FREE ESSAY ON OBSESSIVE COMPULSIVE DISORDER

OBSESSIVE COMPULSIVE DISORDER

Are you the type of person who has a phobia of germs, dirt, or contaminated bodily fluids?
Is the only way to feel safe and pure is for you to cleanse yourself countless times a
day? Or maybe you're the type of person who has to check things twice, three times or
more. Perhaps you're the type of person who has to do everything twice, or by a fixed
number. Maybe you are the type of person who must have everything neatly placed, and if
misplaced at all you throw a tantrum. If you are a person who happens to do any of these
things then maybe you have OCD, the acronym for Obsessive-Compulsive Disorder.
Obsessive-Compulsive Disorder (formerly known as obsessive neurosis) "is categorized as
an anxiety disorder because the main focus seems to be anxiety and discomfort that is
usually increased by the obsessions (thoughts) and decreased by the compulsions or
rituals (actions)." (Baer 3) According to Baer, Obsessions are defined as recurrent,
persistent ideas, thoughts, images, or impulses that are experienced, at least initially,
as intrusive and senseless. Compulsions are defined as repetitive, purposeful, and
intentional behaviors that are performed in response to an obsession or according to
certain rules or in a stereotypical fashion. (Baer 3)
Obsession-compulsive disorder usually begins in late adolescence in one to two thirds of
reported cases. The problem is associated with significant life changes.
Obsessive-compulsive disorder results from biological and psychological influences.
Abnormal levels of the neurotransmitter serotonin may play a role in OCD. Catscans of
people with OCD have discovered irregularities in the activity level of the orbital
cortex, caudate nucleus, cingulate cortex, and a brain circuit that assists control
movements of the limbs. (Pato 8) Many patients report having numerous neurotic problems
during childhood. These patients become socially isolated, and consequently fall into a
deep depression. This disorder affects males and females quite differently. People with
OCD tend to have a high celibacy rate, particularly males. Both sexes tend to marry at an
older age than other types of psychiatric patients, and they have a low fertility rate.
(Rachman 6)
Most studies concluded that OCD patients possess higher than average intelligence. The
average OCD patient has many types of compulsive behavior. The anxiety of OCD is caused
through its persistence. (Mavissakalian 15) And maybe this is why cleaning and checking
rituals are the most common types of obsessive-compulsive disorder. These patients carry
out activities as disinfecting of objects, excessive hand washing until the hands are so
clean that they crack and bleed, excessive showering, and excessive rinsing of dishes.
Securing locks, alarm clocks, gas jets, and looking under the bed are some of the
checking rituals OCD patients have. If the obsessive-compulsive person qualms and ponders
when the ritual is not performed systematically. The task of this patient must be carried
out to perfection or it will not be preventative or restorative. The checking ritual is
described as intending to prevent some state of balance and order to avoid infectivity
from some distressing stimuli. (Rachman 14)
Some obsessional people often feel a compulsive need to arrange things in their
environment. To the observer, compulsive arranging seems identical with the activities of
normal, neat-minded people. The major distinction is the accompanying experience of
compulsivity.
The frustration experienced by the obsessional person is a result of disobedience of a
different order severely disturbed by any deviation from the set order and feels
compelled to reposition the status quo. (Reed 38) For example, if someone puts a document
on your desk then this person just moved an item from your possession, in turn when you
arrive, you have to remove the item and put anything that was interfered with back to a
precise order.
Sigmund Freud was particularly fascinated in the obsessive-compulsive disorder. He
referred to it as the obsessional neurosis, and in 1926 Freud wrote it was
"unquestionably the most interesting and re-paying subject of analytic research. But as a
research it has not been mastered." (Cooper 9) Freud also found evidence of passive
sexuality, and sexual experience yielding pleasure. The defenses used in obsessional
neurosis are denial, repression, regression, reaction formulation, isolation, undoing,
magical thinking, doubting, indecision, intellectualization, and rationalization. Washing
is most frequently engaged to an undoing of a dirtying action. In analytic therapy,
obsessive-compulsive neurosis is regarded as the second type of transference neurosis. In
hysterics, the ego forms an alliance with the analyst to battle the neurosis. 
In compulsive neurotics, the ego is split, with one part working logically while the
other thinks in fantasy. (Cooper 14)
Obsessions and compulsions are also linked to toxic conditioned stimuli obtained by
classical conditioning events. The response and stimulus are used identically because
they have double properties. An example of this is fear. Fear is a response, but also it
is an obsessive thought of hurting, which would make it a stimulus also. The interaction
between the repeated ruminations and mood turbulence increases the provocation of the
individual and increases the tendency to reflect even further. Temporary relief produced
from the ritual, or motor act terminates an aversive condition. This makes the resolution
prototype likely to be repeated the next time producing a disturbing thought. The
classical conditioning will result an anxiety. This will now become a conditioned
stimulus for a response. When this stimulus is then paired again to another neutral
stimulus, the conclusion also acquires aversive connotations and its presence will bring
out anxiety. While this is occurring, the original anxiety response is likely then to
expand into a general feeling of discomfort, in which is now turned into the
obsessive-compulsive disorder. (Cooper 21)
Obsessive-Compulsive Disorder is also linked to many diseases and disorders, such as
Tourette's syndrome. Tourette's syndrome is a neuropsychiatric and behavioral disorder
with childhood onset that is characterized by a motor disorder. It involves both motoric
and vocal tics that can range from relatively mild to very sever over the course of a
patient's lifetime. OCD occurs in about one out of a hundred cases in the general
population. 30-60% of Torette's Syndrome patients have reported obsessive thoughts and
compulsive rituals that occur many years after the motor tics start. 
