Explanations For OCD

What is OCD?

OCD stands for obsessive compulsive disorder and is a mental illness in which sufferers are afflicted by irrational obsessions and their subsequent compulsions.

For example, a common obsession is being overly concerned with disease and a common compulsion for this obsession is washing your hands repeatedly (sometimes up to 100 times).

What is an Obsession?

An obsession is a thought, image or idea that recurs without a person's wanting it to. The range of obsessions by this definition is huge and includes less drastic obsessions like constantly worrying that you left your door unlocked when you go out to town, to much more serious ones like the recurring idea of violently murdering a loved one.

Obsessions often consume a person's mentality so that they are almost always thinking about some aspect of their obsession. Obsessions are therefore involuntary and sufferers find it difficult or impossible to distract themselves away from thinking about them.

A Common Compulsion: Hand washing.

One of the most common compulsions of OCD sufferers is overly frequent hand washing.
One of the most common compulsions of OCD sufferers is overly frequent hand washing. | Source

What is a Compulsion?

A compulsion is repetitive activity that a person with an obsession performs in order to ease the anxiety of that obsession. Sufferers often admit that these activities are irrational and can see how what they're doing doesn't make much sense, but will still perform the action in order to ease their anxiety regarding the obsession. This can lead to depression through the shame of doing these ritual activities.

There are 5 general categories for people with OCD:

  1. Washers: compulsively wash things due to a fear of pathogens.
  2. Checkers: obsessed with danger from particular objects and so compulsively check dangerous objects like ovens, doors etc.
  3. Doubters: fear that if things are not done perfectly, terrible consequences will arise.
  4. Counters and Arrangers: obsessed with systems, order and symmetry. They arrange things in (seemingly random) specific ways. They have superstitions about numbers and colours.
  5. Hoarders: collect things compulsively with the fear that something bad will happen if they throw something away.

It's all in the genes.
It's all in the genes. | Source

1. The Genetic Explanation of OCD

Many people see the causes of OCD as being purely to do with our genes. It has been proposed that the likelihood of having OCD is increased by having certain genes that make us more prone to the disease.

Evidence

  1. McKeon and Murray (1987) found that OCD sufferers were more likely to have a brother, sister, parent or child who suffers from an anxiety disorder than people who don't, suggesting that anxiety disorders and OCD have a genetic link.
  2. Pauls et Al. (1995) found that 10.9% of patients with OCD had a family member who also had OCD whilst a control group (of non-sufferers) had only a 1.9% chance of having a family member with the disease.

Conclusion
The cause of OCD can be attributed to something in our genes that make us more prone to developing it. A specific gene has seemingly not been identified as of yet.

It's All About the Serotonin

Meet serotonin.
Meet serotonin. | Source

The Biochemical Explanation of OCD

Other people see our biochemistry as the reason for the cause of OCD.

Evidence -

  • Serotonin
    Although most anxiety disorders can be treated with a whole variety of drugs, OCD has only been found to respond well to drugs that affect levels of the neurotransmitter serotonin.
  • Drugs like SSRI (anti-depressants) reduce the symptoms of OCD by increasing the levels of serotonin in the brain, giving strong evidence to the idea that OCD is caused from a lack of serotonin in the brain.

Criticisms/Concerns

  • Insel (1991) found that the use of SSRI's would only reduce the symptoms of OCD by around 50% and not fully treat the condition - therefore low serotonin levels cannot be the only cause of OCD.
  • Increasing serotonin levels may only be a treatment for OCD and not actually anything to do with the cause of it - painkillers get rid of the feeling of pain but the pain was not caused by a lack of painkillers.
  • It usually takes 4-12 weeks for a patient who takes SSRI treatment to report improvements but the SSRI drug itself actually increases serotonin levels within hours of taking it. This delay in improvement needs an explanation in order for serotonin theories to be validated.

It's About having the Right Conditions

Humans can be trained via the same behavioural techniques we use with dogs - conditioning.
Humans can be trained via the same behavioural techniques we use with dogs - conditioning. | Source

The Behaviourist Explanation of OCD

Operant Conditioning can also be used to explain the cause of OCD in the following way:

Step 1. An association is made between two things: coming into skin contact with someone else is associated with disease and illness.

Step 2. Another act is thought up of in order to combat the anxiety from the first two things associated: the worry of catching a disease can be relieved by washing our hands.

Step 3. The behaviour is reinforced: each time a person comes into skin contact with another person they wash their hands and relieve themselves of some anxiety, reinforcing the behaviour in the process.

Step 4. This creates a strong tendency: to wash hands every time anxious about poor hygiene and the effect becomes very difficult to extinguish or reverse back to neutral.

Evidence
1.
Operant conditioning states that if a person with an OCD were to be prevented from doing their relieving compulsion then anxiety would rise steeply but then fall rapidly if the patient is allowed to perform his normal ritual.

2. Rachman and Hodgson (1980) found that this was indeed the case, and if a compulsive act is prevented the patient suffers great levels of anxiety for a long period of time, although eventually this anxiety drops by itself.

Critcisms
Although the behaviourist approach gives a very strong explanation for how OCD is continued, it does not explain how it arises in the first place – surely we are all prone to this reinforcement cycle that would lead us to OCD compulsions?

It's All About Robots

The human brain can be said to be analogous with  a computer and its various functions: memory, encoding, recall etc.
The human brain can be said to be analogous with a computer and its various functions: memory, encoding, recall etc. | Source

The Cognitive Explanation of OCD

Since people with OCD initially have obsessive thoughts, there must be an internal cognitive cause. The cognitive explanation for OCD is that people with the disease have a hypervigilant attention system i.e. the system used to respond to environmental cues is overactive.

