Health
OCD Awareness Week | Rituals of a different, painful kind
Rituals, purity, scrupulosity— these are words that come to mind when speaking about religion. They also come to mind when tackling the gnarly subject of Obsessive Compulsive Disorder (OCD), a mental disorder that affects approximately 1-2% of the global population. While often characterised in popular media by one of its better-known manifestations—compulsive hand washing or cleaning— OCD is a complex, multi-faceted disorder.
Each year, the second week of October is set aside to raise awareness and promote understanding of this disorder; this year’s edition took place from October 8 to 14. As it winds down, here’s looking at some of the dimensions of OCD disorder, and how it may affect individual existences.
What is OCD?
OCD is a disorder characterised by frequent, unwelcome intrusive thoughts— the obsessions — and repeated actions to bring relief for the distress generated by these thoughts — the compulsions.
While previously considered a part of the anxiety spectrum of disorders, the fifth version of Diagnostic and Statistical Manual of Mental Disorders (DSM-5),published by the American Psychiatric Association, places Obsessive-Compulsive Disorder in its own category titled ‘Obsessive-Compulsive and Related Disorders,’along with a host of other conditions such as body dysmorphic disorder, trichotillomania (hair pulling disorder) and hoarding disorder.
OCD thoughts are ego-dystonic— not in line with a person’s self-perception or what they believe to be fundamental to their being. Individual sufferers may present different levels and types of obsessions and compulsions— some may seemingly suffer from obsessional thoughts alone, a form sometimes separately described known as ‘Pure O‘ by some researchers and writers.
Compulsions may run the gamut from the more well-known repeated cleaning and hand-washing rituals, to checking and mental compulsions. The eventual goal of these is to enable the sufferer to ‘set things right’ mentally— not performing the compulsion may feel like not preventing a terrible incident from occurring, or continuing to feel distress. OCD can centre around a host of subjects — contamination (both internal and external), checking, sexual subjects, religion or scrupulosity, harm, and symmetry. It may also alter throughout a patient’s life-time.
The jury is still out on the exact causes for OCD; theories centre around abnormalities in brain structure and functions, genetics, and the environment.
A common theme reported among OCD patients is feeling ashamed, guilty or embarrassed. In some cases, it can be debilitating to professional and personal life, with persons requiring hospitalisation. As with several mental illnesses, there is also a heightened risk for suicidal tendencies.
Obsessive thoughts and history
The term obsessive compulsive disorder is noted to have come into being in the 20th century, following on the heels of the term obsessive neurosis described by Sigmund Freud.
Obsessive thoughts and ideas themselves have been a part of historical description in many cultures, a paper notes. The word obsession itself, it highlights was derived from the Larin obsidere, which means being possessed, occupied or preoccupied by something.
Religious ideas as the focal point of obsession have been described in texts belonging to various cultures and religions; some examples cited include an Arabic manuscript entitled Sustenance of the Body and Soul written by Muslim scholar Abu Zayd al-Balkhi in the 9th century AD and an ascetic text entitled The Ladder of Divine Ascent, written by Saint John Climacus, abbot of St. Catherine Monastery, Sinai, in 7th century AD— which talks of blasphemous thoughts.
It was Sigmund Freud who came up with the hypothesis that there was a relation between what he described as obsessive-compulsive (OC) neurosis and religiosity, referring to it in multiple writings starting from 1907. He notably described religion as a universal obsessional ritual.
This hypothesis did not find favour among religious leaders or psychologists; indeed there was also the counter-argument that religion contributed to social connection and cohesion. And now, science and psychology have progressed through multiple evolutions; many of Mr. Freud’s theories were discarded as psychological and physiological investigations into mental illnesses progressed. Advancements included a growing understanding of the nature of thoughts, their pathological basis and clinical descriptions. Indeed in the 1980s, Rachman and Hodgson suggested that “
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