Dr. Deb’s Mental Health Vitamin: Obsessive-Compulsive Disorder

Dr. Deb Wade

By Dr. Deb Wade
GCU Vice President, Counseling and Psychological Services

I once had a client who entered my waiting room and could not find a seat. Oh, there was ample seating available in the waiting area  She came in and she chose one. After a few seconds, she got up and moved to another seat; again, in a few seconds, she got up and sat in a different one.

This action was repeated until it was her time to come into my office. Once in the office, she actually changed seats twice during the session. Why? Because she was living with Obsessive-Compulsive Disorder. It is a real diagnosis, can be very debilitating, and the one who is afflicted can feel powerless to change things.

Obsessive-Compulsive Disorder (OCD) can be the “go-to response” for many who are frustrated, overwhelmed, and scattered. They might say, “Oh, I’m so OCD today.” 

However, when the diagnosis is present, it is not a sometime thing; it’s an all-the-time thing.

Of course, virtually everyone has experienced worries, doubts, or fears at one time or another. And … it’s natural to worry about life issues such as one’s health, the wellbeing of someone you love, paying bills or what lies ahead. Likely, too, everyone has had an intrusive thought – even a “bad” one – but none of that is OCD.

OCD is characterized by obsessive thoughts, impulses or images and compulsions (either overt or mental rituals) that are difficult to suppress and take a considerable amount of time and energy away from the living of a normal, healthy life.  

Back to my client: Not only did she exhibit ritualistic and repetitive behaviors in my office (the rapid changing of seats and being uncomfortable in each of them); her work life was also greatly impacted by her condition.

She worked as a teller in a bank, which required that she “balance her drawer” every evening before leaving. She described to me, through much emotional pain and tearfulness, that she was “so afraid that I’ll get fired” because most nights she would check, re-check, re-check and re-check – even if the drawer balanced – because she could not trust herself enough to believe that she was free to go home.

Many nights she was there late enough to walk out of the building with the night custodian only after his task of cleaning the bank was complete.

Furthermore, her compulsions did not stop there – once home, she was involved in a “checking ritual.” She would repeatedly check the locks on the doors and make sure that her oven, stove and coffee pot were turned off.

Many times, she would not get sound sleep because she was in the compulsive ritual of getting out of bed repeatedly to “check” these items. Needless to say, she was physically and emotionally drained!

If any of this sounds familiar, let’s examine the symptomatology of Obsessive-Compulsive Disorder:

Obsessions – Intrusive, irrational thoughts or impulses that repeatedly occur. People who are afflicted know these thoughts are irrational but are afraid that somehow they might be true. Examples include:

  • Doubts about something being done right, such as turning off the stove or locking a door
  • Unpleasant sexual images
  • Fear of saying or shouting inappropriate things in public
  • Recurrent, persistent thoughts, urges or images that cause significant anxiety or distress

Compulsions – Repetitive acts that temporarily relieve the stress brought on by the obsession. People afflicted know that these rituals don’t make sense but must perform them to relieve anxiety and, in some instances, to prevent something bad happening. Examples include:

  • Excessive hand washing because of a fear of germs
  • Counting and recounting money
  • Reading a passage over and over because of a fear that something bad will happen
  • Walking in a specific pattern in order to prevent serious harm to a loved one

If any of this sounds familiar to you or you’ve witnessed a loved one engage in these behaviors, there is help for this.

My client worked extremely hard to understand the illogical nature of her thoughts with cognitive-behavioral therapy (CBT) but also was willing to be “flooded” with opportunities in which she then denied herself the engagement of her ritual behaviors (Exposure and Response Prevention – ERP).

It was a painful process – one in which she failed a few times before she succeeded – but, ultimately, she was able to break free and now lives a healthy life. Oh … and she did leave the bank job – she found something much less anxiety-provoking so that she could get a fresh, clean start.

If my client’s story is familiar, please get help. A licensed mental health professional can help you break the chains of bondage with this disorder! The time you dedicate to the therapy needed is a very sound investment! The powerful payoff?  Freedom … which never felt so good!