental health professional than it does for the general public. The first definition of obsession, by a German psychiatrist Karl Westphal states that obsessions are thoughts which come to the mind of consciousness in spite of and contrary to the will of the patient, in which he cannot suppress and he is aware of this abnormality and all of the characteristic of himself (Osborn, pg 30). Obsessive Compulsive Disorder is when thoughts enter a person’s mind like an electric shock very gradual. Obsessive Compulsive Disorder is a pattern of repetitive thoughts and behaviors that are extremely difficult to get over. These thoughts are repeated many times making it very difficult to stop thinking them or to change to other thoughts. Initially the thoughts may seem to be related to a real event or issue, later appearing extreme, purposeless and crazy to others. These thoughts create doubts about whether harm has happened or will happen to others of one’s self. The thoughts are usually ongoing and ongoing of compulsive questions and checking and looking for reassurance about weather the thought is or is not true. No answering or reassuring will ever satisfy someone with this problem. The OCD person can have more information than the average person would need to make a decision, but can not, believing that they do not have enough information. It is not that they don’t have enough information, but due their doubts they cannot process the information in a way that could eradicate their doubt (Penzel, pg 1, pg 2).
Symptom Clusters
Checkers
A person with checkers OCD is one who checks constantly to prevent something bad from happening. Some common concerns of a checker are checking to make sure the stove has been turned off, or the iron has been turned off. The checker thinks if the stove or iron has not been turned off a fire will start and the house will burn down. The checker gets caught up in hours of repeated checking and doubting of the same thing. Allowing someone else to lock up the house is a way of getting the check out of the house or to go on with his or her day (Foa & Wilson, pg 9).
Washers and Cleaners
Washers and cleaners are worried about contamination by certain objects or situations, such as germs, disease, and bodily secretions. To make sure there is no chance of contamination the washer and cleaner will create one or more rituals of taking a long shower, washing their hands repeatedly, and cleaning their house for hours. The washing and cleaning is done to prevent death and illness. The washing and cleaning can go form one half hour up to ten hours. The washer and cleaner will avoid anything that they think is contaminated (Foa & Wilson, pg 8).
Repeaters
Repeaters are those who repeat their actions. When a fearful thought enter their mind they feel the need to repeat the some action to keep the thoughts from coming true. The repeater is like the checker in trying to prevent something bad from happening. However, the repeater can’t tell the difference between obsession and compulsion. An example of a repeater preventing a spouse from dying would be getting dressed and undressed until the thoughts of death are gone (Foa & Wilson, pg 9).
Orders
Orders are people who want things around them arranged in a certain way of symmetrical patterns. Orders utilize lots of time making sure things are in the right place and will notice right away when the pattern of something has been changed. They usually get upset when something of theirs has been rearranged or things are not perfect. For example an orderer will lay out their daily medication of vitamins in a special design on the kitchen counter rearranging the design every time a pill or vitamin is taken (Foa & Wilson, pg 9).
Hoarder
A hoarder collects objects or things that they find impossible to get rid of. A hoarder will collect things and put them away with the intent of using them in the future. An example of a hoarder is when a person collects newspapers for a long time thinks they will need a specific article (Foa & Wilson, pg 10).
Thinking Ritualizes
The thinker ritualize has repetitive thoughts or images to counteract their anxiety provoking thoughts or images, the obsession. The patterns of the thinker ritualizer is closely related to the repeaters, except the thoughts are repetitious ritualistic instead of behaviors. Praying repeating specific words or phrases, and counting are the most common rituals of the ritualizer. For example, Stuart, a thinker ritualizer associated a number to bad luck and a
number to good luck. When a thought with the numbers that Stuart associated with good or bad luck would enter his mind he would repeat the number six or several times to stop bad luck or good lock. Thinking ritualizer will try to remember events in detail and repeat a mental list to ensure safety. For example, a sixty – seven year old man spent hours tested his memory every day by trying to remember unimportant events in order to prevent Alzheimer’s disease (Foa & Wilson, pg 100).
Worriers and Pure Obsessionals
Worriers and Pure Obsessionals have repetitious negative thoughts that they can’t control and are very upsetting to them. The worrier does not experience any repetious behavior, such as checking or hand washing, or any thinking compulsions. The worriers and pure obsessionals worries about health problems, past traumatic events, or failing at some task in the future. An example of some one not demonstrating any compulsive behavior that could temporary alleviate their distress would be someone worrying about losing all of their saving in the market crash and not being able to educate their children. A severe example would be shameful images of inappropriate sexual behavior, or impulses to kill or hurt themselves or their love ones. Afterward, the person may dwell on how these thoughts may come true for hours or days (Foa & Wilson, pg 11).
