Dr. Phil Kronk: What you should know about obsessive thoughts and compulsive behaviors

“Everybody is dealing with how much of their own aliveness they can bear and how much they need to anesthetize themselves.” Adan Phillips, Ph.D.

 “To grow up is to discover what one is unequal to.” Adam Phillips, Ph.D.

You are not alone if you suffer from an anxiety. At times, the world can feel overwhelming.

While we tend to see television commercials for depression or for bipolar disorder, the reality is that anxiety disorders are the most common form of mental suffering in our country.

One of five adults report some form of anxiety each year, but only slightly more than one third of these individuals receive treatment and relief from their suffering.

This month, in this column, I would like to focus on obsessive-compulsive forms of thinking and behaving.

For decades, mental health professionals viewed obsessive-compulsive disorder (OCD) as purely one type of anxiety disorder. While anxiety is certainly an important experienced component of OCD, today it is diagnosed as an “impulsive-compulsive disorder.”

Today, many clinicians and researchers realize that OCD is related to impaired neural brain circuits. I will share where mental health professionals believe these impaired neural brain circuits are located in one of the next columns.

Obsessions are intrusive and unwanted thoughts, urges or images that cause distress or anxiety.

Compulsions are repetitive behaviors or mental actions (such as counting, etc.) that a person performs in a rigid way in an attempt to respond to and alleviate an obsession.

Such anxiety can affect anyone. The singer-songwriter, Fiona Apple, shares that she “had a really bad obsessive-compulsive disorder.” She remembered that “At its worst, I was compelled to leave my house at three o’clock in the morning and go out in the alley because I just knew that the paper-towel roll I threw in the recycling bin was uncomfortable, like it was lying the wrong way, and it should be down in the garbage.”

Anxiety is rarely experienced by itself for many individuals. Depression often accompanies an anxiety disorder in half of those diagnosed with an anxiety disorder.

While the average age for an obsessive-compulsive disorder’s onset is around nineteen years of age, children also experience such symptoms.

In the next four weeks, in this column on mental health, I would like to share the extent of the destructiveness of the tendency to ruminate for individuals with obsessive-compulsive behaviors. I will also share some techniques to quiet the ruminations.

The need for perfection will be addressed, and the strain it can place on an individual. Guilt and shame are often intertwined with an over-concern about what others are thinking of us.

The obsessive-compulsive’s need to control will be addressed. So, will the need to be “sure.” And, the need, by some, to known what exactly reality is.

The difference between anxiety and fear will be addressed, as will be the fact that anxiety has both a biological and a cognitive etiology.

This is important because effective treatment for obsessive thoughts/urges and compulsive actions needs to have a dual form of combined treatment. Both cognitive therapy and medication can be effective in bringing relief and ending suffering.

Phil Kronk, M.S., Ph.D. is a semi-retired child and adult clinical psychologist and clinical neuropsychologist. Dr. Kronk has a doctorate in clinical psychology and a postdoctoral degree in clinical psychopharmacology (the use of drugs to treat mental disorders.) His year-long internship in clinical psychology was served at the University of Colorado Medical School. Dr. Kronk writes a weekly, Friday online column on mental health for the Knoxville News Sentinel’s website, knoxnews.com. He can be reached at (865) 330-3633.