NAMI Mercer County

Families Meeting the Challenge of Mental Illness

OCD

The Object of All Desires

By

Bella Santulli, NAMI Intern

The definition of obsession is: an idea or thought that continually preoccupies or intrudes on a person’s mind. In some lights, obsession can be beautiful–a devotion to a routine, a person, an object of desire, and others–the mere actions of making you whole again are also tearing you apart. To have someone kneel to your every want and emotional satisfaction while their gloom spreads over their heart. To twist the doorknob three times before opening, so the doors in your mind will not collapse around you. But how far does that insatiable light extend? What are the connotations attached to the extent of our illness that consumes our souls? 

In the realm of psychopathology, or mental health disorders, obsessions frequently look like fears about becoming contaminated by things, aggressive impulses that one fears acting on, thoughts about keeping things in order, doubts about whether something happened or is true, or sudden and intrusive sexual thoughts. As you might imagine, given the content of these thoughts, they are frequently experienced as upsetting, especially by people with diagnoses of obsessive-compulsive disorder or an anxiety disorder. 

While people with certain mental health disorders experience more frequent, long-lasting, and distressing obsessive thoughts than people without mental health disorders do, most people–as many as 90% of adults in the general population–report that they have had obsessive thoughts at least once. These obsessive thoughts tend to be similar in their nature to the obsessive thoughts of people with OCD or anxiety, but just not as intense and difficult to learn to cope with. For this reason, psychologists think of obsessive thoughts as existing on a spectrum from relatively harmless to extremely distressing or impairing.  

I find the stigma surrounding obsessions an interesting study due to the particular standards we uphold as a society. Why is it that obsessing over your craft or work in attaining greed, fame, or pleasure is deemed acceptable, but it is “weird” or you are framed as a “geek” if you have obsessions about special interests or comic books? I have always been seen as a nerd/geek since my younger years. Whether through my obsessions with the Marvel Universe, the genre of horror, or my love of reading, there have always been those comments that have spread into my life. I believe it is essential to ask ourselves why we always look to judge others when we should be looking at ourselves. Because in the end, we never know what someone else is going through or what thoughts corrupt our minds. 

Compulsions are repeated behaviors aimed at dealing with obsessive or intrusive thoughts. Obsessions differ from compulsions, but they often go hand in hand–some obsessions may even cause people to develop compulsions. However, compulsions can take on obsessive or extreme intensity. For example, here are some common examples of compulsions:

  • Reiterating the notion that you cannot hurt anyone—by removing all knives from your kitchen
  • Making sure appliances are turned off multiple times
  • Checking if doors and windows are locked various times before leaving home
  • Checking your body to make sure you don’t have physical symptoms
  • Reviewing or going over events or conversations that have happened

Sometimes, people develop compulsions because they feel they can keep negative things from happening by taking these compulsive actions.

The National Library of Medicine proposes that obsessions are caused by catastrophic misinterpretations of the significance of one’s thoughts (images, impulses). These obsessions will persist as long as these misinterpretations continue and diminish when the misinterpretations are weakened. On the contrary, weakening or eliminating these misinterpretations is expected to lead to a reduction in the intensity and frequency of obsessions. I recommend taking a look at a fellow NAMI Intern’s blog, Angelina Villalva, specifically the Observing OCD Post that outlines obsession in OCD and how to cope with intrusive thoughts. Additionally, multiple toolkits outline resources, help, and coping strategies for living with OCD/intrusive thoughts.  

Book of the Week: The Secret History by Donna Tartt 

The Secret History by Donna Tartt explores the psychological unraveling of a close-knit group of classics students at an elite college, driven by intellectual elitism and a growing obsession with beauty, power, and control. As their fixation deepens, moral boundaries dissolve, illustrating how obsession can distort reality and lead to destructive consequences—echoing the these themes of psychological fixation. “I am nothing in my soul if not obsessive.”

Resources

  • NAMI Mercer Helpline Phone Number: 609-799-8994 x17
  • NAMI Mercer Helpline Email: helpline@namimercer.org
  • https://iocdf.org/ocd-finding-help/other-resources/

References 

  • VanDerBill, Brittany. “The Psychology behind Obsessions.” Psych Central, 8 Apr. 2022, psychcentral.com/ocd/psychology-of-obsessions.
  • Rachman S. A cognitive theory of obsessions. Behav Res Ther. 1997 Sep;35(9):793-802. doi: 10.1016/s0005-7967(97)00040-5. PMID: 9299799.