Etiology and Treatment
Researchers and mental- health professional do not know the causes of OCD. Several theories suggest a biological basis for OCD and there are studies that are exploring the possibility. The Positron emission transaxial tomography (Pett) and other brain imaging techniques have indicated that there may be some brain abnormalities in the frontal lobe and the basal ganglia that cause OCD symptoms. There are other studies that indicate abnormalities in certain neurotransmitters may be involved. One neurotransmitter that may be involved is the serotonin. The serotonin helps regulate mood aggression, and impulsivity. The neurons that respond to serotonin are found throughout the brain and especially in the frontal lobes and the basal ganglia (Barlow, pg21). Recent preliminary testing of the brain has shown that someone with OCD has significantly less white matter than someone who does not have OCD (http://www.nimh.nih.gov/publicat/ocd.cfm, 07/17/2003).
OCD is sometimes brought on by depression, eating disorders, drug abuse disorder, personality disorder, attention deficit disorder or another anxiety disorder. Co-existing disorders can make it difficult to diagnose and treat OCD. Other theories about the cause of OCD that are not incompatible with biological explanations focus on the interaction between behavior, environment, beliefs, attitudes, and how information is processed (http://www.nimh.nih.gov/publication/ocd.cfm, 07/17/2003).
Researchers are still not clear on weather OCD is hereditary. Although, preliminary scientific data has shown a genetic link. One study for genetic cause has been found in twin studies. It has been observed that OCD in pairs of identical twins is greater than fraternal twins. A higher incidence of OCD within a certain family tree than is expected simply at random. A higher rate among children with OCD verses those without have also been observed (Penzel, pg 322). As of now no gene has been identified with OCD and there is no genetic test. It is very difficult to find and interview relatives of one with OCD, as well being able to properly diagnose one for OCD based only on an interview (Penzel, pg 323).
There are two effective treatments in the majority of obsessive-compulsive disorder cases. They are behavior therapy and medication. Behavior therapy seems to have a higher percentage of completed treatment, compared to medication. Eighty percent of people that use the behavior therapy complete their treatment as compared to only fifty to seventy of those who choose to take medication. Behavior therapy cast less than the medication and there are no side affects (Osborn, pg 68).
All behavioral therapies are not the same. There is different one that is applicable to different types of disorders. The therapy that works best for the OCD is the Exposure and Response Prevention (E&RP). People with OCD usually do not stay in the presence of what they are feeling long enough to find out that what they were fearing was not really dangerous enough for anything bad to happen, an that the anxiety that they were feeling would have gone away on it’s own. Their thinking is based on short – term avoidance rather than long term consequences. They are only worried about how they will feel in the next five minutes rather than in the next five years. The E&RP encourages participants to expose themselves to their obsessions a try and stop themselves from the compulsions to get rid of the anxiety that they are feeling (Penzel, pg 22). The participant approaches his fearful thoughts or situation with a gradual increase in the amount of time. This is done in a time frame from several weeks to several months. When you face your fears over a long period of time realizing that no harm will come to you or others it is called habituation. Avoiding the thing that you fear is what keeps you trapped in the OCD.
The result of facing your fear is that you slowly build up a tolerance for what you are fearing that causes that same amount of anxiety. Individuals that suffer with OCD are generally over controlled individuals living their lives risk free, having no spontaneity, only revolving their life around what they don’t fear. By agreeing to participate in the E&RP the individual is gradually giving up that rigid control and gaining control over the OCD. A study done by Dr Foa and colleagues in 1980 comparing the use of E&RP to the use of exposure alone or response prevention alone. The study revealed that exposure alone will reduce anxiety and very little improvement in compulsive rituals. The study also revealed if response prevention was used alone anxiety would improve a little and the compulsive will improve a lot. The two treatments are needed in order to get rid of the difference between the two studies.
Behavior therapy cannot be guaranteed, but with the behavior therapy the obsession will be lessen due to the overall anxiety and stress level are lower. After the behavior therapy obsessions can and do occur, and it is realistic to expect them to occur. The suffers may not get rid of the obsessions completely, but they will not need to react with fear and compulsion in ways that will destroy their life (Penzel, pg 23).
Roselyn Gardner
August 12, 2003
References
Foa, Edna B. and Wilson, Reid. (2001). Stop Obsessing! New York: Bantam Books.
Osborn, Ian. (1998). Tormenting Thoughts & Secret Rituals. New York: Pantheon Books.
Penzel, Fred. (2000). Obsessive Compulsive Disorders. New York: Oxford University.
