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View Full Version : Two components to Obsessive-Compulsive "Disorder"



tashirosgt
2011-Nov-15, 06:02 PM
Reading about Obsessive Compulsive Disorder on the web, it appears there are two components to it. 1) Some uncontrollable thoughts or behaviors 2) Shame or anxiety about the thoughts or behaviors. So what it is called when people have 1) but not 2)?

For example, hoarding is listed as an OCD. I have friends that hoard things and have the compulsion to take things out of wastebaskets (wastebaskets anywhere, not just their own), but these friends don't have any feelings of shame or anxiety about this behavior.

Gillianren
2011-Nov-15, 06:44 PM
I don't think 2 is a necessary component of the disease. It's also possible that they have those feelings but don't share them with you.

LaurelHS
2011-Nov-15, 07:41 PM
It's also possible that they would experience anxiety if they didn't give in to their compulsions.

profloater
2011-Nov-15, 07:45 PM
no expert I, but I know some with obsessive compulsive (allegedly) yet still under some control and no shame, also I knew someone who always spun round a full circle before going anywhere but he was completely unaware he was doing it. It got worse then better with treatment. Maybe it is a spectrum because I also know two or three who always rearrange their knife and fork even when unnecessary and will deny they did so when challenged, but it seems guilt is a completely separate thing.

Moose
2011-Nov-16, 03:45 AM
I only experienced anxiety and shame up until the moment I was diagnosed. Now that I understand why (after a fashion) I obsess/compulse in certain situations, I can ride it out, or ignore it, or redirect it to a more discreet ritual without much grief.

... Granted, that was hard to do when my Environmental Science professor took us on a field trip into a local quaking bog. I did it, but it took every ounce of willpower I had. I'm glad I did, it was fascinating... now that I'm years off it. *chuckle*

*shrug* It's who I am and what I do. No guilt needed.

Jens
2011-Nov-16, 05:27 AM
I may be wrong, but I think one way to understand it is that everybody has uncontrollable thoughts and behaviors. It is when there is (2) that it becomes a disorder.

There is a Japanese psychologist who developed a method for anxiety based on the idea that anxiety is a normal human emotion, whereas being anxious about being anxious is a disorder.

Strange
2011-Nov-16, 11:26 AM
I only experienced anxiety and shame up until the moment I was diagnosed. Now that I understand why (after a fashion) I obsess/compulse in certain situations, I can ride it out, or ignore it, or redirect it to a more discreet ritual without much grief.

Reminds me a bit of a description I read of what it is like to have Tourette's (1). He said it was not like something that happened without you having any control, but more something you felt an overwhelming need to do. I don't remember exactly what he compared it to but something like an itch (2). You can resist scratching for so long, then the need to do it becomes too strong and you do it. For a little while you are satisfied and then the feeling starts growing again...


(1) probably from The Man Who Mistook His Wife for a Hat
(2) or maybe trying not to blink

Swift
2011-Nov-16, 02:35 PM
I may be wrong, but I think one way to understand it is that everybody has uncontrollable thoughts and behaviors. It is when there is (2) that it becomes a disorder.

There is a Japanese psychologist who developed a method for anxiety based on the idea that anxiety is a normal human emotion, whereas being anxious about being anxious is a disorder.
My "may be wrong" thought is similar, but my (2) is different - it is not shame or anxiety about the thoughts or behaviors, it is that the thoughts or behaviors start having significant negative impacts on your life or on your interactions with other people. I have heard similar ideas about depression - everyone gets depressed (in the common, not clinical sense of the word) at times, it is when the depressions starts to effect what you do, like you don't go to work or have trouble interacting with your friends and family, that it becomes a disorder.

Moose
2011-Nov-16, 05:36 PM
Reminds me a bit of a description I read of what it is like to have Tourette's (1). He said it was not like something that happened without you having any control, but more something you felt an overwhelming need to do. I don't remember exactly what he compared it to but something like an itch (2). You can resist scratching for so long, then the need to do it becomes too strong and you do it. For a little while you are satisfied and then the feeling starts growing again...


