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What is OCD

  
 
Peach Pie
15:39 / 02.05.07
A very scrupulous friend has recently been under a lot of stress... the behaviors she has started to demonstrate has me wondering if she has OCD. She's prone to perennial seeking of reassurance that she hasn't done things wrong, and is obsessed with having got things right in the past.

What confuses me is that she has none of the mroe well-known symptoms - ritualistic handwashing, cleanliness etc. But she's forever obsessed with moral concerns - is she a good enough person - has she harmed someone. There's *never* a rational basis for this, as far as I can see.
 
 
Ex
16:07 / 02.05.07
This is an ill-informed layman's tuppence, but concerns about moral worth have been often identified with a particular variation on obsessive behaviour - I mainly know this from Jennifer Traig, who's written her autobiography. It's hilarious as well as insightful.

Traig became really emotionally invested in repetative religious behaviour around her teens. There's a technical term for the 'religiously observant' flavour of OCD which is, coincidentally or not, how you described your friend - scrupulosity. Although that's traditionally based pretty firmly in established religious ritual, and your friend's sensitivity to guilt and harm may not bear any resemblance.

(My favourite part of Traig's account is that she doesn't measure her behaviour against an accepted secular 'normality' - in the end she finds escape from obsessive religious behaviour, but retains a greater-than-average relationship with her faith, managing to find a balance that enriches her life. As she says , she becomes scrupulous in a good sense.)

The usual Barbelith caveats about pathologising things versus having a label to have a handle on them probably apply, so I don't offer this as a stick-on cure-all, just an interesting side-alley. Very good luck with your friend.

(Also, it's fascinating stuff, but I think you may do better in another forum - if you're looking for helpful advice or support rather than a more abstract discussion of pathology and normalising behaviour and so forth. On the other hand, give me permission and I'll come back for more discussion on that...)
 
 
Quantum
16:08 / 02.05.07
I think you might want to put this thread in the conversation or Laboratory. Threads on psychiatry, psychology and such tend to do well in Lab, threads on personal experience with OCD probably in convo, Headshop is more for theory and such. Just PM me and let me know which you prefer and we'll transplant it.
Meanwhile check out wikipedia and www.myOCD.org perhaps.

OCD is most commonly characterized by a subject's obsessive, distressing, intrusive thoughts and related compulsions (tasks or "rituals") which attempt to neutralize the obsessions.

...

Symptoms may include some, all or perhaps none of the following:

Repeated hand-washing.
Repeated clearing of the throat, although nothing may need to be cleared.
Specific counting systems—e.g. counting in groups of four, arranging objects in groups of three, grouping objects in odd/even numbered groups, etc.
One serious symptom which stems from this is "counting" steps, e.g. feeling the necessity to take twelve steps to the car in the morning.
Perfectly aligning objects at complete, absolute right angles, or aligning objects perfectly parallel etc. This symptom is shared with OCPD and can be confused with this condition unless it is realized that in OCPD it is not stress-related.
Having to "cancel out" bad thoughts with good thoughts. Examples of bad thoughts are:
Imagining harming a child and having to imagine a child playing happily to cancel it out.
Sexual obsessions or unwanted sexual thoughts. Two classic examples are fear of being homosexual or fear of being a pedophile. In both cases, sufferers will obsess over whether or not they are genuinely aroused by the thoughts.
A fear of contamination (see Mysophobia); some sufferers may fear the presence of human body secretions such as saliva, sweat, tears, vomit, or mucus, or excretions such as urine or feces. Some OCD sufferers even fear that the soap they're using is contaminated. [2]
A need for both sides of the body to feel even. A person with OCD might walk down a sidewalk and step on a crack with the ball of their left foot, then feel the need to step on another crack with the ball of their right foot. If one hand gets wet, the sufferer may feel very uncomfortable if the other is not. These symptoms are also experienced in a reversed manner. Some sufferers would rather things to be uneven, favoring the preferred side of the body.
An obsession with numbers (be it in math class, watching TV, or in the room). Some people are obsessed with even numbers while loathing odd numbers (they cause them a great deal of anxiety and often make the person uncomfortable or even angry) or vice versa.
 
