OCD may be expressed in
the following ways:
- Excessive worry
- that dirt and germs will cause
illness, resulting in excessive washing,
-about “being good” (not sinning), resulting
in excessive prayer,
-not “acting stupid”, or doing something wrong,
resulting in avoidance of social interaction or attending
school or work
- Recurrent thoughts
-about accidents, bodily harm, death and destruction, resulting
in avoidance of even simple tasks
-ruminating about the arrangement
of items, e.g., furniture, tools, stuffed
animals, books, clothes, resulting in distress if this arrangement
is modified
- Repetitive questioning or exaggerated explanation
-about the same subject or topic, seeking reassurance
-the need to tell or confess "everything" to a parent or a spouse
- Excessive checking in order
to feel safe
-rechecking locks, windows and area under the bed
-re-reading, re-writing and re-tracing steps in order
to assure “correctness”
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OCD may manifest in many different ways. Here are four (4) case scenarios:
Case 1. "Dr. Tom", a 53 year old surgeon, is increasingly distressed because he finds himself, at the end of his office work, repeatedly checking to ensure that his office computer and equipment are "properly" set or turned off and that all the doors are locked. Before leaving the office, he may return to check each lock 4 or 5 times. Very often, even after leaving the office and driving
away, he returns to the office to, again, check the office equipment and the door locks.
Case 2.
Pamela, a 31 year old housewife and mother of two small children,
is obsessed with the thought that her dishware, cutlery, kitchen knife and
cutting board become contaminated or "infected" after ordinary use
and are passing germs to her family. As a result, she repeatedly
scrubs the dishes, utensils, and cutting board. Even after putting them away, a
few minutes later, she retrieves them and, again, repeats the washing.
Distressingly, this cycle may recur 8 to 10 times a day which results in her
missing appointments and even being late to pick up her children at the day
care center.
Case 3. “Steve”,
13 years old, had always been a “very
good” student, getting As and Bs on his report card.
However, his grades began to decline suddenly for which his
parents contacted his teacher. The teacher stated that Steve
had not been completing his in-class work, including quizzes
and tests, and had not turned in several homework assignments.
When the parents questioned Steve about his poor academic performance
and offered to get him tutors, Steve stated that he did not
have a problem understanding the subject matter in his classes.
Rather, he was not able to complete his school work in a timely
manner because he felt compelled to re-read and to re-write
his assignments which made him feel very frustrated. Additionally,
Steve admitted that he did not even attempt to do homework
assignments just to avoid feeling aggravated.
Case 4. “
Karen”, 9 years old, began having arguments each school
morning as her mother assisted her in getting dressed and doing
her hair. Although Karen had always been a soft-spoken and “easy
going” child, her behavior would radically change during
the morning routine with mom. Karen would repetitively try
on clothes until she found ones that felt and looked “right”;
this could take 20 minutes to over an hour. Also, Karen would
insist that her mother re-do her hair until it, too, looked “just
right”. If mom attempted to help speed up the process
by telling Karen that she looked great and forbidding her from
trying on yet another outfit or by refusing to re-do her hair,
Karen would react in a fit of rage, often crying vehemently.
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