National Institute of Mental health. (July 06, 2001). Obsessive –Compulsive Disorder. Maryland: http://www.nimh.nih.gov/publica/ocd.cfm. (July 17, 2003).
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~Lindsay, Forum Super Administrator   Hotlines
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Oct 20 2006, 09:31 AM
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Junior Member
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From: Ozark, AR
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WOW. I used to do the thing counting the stripes on the road and all that and never thought of it as anything and also wash my hands a lot. Not obsessively but just feel like after I touch anything I have to clean them. But I dont think I havd OCD just some symptoms of it. Just glad to know I'm the only person doing the road thing...LOL
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I yam what I yam and thats all that i yam.
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Nov 24 2007, 01:38 AM
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Newbie
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i had ocd since i was 6 i guess its hereditary. cuz i was just a tot :P
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Jan 6 2008, 01:20 AM
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QUOTE (sourbubblegum1 @ Nov 24 2007, 01:38 AM)  i had ocd since i was 6 i guess its hereditary. cuz i was just a tot :P Mine started when I was around 3 or 4 years old. Ain't no way that **** is "learned behavior" in my case. I don't ever remember not having my OCD.
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Feb 6 2008, 09:44 AM
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Wow, reading stuff like this really makes things hit home. I think I fall victim to a few of the categories. I am indeed obsessive, when I want something I have to have it immediately or at the earliest opportunity, if I get an interest I have to know absolutely everything humanly possible about it. I also get obsessive about food, producing eating timetables and not allowing myself to defy my regulated calorie intake.
It doesn't happen all the time, but once I do start thinking about things being unstraight or out of place, it drives me mental. If I'm watching a film and mis-hear a word, I HAVE to rewind to know what it is to the point where I will add subtitles if neccessary. I occassionally find myself having to step on certain tiles on roads, but having to feeling equal pressure in both hands is one of my stranger OCD's. When checking the back door is shut by tapping on the handle, I then have to with the other to feel the same. Similarly if I throw salt over my shoulder, I have to throw it over the other also! If I'm in the car and the cd player does not display an equal number I find myself getting fairly anxious.
I find it hard to throw things out, and hoard even useless things. I'm not a fan of change.
This post has been edited by gzu: Feb 6 2008, 09:49 AM
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Mar 10 2008, 07:43 AM
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QUOTE (jstone3503 @ Oct 20 2006, 09:31 AM) WOW. I used to do the thing counting the stripes on the road and all that and never thought of it as anything and also wash my hands a lot. Not obsessively but just feel like after I touch anything I have to clean them. But I dont think I havd OCD just some symptoms of it. Just glad to know I'm the only person doing the road thing...LOL Hi I count the number of spokes on the wheels of cars and keep repeating until that vehicle has moved or until I have moves....
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Mar 18 2008, 09:39 AM
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Just Registered
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Hi All,
I'm not sure if I'm posting at the right place or what?
Trying to find out info on OCD. We've had quite a few problems with our oldest son (he's 17). It's all a long story. I've thought for a couple years (or l
onger) that he might have mild OCD. Breifly I'll try to run some of this by you & would appreciate any input.
Probably around junior high it seemed to "start". He's always been kinda hard to get to know - won't really talk about what's goin on - never gives out info. He doesn't like to be touched, always seems grumpy like he hates it here. Yet, everyone else says what a great kid he is. I've observed him in public situations - a totally different person. All in all he's a good kid working hard at inproving his GPA right now - working part time a pizza hut. Some things that makes me suspect OCD are.... He doesn't like to use dishes.. if he does have to have a plate he'll wash the CLEAN plate for a while then use a paper towel on the plate before he puts food on it. He could be outside - hands gruby - won't wash his hands, but will scrub that clean cup from the cupboard before he gets a drink . Mostly he justs wants to drink from the jug, eat from the box ect.. all to avoid the dishes I think? Laundry washing is crazy he is always washing (& sometimes I know for a fact rewashing things I just washed). Seemed to start around junior high - I just thought he was becoming more self conscience of appearence ect... all the sudden you know they get to that age when you don't have to tell them to bathe anymore lol! His brother could just breathe on his plate - he throws it away - a hair - a fly - same thing. He's always checking expiration dates on food products. Many times he throws out the bread cos best by date is today. I say if it's soft & not green - it's still good? Or bananas he throws out the bananas once the peel starts to show brown spots - I tell him they are just getting ripe then & I don't like my bananas green. His sister was upset he threw out the brownies she made - because they were made the night before - so I guess that makes them no good. He used to really have a elaborate shower routine - I think that has gotten a bit better. He can have change - (spent the weekend at youth group retreat). He hasn't had a friend over in over four years ( I think it's because he's someone else around everyone else.) So are we getting the real one & every one else a phony front or vise versa? ALthough for the first time he had a g/friend & did bring her over a few times & he was a different kid - happy, excited, would talk to us. They're no longer together & mums the word on what happened there? We did get him involved in a youth group in a round about way a couple years ago & that's good for him & he has friends there. He mostly just acts like he hates all of us brother, sister, dad & I'm the stepmom - that is a another factor - how dysfunctional things were there (at his mom's). He ( & his brother) moved in with us when he was 6. Sometimes I think he missed something he needed those first years? Something you can't fix? Boy? - so much for brief! Anyway big fight with him last night & 90% of the time if he has to do anything. "Your turn for kitchen tonight" & same thing again he'd rather have a 3 hour blowout than take the 15 minutes to load the dishwasher. Like life is so unfair to him? Or.... is it the have to stop what he's doing & change to something else? Just typical teenager? He's the oldest. Well, there's more, but I think this is long enough. I looked though OCD symtom info - not sure if this fits?????????