Observing OCD

By

Angelina Villalva, NAMI Intern

Have you ever entered a space and felt something was off? Perhaps it’s a slightly off-centered painting in a living room. Or some books haphazardly placed on a shelf without order. Sometimes it’s not even a space, but a thing, looking in the mirror and seeing that you have one hoodie string that is ever so-slightly longer than the other. 

While small, almost imperceptible to anyone else, to you these details scream out that something is markedly incorrect, and needs to be fixed immediately. To other people, these things may not matter, but for someone who strives for absolute perfection, it is imperative to have things the right way. As my mother liked to tell me growing up, “a place for everything and everything in its place.” 

Some may call it obnoxious, while others may call it obsessive. Most will say it is a clear sign of OCD, a Type A person who needs to have their whole life orderly and refined, all the way down to the laces on their shoes. 

The truth is, OCD is not as simple as needing to organize and keep things clean. It is distressing, and takes control over people’s lives in a way that causes them extreme anxiety and in some cases, physical harm. 

While exaggerated, it is true to some extent that individuals diagnosed with OCD may have issues with cleanliness and organization. However, this is not just due to a simple need to have things perfectionistic, but from feelings and thoughts referred to as obsessions and compulsions (which of course come together to an Obsessive Compulsive Disorder). 

Obsessions consist of lasting and unwanted thoughts that keep recurring. These unwanted thoughts are similar to intrusive thoughts, often relating to fears and horrible imaginations that can completely take over your headspace. Some common themes of obsessions include: 

  • Fear of contamination or dirt
  • Having a hard time dealing with uncertainty
  • Needing things to be orderly or balanced
  • aggressive/horrific thoughts about harming yourself/others
  • Unwanted thoughts including aggression, sexual, or religious subjects

These obsessions then lead into compulsions, repetitive behaviors that are meant to reduce anxiety related to the obsessions. Compulsions are sometimes referred to as rituals, as individuals who have these compulsions often partake in them at specific times and must be completed in a specific way. While meant to reduce the anxiety of obsessions, compulsions often result in no pleasure and provide limited relief from the obsessions. Common themes of compulsions may be: 

  • Washing and cleaning
  • Checking
  • Counting
  • Ordering
  • Following strict routine
  • Demanding reassurance

Compared to obsessions, compulsions can result in physical harm. For example, obsessions revolving around cleanliness and contamination of germs can result in having compulsions of hand-washing until skin becomes raw. If an individual with OCD does not complete these compulsions, they will fear something bad may happen to themselves or the people around them (friends/family). 

Currently 1-2% of people in the US are affected by OCD. Anyone can be affected, although the average age onset is around 19 years. Causes of OCD can occur due to childhood trauma, genetics (family heredity), brain changes (damage to frontal cortex and subcortical structures) and PANDAS syndrome. 

Treatments for OCD include several types of therapy and medication. The three types of therapy treatments include cognitive behavioral therapy (CBT), exposure and response prevention (ERP), and acceptance and commitment therapy (ACT).

  • CBT → helps to examine and understand thoughts/emotions
  • ERP → helps to expose individuals to feared situations 
  • ACT → helps to learn to accept obsessive thoughts as just thoughts and take power away from them

Current medication for OCD are SSRIs (selective serotonin reuptake inhibitors). There are several types of SSRIs, and it is important to consult with a doctor to determine which one may be the right treatment for you or someone you know. When taking medication for OCD, it often takes 6-12 weeks to see improvement, so it’s important to allow for time for the medication to work. 

OCD is a lifelong condition. Similar to most other mental health conditions, ensuring that you take care of both your physical health and mental health will allow for the most influential positive change. Participation and support of others in treatment such as friends and family may improve the likelihood of treatment success. 

For anyone who is living with OCD, always remember that your struggles are not small. Your fears are not silly.  It is okay to receive help and support. And you will be able to take back control of your life. QOTD by Ralph Waldo Emerson, “Do the thing you fear and the death of fear is certain.” 

Resources:

Citations:Â