Obsessive-compulsive disorder (OCD) is a potentially debilitating condition that affects 2.2 million American adults, according to the National Institute of Mental Health. A person with OCD feels as though they are being held captive by irrational thoughts and impulses. These thoughts intrude on daily activities and trigger great anxiety, disgust or dread. To compensate, the person feels compelled to perform repetitive behaviors to relieve stress. In a 2009 report that appeared in "The Lancet," psychologist Jonathan S. Abramowitz classified these obsessions and compulsions into five dimensions: danger, balance and order, cleanliness, morality and hoarding.
Danger
In some cases of OCD, danger becomes a preoccupation. The person may become increasingly obsessed by his role in preventing harm. If he becomes consumed by visions of his home being burglarized, for example, he will attempt to manage this stress by repeatedly locking each door and window in succession before going to bed. The parent with OCD may check on her infant dozens of times during the night to ensure the child is still breathing.
Balance and Order
Lack of balance (or symmetry) can trigger extreme anxiety in the person with OCD. OCD Chicago, a nonprofit support group, reports that these types of obsessions have become stereotyped because of television characters who constantly rearrange misaligned items for comic effect. In reality, however, these behaviors can result in several hours lost each day while the person straightens framed pictures, rearranges pillows on a sofa, or aligns books on a bookshelf by height. In extreme cases, the person may repeatedly count or touch objects, or discard items because she has "too many" to achieve the balance she seeks.
Cleanliness
An irrational fear of contamination can cause the person with OCD to compulsively wash his hands, avoid touching other people and objects, and avoid public places. The home is never clean enough, and even a freshly laundered shirt may need to be re-washed if accidentally placed in a drawer that wasn't recently dusted. Depending on the degree of "contamination," articles of clothing or other objects may need to be discarded to ease anxiety. This type of fear is often observed in women who have been the victims of rape or domestic violence.
Morality
OCD that concerns religious and moral fears is called scrupulosity. The person may be afraid of being possessed by evil spirits and repeatedly confess perceived sins. She may say prayers continuously to alleviate fears of omitting something important. Life becomes a scorecard of canceling out "bad" thoughts by thinking the same number of "good" thoughts. These types of obsessions also frequently affect the person's view of sexuality, hampering social and romantic relationships. For the person who also has fears of germs or contamination, these obsessions over morality can lower sex drive and interfere with sexual arousal.
Hoarding
Compulsive hoarding often stems from an irrational fear of loss. Hoarding differs from collecting---often the items being saved are obviously useless. Rather than make a decision over what to throw away, the person throws nothing away. She may save broken items or buy items in bulk even if she has no use for them and cannot afford the expense. Sadly, cases of animal hoarding seem to be increasing in which great numbers of dogs and cats are found in deplorable conditions because the owner was unable to make rational decisions about the animals' welfare.
References
- National Institute of Mental Health: Obsessive-Compulsive Disorder
- Mental Health America: Obsessive-Compulsive Disorder Factsheet
- "The Lancet"; Seminar: Obsessive-Compulsive Disorder; Jonathan S. Abramowitz; August 2009
- OCD Chicago: Extreme Need for Symmetry or Exactness
- "CNS Spectrums"; Association of OCD With a History of Traumatic Events Among Patients in Methadone Maintenance Treatment; Einat Peles; October 2009
