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This is the best word to describe what it’s like to have Obsessive-Compulsive Disorder. And if I had to rank the disorders that afflict LuLu and how they negatively impact her life OCD would be at the top of the list.
OCD is a crazy-making disorder. Unlike other psychiatric disorders, a person with OCD realizes that he/she is not processing the world correctly. OCD is classified as an anxiety disorder and is characterized by obsessive, intrusive thoughts and compulsive rituals. OCD is made worse by anxiety and stress.
If you’re not sure what an obsession or a compulsion are, the DSM-IV Quick Reference Guide has a very clear definition:
Obsessions are defined by:
1. Recurrent and persistent thoughts, impulses, or images that are experienced at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress.
2. The thoughts, impulses, or images are not simply excessive worries about real-life problems.
3. The person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action.
4. The person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind, and are not based in reality.
5. The tendency to haggle over small details that the viewer is unable to fix or change in any way. This begins a mental pre-occupation with that which is inevitable.
Compulsions are defined by:
1. Repetitive behaviors or mental acts that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly.
2. The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive
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OCD is also defined by the sufferer realizing that these thoughts and behaviors are intrusive and inappropriate. And that produces even more anxiety, which in turn can make the thoughts and behaviors more intrusive. Like I said…it’s a crazy-making disorder.
And it is a major factor in LuLu’s world, causing great distress and impairment in her daily functioning. She gets STUCK…we know it; she knows it. Depression is a major side-effect that tends to grow over time, as the child matures and believes that he/she is helpless to stop the intruding thoughts.
The stuck thinking that comes from OCD can manifest itself in many areas. It can come in the form of very aggressive thoughts to harm yourself or other people. It can come as a fear of contamination, germs or disease that leads to compulsive acts or in an obsessive need for symmetry and order to your world. It can also come in the form of “scrupulosity” which is obsession on one’s own “sin”.
In olden times, people suffering from OCD were believed to be demon-possessed. Exorcisms were often performed. And one could see how this might be the belief. People with uncontrolled OCD are tortured souls for sure. Mostly because they are usually very aware of their intrusive thoughts and odd behaviors and try as they might to suppress them, they just can’t
This is illustrated by this experiment. Think about a big brown bear for 3 minutes. Try to keep it focused in your mind and concentrate on it. Yes, your mind will wander off of it, but try to hold your thoughts there. Then, tell yourself that you will NOT think of this brown bear again. Banish it from your mind. How often doe the brown bear that you are trying to NOT think about pop into your mind? How hard is it to keep yourself from thinking about the bear? This is a microcosm of OCD. And I believe that it is the way in which OCD links with ODD. Because children diagnosed with ODD are defiant even with defiance will not gain them anything, it, too, is stuck thinking. And it may be an outward manifestation of the inability to suppress the obsessive thoughts.
At least in LuLu’s case it appears this way. Although literature says it’s very uncommon for people with OCD to be violent, LuLu’s aggressive behaviors all stem from getting stuck. She gets stuck several times a day. And because she can’t cast the thoughts out of her mind and shift on to something else, she really gets into a rut and her behaviors deteriorate rapidly.
Last night was one of those times when she deteriorated rapidly. She got stuck on something I said, rather benignly, and she thought I said it was going to happen (it isn’t). So she expressed her frustration. Despite repeatedly telling her, very calmly, that she had misunderstood me and she needed to “drop it”, she was in stuck mode. We were just entering a restaurant for dinner at the time. She proceeded to try to kick the patrons in front of us (acting on an intrusive thought triggered by the anxiety of what she thought I said). See what I mean about “crazy-making”. We ended up getting dinner to go and retreating quickly to the car.
Then, I did the exact WRONG thing in terms of her OCD. I announced, in true parent consequencing fashion, that we were not going out to eat again until I knew she was able to control herself in public, however many weeks or months that took. LuLu, looking for further confirmation that she’s “bad” (her self-image” and knowing that we always go to dinner at church on Wednesdays asked, “does this mean we’re not eating at church tomorrow/” “Of course we’re not eating at church!” I responded. And she melted down even further.
This is an example of why reward and punishment-based behavior mods don’t work with my child (and any OCD child, I’d dare to say). She was now stuck on the fact we’re not eating at church and began all sorts of ways of dealing with that – threats, self-injury, attempting to make deals with me. Truth is, I can’t take her out if she’s volatile and I didn’t see that volatility coming last night. But I should have kept it to myself about not going to church. Its just that frustration with her behaviors causes a very human response within me…one where I want some measure of revenge and I get that by issuing a threat or ultimatum. Yet, this is exactly the scenario that played out over and over at her school and always resulted in a lose-lose situation for all involved.
We had a stormy evening for sure. I missed the meeting I was supposed to be at for my church. And finally, after LuLu bathed and collapsed exhausted into bed, I did the same, much earlier than I usually retire…exhausted.
OCD is a huge obstacle in daily life. While it’s funny to watch Monk and to relate to the odd behaviors these sufferers exhibit, to live as a prisoner to the stuck thinking daily is an awful existence.
Related links:
Organized Chaos – site for teens and young adults with OCD
“Monk” also addresses the existance he leads – a brilliant man fully cognizant of his issues, and able of finding ways to cope and lead a reasonably normal life. A brilliant detective. Then the catalyst comes – his wife’s murder, a crime he has not been able to solve – and life is never the same, as his tortured soul has a completely different dimension.
But I digress…. would you please address some of the coping mechanisms and treatments for OCD? Both for the person and those who love them?
I struggled w/OCD for many years. For me, learning how to safely process anger and rage greatly reduced my symptoms. For many people, repressed anger manifests as anxiety and depression. For people like me who repressed enormous amounts of rage, the symptoms can become even more severe.
Yoga and meditation have been very helpful for me in calming the anxiety that fueled the disorder. Like you said, I knew that it was “crazy” to recite different phrases repeatedly in my head or to blow on my hands over and over again, but doing those things reduced the anxiety. If I did not do them, then the anxiety because nearly unbearable. I still have minor OCD issues, but it is no longer intrusive enough in my life to be a disorder any longer. YEAH!!
Do you know much about Lulu’s history? Much of what you write sounds consistent with her suffering trauma at a young age.
Take care,
- Faith
Sometimes in frustration, I too, make statements that make the situation worse. Part of being human unfortunately. Then, I’ve missed appointments too, after such incidents.
So sorry, Julie. Thinking of you!
Aggression is pretty common in people with a combo of OCD and neurological impairments. Cognitive-behavioral therapy, Anafranil, and/or SSRIs are the most successful treatments. My daughter’s OCD is very frustrating for us, but Anafranil made a huge difference for her. She also really likes watching Monk, because she can relate so much!