An obsessive-compulsive disorder (OCD) is an anxiety disorder that usually begins in adolescence or early adulthood, but can also begin in childhood. It is a problem where the central axis is the fear of something terrible happening. The characteristic of the obsessive-compulsive problem is the presence of obsessions or compulsions.
Obsessions are high-frequency, repetitive involuntary thoughts that pop into our minds without our wanting it. They can be expressed in the form of words and phrases or images. The content is threatening, morally unacceptable, grotesque or strange for the person who suffers it; For example, believing that you have contracted AIDS, that the cigarette butt you put in the ashtray is going to start a fire, or that you want to insult someone.
Compulsions are stereotyped, voluntary behaviors that can become highly organized and elaborate. They are intended to reduce the possibility of the dreaded catastrophe or block the anxiety caused by the obsession itself. It can be done physically, such as washing hands or checking that the phone is on the hook, and mentally, such as doing mathematical operations.
We will classify them based on the type of basic ritual. Since the emotional response is always anxiety, we will describe triggers, obsessions, and rituals.
The obsessions are centered on the topic of pollution, dirt, diseases or similar topics. There are specific fears of catching a certain disease, but other times the obsessions are more diffuse, they could be reflected in thoughts such as how disgusting, not supporting being dirty or this is disgusting. The rituals are usually washing or cleaning.
The obsessions are centered on the occurrence of possible catastrophes that vary according to the type of situations in which they appear. The most frequent are fears of fires or gas explosions, electrical appliances or cigarettes, and the rituals logically have to do with checking the good condition of these items. Other times the fears speak of the possibility of being robbed and the compulsions are to check doors, windows or car locks.
More infrequently, but not uncommon, is to find verifiers of documents, numerical works and in general of any professional execution. For example, compulsively checking for spelling mistakes or repeatedly performing arithmetic to make sure there are no mistakes.
Special mention should be made of those cases of people who greatly ritualize a part of their work. Within this category, there is a rare but spectacular subtype. The triggering situation is usually driving. Sometimes in specific circumstances such as overtaking or hitting potholes, it causes doubts about whether someone has been run over or an accident has been caused. The check is usually to look in the rear view mirror, put your head out the window and get out of the car to check if someone has been run over, or even repeat the same journey several times with the same objective.
In general, all testers in addition to rituals and the avoidance of problematic situations tend to use the reassurance strategy a lot: "Have you seen me put out the fire?".
Obsessions tend to be somewhat abstract and could be generically summarized in that it is absolutely essential that everything is organized, arranged and in its place. From there it is easy to deduce the type of rituals that they develop, such as that the furniture is organized in a certain way, they often look for symmetry, desks or decorative objects are placed following inflexible rules.
Fears or obsessions are about anticipating a catastrophe and the way to neutralize it is to repeat a daily action several times. The most feared catastrophes are that they or loved ones have traffic accidents, illnesses or problems at work. The range of repeated actions is very wide: to touch the door handle several times, cross yourself repeatedly, make faces, swallow several times in a row looking at a wall, etc..
Obsessions are related to the fear of throwing away something important or that they may need in the future. The compulsions consist of accumulating, saving, storing objects that most of the times it does not make any sense to keep.
Obsessions are about hurting certain people or oneself. Many times they fear doing harm to especially helpless people who, due to their condition (children and the elderly), because of their position (being on their back) or their activity (sleeping, studying) are especially vulnerable. It is very common for some of these obsessions to appear when being parents, especially in situations of manipulating the baby. These obsessions are very disturbing, especially if they appear in the person with an imperative format: "hit him." At other times they appear in the form of a question mark: "What if I stuck the scissors in his face??
Neutralization strategies are consequently designed to prevent acts of violence, such as avoiding being alone with the victim or removing objects that they would use to harm.
A variant of these obsessions would be the obsessions of sexual violence, suicide obsessions and people who are afraid of losing control in the form of verbal attacks or publicly telling intimacies or secrets.
In all the types of obsessive compulsive disorder described so far, the neutralizing behaviors tend to be predominantly physical, that is, people avoid risky situations and act compulsively to get rid of discomfort.
Below we will describe different categories where the most relevant blocking strategies are those thought.
Many of the following categories were classically labeled as "pure obsessions" or also called "ruminations".
The most characteristic example of this category involves having an obsession in the form of profanity that can sometimes take the form of an image. The cognitive ritual is to create a "good" image, to replace the bad. This type of problem is often suffered by people with deep religious convictions. Also related to this religious theme, sometimes obsessions with demonic content may appear whose rituals typically include praying or mentally repeating that what they fear is not going to happen. A modality of mental restitution, are those who fear being homosexual, one of the neutralization strategies is to rescue data many times in the form of an image that they are indeed heterosexual.
They would be the covert or mental version of the physical testers. Characteristic catastrophes, robberies, fires, explosions, etc. are feared. They block discomfort and reduce the possibility of catastrophe by mentally checking that dangerous situations are safe..
As in the case of physical repeaters, personal catastrophes or in loved ones are feared, but the main strategy to free oneself from fear is to covertly repeat phrases, words, mathematical operations or even images.
The obsession is related to finding bodily perfection, which is defined in terms of symmetry, the characteristic ritual is to compare by looking at, touching, measuring, the left and right parts of the limb or body area in question..
The disturbing obsession is getting the perfect performance, usually everyday actions, shaving, a shower, etc..
Obsession is a question about any area of human knowledge. Rituals are attempts to answer again and again possible answers. Here we also include those people who have doubts about the meaning of the words.
Obsessions are thoughts about your own death or the death of loved ones. Rituals consist primarily of rationalizing.
Here the doubts are about how to decide daily aspects of his own life: what clothes should I wear? ”. The neutralization behaviors are a constant analysis of the pros and cons of each of the alternatives that seem to have no end. Even if they make a decision for practical reasons, they are never satisfied that they decided the right one. They use reinsurance a lot in the form of asking others for advice.
They are jealous. Not all people who have the problem of jealousy have it in the form of obsessive compulsive disorder. Pathological jealousy is a very complex and multi-causal problem. It can be related to the lack of self-esteem and personal insecurity, a feeling of possession towards the other person or with a sense generically suspicious towards everyone. Obsession is a thought or image that the person's partner could be with another, or like or interest them, and the ritual has to do with verifying that this is not the case: interrogating, calling on the phone or checking things.
They are obsessions that come from relationships with other people, even from past relationships. Their discomfort comes from thinking if their performance was adequate or the one they wanted to do: what did I tell them? Is my position clear? The rituals, always cognitive, try to review how the conversation was, remember what was said and what was not, or find a better alternative response to handle the situation. There is no end, they never come to a conclusion.
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