Interview with Silvia García Graullera: the keys to understanding OCD

Obsessive-Compulsive Disorder (OCD) is a psychological disorder that is very sensitive to changes in the context in which the person who develops it lives.

Therefore, in the current pandemic crisis situation, there are many people who suffer especially from OCD and need professional help.

In order to understand what are the key aspects of Obsessive-Compulsive Disorder during the coronavirus pandemic, On this occasion we interviewed Silvia García Graullera, a psychologist with a lot of experience offering treatment for people with OCD.

• Related article: "Obsessive-Compulsive Disorder (OCD): what is it and how does it manifest itself?"

OCD in times of coronavirus: interview with Silvia García Graullera

Silvia Garcia Graullera He is part of the management team of the PSICIA psychotherapy center, located in Madrid. On this occasion, she tells us about the main characteristics of OCD, and how it can affect us during the pandemic.

As you see it, what is Obsessive-Compulsive Disorder, beyond the definitions that appear in diagnostic manuals?

OCD is a disorder of anxiety, generally quite disabling, characterized by the presence of intrusive thoughts and compulsions. Obsessions are persistent and involuntary ideas or thoughts that "invade" the person's mind and cause great anxiety. To reduce this discomfort, the person seeks to suppress or alleviate these thoughts through other behaviors, called compulsions.

A typical example in the case of checks can be the following obsessive thought: “if I don't check that I have turned off and unplugged everything before leaving the house, I can cause a fire, burn down the building and many people die because of me blame…". The compulsions will consist of checking the ceramic hob several times, unplugging all electrical appliances, touching the iron to notice if it is cold, even take photos to be able to continue making sure when leaving the house... like this a long etc…

No matter how much he checks, he will notice a momentary relief but immediately the doubt will assail him again:- "and if I haven't checked it well... and if in the end I didn't unplug the toaster??? No matter how much he checks, he is never satisfied, and every time he feels the need to expand all the rituals.

Although the person with OCD recognizes that their thoughts and compulsions are irrational and exaggerated, they cannot avoid them, causing much suffering and interference in their lives.

What are the types of OCD that you see the most in consultation? Which ones are seen more because of the COVID-19 crisis?

The types of OCD are very varied and can change in the same person over the years. Those related to checks and infections are very common. Currently, with the COVID-19 crisis, OCD cases related to this issue have skyrocketed and they do not have to be new cases, but sometimes They are from people who in their day could have had an obsession related to the contagion of AIDS and later with that of mad cows and then with the ebola.

Other typical cases are the urgent need to have everything orderly and symmetrical, obsessions related to the possibility of being able to attack someone (eg. not being able to get close to a knife because the thought of attacking a family member comes to mind), religious obsessions and conscientious scruples, the obsession with the possibility of natural catastrophes, wars, attacks etc

How does Obsessive-Compulsive Disorder begin to develop, in the stages in which it is not yet a problem? In your experience, does it take people with OCD to realize that something is wrong?

Obsessive-Compulsive Disorder usually manifests in adolescence or early adulthood. At the beginning, people know that something is not going well, and they tend to experience it with great fear, since both because of the content of the thoughts (generally very absurd) as well as the imperative need to neutralize them, they state that they have the sensation of "becoming crazy”.

At first they usually hide it out of fear and shame, but once the diagnosis is established and they talk about it with a professional, they feel a great relief knowing that their disorder has a name and that it can be sort out.

Is it common for the family to blame the person with OCD for, in theory, not wanting to stop performing these rituals? In these cases, what is done from the psychological intervention?

Families are often quite bewildered by this disorder, and feel quite helpless. At first they usually react badly and there are often conflicts over the handling of rituals. After time and given the impossibility of handling the situation, they usually end up giving in and we see how many families end up living under the rules of OCD.

It is essential that the family or couple be involved in the psychological intervention, in order to give them some guidelines and that they can help in the treatment of the patient.

Is there a specific case of a patient with OCD that, as a professional, you remember with great satisfaction due to the results achieved in therapy?

In reality, we see many cases and people who are totally limited in their daily life. Whenever a patient is discharged and goes to the follow-up phase, it is a great satisfaction. In fact, when we do group therapy with people with OCD, former patients who have already Once their problem has been solved, they usually offer to help and collaborate in said therapies with other patients with OCD. This factor is usually very helpful, since it is very motivating to see how others have gone through the same thing and have managed to overcome it.