New Zealand Listener – August 03, 2019

40 LISTENER AUGUST 3 2019

THIS LIFE

G
ET

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IM

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here are a lot of things that obsessive-

compulsive disorder (OCD) is not. Having

a tidy desk or liking a clean kitchen is not

OCD in and of itself. Dressing up in your

Brad Thorn-autographed Crusaders jersey to watch

the game every weekend or collecting teaspoons

isn’t necessarily OCD, either. Wanting the same

hairstyle as the celebrity you follow on Twitter is

not automatically an obsessive compulsion. And

putting “I’m so OCD right now” on a meme is

almost certainly not OCD.

Suggesting this is the case, without good reason,

will probably frustrate people who either experience

clinical OCD or care about someone who does.

There are also a variety of

ways that OCD manifests. These

include, but aren’t limited to:

checking things repeatedly,

ordering things, worrying about

and avoiding contamination,

hoarding and having intrusive

thoughts – usually about

checking, ordering, contamination

or hoarding. Again, though, even

extreme hoarding isn’t necessarily

OCD – something I point out to

my family when they suggest I

need to clear out the garage.

Importantly – and this is one of the things that

differentiates OCD from a preference for tidiness

or fondness for back issues of the Listener – is the

distress factor. If OCD involves repeatedly checking

the lock on the door, it’s not because you really

can’t remember if it’s locked, but because you feel

compelled to do so and the thought of not doing it

is distressing – impending-doom distressing.

In the most recent edition of the Diagnostic

and Statistical Manual of Psychological Disorders,

obsessive-compulsive disorders are a category in

their own right and include more than “just” the

OCD I’ve described, but also disorders such as

trichotillomania (in which someone can’t resist

Talk ing c ur e

Obsessive-compulsive

disorder causes enormous

distress to sufferers, but

it is treatable.

the urge to pull out their hair) and

body dysmorphia (pathological and

extreme belief that there’s something

wrong with how a part of the body

looks). Importantly, these things

have been separated from “straight”

anxiety disorders (though they also

involve anxiety) and trauma-related

conditions such as post-traumatic

stress disorder (PTSD).

W

hy does OCD happen?

As usual, it’s complicated.

There appears to be a

genetic component

• it can run in
  families – meaning
  that a person
  with a relative
  experiencing OCD
  is about four times
  more likely to also
  experience it. As
  with many things,
  a genetic propensity
  isn’t enough to
  make OCD a dead
  cert among family
  members of a person diagnosed
  with the disorder, but it does mean
  that environmental factors such as
  stress can trigger it in those with a
  predisposition.
  Something that I’ve come across
  as a potentially important part of
  the equation, and that appears to be
  associated with severity of OCD, is
  “thought-action fusion”. Someone
  who exhibits this cognitive distortion
  experiences thinking about an action
  as equivalent to carrying it out. Have
  you ever had the feeling, in a lecture

or public event, that you could just

stand up and scream at the top of

your lungs? Well, thought-action

fusion means that just having that

thought is as bad as actually doing it.

Not only is this distressing, but

it means that many people with

OCD have the strong feeling that

thinking about something bad can

make it more likely to happen. An

overreaction to this, because it’s so

distressing, might be to suppress the

thought. This ultimately backfires

because deliberately not thinking

about something makes it more likely

to come back and intrude on your

thoughts.

Thankfully, this presents an

opportunity for intervention. Talk

therapies might invite a person with

OCD to reality-test this idea: was

there actually a volcanic eruption

when you thought about there being

a volcanic eruption? This makes it

sound easier than it is, but the thing

to remember is that OCD is treatable.

If this sounds like you, or someone

you care about, good places to look

for information and support include

your GP (for a referral) and the

Ministry of Health and Mental Health

Foundation websites. l

by Marc Wilson

PSYCHOLOGY

Have you ever had the

feeling, in a lecture

or public event, that

you could just stand

up and scream at the

top of your lungs?