(1) probably from The Man Who Mistook His Wife for a Hat
(2) or maybe trying not to blink

Best description I've seen yet, although even then, it's doesn't _quite_ capture the nuance. 95%, maybe. I'm not sure there are words to accurately describe it.

Yeah, I can (for but one minor example) eat my meal without my knife and fork reversed from proper place setting, I can have my napkin somewhere other than the 12 o'clock position, almost under my plate, and my drink not at the 2 o'clock (slightly far) position, but I'm going to spend the meal fretting about knocking over my drink, or accidentally flinging my steak across the room, or getting my elbow in something, or something equally ridiculous.

Actually, a college buddy of mine didn't completely believe I had OCD (as I'm fairly discreet about my rituals) until one day he impulsively moved my drink an inch. I was moving it back almost before he'd let go. He repeated it three times in rapid succession, and I couldn't help taking the bait. Even though I knew I was doing it, and trying not to, it was over before I really had time to build any resistance to the reflex.

My ritualizing is far more obvious when you watch me hand-wash dishes*. Unless I force myself not to, I'll invariably rinse the suds off my hands (and often dry them if I'm even halfway distracted) before reaching in for the next plate.

I'm not ashamed of any of it, nor feel any guilt about it (except when someone else does the greasy pots for me; I don't like imposing on people to do things I'm reluctant to do.) And anxiety isn't really the word for it, nor am I not in control. I can resist any of my rituals indefinitely given enough concentration and willpower.

But what makes it OCD is that it takes some degree of concentration and willpower to resist them. If I'm even remotely distracted, I'll ritual in predictable ways.

/ There's lots more, but it's getting into TMI territory, so I'll spare you.
// * Oh, and just saying: my portable dishwasher is my most valued kitchen appliance. From long experience, I can't keep my home clean without it.

Strange
2011-Nov-16, 05:46 PM
Best description I've seen yet, although even then, it's doesn't _quite_ capture the nuance. 95%, maybe. I'm not sure there are words to accurately describe it.

I'm sure it wouldn't be spot on because the conditions are no doubt quite different. I'm pretty sure Tourette's is neurological (1) and can often be treated by medication. I don't know about OCD, but I had the impression it was more psychological (2) and can be "unlearned" if the "victim" really wants to (like phobias(3), for example).

You should read the book, if you haven't. Quite life affirming to read how people can carry on (relatively) normal life with sometimes quite devastating neurological damage.


(1) not sure if the cause is well understood, though
(2) if a clear distinction can be made between these categories
(3) which I managed to do (nearly)
(4) why do I feel the need to obsessively footnote in this thread....

Moose
2011-Nov-16, 06:00 PM
I don't know about OCD, but I had the impression it was more psychological (2) and can be "unlearned" if the "victim" really wants to (like phobias(3), for example).

My understanding is that the cause is biochemical, but the symptoms can be managed through psychology. No, my obsessions and compulsions are still there. They'll never go away entirely. But by recognizing them for what they are when they happen, I gain some measure of power over them. I can delay them; I can redirect them; I can ignore them; I can take advantage of the beneficial rituals; I can ride them out. To paraphrase Dalton: "Pain don't hurt."

Gillianren
2011-Nov-16, 07:42 PM
(2) if a clear distinction can be made between these categories

Yes, and OCD definitely has a biochemical aspect. PTSD is an example of a psychological condition--you didn't have it at birth. (Though it's possible that some people were born more susceptible.) There are several others like that. But there is medication for OCD; there is medication for PTSD, come to that, so it's not a good distinguishing difference. And it's a heck of a lot more complicated than just unlearning, because the OCD behaviour is wired into your brain. Maybe not your particular ritual, so your ritual can be worked around, but the obsessive-compulsive thought patterns.

