What do people with obsessive-compulsive disorder do
Obsessive-compulsive disorders can occur in a variety of ways. Professionals differentiate between compulsive acts and obsessive thoughts. While the obsessions are actually being performed, the obsessions are only happening in the head. However, it rarely happens that a person has only obsessive-compulsive thoughts without compulsions; 70 to 90 percent of those affected suffer from both disorders, for example an obsessional control and obsessive-compulsive thoughts.
To the most common Types of Compulsionscounting:
- Compulsory washing / compulsory cleaning
- Control compulsion (colloquially also called control addiction)
- Compulsion to collect (this also includes the "messie syndrome")
- Compulsory counting
- Repetition compulsion
- Forced touch
To the most commonObsessive thoughtscounting:
- Magical thinking
- Compulsion to brood
When do rituals become questionable?
Of course, some of these behaviors also occur in healthy people. For example, many people take another look at whether the iron is really switched off before they leave the apartment, they like it when the books are neatly on the shelf and the house is always tidy and cleaned
The extent of these actions is decisive for the diagnosis of a mental disorder: Do you only spend a few minutes checking the stove, window and door, or does it take up to an hour to finish? Do you just feel safer if you have checked everything again or do you fear a terrible catastrophe such as a house fire or a flood? Is it okay if you don't check whether the door is locked or do you immediately feel an enormous inner tension and fear that is so strong that you have to check it?
Many sufferers also suffer greatly from having to carry out their compulsive behavior and not being able to stop it. This level of distress is another clear symptom that a mental illness is present.
The Serious Consequences of Obsessive Compulsive Disorder
Affected people have to invest a lot of energy and time every day to pursue their coercion; on average, an affected person spends up to four hours a day doing compulsive acts. On the one hand, this can have consequences for their day-to-day work, such as being late for work, needing too much time to complete a professional task or having difficulties working with others.
Partners, family, and friends also often suffer from the person's obsessive-compulsive disorder. For example, when visitors are no longer allowed to come home because the guests could bring in dirt and germs, all items at home always have to be precisely sorted and the obsessive-compulsive patient gets angry as soon as a towel is not hung up exactly according to the rules he has set or the family Has already driven off to the holiday destination by car and the person concerned insists on turning back again in order to be able to check the stove at home again (which he has already checked ten times before), this creates arguments and serious conflicts.
Coercion can also damage the health of the person concerned. If a person with compulsory washing takes a shower for hours every day and washes his hands fifty times, his skin will soon have chafed sores, cracks, bloody spots, eczema and inflammation can appear.
In general, all compulsions can burden the professional and private life of the person concerned, lead to dismissal, separation and social isolation and promote the development of further illnesses such as depression or addiction.
Obsessive-compulsive disorder as a sign of intelligence?
It was Sigmund Freud, the founder of psychoanalysis, who once claimed that people with obsessive-compulsive disorder have a higher intelligence quotient. This thesis has been refuted by a study by the Universities of Ben-Gurion, Texas State and North Carolina (Chapel Hill). In a meta-analysis, the researchers examined 98 psychiatric studies and found that obsessive-compulsive disorders are not associated with a higher IQ, but that those affected usually have a normal IQ.
It is also a mistake that obsessive-compulsive illnesses have memory impairments. For example, the repeated checking of a stove is not caused by the fact that the person concerned processes the perceived information ("The stove is off") poorly and poorly stored in memory, but rather because he is very afraid of making a mistake and in certain cases (compulsory triggering) situations does not trust his perception or his ability to remember.
In moments that have nothing to do with guilt and responsibility, he does not doubt his ability to remember.
These are thoughts, ideas or impulses that keep the person concerned busy and torment him.
Examples for obsessive thoughts:
Most obsessive-compulsive thoughts have aggressive, sexual, or blasphemous content. For example, during a business meeting or at a meal with their in-laws, those affected come up with obscene words and fear that they will immediately pronounce these terms out loud and the others will then think they are “crazy”. Some people have the thought of attacking their loved one with a knife or killing them.
The obsessive-compulsive patients are horrified that they have these thoughts and are ashamed of them. Also thoughts like “What if I jumped in front of the arriving train now? Or fall down from the balcony? ”Can happen. The person concerned has no intentions to commit suicide and is shocked about it, sometimes so much that his stomach feels sick and he holds on to something to be on the safe side.