Thanks!
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 Jun 8 2008, 11:22 AM
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The above article is the absolute greatest one I ever read, it really sums it all up while touching every aspect of the disease. Sometimes it can be tricky to explain to someone not afflicted with the disease. The above, really does the job.
My OCD started as a child. I remember being in fifth grade to high school having weird rituals and just was generally way more "neat" and careful then most kids my age. I also worried allot.
I remember as a kid always worried about burglars. I would constantly come down at night to check the windows and doors, making sure they were locked. I would do this even when I already had done it 5x over and knew they were locked. It was uncalled for but if I didn't do it, I would not be able to get to sleep. I also checked the stove -- jiggling the knob over and over as well as smelling the burners for gas. A few years after that I got a dog, things became worse then. It was always worse when I had something I cared about in the house at the time. I would constantly worry about "is the cage locked?" as if it is not, the pup may get out and get into something that kill's her. This had me late for school over and over again. My mother never understood as I would always get yelled at, etc. I would especially get yelled at for loose doorknobs to our front door from pulling on them so long, hard and often.
I also remember bouts of having to be clean, scrubbing that last spot on my body over And over again but this has since died off as the other I mentioned above I still battle.
My rituals as a kid were to step on every crack while walking home from school. If I missed one, I would not feel "right." I guess it is bordering the dyslexic version of the stereotyped "don't step on any cracks" Ha.
Over the years into my teens I became a heavy drinker. Although I do not drink now and actually cannot even stand the taste of it in mouthwash, I think I may have been self medicating myself. People do not understand how time consuming, frustrating and annoying it is to live with this. Matter of fact, I did not even understand what was wrong with me, at times I felt it was normal and I was a "Perfectionist" and other times I felt the opposite, I knew I was acting strangely but even still, could not stop.
I do believe it is hereditary as I can just look at my mother and her 6 other siblings and see it. All in different ways. They are all in denial and there is no chance in hell they will ever seek help. I on the other hand and getting help now with Luvox only as I was at the end of my rope. My grandmother actually is a hoarder, she has over 5000 newspapers in her house. She saves every copy, sometimes more then one of the same. Her house is a fire trap!
Anyway, back to me. A few years ago -- 3 to be exact the mother of my children whom I was with for 6 years had cheated on me at work with a CO worker. I'll save the details but I found out and from there on my OCD came back full fury.
I first went into a depression as anybody would. It then ate up two years of my life asking repetitive questions of the situation, needing to know every detail but nothing ever satisfied me -- grant it her lien then coming clean, lien then coming clean did not help.
I eventually went into a silent retreat, doing what I had to do to keep a roof over our heads but constantly, everyday to be exact would have doubts, thoughts (unwanted) about the situation. I could not let it go. This is not the typical thoughts a man would have but 10 to 100 times per hour. Sometimes it would have me staring at a wall while at work for ten minutes, just thinking, what if?
Anyway, I tried lexapro, hated it. I did develop a habit along the way of pain medication. Percocet to be exact. They did help me cope and still do from time to time along with the Luvox I am on now. The thoughts have diminished allot but I am unsure if time just made me numb and I feel out of love or the medicine got the best of my disease? Maybe I will never know.
I do however still have some ticks that are annoying. I won't go into them all as some are embarrassing but my biggest one now is with my kids. I cannot leave them alone or out of my sight for more then 2 minutes or I see visions in my head of them sticking something in there mouth and choking. I always run upstairs to check or send my girlfriend to check. If I don't, I can't relax or do anything else. I'd prefer they were always in front of us but I know it is outrageous. I really think they are going to choke one day. It has gotten so bad that my daughter is afraid to cough in front of me. I hate that I done that to her, but I can't help it. Sometimes I see me in her. I hope not!
