Where are you on the OCD continuum?

This is an archived article and the information in the article may be outdated. Please look at the time stamp on the story to see when it was last updated.

I like to think of myself as easygoing.  Unless I come to your house and the toilet paper is hangingIMG_0299 from underneath the roll, instead of over the top. Then I will attempt to change it so it’s correct. When my closet got out of hand, I reorganized by color-coding my blouses and now it’s the only way I hang my clothes.  I used to have to close the door to my sons’ room, because if I saw clothing on the floor I would throw it in the washing machine.  My boys would joke that their clothes weren’t in the hamper for more than a day. And when any meal is done at home, I can’t unwind until the dishes are washed or in the dishwasher and the counter is wiped down.

Even with all these ‘particular’ traits, the experts will tell you I don’t have Obsessive Compulsive Disorder, or OCD, because there’s no biological or serious environmental reason I started doing any of these things and I do them voluntarily.  In other words, I can control my behavior.  Like a friend who told me, “all the light switches used to have to be in the same direction in my house. I did that for years until I started holding my arms as I walked by the switch and now I don’t even notice which is up or down.”

That’s in contrast to someone who has OCD, defined by the International OCD Foundation as “a disorder of the brain and behavior. OCD causes severe anxiety in those affected. OCD involves both obsessions and compulsions that take a lot of time and get in the way of important activities the person values.”

While it’s true I haven’t been late to work because I was color-coding my clothing or imgreschanging out toilet paper rolls, Denver Counseling and Executive Life Coach Frances Forgione says “think of it like a continuum, the more you go on the extreme, the tougher it is to manage daily life.  But we all have traits.”

While OCD can begin in early childhood for some, it typically manifests between the ages of 8 and 12 or in the late teens to early adulthood. That adds up to about 1 in 200 kids and teens who have OCD.

David, who’s only ten years old, shared his story on beyondocd.org

I have to scratch things evenly, for example, both ears, even if the other side doesn’t itch. When someone else does something to do with my OCD, it drives me crazy, because I can’t say, “please scratch your other side.” It helps to not look at them.

The International OCD Foundation’s Dr. Aureen Wagner says therapists, family doctors, pediatricians, psychologists or psychiatrists, are looking for three things when they make a formal diagnosis:

  • The person has obsessions,

  • He or she does compulsive behaviors, and

  • The obsessions and compulsions take a lot of time and get in the way of important activities the person values, such as working, going to school, or spending time with friends.

Forgione says in her practice, “OCD typically falls in two categories.  It’s either biological, like if someone has a family history, or environmental, where a trauma or life event that left you with no control is now making you focus on something you can control, such as excessive hand washing, counting, cleaning, or organizing.”

la-ca-jc-david-adam-20150118-001David Adam, who suffered from OCD for 20 years wrote the book, The Man Who Couldn’t Stop, to try to understand the condition and his experiences.

The obsessive thoughts of OCD are different and tend to cluster around a limited number of themes. Obsessions of contamination with dirt and disease are the most frequent and feature in about a third of cases. Irrational fears of harm – did I lock the back door? Is the oven switched off? – are the next most common, and affect about a quarter of people with OCD. About one in ten wrestles with an obsessive need for patterns and symmetry. Rarer, but still significant, are obsessions with the body and physical symptoms, religious and blasphemous thoughts, unwanted sexual thoughts, and thoughts of carrying out acts of violence. It’s because obsessive thoughts are so often within these taboo and embarrassing subjects that so many people with OCD choose to hide them.

Once someone is out in the open, Forgione says she’s seen Dialectical Behavior Therapy, a cognitive behavioral treatment, effective in working with someone who has OCD.  She uses the following steps:

Mindfulness: the practice of being fully aware and present in this one moment.

Distress Tolerance: how to tolerate pain in difficult situations, not change it.

Emotion Regulation: how to bring your emotions to a normal level from either too high or too low.

Interpersonal Effectiveness: how to ask for what you want and say no while maintaining self-respect and relationships with others.

Writing in the Huffington Post article Living with OCD, Peter Mason, says he’s had some success with this approach:

I’ve used cognitive behavioral therapy to control both the “O” and the “C,” and since I utilize it daily, I find areas where I need to take back control from my OCD and keep at an even keel with certain tasks. Rather than vacuum every other day, I can manage a little dog hair and vacuum weekly at the most, but resist the “as-needed” approach, because that will open the door for the thought that “Well, it needs it today,” every day of the week.

Forgione says “I like to ask my clients to identify what is going on that triggers an OCD episode, so they might be able to find other ways to behave.  The truth is, if we could know each person’s full story, including someone’s biological nature, everything they’re doing would make perfect sense.  Still, it is advantageous to change this behavior because the uncontrollable thoughts and compulsive behavior to relieve those thoughts are all consuming for that person and they interfere with life.”

So the next time you alphabetize your canned foods, or count every step in your house, or triple check whether you locked the door, know that you’re somewhere along the continuum.  It’s when that obsession and compulsion get in the way of daily life that it may be time to get help.

It does make you wonder, as  Animation Domination High-Def does, what if Superman had OCD ?




1 Comment

  • Janet (ocdtalk)

    I have to take issue with Ms. Forgione’s comment that OCD is on a continuum and we all have traits. This only perpetuates the misinformation and misunderstanding of what OCD truly is. Its like saying Crohn’s disease is on a continuum and a stomach ache is at the far end. While symptoms might overlap, a stomach ache is in no way Crohn’s, just as organizing a closet is (typically) in no way OCD. How many people realize that OCD can be so severe that many sufferers wish they were dead, and in fact, do take their own lives?
    The other issue I have with this article is that there is no mention of the front line psychological treatment for OCD as recommended by the American Psychological Association: exposure and response prevention (ERP) therapy. This is an evidence-based CBT that yields the best results for those with OCD. It is mind-boggling that many therapists are not aware of this therapy and instead use other therapies that either do not help their clients, or even worse, harm them.
    I talk about anything and everything to do with OCD on my blog at http://www.ocdtalk.wordpress.com and recount my son’s triumphant journey through severe OCD in my recently released book, Overcoming OCD: A Journey to Recovery. OCD is a horrible disorder, but it is also treatable. There is truly hope for all those who suffer from OCD!

Comments are closed.

Notice: you are using an outdated browser. Microsoft does not recommend using IE as your default browser. Some features on this website, like video and images, might not work properly. For the best experience, please upgrade your browser.