Evidence
The following two studies show that there is a link between OCD and memory (and so an internal cognitive process).

  1. Sher et al. (1989) found that people with OCD have poor memories for their own actions.
  2. Trivedi (1996) found that OCD sufferers had low confidence concerning their own memory competences and had impaired non-verbal memory.

But more conclusively:

  • Rachman (2004) had a patient who had a severe fear of blood. Her brain was hypervigilant when scanning the room (you could see her eyes move rapidly) for things that looked like blood, her brain would even often mistake dark red spots for blood and get a false sense of danger. As a result of her hypervigilance, she could also recall, in much greater detail than usual, events or images that she decided were relevant to blood.

A Summary of the Explanations of OCD

In short:

The biological approach to psychology offers:

  • Genetic Explanation - we have genes that make us more likely to acquire OCD
  • Biochemical Explanation - OCD results from below average levels of serotonin in the brain.

The behaviourist approach offers:

  • The behaviourist explanation - OCD is a result of the reinforcing nature of compulsions which eventually become very ingrained into a person's mentality.

The cognitive approach offers:

  • The cognitive explanation - suggests that OCD is a result of a hypervigilant 'awareness centre' or other part of the brain.

Make sure to cast your vote on which approach you think is most convincing in explaining OCD.

Have Your Say!

Which do you think is the most convincing explanation?

  • The Genetic Explanation
  • The Biochemical Explanation
  • The Behaviourist Explanation
  • The Cognitive Explanation
See results without voting

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Comments 11 comments

carlajbehr profile image

carlajbehr 3 years ago from NW PA

Thank you for your informative and well-written hub. The illustrations were very helpful to those who may not understand the disorder. A marvelous further read on OCD is the book, "The Imp of the Mind" by Lee Baer. It is a often misunderstood disorder and I applaud you for publishing a great article on it.


Philanthropy2012 profile image

Philanthropy2012 3 years ago from London Author

Thank you very much for your kind words and your reference to a book on the subject matter - have a great evening!

Philanthropy,


Borsia profile image

Borsia 3 years ago from Currently, Philippines

My ex developed OCD after we had been together for 12 years. Her compulsion is buying designer clothes at extremely low prices at places like Goodwill or other thrift stores. She would go so far as to buy clothes or shoes that aren't her size so that someone else won't get her great deal. After 15 years of trying to break her compulsion (27 years together) we parted ways.

I went to see a psychologist and I thought her answer was insightful.

She said that my ex didn't have a problem because what she as doing wasn't a problem in her mind.

I once needed to use her car and I removed 315 lbs of junk, mostly clothes.

The last time I saw her se was paying for 3 storage units, all filled to the top with clothes, shoes, bags and such.


Philanthropy2012 profile image

Philanthropy2012 3 years ago from London Author

Wow that is certainly a severe case of hoarding! And I can't help but disagree with the psychologist, if something is driving you to do something that affects your life (especially one that affects a relationship with the great Borsia!) then it definitely is a problem!

You can certainly see how the behavioural reinforcement of buying clothes for a cheap price would encourage similar behaviour - a very interesting case, thanks for your interesting comment as always!

Philanthropy,


Borsia profile image

Borsia 3 years ago from Currently, Philippines

What the psychologist said was that she didn't have a problem in her own mind. She saw nothing wrong with her hoarding and that until she recognized the problem she couldn't be treated or helped.

She told me that my only choices were to either accept my ex's or leave, I chose to leave.


Philanthropy2012 profile image

Philanthropy2012 3 years ago from London Author

Mmm, I trust you made the right choice - you're a very intelligent person after all. Though, of course, there is often very little room for intelligence in matters of love.

You're clearly okay to this day is what I can say!


Rosie writes profile image

Rosie writes 3 years ago from Virginia

This is an excellent article, covering all facets of this disorder. I have a close family member who is an extreme hoarder and it rules his life. He has a very high IQ and my conclusion based on his case, is that his disorder has a cognitive nature. Voted up and useful.


Borsia profile image

Borsia 3 years ago from Currently, Philippines

Ph; What she said is that it was my problem because my ex wasn't at all bothered by her OCD and was absolute in her denial that there was ever a problem. Until the person is willing to admit that they have a problem, and unless they see the problem, as far as they are concerned there is no problem.

Because I see and feel the problem it is "my problem" no matter as was the decision to separate. She told me that it is highly unlikely that my ex will ever see her behavior as problematic nor is she likely to try to change.

She agreed that my ex has a serious OCD problem but told me that I had to either live with it or get out. One can't force someone to see their problem if they can't or won't and you can't force someone to get treatment they don't want.


Philanthropy2012 profile image

Philanthropy2012 3 years ago from London Author

@Rosei Writes, Thanks for your say Rosie, and Borsia that all seems clear to me :) shame it didn't work out but I can only imagine you went on to do better things anyway ;)

Philanthropy


Borsia profile image

Borsia 3 years ago from Currently, Philippines

Thanks PH, yes I am in a good place with a good woman who makes me happy.

My advice to everyone from the experience is that if you find yourself in a similar situation don't waste time. If your partner refuses to recognize the problem and refuses to try to remedy it get out.

Don't waste 15 years like I did, time is something that we only get a little of and being happy and stress free is the most important thing there is.


Philanthropy2012 profile image

Philanthropy2012 3 years ago from London Author

Thanks Borsia and I think that's excellent advice - glad to hear you're in a healthy relationship! Enjoy it!

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