Essay, Research Paper: Obsessive Compulsive Disorder

Psychology

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Are you the type of person who has a phobia of germs, dirt, or contaminated
bodily fluids? Is the only way to feel safe and pure is for you to cleanse
yourself countless times a day? Or maybe you`re the type of person who has to
check things twice, three times or more. Perhaps you`re the type of person who
has to do everything twice, or by a fixed number. Maybe you are the type of
person who must have everything neatly placed, and if misplaced at all you throw
a tantrum. If you are a person who happens to do any of these things then maybe
you have OCD, the acronym for Obsessive-Compulsive Disorder.
Obsessive-Compulsive Disorder (formerly known as obsessive neurosis) is
categorized as an anxiety disorder because the main focus seems to be anxiety
and discomfort that is usually increased by the obsessions (thoughts) and
decreased by the compulsions or rituals (actions). (Baer 3) According to Baer,
Obsessions are defined as recurrent, persistent ideas, thoughts, images, or
impulses that are experienced, at least initially, as intrusive and senseless.
Compulsions are defined as repetitive, purposeful, and intentional behaviors
that are performed in response to an obsession or according to certain rules or
in a stereotypical fashion. (Baer 3) Obsession-compulsive disorder usually
begins in late adolescence in one to two thirds of reported cases. The problem
is associated with significant life changes. Obsessive-compulsive disorder
results from biological and psychological influences. Abnormal levels of the
neurotransmitter serotonin may play a role in OCD. Catscans of people with OCD
have discovered irregularities in the activity level of the orbital cortex,
caudate nucleus, cingulate cortex, and a brain circuit that assists control
movements of the limbs. (Pato 8) Many patients report having numerous neurotic
problems during childhood. These patients become socially isolated, and
consequently fall into a deep depression. This disorder affects males and
females quite differently. People with OCD tend to have a high celibacy rate,
particularly males. Both sexes tend to marry at an older age than other types of
psychiatric patients, and they have a low fertility rate. (Rachman 6) Most
studies concluded that OCD patients possess higher than average intelligence.
The average OCD patient has many types of compulsive behavior. The anxiety of
OCD is caused through its persistence. (Mavissakalian 15) And maybe this is why
cleaning and checking rituals are the most common types of obsessive-compulsive
disorder. These patients carry out activities as disinfecting of objects,
excessive hand washing until the hands are so clean that they crack and bleed,
excessive showering, and excessive rinsing of dishes. Securing locks, alarm
clocks, gas jets, and looking under the bed are some of the checking rituals OCD
patients have. If the obsessive-compulsive person qualms and ponders when the
ritual is not performed systematically. The task of this patient must be carried
out to perfection or it will not be preventative or restorative. The checking
ritual is described as intending to prevent some state of balance and order to
avoid infectivity from some distressing stimuli. (Rachman 14) Some obsessional
people often feel a compulsive need to arrange things in their environment. To
the observer, compulsive arranging seems identical with the activities of
normal, neat-minded people. The major distinction is the accompanying experience
of compulsivity. The frustration experienced by the obsessional person is a
result of disobedience of a different order severely disturbed by any deviation
from the set order and feels compelled to reposition the status quo. (Reed 38)
For example, if someone puts a document on your desk then this person just moved
an item from your possession, in turn when you arrive, you have to remove the
item and put anything that was interfered with back to a precise order. Sigmund
Freud was particularly fascinated in the obsessive-compulsive disorder. He
referred to it as the obsessional neurosis, and in 1926 Freud wrote it was
unquestionably the most interesting and re-paying subject of analytic research.
But as a research it has not been mastered. (Cooper 9) Freud also found evidence
of passive sexuality, and sexual experience yielding pleasure. The defenses used
in obsessional neurosis are denial, repression, regression, reaction
formulation, isolation, undoing, magical thinking, doubting, indecision,
intellectualization, and rationalization. Washing is most frequently engaged to
an undoing of a dirtying action. In analytic therapy, obsessive-compulsive
neurosis is regarded as the second type of transference neurosis. In hysterics,
the ego forms an alliance with the analyst to battle the neurosis. In compulsive
neurotics, the ego is split, with one part working logically while the other
thinks in fantasy. (Cooper 14) Obsessions and compulsions are also linked to
toxic conditioned stimuli obtained by classical conditioning events. The
response and stimulus are used identically because they have double properties.
An example of this is fear. Fear is a response, but also it is an obsessive
thought of hurting, which would make it a stimulus also. The interaction between
the repeated ruminations and mood turbulence increases the provocation of the
individual and increases the tendency to reflect even further. Temporary relief
produced from the ritual, or motor act terminates an aversive condition. This
makes the resolution prototype likely to be repeated the next time producing a
disturbing thought. The classical conditioning will result an anxiety. This will
now become a conditioned stimulus for a response. When this stimulus is then
paired again to another neutral stimulus, the conclusion also acquires aversive
connotations and its presence will bring out anxiety. While this is occurring,
the original anxiety response is likely then to expand into a general feeling of
discomfort, in which is now turned into the obsessive-compulsive disorder.
(Cooper 21) Obsessive-Compulsive Disorder is also linked to many diseases and
disorders, such as Tourette`s syndrome. Tourette`s syndrome is a
neuropsychiatric and behavioral disorder with childhood onset that is
characterized by a motor disorder. It involves both motoric and vocal tics that
can range from relatively mild to very sever over the course of a patient`s
lifetime. OCD occurs in about one out of a hundred cases in the general
population. 30-60% of Torette`s Syndrome patients have reported obsessive
thoughts and compulsive rituals that occur many years after the motor tics
start. Usually during the preadolescent years. Research states that a single
major gene or that the sex may determine if the disorder is related OCD or
Tourette`s Syndrome. Females are more likely to have OCD without tics, when the
diagnosis of the disorder was undetermined. (Sanberg 349) A device called the
positron emission tomography (PET) scanner, studies the brain of patients with
OCD. OCD patients have patterns of brain activity that differ from those of
people without mental illness or with other mental illness. The PET shows
abnormal neurochemical activity in regions known to play a role in certain
neurological disorders. This suggests that these areas may cause the origins of
OCD. There is also evidence that treatment with medications or behavior therapy
induce changes in the brain coincident with clinical improvement (Strock)
Obsession patients often attempt to negotiate how the treatment is to be
conducted. Many patients, especially those who have had the disorder for a long
time, do not believe that treatment will be effective because they have tried so
many other approaches beforehand. An important part of preparing the patient for
treatment is to inform them that their disorder is chronic and that they will
have to learn to understand themselves and their limitations in order to manage
and control it. (Turner 49) There are many types of treatment for OCD patients.
One patient may benefit from behavior therapy, while others will benefit from
pharmacotherapy. Some may even use both medication and behavior therapy. Some
may begin with medication to gain control over their symptoms and then continue
with behavior therapy. Exposure and response prevention is effective for many
people with OCD. The patient intentionally and willingly deals with the feared
object or idea, either by imagination or directly. The patient is urged to
refrain from ritualizing with the patients loved ones. For example, a compulsive
hand washer may be encouraged to touch an object believed to be tainted, and
then advised to avoid washing for numerous hours until the provoked anxiety has
greatly decreased. The process then moves to the patient`s ability to bear the
anxiety and to control the rituals. Most patients even experience less anxiety
from the obsessive thoughts and are able to oppose the compulsive urges. The
patient needs to have an extremely positive outlook for life and to maintain a
high self-esteem. Cognitive-behavioral treatment or psychotherapy may also
provide effective for OCD. This alternative behavior therapy highlights changing
the obsessive-compulsives beliefs and thinking patterns and is 60-70% helpful
with OCD patients. Drugs that affect the neurotransmitter serotonin can
considerably reduce the symptoms of OCD. Serotonin reuptake inhibitors (SRIs)
particularly approved for the use in the treatment of OCD was the tricyclic
antidepressant clomipramine (Anafranil), and selective serotonin reuptake
inhibitors" (SSRIs). Food and Drug Administration for the treatment of OCD
approved flouxetine (Prozac), fluvoxamine (Luvox), and paroxetine (Paxil) and
Sertraline (Zoloft). Medications relieve symptoms of OCD by alleviating the
frequency and intensity of the obsessions and compulsions. You will typically
see result in at least three weeks. Medications are helpful in controlling the
symptoms of OCD, however, if the medication is discontinued, relapse is
inevitable. About 80% of people with OCD that combine psychotherapy and
medication show improvement. Also, when the symptoms are gone, most people must
continue taking the medication for the rest of their life. Many of them go on a
lowered dosage, except it is possible that they will become addicted to the
drugs if they ever stop taking it. (Strock) As long as you have a will to change
and follow through with the treatment, then you may be able to surpass this
disorder.