 
Princess
16:23 / 02.05.07
Perhaps this would do better in Convo? With a big old SBR on it?
 
 
Phex: Dorset Doom
16:34 / 02.05.07
I'd advise against two things here:

1) Diagnosing friends with specific psychiatric conditions. Once you've got it into your head that X has OCD that's what you'll see in every aspect of their behavior. The percentage of the population qualified to make a successful diagnosis of OCD or anything else is small, and even they don't get it right 100% of the time. Also, it's just plain disrespectful to your friend. You're essentially talking behind their back here, even though your intentions are benign.

2) Trying to get a diagnosis over the internet, which seems to be what you're doing here. We don't have many, or any, psychiatric professionals on this site (one, Ganesh, left shortly before you showed up DD), and even if they did they wouldn't be able to make a diagnosis without talking to this person.

The best thing you can do DD is talk to friends you and the person you suspect has OCD have in common and, if you all agree there is a problem, talk to your friend about going to see a counselor.
 
 
ONLY NICE THINGS
16:44 / 02.05.07
Point of info - Donnie Darko was formerly Secret Goldfish, with whom Ganesh had many a fine and productive conversation.

This coould go in Conversation, or Laboratory for that matter. Since it is not concerned with sex, bodies or relationships, however, I'm not sure why an SBR tag would be useful.

Is there much to say, though? It sounds like your friend, under stress, is exhibiting changes of behaviour. If these behavioural patterns remain after the stress level is reduced, or if they are affecting her happiness or ability to function normally, it may well be a good idea for her to try to determine whether she is suffering from some form of treatable condtition, and if so to seek treatment, but as Phex says it is not really within Barbelith's power to diagnose her based on a second-hand account of symptoms. If she is suffering, best to try to get at least a professional opinion.
 
 
Quantum
17:11 / 02.05.07
We are moving to the Lab, perhaps we could discuss OCD and perceptions of it instead of DD's friend specifically.
 
 
Peach Pie
12:07 / 03.05.07

ok generally... I just don't "get" it. I understand it as an anxiety disorder... how exactly is it different from depression? doesn't everyone who has depression suffer unwanted thoughts?
 
 
Quantum
12:46 / 03.05.07
unwanted thoughts? ...and related compulsions (tasks or "rituals") which attempt to neutralize the obsessions.

Think of it as an addiction to superstition. Imagine if you had to click the light switch on and then off seven times every time you turn the light on, or else something terrible will happen to your mum.
Go look at ocduk.org, a charity that helps people with OCD and their friends & family, or perhaps read a bit about it on wikipedia, there's a link I gave you in the post yesterday, then you might get it a bit. It's not difficult to grasp obsessive behaviour surely? Everyone does it to some extent.
 
 
MacDara
12:57 / 03.05.07
It's not difficult to grasp obsessive behaviour surely? Everyone does it to some extent.

Exactly. Someone very close to me has OCD, and basically explained that it's best understood as part of a spectrum of behaviour (or whatever other term fits better here).

I can see in myself, for example, a few irrational things that I do, or feel compelled to do, to put my mind at rest or make myself feel comfortable; it's an automatic thing for me and I tend not to even think about it. But if I had OCD these tendencies would become crippling to my functionality as a 'normal' person. That's the difference.
 
 
Peach Pie
13:59 / 03.05.07

what i still don't understand though... is it possible to have , say scrupulous obsessions, with compulsions other than handwashing or checking? What if someone constantly worried and then felt compelled, say, to drink tea all the time? Would that fall outside the range of compulsions that qualified?
 
 
MacDara
14:33 / 03.05.07
As far as I'm aware, there doesn't have to be a specific compulsion to go with an obsession; sometimes the obsession itself is the compulsion. (Which seems clear if you take it that at the brain electro-chemical level, the thoughts and behaviours are the result of a synaptic feedback loop.)
 
 
grant
15:12 / 03.05.07
What if someone constantly worried and then felt compelled, say, to drink tea all the time? Would that fall outside the range of compulsions that qualified?

To momentarily channel Ganesh, I think the only things that qualify are things that have a deleterious effect on your sense of well-being.
 