Also the so-called magical thinking belongs to the obsessive-compulsive thoughts. Those affected usually develop their own beliefs, such as: If I get seat 22 on the plane, the machine won't crash or if my favorite song is on the radio right now, I'll be successful in tomorrow's interview. Others fear that a certain thought could have devastating consequences for someone. For example, they read a stranger's obituary in the newspaper and think that it could result in the death of a relative or close friend of their own.
Obligation to brood: With an obsession with brooding, the obsessive-compulsive disorder very often thinks about negative things, for example whether he said something insulting in a conversation with a colleague or a friend. Often those affected then try to reassure themselves and ask others if they have uttered something strange. Because of this, some obsessive-compulsive disorders never speak on the answering machine for fear that they will say something wrong and that it will be recorded on the tape.
These are certain actions that are carried out very often and according to certain rules. The person concerned does not trust his own perception and needs these ritualized actions to give himself a feeling of security that he is not making a serious mistake or even causing a catastrophe.
During the compulsive action, he feels a slight relaxation. If, on the other hand, he resists the compulsion and does not practice the rituals, the inner tension and fear increase significantly.
Examples of compulsive acts:
Compulsory washing / compulsory cleaning: Those affected are extremely afraid of being infected with pathogens (especially serious illnesses such as HIV or hepatitis) and therefore very often clean their bodies intensively, especially their hands. For example, as soon as you touch a doorknob or shake someone's hand, you immediately feel the urge to clean your hands thoroughly.
Some people clean the skin from the hands to the elbows for five to ten minutes. This can also take on such serious proportions that the obsessive-compulsive disorder not only cleans his body with soap products, but also scrubs it with cleaning agents.
Some people affected cannot take a seat on the bus because strangers had previously sat there and the fear arises that there are germs in the area. Even if, for example, a shopping bag has been placed on the floor, an obsessive-compulsive disorder can feel the impulse to wash off all the food in the bag immediately or to throw it away.
For some people, the “cleanliness craze” extends to the entire apartment. They scrub the bathroom every day (sometimes every tile is cleaned for minutes) and also clean other living spaces thoroughly. Some use surface disinfectants that are normally used in hospitals in order to destroy as many germs as possible at home.
Control obligation: For example, those affected check twenty times whether the stove or iron is switched off. Some people hold their hands on the record, turn the switch back and forth umpteen times, or stare at the device for a long time to make sure that it is safely switched off. Before they leave their home, others pull all the plugs of devices out of the socket and place them at a safe distance from the socket, shake the front door and check several times whether the handbrake in the car is firmly on.
Some obsessive-compulsive illnesses have a checklist that they use to check the apartment (for example, first the sockets, then the stove, then the faucet, then the door). If you feel that the control of one of these things does not run optimally, you start from the beginning to check everything. It stands to reason that for these obsessive-compulsive patients leaving their homes means a great deal of effort.
Since they also take a long time to "finish" their control ritual, many are late for work or private appointments. This late arrival is a typical symptom of control compulsions. Because those affected are ashamed of their behavior, they often use white lies to explain that they are not punctual.
There are obsessive-compulsive illnesses who are afraid of running over someone while driving and do not notice it. In great concern, they drive the route again (this can be 100 km or more) and check whether there is an injured person on the road or at the side of the road. Some of them listen to the radio news and pay close attention to whether there is an accident report including a hit-and-run. It may be that on the way back they become unsure again and drive off and search everything again.
Control compulsions can negatively affect relationships, partnerships, or family life.
Order: Those affected experience very high pressure to organize all objects in the home and at work according to a certain system. You determine this principle of order yourself. For example, they sort all items of clothing in the closet according to their color and stack them exactly on top of each other or they place books on the shelf in such a way that all the spines form a straight line with millimeter precision, no book may be tilted or on top.
If this is the case, the person concerned becomes very restless, feels a strong inner tension and then tries - in the truest sense of the word - quickly to restore the accustomed order and is about to clear the book. There may also be times when he keeps going back to the bookshelf to make corrections. He can spend many minutes or even hours placing everything very precisely.
In the office, too, the desk is usually meticulously tidy, pens are exactly next to each other (or at a certain angle) and everything is always positioned wherever possible.