BibliographyBaer, Lee, Michael A. Jenike, and William E. Minichiello. Second Edition
Obsessive Compulsive Disorder: Theory and Management. Missouri: Mosby-Year Book,
Inc., 1990 Cooper, Marlene. Behavioral Treatment Of A Client With an
Obsessive-Compulsive Disorder: A Single Subject Design. New York: UMI
Dissertation Services, 1988 Margaret Strock. ⌠Obsessive-Compulsive
Disorder.■ National Institute of Mental Health (1999): Online. Internet.
22, Oct. 1999. Available http://www.nimh.nih.gov/publicat/ocd.htm#ocd4.
Mavissakalian, Matig, Samuel M. Turner, and Larry Michelson.
Obsessive-Compulsive Disorder: Psychological and Pharmacological Treatment. New
York: Plenum Press, 1985 ****Pato, Michele Tortora, and Joseph Zohar. Current
Treatments of Obsessive-Compulsive Disorder. Washington, DC: American
Psychiatric Press, Inc, 1991 Reed, Graham F. Obsessional Experience and
Compulsive Behaviour: A Cognitive-Structural Approach. Florida: Academic Press,
Inc., 1985 Sanberg, Paul R., Klaus-Peter Ossenkopp and Martin Kavaliers. Motor
Activity and Movement Disorder: Research Issues and Applications. New Jersey:
Humana Press Inc., 1996 Turner, Samuel M. and Deborah C. Beidel. Psychology
Practitioner Guidebooks: Treating Obsessive-Compulsive Disorder. New York:
Pergamon Press, Inc., 1988
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