Usually during the preadolescent years. Research states that a single major gene or that
the sex may determine if the disorder is related OCD or Tourette's Syndrome. Females are
more likely to have OCD without tics, when the diagnosis of the disorder was
undetermined. (Sanberg 349) A device called the positron emission tomography (PET)
scanner, studies the brain of patients with OCD. OCD patients have patterns of brain
activity that differ from those of people without mental illness or with other mental
illness. The PET shows abnormal neurochemical activity in regions known to play a role in
certain neurological disorders. This suggests that these areas may cause the origins of
OCD. "There is also evidence that treatment with medications or behavior therapy induce
changes in the brain coincident with clinical improvement" (Strock)
Obsession patients often attempt to negotiate how the treatment is to be conducted. Many
patients, especially those who have had the disorder for a long time, do not believe that
treatment will be effective because they have tried so many other approaches beforehand.
An important part of preparing the patient for treatment is to inform them that their
disorder is chronic and that they will have to learn to understand themselves and their
limitations in order to manage and control it. (Turner 49) There are many types of
treatment for OCD patients. One patient may benefit from behavior therapy, while others
will benefit from pharmacotherapy. Some may even use both medication and behavior
therapy. Some may begin with medication to gain control over their symptoms and then
continue with behavior therapy.
Exposure and response prevention is effective for many people with OCD. The patient
intentionally and willingly deals with the feared object or idea, either by imagination
or directly. The patient is urged to refrain from ritualizing with the patients loved
ones. For example, a compulsive hand washer may be encouraged to touch an object believed
to be tainted, and then advised to avoid washing for numerous hours until the provoked
anxiety has greatly decreased. The process then moves to the patient's ability to bear
the anxiety and to control the rituals. Most patients even experience less anxiety from
the obsessive thoughts and are able to oppose the compulsive urges. The patient needs to
have an extremely positive outlook for life and to maintain a high self-esteem.
Cognitive-behavioral treatment or psychotherapy may also provide effective for OCD. This
alternative behavior therapy highlights changing the obsessive-compulsives beliefs and
thinking patterns and is 60-70% helpful with OCD patients.
Drugs that affect the neurotransmitter serotonin can considerably reduce the symptoms of
OCD. Serotonin reuptake inhibitors (SRIs) particularly approved for the use in the
treatment of OCD was the tricyclic antidepressant clomipramine (Anafranil), and selective
serotonin reuptake inhibitors (SSRIs). Food and Drug Administration for the treatment of
OCD approved flouxetine (Prozac), fluvoxamine (Luvox), and paroxetine (Paxil) and
Sertraline (Zoloft). Medications relieve symptoms of OCD by alleviating the frequency and
intensity of the obsessions and compulsions. You will typically see result in at least
three weeks. Medications are helpful in controlling the symptoms of OCD, however, if the
medication is discontinued, relapse is inevitable. About 80% of people with OCD that
combine psychotherapy and medication show improvement.
Also, when the symptoms are gone, most people must continue taking the medication for the
rest of their life. Many of them go on a lowered dosage, except it is possible that they
will become addicted to the drugs if they ever stop taking it. (Strock) As long as you
have a will to change and follow through with the treatment, then you may be able to
surpass this disorder.
Bibliography
Baer, Lee, Michael A. Jenike, and William E. Minichiello. Second Edition Obsessive
Compulsive Disorder: Theory and Management. Missouri: Mosby-Year Book, Inc., 1990
Cooper, Marlene. Behavioral Treatment Of A Client With an Obsessive-Compulsive Disorder:
A Single Subject Design. New York: UMI Dissertation Services, 1988
Margaret Strock. "Obsessive-Compulsive Disorder." National Institute of Mental Health
(1999): Online. Internet. 22, Oct. 1999. Available
http://www.nimh.nih.gov/publicat/ocd.htm#ocd4.
Mavissakalian, Matig, Samuel M. Turner, and Larry Michelson. Obsessive-Compulsive
Disorder: Psychological and Pharmacological Treatment. New York: Plenum Press, 1985
****Pato, Michele Tortora, and Joseph Zohar. Current Treatments of Obsessive-Compulsive
Disorder. Washington, DC: American Psychiatric Press, Inc, 1991
Reed, Graham F. Obsessional Experience and Compulsive Behaviour: A Cognitive-Structural
Approach. Florida: Academic Press, Inc., 1985
Sanberg, Paul R., Klaus-Peter Ossenkopp and Martin Kavaliers. Motor Activity and Movement
Disorder: Research Issues and Applications. New Jersey: Humana Press Inc., 1996
Turner, Samuel M. and Deborah C. Beidel. Psychology Practitioner Guidebooks: Treating
Obsessive-Compulsive Disorder. New York: Pergamon Press, Inc., 1988