Noclevername
2011-Nov-16, 08:04 PM
I've managed to control my OCD, but it's always there, that sensation that I have to do things a certain way. The depression is more complex, since it's responsive to circumstances. The worse things get, the easier it is to give in to depression. But just because things get good for a while doesn't mean the depression just goes away. It does (usually) get easier to resist during the good times.

Gillianren
2011-Nov-16, 10:07 PM
Can I throw out how much I hate the quotes around "disorder" in the thread title? It makes it sound like it isn't a real problem. But possibly people who don't have it don't realize how much of a problem it can be. (Not that I have it, though I have certain obsessive-compulsive tendencies.)

Solfe
2011-Nov-16, 11:09 PM
When I jumped into the thread, the quotes lead me to believe that the topic would not be about real Obsessive-Compulsive Disorders but the way the phrase is abused.

I had thought that the disorder was too rare to actually speak to people who have it, let alone describe it with a less clinical description. Now my question is, "is it really all that rare"?

I guess my next question would be is there a relationship between PTSD and Obsessive-Compulsive Disorder or I did I miss something in the posts above?

Strange
2011-Nov-16, 11:22 PM
I've managed to control my OCD, but it's always there, that sensation that I have to do things a certain way.

I wonder if this is a clue as to why it exists. The ability to learn certain ways of doing things would have been an important survival skill at one time. You react this way if you see a predator; don't eat the fruit from that tree... In fact it is still important: if I am not able to wash my hands after certain activities I have this nagging feeling until I do. In some people maybe this ability to learn routines is just a bit too strong. And, no doubt, in others it is too weak ("which side of the road did you say I should drive on?").

Strange
2011-Nov-16, 11:25 PM
I guess my next question would be is there a relationship between PTSD and Obsessive-Compulsive Disorder or I did I miss something in the posts above?

Gillian was just highlighting the difference between something which is (largely) a psychological problem and something that has a bicochemical/neurological basis (but may well have environmental factors).

Correcting my misapprehension (for which, thanks by the way).

Jens
2011-Nov-17, 12:22 AM
(Not that I have it, though I have certain obsessive-compulsive tendencies.)

I wonder if there is anybody who doesn't have any obsessive-compulsive tendencies at all.

Gillianren
2011-Nov-17, 12:34 AM
I had thought that the disorder was too rare to actually speak to people who have it, let alone describe it with a less clinical description. Now my question is, "is it really all that rare"?

No. Two percent of the US population suffers from OCD to one extent or another. It's about as common as asthma.


Gillian was just highlighting the difference between something which is (largely) a psychological problem and something that has a bicochemical/neurological basis (but may well have environmental factors).

Correcting my misapprehension (for which, thanks by the way).

Quite. One of my jobs around here is correcting misapprehension about mental illness, I think, and I'm glad to do it. Fighting these battles one person at a time is a lengthy process, but at least it means people's misapprehensions get cleared up!


I wonder if there is anybody who doesn't have any obsessive-compulsive tendencies at all.

Almost certainly not, but mine are in places only just barely sub-clinical.

Solfe
2011-Nov-17, 01:13 AM
Quite. One of my jobs around here is correcting misapprehension about mental illness, I think, and I'm glad to do it. Fighting these battles one person at a time is a lengthy process, but at least it means people's misapprehensions get cleared up!


I had a friend who had some issues that spiralled out of control to the point where she had to leave work for months. On her return she was medicated. One of her primary concerns was that people would look at her differently. Being my somewhat evil self, I pointed out that 'Of course we are going to look at you differently... We are jealous because we don't have names for what is wrong with us. And as long as you are receiving treatment you are the only one here who can medically say "it's not me, it must be one of you".' She thought that was pretty funny.

Yes, I am jerk, but I try to be funny.

HenrikOlsen
2011-Nov-17, 04:14 AM
And as long as you are receiving a treatment that works you are the only one here who can medically say "it's not me, it must be one of you".
I fixed that for you.

