Obsessive Compulsive Disorder

Obsessive Compulsive Disorder (OCD) is primarily an anxiety disorder characterised by repeated thoughts, ideas, or sensations (obsessions), accompanied by driven behaviour (compulsions) aimed at getting rid of the unwanted thoughts. The compulsions bring temporary relief, which is very quickly followed by even more anxiety. This then becomes a vicious cycle.
An example is the person who has to check that the stove is off several times a day – as the fear of burning the house down creates so much anxiety that repeated checking becomes a compulsion to alleviate the anxiety – which of course never happens.

What kind of perfectionist are you?
The more severe the disorder, the more rigid and ritualistic the behaviour, which can so impede a person’s daily functionality that normal work and relationships are often impossible.
Perfectionists can experience different levels of obsessive thoughts concerning how things ought to be done, and they often display some compulsive behaviour to ensure that their high standards are continuously met. Research shows that there are two types of perfectionism:
Adaptive perfectionism – this is seen as a more healthy perfectionism characterised by high standards – both of the self and of others. Healthy perfectionists are conscientious and goal-directed individuals with an aptitude for delivering results and effectively organising themselves and everyone around them. They are often high achievers in society.
Maladaptive perfectionism – this is the unhealthy kind where a person is plagued by obsessive worrying about making mistakes in the past, present or future. They experience a lot of self-doubt and are concerned about being acceptable to other people. They are often labelled “control freaks” by their families. The high level of control helps them to alleviate their anxiety around what they could do wrong. Most often these people have low self-esteem and high levels of stress. In severe cases it can result in other mental illnesses including OCD.

Markers for OCD:

Always wanting to do things 100% correct and in a very specific way
Irrational thoughts of controlling the outcome of life events if you “just do it right” – like preventing the death of a loved one if you check that the doors are locked and the alarm is on in a ritualistic and obsessive way
Doing things over and over again to make sure that there won’t be some catastrophe as a result of your mistake
Obsessions and irrational beliefs – for example that you should control your thoughts, walk on a certain side of the road, that one has to rid oneself of germs (by washing your hands compulsively) to prevent a deadly disease, ‘rules’ about certain behaviours, excessive hoarding of items in case they are needed for later use and irrational counting of items/steps
Inability to get rid of unwanted thoughts and behaviours, resulting in even less self-confidence, lower self-esteem and more controlling behaviour to compensate.

It is important to note that symptoms vary, can come and go or can change over time. It can also worsen with age. People often resort to ineffective coping mechanisms to control their thoughts and behaviours like using drugs or alcohol to combat their feelings of anxiety.

What can be done?
People with OCD benefit greatly from therapeutic interventions aimed at changing their irrational thoughts and behaviour. The most effective of the therapeutic methods is Cognitive Behavioural Therapy (CBT). This aims at gradually reprogramming thoughts around the triggers, as well as coping with the anxiety and resisting the urge to engage in the compulsive behaviour. Cognitive restructuring helps one to rationally evaluate beliefs that create fears and compulsions.
From a Christian counselling perspective, we are reminded of the many Scriptures telling us not to fear, to renew our minds and to take every thought captive in obedience to Christ.

The Holy Spirit will help you
With the help of the Holy Spirit – who gives us the ability to control ourselves and our urges (compulsions), as well as a trusted counsellor who can offer some useful CBT techniques, it is possible to combat unhealthy kinds of perfectionism and obsessive-compulsive tendencies. In severe cases the need for appropriate medication in addition to the above might be necessary. Other techniques that are especially helpful are:

Stress management techniques like exercising, deep breathing, following a nutritional diet and avoiding anxiety inducing drugs like caffeine
Support groups to share problems and gain fresh perspective on one’s ideas and problems have shown to be highly effective
Practising mindfulness and gratitude has been shown to decrease anxiety levels. In addition one has to practice giving up the control and hand it to God. 

ROCHÉ SNYMAN is a Counselling Psychologist and a part time lecturer at the Institute of Christian Psychology. For more information call  011 827 7611 or www.icp.org.za

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