Obsessive-Compulsive Disorder (OCD): What is it?

Not all mental disorders are based on an abnormal perception of reality. Some, like Obsessive-Compulsive Disorder (OCD), are not expressed through the way in which the information from the surrounding world is interpreted, but through actions that arise from the subject himself: the so-called repetitive behaviors, or compulsions, which undermine people's quality of life by producing unpleasant sensations and limiting their degree of freedom.

However, talking about this type of behavior is only telling half the story. The other half is found in intrusive thoughts, which are closely linked to compulsions.. From a psychological perspective, it can be said that both intrusive thoughts (or obsessions) and Compulsions are the two main gears through which the Disorder is articulated Obsessive compulsive. But... How do these two pieces become activated?

Obsessive-Compulsive Disorder: intrusive thoughts and compulsions

Obsessive-Compulsive Disorder is usually considered, in many respects, an alteration linked to

anxiety disorders, and therefore is characterized by being associated with a feeling of fear, anguish and stress continued in a magnitude that represents a problem for the day to day and has a negative impact on the quality of life of the person in practically all the areas in which they go developing.

In the specific case of Obsessive-Compulsive Disorder, the motor of these crises of anxiety is he obsession-compulsion cycle. Obsessions occur spontaneously, regardless of the will of the person, and become so frequent that they are invasive. These are mental images or recurring thoughts that disturb the person and that do not go away. the head, causing it to desperately search for strategies to stop focusing its attention on it.

In addition to creating anguish, these intrusive thoughts trigger a series of repetitive behaviors aimed at reducing the anxiety produced by obsessions: it's about compulsions.

Compulsions are a kind of ritual that must always be performed in the same way, and if not, the person starts over the chain of actions that compose them. It is very difficult to resist the urge to perform these compulsions, and at the same time, the more they are performed, the more you depend on them.

Thus, OCD is characterized by being a disorder in which the symptoms of anxiety and those of problems controlling your own impulses. Its two-phase structure makes the attempt to remedy the situation part of the problem, by providing a temporary relief but it does serve to reinforce the association between obsession and compulsion and vice versa.

OCD is also characterized by repetitive behaviors

However, far from being useful, repetitive behaviors are actually compulsions, that is, stereotypical behaviors that are beyond the person's control, just like the thoughts whose negative effects they try to mitigate. That is why the diagnostic picture of Obsessive-Compulsive Disorder not only includes intrusive thoughts, but also the stereotypical actions that follow them.

By dint of repeating themselves, both obsessions and compulsions come to take control of the person's life, just as pathological gambling takes over the daily life of the person. compulsive gambler. The obsession-compulsion cycle causes anxiety to persist, since the person experiencing the Disorder Obsessive-Compulsive anticipates the appearance of intrusive thoughts and stereotypical behaviors and knows that they escape at her will. In this way, a loop of action and reaction is entered that is increasingly difficult to undo.

The most common compulsions in OCD

The compulsions associated with OCD cover a range of possibilities that are practically infinite and endless, and also its variety grows as technological changes are being introduced in our lives.

However, there are certain compulsions that are much more common than others. What are the most common behaviors among those with this disorder?

1. Need to clean

These compulsions are usually related to obsessions that have something to do with the idea of ​​dirt or putrefaction, literal or metaphorical. People with these types of compulsions they can clean their hands too often, or do the same with objects or other parts of the body. It is all part of a desperate and urgent attempt to get rid of the dirt that invades what should be pure.

This is one of the most common variants of Obsessive-Compulsive Disorder, and can lead to skin lesions due to erosion.

• Know more: "Obsession for cleanliness, causes and symptoms"

2. Need to order

For some reason, the person with this type of Obsessive-Compulsive Disorder compulsion you get the impression that you need to sort multiple itemsEither for the intrinsic value of being in a place with the things well collected or to make a good impression. This type of compulsion has been linked to the classic Gestalt laws, since according to this psychological current we notice a feeling of tension or a slight discomfort if what we perceive does not form a meaningful and well-defined set. In this sense, a disorderly environment would create discomfort by presenting difficulties to be perceived as a perfectly defined whole: a study room, a dining room, etc.

Thus, Obsessive-Compulsive Disorder would occur when this feeling of discomfort is amplified so much that It harms the levels of well-being and quality of life of the person, by forcing them to order so as not to feel wrong.

3. Compulsions related to hoarding

In this type of Obsessive-Compulsive Disorder, the person has the need to save all kinds of elements, attending to their possible use in the future, despite the fact that by pure statistics it is highly unlikely that there will be a situation in which each of the accumulated things will be able to be used.

