Photo by cottonbro studio, Article written by Dr. Michelle Strydom MD
In short, obsessive compulsive disorder is where a person has an abnormal obsession about something, for example that their hands are dirty and contaminated. This obsession causes significant anxiety which leads to the compulsion where the person repeatedly washes his hands. The compulsion is the act that the person performs to relieve the anxiety from the obsession. Another example is that a person can become obsessed about locking his house. When he (or she) leaves for work in the morning, he goes back to check that every window and door is locked and keeps doing it over and over again for several hours, thus making him late for work. Then when the person gets to work, he may still feel anxious about whether or not the house is locked and will want to drive back and check again. In severe cases this can eventually take up the whole day, leading to a total impairment in social and occupational functioning.
1.The medical criteria used to diagnose an obsessive compulsive disorder are:
a. Obsessions are defined by:
- • Recurrent and persistent thoughts, impulses or images that are experienced, at some time during the disturbance, as intrusive and inappropriate and that cause significant anxiety or distress.
- The thoughts, impulses or images are not simply excessive worries about real life problems.
- The person attempts to ignore or suppress such thoughts, impulses or images or to neutralize them with some other thought or action (i.e. a compulsion).
b. Compulsions are defined by:
- • Repetitive behaviors for example hand washing, ordering, checking or mental acts such as counting or repeating words silently. The person feels driven to perform these repetitive behaviors in response to an obsession, or according to rules that must be applied rigidly.
- 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.
2. At some point during the course of the disorder, the person has recognized that the obsessions or compulsions are excessive or unreasonable.
3. The obsessions or compulsions cause significant distress, are time consuming (take more than one hour a day) or significantly interfere with the person’s normal routine, occupational or academic functioning or usual social activities or relationships.
4. The obsessions and compulsions are not due to another psychiatric illness for example, preoccupation of food in the presence of an eating disorder; preoccupation with drugs in a substance abuse disorder (addiction); preoccupation with having a serious illness in the presence of hypochondriasis or guilty ruminations in major depressive disorder.
5. The disturbance is not due to the direct physiological effects of a substance (drug abuse or medication) or a general medical condition.
The following criteria are used to diagnose a person with an obsessive compulsive personality (which is not as severe as obsessive compulsive disorder):
A pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness and efficiency, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:
1. The person is preoccupied with details, rules, lists, order, organization or schedules to the extent that the major point in the activity is lost.
2. The person shows perfectionism that interferes with task completion, for example is unable to complete a project because his (or her) own overly strict rules are not met.
3. The person is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity).
4. The person is over conscientious, scrupulous and inflexible about matters of morality, ethics or values (not accounted for by cultural or religious identification).
5. Is unable to discard worn-out or worthless objects, even when they have no sentimental value.
6. The person is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things.
7. The person adopts a misery spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes.
8. The person shows rigidity and stubbornness.
When people feel bad about themselves, they usually become involved in obsessive compulsive or addictive behaviors of some kind.
Emotional insecurity as a result of a low self-esteem is behind obsessive compulsive disorder (OCD). When people are feeling bad about themselves, they will usually become involved in obsessive compulsive behavior or addictive behaviors of some kind. Remember your hypothalamus is the area in your brain that translates everything that is going on in your thought life into a physical reaction – it is the mind body connection. When you have a lack of self-esteem and your thought life is dominated by thoughts of self disapproval, self-condemnation, guilt, self-hatred and the like, your hypothalamus senses these spiritual and emotional problems. One of the first things that the hypothalamus does in response to this is to lower the levels of a chemical in your brain called serotonin. Serotonin is the chemical that was designed to make you feel good about yourself. Therefore when the levels of serotonin are low, you feel bad about yourself. The spiritual and emotional feelings of unloveliness are now reinforced by the chemical deficiency. The obsessive compulsive behavior is an attempt to neutralize these feelings.
Healing from obsessive compulsive disorder has to begin with changing your thinking concerning how you think about yourself. Building a healthy self-esteem starts with knowing who you are in Christ and establishing your identity and sense of self worth in Him. You need to learn to see yourself as God sees you. Turn to page 498.
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