Are you plagued by fear? Do you engage in rituals motivated by superstition? How do you know if these are normal or are symptoms of a clinical disorder?
The general public is grossly uneducated when it comes to understanding obsessive-compulsive disorder. The acronym OCD is tossed about flippantly today, being used to describe behaviors as innocent as eating only blue M&M’s to more stereotypical rituals such as excessive hand-washing. This article provides some much-needed clarification.
Individuals with obsessive-compulsive disorder may exhibit just one symptom (i.e. they experience obsessive, intrusive thoughts but do not engage in any compulsive behavior), but many sufferers exhibit both. Examples of single-symptom sufferers might include individuals characterized as workaholics or those with anal-retentive personalities.
Those who fall under the more common dual-symptom category experience obsessive thoughts and attempt to resolve their discomfort by performing the compulsive behavior. These people are usually cognizant of the fact that their thoughts and behaviors are not rational; the impulse to act on the thought is just too strong to resist.
Descriptions of those experiencing obsessive thoughts might surprise you. According to Michael Maccoby, “[Obsessives] are self-reliant and conscientious….They look constantly for ways to help people, listen better, resolve conflict, and find win-win opportunities. They buy self-improvement books…and they like to focus on continuous improvement at work because it fits in with their sense of moral improvement.”
For those who are deep thinkers (e.g. philosophy professors, poets), obsessions are not always answered with compulsive behaviors. The nature of these obsessive thoughts, however, is quite unlike ordinary daydreaming. These individuals spend a considerable amount of time mentally running through scenarios, arguments, and ideas.
The philosophers of the ancient world are a classic example of thinkers who spent hour upon hour pouring over moral debates and ruminating over unanswerable questions. Not what many would call “normal” behavior.
In her book Psychoanalytic Diagnosis: Understanding Personality Structure in the Clinical Process, Nancy McWilliams illuminates the personality differences that delineate the obsessive individual from the compulsive. The former feels no compulsion to act upon their continual, intrusive thoughts (p. 290).
Individuals with this obsessive personality structure are characterized as stubborn, tidy, prompt, thorough, thrifty, rigid, cerebral, persistent, and prone to arguing over semantics. McWilliams adds that “[t]hey are generally dependable and reliable and have high standards and ethical values” (p. 291). Their internal standard of excellence, while admirable, is often unachievable.
Unable to measure up to their own ideals, individuals with obsessive-only OCD battle shame and attempt to cope with it by rationalizing, moralizing, intellectualizing or compartmentalizing their intrusive thoughts. In tandem with shame, anger plagues these individuals who interpret negative emotion as inadequacy.
Rather than deal with this anger toward self for what it is, people with obsessions direct the anger toward “legitimate” targets to protect themselves from further shame (p. 293). This tendency to self-protect from negative emotions prohibits these individuals from expressing their emotions effectively.
Those who struggle with obsessive-type OCD not only have difficulty expressing emotion, but they also have difficulty making decisions as well. The thought of making a wrong choice often paralyzes them from making any choice, leading these individuals to vacillate between options until they eventually refuse to choose.
McWilliams gives a poignant example of this trait by illustrating how it would impact an expecting mother. In this illustration, the pregnant patient selects two obstetricians with different treatment philosophies from which she would choose one to deliver her baby. She deliberates so long, wavering between the two options, that she eventually goes into labor and has no other option but to have her baby delivered by the resident on duty at the nearest hospital.
Individuals with compulsions also self-protect against the shame of making a wrong decision, but instead of vacillating between options, these individuals impulsively choose one without any deliberation. Becoming sexually active with any individual with whom one has sexual chemistry is an example of this type of impulsivity.
What characterizes the behaviors as compulsive has little to do with whether the activity is beneficial or even logical; what makes the action compulsive is its irresistible nature. Interestingly, people with compulsions prefer manual tasks (i.e. woodwork, needlework) that do not involve much thinking.
Compulsive individuals do not hold a monopoly on ritualistic behaviors that have little bearing on outcomes. It would be difficult to find a person who has not acted compulsively at one time or another. Athletes perform rituals before or during their competitions, people “knock on wood” when a friend forecasts favorable results, and gamblers slide one more quarter into the slot machine for good measure (p. 301).
The ritual is motivated by a desire to prevent an unwanted event, such as a man with a compulsive personality who buckles and re-buckles his seatbelt four times to avoid a car accident. What makes these thoughts and behaviors a clinical issue is the amount of distress experienced by the individual as a result.
Obsession and Compulsion Together
While it is possible to experience one symptom or the other, as discussed previously, it is common to experience both obsessions and compulsions together. Clinically speaking, the compulsive behaviors aim to resolve the anxiety produced by the intrusive or obsessive thoughts. Ultimately, the two battle with each other for control.
A&E airs a show called “Obsessed” (available instantly on Netflix) which chronicles the struggle of sufferers with OCD. One episode follows Karen, a woman battling a fear of death after spending years in an abusive relationship. The constant anxiety and fear for her life that she experienced during this relationship metastasized into a pervasive terror even after the termination of that relationship.
Her obsessions involve thoughts of strangers lurking behind corners waiting to kill her, other drivers swerving on the road to hit her head-on, and earthquakes opening the ground to swallow her. Her compulsions involve repeatedly checking under her bed and in her closets for fear that an intruder entered her apartment since her last check. While she knows how irrational these obsessive thoughts are, her fears and anxiety compel her to act.
Christian Counseling for OCD
Individuals with OCD do not have to be enslaved to their obsessions and compulsions. Your struggle is not a sign of weak faith or disobedience to God’s exhortation to “fear not.” Obsessive-compulsive disorder is a clinical condition that requires professional treatment. The hope of Matthew 6:27, 31 and Philippians 4:6 is that He offers us the antidote for fear!
If this article resonates with you or sounds like someone you know, there is help. No one has to struggle alone. Contact a professional Christian counselor in Newport Beach who can come alongside those battling OCD and start the journey of recovery. Using research-based treatment techniques in a faith-based setting, these professionals can help you discover the roots of your thoughts and behaviors and help you learn to manage your symptoms. There is hope for you – freedom from fear awaits!
ReferenceMcWilliams, N. (2011). Psychoanalytic diagnosis: Understanding personality structure in the clinical process (2nd ed.). New York, NY: Guilford Press.
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