OBSESSIVE COMPULSIVE DISORDER


This month I am going to talk about Obsessive Compulsive Disorder, one of the psychiatric disorders that negatively impact productivity and performance at the work place.


Obsessions are persistent, repetitive, disturbing, often threatening thoughts that the individual cannot put out of his/her mind, flooding his/her consciousness beyond his/her will or control. These thought usually strike the individual as absurd or meaningless. Obsessions are usually tentative, and can never be stated clearly. They are usually thoughts such as, “What if I do ….,” “What if I’ve done…,” “What if it has happened…” or “Has this happened, or not?” Such control obsessions take up a great deal of the individual’s time, and make focusing on other things difficult.


Compulsions are actions that emerge as a reaction to obsessions. These reactions may be externally observable, or they may be in the shape of thoughts not seen externally. Compulsive behaviour is also repetitive, and non-avoidable for the individual. The reason for compulsive behaviour is to minimize or eliminate the anxiety triggered by the obsessions. Compulsions are time consuming and therefore might hinder other functions of the individual. They might reach the level where they bring harm to the individual and to his/her environment, such as washing hands until they bleed, or causing material loss through frequently throwing out clothes and possessions.


Obsessions are usually considered threats, and compulsions are seen precautions against these threats.


There are repetitive actions that an obsessive – compulsive individual cannot avoid. Some of those actions can be observed, such as washing hands, wiping, not touching, sitting or even walking on certain surfaces through fear of getting dirty. There are also obsessions that cannot be observed, such as counting or repeating a certain sentence over and over again in one’s mind.


Obsessions and compulsions prevent a person from focusing his/her attention on one thing, which in turn causes the person to experience inadequacies in his/her mental activities and a breakdown of his/her functionality. All this may adversely impact the individual’s quality of life.


The primary principle in the treatment of Obsessive – Compulsive Disorder is the handling of avoidance behaviour. Cognitive – behavioral therapy aims to reduce anxiety by identifying the situations that the individual tends to avoid, and gradually exposing him/her to those situations. Medical treatment is supportive, and does not cure the disorder completely on its own. Medical treatment gives the best results together with cognitive – behavioral therapy.

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