Many problems of this type don't have medication that works even when it's well documented that it's biochemical/neurological.
One reason for that is that drugs developers don't have any models1 for the various disorders so discovery is really hit and miss.

1) critters (likely mice or rats) that have the same disorder and reacts the same way to drugs as humans. Even humans don't react the same way to the drugs as other humans so it's a really hard problem to solve.

Solfe
2011-Nov-17, 04:34 AM
True enough. :)

Gillianren
2011-Nov-17, 05:25 AM
I'm currently completely unmedicated for my bipolar disorder, because there aren't any treatments which have worked. I also don't have any left to try which don't have at least the possibility--and in some cases probability--of debilitating side effects. Like, because I have mild sleep apnea as well, death.

jokergirl
2011-Nov-17, 09:17 AM
I guess my next question would be is there a relationship between PTSD and Obsessive-Compulsive Disorder or I did I miss something in the posts above?

<si tacuisses, philosophus mansisses, or I-ANAPsych*, but>

I don't know, but I do know that when I am under stress, I sometimes revert to rituals that seem OC, and I see the same in others. So there might well be a link, not in the biochemical sense but at least in a behavioral/psychological sense.

But then I don't know much about PTSD, and I'm under the impression the psychologers don't know all that much, either. It seems highly individual in how it presents, or am I mistaken?

;)

Strange
2011-Nov-17, 09:33 AM
Quite. One of my jobs around here is correcting misapprehension about mental illness, I think, and I'm glad to do it. Fighting these battles one person at a time is a lengthy process, but at least it means people's misapprehensions get cleared up!

It's enough to drive you crazy :)

Gillianren
2011-Nov-17, 07:37 PM
But then I don't know much about PTSD, and I'm under the impression the psychologers don't know all that much, either. It seems highly individual in how it presents, or am I mistaken?

Psychologists actually know quite a lot about PTSD. The thing is, most mental illnesses are individual in how they present, more so than most physical illnesses. If you get diagnosed, it's because you meet enough items on the check list, and it is probably always possible to find someone who will disagree with any given diagnosis. (My psychiatrist and I are still in disagreement on a finer point of mine!) But that doesn't mean the illness itself is any less understood than any other psychological condition.

closetgeek
2011-Nov-19, 02:26 AM
Can someone with experience with OCD answer a question or two for me? I've heard OCD referred to as the doubter's disease but is that a general title or a specific type of OCD? I know it presents itself in different ways for different individuals and I do not have any experience with anyone who actually has the disorder. A more popularized case would be someone who obsessively washes their hands or has to do a routine a specific amount of times, each time they do it (Jack Nickolson locking the door 5 times in that movie). Is it the doubter's disease because the person cannot be sure that their hands are clean or the door is locked so they have to do it so many times? Is it like an impulse thought telling you that it's not right unless you follow the specific pattern? Alright so that's more like three questions but still...

Moose
2011-Nov-19, 04:45 AM
Can someone with experience with OCD answer a question or two for me? I've heard OCD referred to as the doubter's disease but is that a general title or a specific type of OCD?

Not sure, but I'm guessing it's likely people unfamiliar with the disease who are generalizing the general disorder from a specific type of symptom that may or may not be present*. There's a variant of OCD where the rituals are some form of repeatedly double-checking that you've done things. Turning off lights/burners, locking the door, etc. I have a ritual for pat-checking myself for my keys, wallet, and watch**, and I tend to repeat it off and on when standing/idling. (This is one of those kinda useful, mostly discreet rituals I choose to not tamper with much.)

/ * Kind of like how most layfolk think multiple-personality disorder, hearing voices, and schizophrenia are inter-related. They're not. At least not necessarily.
// ** 'Cause, you know, all those rural pickpockets... ***
/// *** Maybe I'm serious, maybe I'm not.