Compulsory counting: Affected people have the compulsive need to perform counting rituals. They keep counting things or people that they come across in everyday life, which can be street lights, trees, cars and passers-by. Some also only touch every second cobblestone with their feet or always have to count on 1-2-3 in their minds before entering a shop or crossing the street at a traffic light.
Compulsory repetition: Some obsessive-compulsive disorders have the urge to repeat actions or sentences. For example, you have to shake the bedspread exactly twelve times in the evening so that you feel relaxed when you fall asleep or silently repeat every sentence you utter in an echo-like manner.
Forced touch: Affected people have to briefly touch things or people. It's like a magical ritual designed to prevent bad luck. For example, some parents always tap their child briefly on the shoulder when they say goodbye. Touching can also take place in a specific order. In some cases, however, a person consistently avoids contact with certain things. This should also help to avert disaster.
Compulsory collection: Many people like to collect something, some are postage stamps, others small model cars or holiday souvenirs. You choose the objects carefully and usually place them in a special place in the apartment. It is different with people who suffer from a compulsion to collect. They hoard numerous objects at home in a disorganized and indiscriminate manner, mostly they collect paper products (newspapers, brochures, notes, books, letters, etc.), but also kitchen utensils, clothing, shoes, food packaging such as yoghurt pots or cereal boxes are often hoarded in stacks.
They are unable to throw things away for fear that they might need them again later. Those affected also collect these items because they have an emotional value for them, either because memories of loved ones are associated with them (e.g. children's clothes, furniture and parents' books) or because they are not alone through the countless things at home feel. The objects take the place of social closeness, they alleviate the inner emptiness, give a feeling of security and strengthen the self-esteem of those affected.
In addition, obsessive-compulsive disorder has major problems planning everyday life efficiently, completing tasks in a structured manner and separating the important from the unimportant.
The litter syndrome (messie syndrome): Over time, the apartment becomes more and more chaotic, with numerous objects forming large piles in the rooms or piling up to the ceiling. While some of those affected still have an order system in the chaos and can still move between the individual meter-high stacks in the apartment (here there is sometimes a corridor system that is reminiscent of the structures of rodents), still pay attention to personal hygiene and pursue a job, prevails in others a total neglect.
The apartment is like a garbage dump, it is difficult or impossible to go to the stove and toilet, there is a lot of rubbish, leftover food and excrement lying around and there is a smelly smell. Those affected are also neglected themselves.
Psychologists also refer to this excessive collecting as litter syndrome, and the term “messie syndrome” (from the English word “mess” = disorder, chaos) has become popular for this. However, the causes of such a litter syndrome are diverse, it can be an obsessive-compulsive disorder, but also an anxiety disorder, depression, addiction or dementia.
The litter syndrome occurs in all social classes, the peak of the disease is in middle-aged people. In Germany there are more than 1.8 million people who live in such chaotic apartments, according to the estimate of the self-help group “Anonymous Messies”.
A special form of messie syndrome is so-called animal hoarding (collecting pets). On average, such animal hoards have 76 animals at home, which suffer enormously from the limited space and poor nutrition and hygiene.
Even if the apartment is almost completely littered, the obsessive-compulsive disorder usually does not seek help. Those affected tend to expand their compulsion to collect, for example by renting a garage or storage room.
If the apartment is cleared out or evacuated, this is a very explosive situation for the person concerned. Some experience the separation from the collected objects as a loss of part of their identity, which can trigger sadness, fear and panic. In severe cases, the person then commits suicide.
It is therefore by no means sufficient to just tidy up the apartment; a person who suffers from a litter syndrome also needs psychotherapeutic help.
Obsessive-compulsive disorder in children
Rituals are very important for children in order to give them a feeling of security, such as reading the bedtime story aloud in the evening, kissing mum's forehead goodbye when the child goes to daycare, or blowing a wound three times to help them heals faster.
In phases of upheaval, such as starting school or moving to another city, a child may develop their own rituals in order to cope better with the situation. Most of these are harmless and often disappear again.However, parents should pay attention if the child suddenly feels depressed more often, withdraws and develops abnormal behavior, for example washing their hands frequently, counting certain things or checking the windows and doors.
The children pay close attention to the performance of certain rituals. If parents notice this behavior in their offspring, they should seek advice from a child and adolescent psychiatrist for advice.
Compulsive acts are mostly performed by children to relieve anxiety or to avoid harm.
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