From some schools of psychodynamic currents, such as the classical freudian psychoanalysis, this tends to be related to Freud's psychosexual theory. However, current clinical psychology starts from assumptions and a philosophy of research and intervention that have nothing to do with psychoanalysis.

4- Checking compulsions

Another typical example of Obsessive-Compulsive Disorder is that of a person who you need to constantly make sure that everything works as it should to the point of doing the same thing several times each day. It is a case of checking compulsion, based on the need to avoid future accidents and, more specifically, to make imaginary thoughts and scenes about accidents that might occur cease altogether and stop producing discomfort. These thoughts appear involuntarily and lead to various checks aimed at reducing the risk of their occurrence, which in turn becomes a difficult habit to change.

Causes of Obsessive-Compulsive Disorder

As in many psychiatric syndromes, little is known about the precise biological mechanisms by which some people develop obsessive-compulsive disorder. It is not surprising because to address it, in addition to studying the complicated workings of the human brain, it is necessary to address the context in which the person has developed, their habits and living conditions, etc. Ultimately, OCD must be understood from a biopsychosocial perspective.

In manuals such as DSM-IV, the set of symptoms that characterize this anxiety disorder are described, but beyond the diagnostic criteria there is no theoretical model supported by a broad scientific consensus that explains its causes with a good level of detail. New research in neuroscience, together with the use of new technologies to study the functioning of the brain, will be decisive to find out what are the causes of OCD.

The relationship between this psychological phenomenon and perfectionism

Many people assume that Obsessive-Compulsive Disorder has to do with perfectionism, given that in compulsions a chain of steps is always followed in the most meticulous way possible. However, everything seems to indicate that OCD is not so closely related to this scrupulousness as it is to the lack of it. For example, while people with Obsessive-Compulsive Personality Disorder score highly High in Responsibility (a feature of the Big Five model created by psychologists Paul Costa and Robert McCrae), those with Obsessive-Compulsive Disorder usually obtain very low scores in this trait.

This indicates that in OCD, there is an intention to pathologically compensate for the tendency to chaotic and spontaneous behavior that occurs in the rest aspects of life, that is, one goes from being very unscrupulous most of the time, to being obsessed with it for a few minutes.

Relationship with Body Dysmorphic Disorder

The Obsessive-Compulsive Disorder presents some symptomatic characteristics that overlap with those of the Body Dysmorphic Disorder, a psychological disturbance that is also based on perceptual rigidity, and in which the person is very concerned that the aesthetics of her body do not go beyond very defined canons. For this reason, its comorbidity is high: where one is diagnosed, it is very possible that the other is also there.

If they occur at the same time, it is important to treat these two disorders as separate entities, since they affect to different aspects of patients' lives and are also expressed through other situations.

Treatment of this psychopathology

The treatment of OCD combines resources from the field of psychological therapy psychiatry. In the first of these forms of intervention, anxiolytics and SSRI-type antidepressants are used mainly, and with regard to psychotherapy, forms of intervention such as systematic desensitization and exposure controlled, in which the person is trained to resist anxiety without reinforcing it through anxious thoughts and compulsion.

Bibliographic references:

• Doron, G,; Derby, D., Szepsenwol. OR. & Talmor. D. (2012). Tainted Love: exploring relationship-centered obsessive compulsive symptoms in two non-clinical cohorts. Journal of Obsessive-Compulsive and Related Disorders 1 (1): pp. 16 - 24.
• Colesa, M.E.; Frostb, R.O.; Heimberga, R.G.; Rhéaumec J. (2003). "Not just right experiences": perfectionism, obsessive – compulsive features and general psychopathology. Behavior Research and Therapy 41 (6): pp. 681 - 700
• Rhéaume, J.; Freeston, M.H.; Dugas, M.J.; Letarte, H.; Ladouceur, R. (1995). Perfectionism, responsibility and Obsessive-Compulsive symptoms. Behavior Research and Therapy 33 (7): pp. 785 - 794.
• Kaplan, Alice; Hollander Eric. (2003). A Review of Pharmacologic Treatments for Obsessive Compulsive Disorder. psychiatryonline.org.
• Sanjaya Saxena, MD; Arthur L. Brody, MD; Karron M. Maidment, RN; Hsiao-Ming Wu, PhD; Lewis R Baxter, Jr, M D (2001). Cerebral Metabolic in Major Depression and Obsessive-Compulsive Disorder Occurring Separately and Concurrently. Society of Biological Psychiatry.