Solfe
2011-Nov-19, 03:11 PM
PTSD does seem very personalized, I worked with a guy who had a very particular noise set off anxiety. It was a repeating whooshing noise, such as a duster buster or broom on a fan or vent that would send him diving for cover.

I call this anxiety a rather than "attack" or something else because his combat experience caused his PTSD. Diving for cover was almost a reflex. He was completely aware of his surroundings afterward, however he was very nervous and upset. That anxiety had a lot to do with his "taking cover" in a public place rather than any remembrance of events. Give him 5 minutes and he was calm and collected again, at least that is how he appeared.

I never did get the full story but is PTSD seem to do with a plane crashing on or near his position, in light of that his reaction seems very reasonable to me.

closetgeek
2011-Nov-19, 04:02 PM
Not sure, but I'm guessing it's likely people unfamiliar with the disease who are generalizing the general disorder from a specific type of symptom that may or may not be present*. There's a variant of OCD where the rituals are some form of repeatedly double-checking that you've done things. Turning off lights/burners, locking the door, etc. I have a ritual for pat-checking myself for my keys, wallet, and watch**, and I tend to repeat it off and on when standing/idling. (This is one of those kinda useful, mostly discreet rituals I choose to not tamper with much.)

/ * Kind of like how most layfolk think multiple-personality disorder, hearing voices, and schizophrenia are inter-related. They're not. At least not necessarily.
// ** 'Cause, you know, all those rural pickpockets... ***
/// *** Maybe I'm serious, maybe I'm not.

It was an educational web site that called it the doubter's disease. It's actually kind of funny how it happened. For years, I've tossed around the term pathologically uncertain as a self description. I thought I coined the term. Recently, I was reading a book that mentioned pathological uncertainty as a disorder and I kind of laughed at myself. Out of curiousity, I googled pathological uncertainty and all the pages with .edu were discussing OCD. One of them started off with, "OCD, also known as the doubter's disease..." Reading about it just sparked my interest.

I am a double checker, sometimes a triple checker but not because of a compulsion. I do it because I am absent minded. I forget really important things like going on a ski trip and only realizing when I got there, I forgot my jacket; or after walking a mile from my house, realizing I only put one shoe on. I would imagine, in to call it a disorder and not just learning from past mistakes; either the thought process would have to be different or the fear of reprocussion would have to be overwhelming.

tashirosgt
2011-Nov-19, 05:10 PM
When I consider any mental disease, it's natural for me to think about aspects of my own mental states and behaviors that might illustrate it. I notice other posters in the thread have the same approach!

I'm interested in whether the examples of obessive-compulsive behavior that normal people (myself included, of course) confess are indeed a good minature repesentations of OCD. Or are the feelings associated with OCD a completely different thing than a normal persons peculiar habits and rituals?

To me, the best example of a truly intrusive mental state is to get a melody "running though my head" all day. A melody is not a coherent thought. I wonder if the intrusive sensation of having a tune in my head is analagous, in strength, to how an OCD sufferer feels intrusive thoughts.

I'd think that obsessions and compulsion of normal people would not cause them much anxiety or shame. It isn't clear to me whether a person with "real" OCD could be free of anxiety or shame if he had a thought such as "I'm going to get my fingers crushed in a door" running through his head with the same force as I experience tunes.

Noclevername
2011-Nov-19, 05:23 PM
I'd think that obsessions and compulsion of normal people would not cause them much anxiety or shame. It isn't clear to me whether a person with "real" OCD could be free of anxiety or shame if he had a thought such as "I'm going to get my fingers crushed in a door" running through his head with the same force as I experience tunes.

Fingers crushed in a door is a rational thing to worry about, but "I must touch the floor tiles in a particular pattern" or "I can't move until the clock hand is on a multiple of 5" are among the compulsions I've had. Conforming to a particular pattern of behavior seems to be common with OCD.

