Obsessive-Compulsive Disorder---The Enemy Within

It is easy to fight an external enemy but difficult to fight against one's own mind or slay the demons which it puts forth.This is exactly what happens when one is tormented by Obsessive Thoughts.They constitute one part of the Anxiety Disorder known as Obsessive-Compulsive Disorder. The other part is compulsive behavior,which may,or may not follow obsessive thoughts.

Obsessive Thoughts
These are persistently recurring inappropriate thoughts,images,impulses or memories which the person recognises as improper but cannot control.They could be violent,sexual,incestuous or blasphemous in nature.Naturally he is alarmed,shameful and miserable on account of these thoughts and begins to doubt his own worth.Actually they are manifestations of a deep seated anxiety but their occurrence worsens his condition by generating uneasiness,apprehension,fear,worry,guilt and more anxiety.
Compulsive Behavior
This refers to meaningless acts which the person indulges in, to counteract disturbing thoughts.They become a ritual for that person.They could take the shape of excessive washing or cleaning,counting,repeating routine functions like locking doors or checking them,stepping on cracks or alternate tiles on a pathway, or silently chanting a 'mantra', for example.
He convinces himself that if he carries out a certain ritual he will be fine or a tragedy will be averted.If circumstances prevent him from performing that ritual to his satisfaction he falls prey to more fears that something terrible is in store for him.Pressing anxiety goads him to carry out the compulsive acts.His tension decreases for the time being but it surfaces soon enough and again that ritual is carried out;so that it becomes a permanent fixture of his personality.
Gradually these activities take up more & more of his waking hours so that he can do scant justice to the roles assigned to him.He becomes a recluse so that he can perform those rituals--which could be overt as well as covert.A person who fears dirt could shut himself in a room,spend hours bathing, and have no connect with anyone else.In this way OCD  takes over his whole life.This has disastrous consequences not only for the patient, but also for his family.There is a lot of ridicule,blame,bitterness and acrimony.The relationships go haywire and the patient is generally ostracized.
Causes of OCD
These could be :--
Psychological-- Like a mental trauma or depression.
Physical--A grave disease.
Biological--Imbalance in brain chemicals.
Genetic Propensity
Environmental--Imbibing it from an afflicted family member.
Treatment
Curing OCD is not easy.The first reason is that patients try their utmost to hide their problem because of the shame or stigma involved.Even when it comes to light they may fight hard to justify their habits.The compulsive personality is usually a perfectionist,conscientious person of high intelligence.He is rigid,meticulous,inhibited,unemotional and preoccupied with existential or health issues.He is not amenable to others' advice and thinks he knows best.All this bars him from admitting that his behavior deviates from normal, and seeking help.By the time he finally goes to a mental health professional his symptoms have taken firm roots.This is a major obstacle on the road to recovery.

Talking of treatment,the earlier it starts the better is the prognosis.

In the initial stages self help guided by CBT is the best bet.

Medication alone is not of much use unless it is supplanted by counselling.

Meditation helps to soothe ruffled emotions.A sufferer told me that she had cured herself with the help of self help and meditation.

OCD causes a lot of tension not only in the mind,but also in the body--making him high-strung and nervy.Relaxation Techniques bring taut muscles back to normal. 

OCD is highly debilitating-take a healthy diet and proper sleep and rest.Pamper your body--it has been misused and overused long enough.

Family therapy is employed to awaken the family members to the patient's needs and explain them about his disease.

How it is done
Countering obsessive thoughts is easier than controlling compulsive behavior although both require enormous will power.Obsessive thoughts spew certain emotions which disturb the person because he does not approve of those thoughts.Yet they invade his mind--despite his disapproval.Naturally his peace of mind is ravaged.The stimulus and the thought create certain pathways in the brain's neurons which become entrenched with each repetition.In order to kill this connection he needs to create new pathways.Like if you have blasphemous thoughts when you see an idol,go and see it and then tell yourself 'this God is kind,he will take care of me';or any other phrase which clicks with you.The aim is to create new associations in your mind.As these associations take root the old ones will vanish-trust me.You have to give it time and patience.Don't avoid the stimulus;give it new associations. 

It is natural to feel worthless in the face of such thoughts.Suppose you have this blasphemous thought invading your mind.Tell yourself--This is not me.I am not like this.It is not from my volition and hence i am not responsible for it.It must be the work of some quirky cells in my brain.Shoo from here.

The first time you try to supplant an inappropriate thought with a permissible one pause to appraise your state of mind.Do you feel a tad better?The thought will return,but with lesser force each time after it has been snubbed.Your sense of well being after each such episode will be motivation enough for you to keep at it until you are totally free of this pest.

Whenever you are troubled by an obsessive thought shift your focus to something you enjoy doing.

Some people write down that thought and throw it in a dust bin.They say it works.

Observe your behavior to understand what starts you off on the obsessive path--beware of those triggers so that you can control your response.

Compulsive actions are harder to overcome.The best course of action here is exposure followed by response prevention.Opt for gradual exposure if you dread touching door handles at public places like Cameron Diaz and must wash your hands fifty times after that.Go to a public place,grasp the door handle with a tissue paper and throw it away.When you go home and feel like washing your hands tell yourself--i did not touch the handle,i do not need to wash my hands.There will be a lot of uneasiness in the beginning but control this urge if you really want to get better.After you have desisted from giving in to your urge for fifteen minutes introspect and you will feel that the anxiety is slightly less than it was before.

Once you have adapted to opening doors with a tissue do it with a kerchief this time and throw it for washing.The discomfort will be great but your determination every time has to be a notch higher than the compulsion.Gradually you can go on to opening doors with your hands.

There is no doubt that OCD is a terrible condition to be afflicted with but it need not rule out a productive life.If total remission does not happen,the symptoms can be reduced by 60-80 %--this probably refers to those  patients who refuse to go ahead with CBT.One out of four patients belong to this category.It is just a disease like any other and one should not be ashamed of it.Many celebrities suffer from this disorder but they are living a normal life.But it is best to contact a Mental Health Professional as soon as one feels that things have gone beyond his/her control.

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