OCD and Christianity

PERSONALITY OF OCDers:  FEARFUL, INTROVERTED AND DEPRESSIVE

Psychologist Stanley Rachman, perhaps our leading expert on obsessive-compulsive disorder over the last few decades, notes in his classic 1980 text Obsessions and Compulsions, that foremost among the traits of OCD sufferers are fearfulness, introversion, and a tendency to depression.

Fearfulness is the most commonly described personality trait of OCD sufferers. They fear that they will act on impulses of violence, fear they will be damned for ideas of blasphemy, fear they will be contaminated by images of germs, and fear generally that they are going insane.   Yet, in fearing thoughts, unfortunately, they only fuel them.  What happens is that, somehow in the mind, fearing a thought exaggerates the importance of that thought, guaranteeing that it will return again and again.  Fearing unacceptable thoughts turns them into obsessions. Jeremy Taylor, a seventeenth century cleric who wrote a great deal on mental problems, said of OCD sufferers: “They dare not eat for fear of gluttony; they don’t sleep for fear of sleeping too much.  If they are single, they fear their temptations.  If they are married they fear doing their duty, then fear that the very fearing of it is a sin.  They repent when they have not sinned, and accuse themselves without reason.  Their virtues make them tremble, and in their innocence they are afraid.”

The trait of introversion refers to a tendency to be absorbed in the inner world of the mind rather than in the world outside.  This inclination to look inward throws a person repeatedly back into any ongoing battles with obsessions, and by doing so escalates the problem. It might be argued that since obsessionals are driven to spend hour upon hour analyzing, repeating, correcting, regretting, and fighting their thoughts, it is having obsessions that makes a person introverted, not the other way around.  However, studies show that obsessions usually develop after age twenty, when the major personality traits, including introversion, are already in place.

Introversion precedes obsessions and almost certainly increases the likelihood of getting OCD.  Rachman observes that extroverted obsessionals are quite rare.

A tendency toward depression also goes hand in hand with severe obsessions.  Anyone who works with OCD patients can’t help noticing this relationship.  Recent research confirms that depression is the most common complication of OCD, and that approximately two thirds of people with OCD suffer severe depression at some time during their lives. It is obvious that the long, demoralizing battles OCD sufferers wage with their thoughts could lead them to depression.  It now also appears certain that depression leads vulnerable people to experience more and more obsessions.  In 1986 researchers in Australia showed that intrusive thoughts in college students are closely related to mood, and speculated that depressed people experience more intrusive thoughts because of an impaired ability to process and get rid of them.  This is seen on a clinical level.  As depression saps peoples’ confidence and breaks down normal means of coping, the result is more difficulty dealing with potentially troublesome thoughts.  Samuel Johnson recognized this clearly: “If the imagination presents images that are not moral, the mind drives them away.  But if a person is melancholic…the images lay hold on the faculties without opposition.”