WHAT IS OBSESSIVE-COMPULSIVE DISORDER?
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OCD is a tormenting disorder. Unwanted thoughts, called clinical obsessions, charge into the mind and won’t go away. They drive a person to perform repetitive acts, clinical compulsions, to get rid of them.
We say that OCD is present when a person suffers from clinical obsessions and compulsions, and they cause significant distress or disability. The difficulty arises in recognizing these two symptoms. The term obsession is often employed for what is more accurately termed a preoccupation, such as coach’s “obsession” with winning. That’s not a clinical obsession. It’s not what we’re talking about here. The unique and distinct nature of clinical obsessions was recognized way back in the 1800’s. The German psychiatrist Karl Westphal wrote:
“Obsessions are thoughts which come to the foreground of consciousness in spite of and contrary to the will of the patient, and which he is unable to suppress although he recognizes them as abnormal and not characteristic of himself.”
Clinical compulsions, the other half of the equation, are purely secondary phenomena, acts performed solely to put right a tormenting thought. They may be physical behaviors, such as checking, washing, or asking for reassurance; or they may be purely mental acts, such as conjuring up a pleasant image or repeating a phrase over and over in one’s mind. An obsession strikes, anxiety mounts, and a repetitive act provides a temporary way out. For our purposes:
Compulsions are repetitive acts that are clearly excessive, performed solely in order to lessen the anxiety caused by an obsession.