You must be familiar with the word obsessive and compulsive – these two terms have actually been part of our everyday language. Obsession in everyday usage means being occupied in specific thoughts – you speak of being obsessed with your looks, your personality, your daughter’s studies, your girlfriend’s whereabouts while she is away from you. You also talk of being obsessed with a particular art form, of guns and rifles, of clothes, of cars, of stamps from different countries.
Compulsion means we are forced or compelled to do something. In ordinary language we may use it to be forced from outside (compelled by my parents) or from inside (compelled by my conscience). But you must remember that these are not technically correct use of the terms obsession and compulsion. So long you are happy and in control of these thoughts, and so long these are not intrusive despite your earnest effort toward them away they are simply fancy words and not components of a disorder
But in psychology obsession means intrusive and repetitive thoughts, images and impulses often of a negative or unacceptable kind, something you don’t like, despite one’s desire to get rid of it. Compulsion means being compelled from within to perform certain ritualistic acts, because otherwise you are afraid of some danger befalling you..
These thoughts do not concern real life problems at the moment, and are often irrelevant to present reality. The person has insight and tries to remove these thoughts, but often cannot succeed. If you look into the content of the obsessive thoughts, you may find unusual fear of contamination, fear of harming oneself or one’s own loved ones, religious themes, themes of sexuality specially the unacceptable forms, wishing ill for others (for example wishing one’s close person dead), doubt about whether one has accomplished things properly. The person does not want to think of these, and when particularly aggressive and sexual thoughts predominate, considers herself ‘bad’. Yet the thoughts continue to haunt her/him. Compulsions are repetitive overt behaviors like washing or checking or mental acts like counting or praying in response to an obsessive thought.
There are a few primary kinds of compulsive acts. These are;
Cleaning (for example, repeated washing)
Checking (for example, repeatedly coming back to home to check if the door has been locked properly)
Counting (for example, counting the number of steps one takes before getting on the bed)
Repeating (for example, coming back to the first word of the line as one is not sure if she has read it properly)
Hoarding (for example, collecting things and not being able to dispose of these things)
Ordering (for example, arranging books on the table in a particular order each time one leaves the table)
a mother like to check her children just before sleeping., saying a prayer to god for her children safekeeping. She did not feel compelled to do the checking and the prayer but if she has a obsessive compulsive disorder, she would always have to perform the check and the prayer to god, even they are sleeping or going to wherever. If she has unable to complete the ritual (prayer), she would also experienced extreme anxiety, fear or distress.
The obsessions and compulsions take plenty of time from one’s daily routine and slow down the entire life process. For some, rituals take the whole day resulting in the sufferer’s inability to anything else at all. Sometimes it results in health hazard; you may rub and clean your skin so much and with such material (like raw dettol) that there are wounds on your body. Also for most people there are multiple obsessions and compulsions.
In fact World Health Organization found obsessive compulsive disorder (OCD) to be the world’s leading cause of disability. It has also been associated with unemployment, marital problem and separation, and impaired social functioning.
TREATMENT OF OBSESSIVE COMPULSIVE DISORDER
In exposure therapy we need to encourage the person with obsessive compulsive disorder to expose themselves to their obsessions. As they are repeatedly faced with their fear and can reduce their anxiety without compulsion they get ‘habituated’ to the new experience.
For example if we want to treat a wife who is bothered by the intrusive or repetitive thought of possible harm of her husband. We must first allow her to be subject to the thought. This is called exposure. We may distract her by discussing the possibility of the harm and after some talking she may feel the fear of harm a bit less. Then we may reinforce this behavior and ask her to practice it. we can give her homework as well so that she may record the number of successful response prevention at home. Gradually she may be convinced that obsessive anxiety may go away even.
Unfortunately neither the drug therapies nor the cognitive Behavioral therapies tend to eliminate the obsessive compulsive disorder completely. The relapse rate with the drug therapies is high once the drugs are discontinued. Exposure therapies help prevent relapse
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