Gillianren
2011-Nov-19, 06:05 PM
I think most of the more common mental illnesses are exaggerated versions of "normal" behaviour. Everyone gets depressed sometimes; clinical chronic depression is when it happens to a debilitating extent and for no external reason. Everybody has the occasional "did I leave the oven on?" moment; clinical obsessive-compulsive disorder is when moments like that are irrational and exert unreasonable control over your life. The problem with this particular assessment is that it makes a lot of people think, "Well, I can just get over those moments, so mentally ill people just aren't trying hard enough to get over theirs."

tashirosgt
2011-Nov-19, 06:48 PM
Fingers crushed in a door is a rational thing to worry about
It's rational to worry about to a certain extent and in certain situations, but it wouldn't be rational to have that thought all day in normal situations.

closetgeek
2011-Nov-19, 09:21 PM
I think most of the more common mental illnesses are exaggerated versions of "normal" behaviour. Everyone gets depressed sometimes; clinical chronic depression is when it happens to a debilitating extent and for no external reason. Everybody has the occasional "did I leave the oven on?" moment; clinical obsessive-compulsive disorder is when moments like that are irrational and exert unreasonable control over your life. The problem with this particular assessment is that it makes a lot of people think, "Well, I can just get over those moments, so mentally ill people just aren't trying hard enough to get over theirs."

...or eat healthier :D

HenrikOlsen
2011-Nov-19, 09:43 PM
I think most of the more common mental illnesses are exaggerated versions of "normal" behaviour. Everyone gets depressed sometimes; clinical chronic depression is when it happens to a debilitating extent and for no external reason. Everybody has the occasional "did I leave the oven on?" moment; clinical obsessive-compulsive disorder is when moments like that are irrational and exert unreasonable control over your life. The problem with this particular assessment is that it makes a lot of people think, "Well, I can just get over those moments, so mentally ill people just aren't trying hard enough to get over theirs."
Which actually makes for a simple (likely oversimplified but still possibly helpful) distinction: It's a disorder when it can't be gotten over by trying harder.

Gillianren
2011-Nov-19, 09:48 PM
Which actually makes for a simple (likely oversimplified but still possibly helpful) distinction: It's a disorder when it can't be gotten over by trying harder.

That works. The problem, I think, is that our understanding of our own brains is so primitive yet that we are almost exclusively reduced to explaining in metaphor, and as we all know, explaining in metaphor has inherent failings. Pointing out that exact issue may help the metaphor feel more real to people who have never experienced mental illness.

Inclusa
2011-Nov-20, 08:38 AM
I wonder if there is anybody who doesn't have any obsessive-compulsive tendencies at all.

There's a really blurry boundary between normalcy and psychological disorders.

Moose
2011-Nov-20, 02:34 PM
There's a really blurry boundary between normalcy and psychological disorders.

Pretty much why they have to use a checklist. So many ticks on the checklist, it's a disorder. One too few, it's a tendency.

Jens
2011-Nov-21, 04:24 AM
I think most of the more common mental illnesses are exaggerated versions of "normal" behavior.

I think that's definitely true with disorders except for schizophrenia and pathological conditions. I'm a bit interested in evolutionary psychology, which tries to explain why. With most of the common (neurotic) disorders it's very easy to understand. After all, not experiencing anxiety would be a fatal condition, because you'd forget to run away from dangerous animals. Compulsiveness is also clearly something that gives us a survival advantage, because it makes you feel compelled to wash your food before you eat it and stuff like that; probably learning requires some kind of compulsiveness. And I suppose that paranoia is really a kind of anxiety; it would probably be a bad idea survival-wise to believe that everyone is going to be kind to you. What's interesting is depression. I read a hypothesis somewhere that depression initially may have been a way to conserve energy in a bad situation.

Gillianren
2011-Nov-21, 07:50 PM
One of my signature quotes on Apollo Hoax, from the animated The Tick, is "This looks like a job for Bipolar Bear, but I just can't seem to get out of bed!"