 
Ex
15:44 / 03.05.07
Nice channelling, grant.
I'm interested in the rational/not rational basis for OCD, as Peach Pie/donnie darko mentioned in the first post - some things have no immediately 'rational' basis (eg. having to align your shoes at night otherwise your relatives will suffer). Other things less so - turning off the oven, washing your hands and having some concern about how others perceive you are all sensible things to do. It's only when, as grant notes, they become intrusive or upsetting that they're a problem.

I believe - from a sketchy reading of some secondary lit - that some curent treatment for 'delusions' is done not on the basis of whether they're 'sensible' or not, but on whether they're distressing. So there's less judgement of the belief framework, more attention to whether it supports you, distresses you or makes it easier or harder for you to interact and function (which is, again, a value-laden term masquerading as a neutral one - are you 'functioning' if you can you manage paid employment? A relationship?).

Possibly it's best to do the same with the 'irrational' behaviours of OCD - accept that a degree of irrationality is common to many people (as MacDara notes), and that even sensible instincts can become intrusive.
 
 
Ex
15:47 / 03.05.07
I think I went a little askew there - clearly Peach Pie can have a sense that people don't hate their chum, and if their chum is concerned about being hated, then that's an apparently irrational fear.
I suppose I want to say that there is no established 'norm' for that kind of thing - how much should I care about other people's opinions, to be normal? The more I read about other people's social interractions the more I realise that the spectrum of feelings about friends and social interraction is huge, and people all over that spectrum find it normal and don't find their feelings distressing. So it would be hard to pin down a definition of OCD to it not 'making sense', as it were.
 
 
Peach Pie
21:43 / 03.05.07
hmmm.... so... in terms of diagnosis, the ultimate key is how distressing the symptoms are by self-report?
 
 
Ex
07:08 / 04.05.07
I'm not sure how diagnosis would work (shoddy layperson, me) - because clearly if obsessive thoughts and behaviours are making someone unable to 'interract' or 'function' (however defined) but insists that it's not problematic, that doesn't prevent them being seen as an exemplary case of OCD. I will backpeddle away quietly.
 
 
Quantum
17:29 / 05.05.07
Peach Pie, have you bothered to read any of the links? Or are you just waiting for us to explain it to you in words of one syllable? I'll copy and paste the section on diagnosis from the wikipedia article for you to make it super easy;

"To be diagnosed with Obsessive-Compulsive Disorder, one must have either obsessions or compulsions alone, or obsessions and compulsions, according to the DSM-IV-TR diagnostic criteria. The Quick Reference to the diagnostic criteria from DSM-IV-TR (2000) describes these obsessions and compulsions:

Obsessions are defined by:

1. Recurrent and persistent thoughts, impulses, or images that are experienced at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress.
2. The thoughts, impulses, or images are not simply excessive worries about real-life problems.
3. The person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action.
4. The person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind, and are not based in reality.
5. The tendency to haggle over small details that the viewer is unable to fix or change in any way. This begins a mental pre-occupation with that which is inevitable.

Compulsions are defined by:

1. Repetitive behaviors or mental acts that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly.
2. The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive.

In addition to these criteria, at some point during the course of the disorder, the sufferer must realize that his/her obsessions or compulsions are unreasonable or excessive. Moreover, the obsessions or compulsions must be time-consuming (taking up more than one hour per day), cause distress, or cause impairment in social, occupational, or school functioning (Quick Reference from DSM-IV-TR, 2000)."
 
 
Peach Pie
15:40 / 07.05.07

Peach Pie, have you bothered to read any of the links? Or are you just waiting for us to explain it to you in words of one syllable?

I have indeed: it's precisely because people have bothered to post them that I'm taking this time to check my understanding of them.

Your sarcasm and the underlying aggression that accompanies it is somewhat off-putting. And unwarranted, as far as I can see.
 
 
grant
19:42 / 07.05.07
It's not necessarily by "self-report" but by "functioning" which includes judgement calls on things like being able to do routine tasks and hold down a job and things.
 
 
*
02:04 / 08.05.07
I was surprised at that, too, Quants; am I missing something?
 
 
Quantum
08:15 / 09.05.07
Sorry if I was snappy.
 
  
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