I also still check the stove, windows and doors amongst a few other things but like I said, it quieted down a bit with the luvox although I am groggy allot. I also like the house clean and pretty much only feel happy when it is, which is not often with two children in the house not to mention the other half does not like cleaning to much. I get so mad. I would prefer to come home to a sparkling clean house after work all day rather then dinner on the table, is that odd?
I still have some thoughts here and there that are not normal, even sometimes regarding what she'd done but it does not effect my life as much as it did. I'd say the hardest part is having a very non-understanding family. I think some of my friends understand me better then my own family.
I wouldn't wish this on anybody but deep down I do believe it has made me a little more successful and who knows, may even have stopped some bad things from happening over the years with my constant checking, etc. Who knows! Us with OCD are usually very successful and more of perfectionist then your average Joe but people do not realize what it does to us. I guess there really is a thin line between genius and insanity.
I guess I am a man of routine all the way down to my peach snapple in the morning!
Can anybody else relate to me or any of my situation explained here in this post? Am I alone?
Look forward to lots O' Responses. Thanks guys and gal's!
--Gregory from the BIG CITY!
BTW: I also like things in a certain order, odd things on my desk, etc. If they are misplaced I usually notice and it causes me intense anger or anxiety.
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Jun 23 2008, 12:50 PM
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Newbie
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QUOTE (Forum Admin @ May 27 2006, 11:09 AM) QUOTE
Worriers and Pure Obsessionals
Worriers and Pure Obsessionals have repetitious negative thoughts that they can’t control and are very upsetting to them. The worrier does not experience any repetious behavior, such as checking or hand washing, or any thinking compulsions. The worriers and pure obsessionals worries about health problems, past traumatic events, or failing at some task in the future. An example of some one not demonstrating any compulsive behavior that could temporary alleviate their distress would be someone worrying about losing all of their saving in the market crash and not being able to educate their children. A severe example would be shameful images of inappropriate sexual behavior, or impulses to kill or hurt themselves or their love ones. Afterward, the person may dwell on how these thoughts may come true for hours or days (Foa & Wilson, pg 11).
Woah, this here seems to fit me like a glove! In my previous posts, someone suggested that I may have OCD, but I hadn't truly understood what it was. I did not know someone could have OCD and not exhibit any outward compulsions! Now, more than ever, I would like to see a psychiatrist to truly figure out if I suffer from OCD.
This post has been edited by Hraesvelgr: Jun 23 2008, 01:07 PM
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Jul 18 2008, 07:08 AM
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Newbie
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That was a very impressive article! Except from the cleaner part I think I got them all. I do remember that as a kid I have some weird thoughts too forexample like being sure nobody is in the room to frighten me or attack me I used to check every room I enter. And also I used to check all the mirrors so that people didn't put a recording video behind them and especially dial the telephone differently at first and after I talked so that I can't be tracked. It's just stupid and a little paranoid. But the obvious symptoms attacked me about 6 years ago when I was 19. The ideas would just pop up in my mind throughout the day and I had to think about it and yet they won't stop. Than I started doing things like touching objects and doing things over and over but they don't have a number I have to do them until it feels right. And yeah right sometimes it just doesn't feel right and I kept doing over and over. And my symptoms all get bigger as I get older probably because I'm trying not to do them. Forexample if I closed the bottle wrong and than a huge anxiety hit me and I had to do it again I forced myself to not do it and leave the bottle and go outside and meanwhile it eats my brain up and finally I had to rewind everything I do and go there walking backwards and doing the exact moves just backwards and close that bottle until it feels right. It sounds so funny when I tell about it but I'm sure it looks five times funnier in real life.
I always had some intimacy problems. They say I'm friendly when I talk but I have zero friends now. I like to be alone I guess but sometimes wish I had some friends to spend some time outside and have fun like all the other young people do but I feel old and tired and overused now. I don't enjoy anything and think that even if I did have friends probably I'll frighten them away. I had very tough times the last few months. I was so stressed that I spent all day like 10 hours in the house thinking and doing excessive things. And had no sleep at nights from the conversations in my mind.
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Sep 13 2008, 12:22 PM
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Junior Member
Group: Awaiting Authorisation
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Symptom Clusters of Obsessive Compulsive Disorder |
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Depression Forums - A Depression & Mental Health Community Support Group > OTHER DEPRESSION & ANXIETY RELATED ILLNESSES > Obsessive Compulsive Disorder - OCD
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