What exactly is OCD?
Simply stated, there are five criteria that need to be met for a diagnosis of OCD. There are, (1), recurring obsessions (persistent thoughts, impulses, images, etc.) that are experienced as disturbing, even dreadful, that the individual may be able to relieve by performing compulsions (repetitive behaviors such as hand-washing, ordering objects, checking to see that doors are locked and/or appliances turned off, or mental acts such as praying, counting, repeating words silently). (2), The individual realizes (or has insight into) the fact that these obsessions or compulsions are unreasonable. (3), these obsessions and compulsions are distressing to the individual, are time-consuming, and disrupt the individual’s normal daily functioning. (4), while there are other disorders that are similar that the individual may also be suffering with, the obsessions and compulsions are not exclusively related to these disorders. And (5), these symptoms are not the result of alcohol, drugs, or a general medical condition.
OCD has been referred to in some clinical circles as the “doubt disorder,” meaning the sufferer will repeatedly and intensely doubt whether or not a certain task has been completed (e.g., did I lock the front door? Am I accidentally going to hit and kill someone with this bat? Did I wash my hands hard enough to get all the germs off?) And OCD sufferers have no room for ambiguity; they HAVE to be certain that the threat of danger has been eliminated. Interestingly, this doubt is usually targeted to just a few areas, albeit quite intensely, while the sufferer could not care less about other ambiguities. For instance, one OCD sufferer may have the irrational fear that his children may die in a flood if he doesn’t check repeatedly to make sure he turned off a garden hose; another OCD sufferer has to scrub her hands literally raw every waking hour. The hose-checker has zero concern about touching something contaminated and the hand washer would think that checking a garden hose would be absolutely crazy. The checking of the garden hose and the scrubbing of the hands are examples of the seven overriding manifestations that OCD tends to take: checking, fear of contamination, counting and repeating, hoarding, magical thinking, scrupulosity, and symmetry.
Treatment for OCD (as well as depression, anxiety, and many other mental health maladies) is about intentional changes to neuropathways that have become problematic. For example, a neuropathway that is helpful is me thinking about picking up a cup and then I'm able to pick up that cup successfully through all the messages sent through my nervous system. When those messages get compromised, I will have problems, and new neuropathways need to be developed. This is how successful treatment for OCD (and the other stated maladies) works, at the neurological level:
Teenagers typically receive their driver's training in cars with automatic transmissions. These young drivers learn to signal appropriately, look in the rear-view and side mirrors, and occasionally put the car in reverse. They suffer the angst-ridden proposition of parallel parking or the dreaded three-point turn. They show acceptable mastery of these skills to a state-trooper and get their state-approved licenses. Driving becomes effortless and joyful for them. However, if you put these kids behind the wheel of an automobile with a manual transmission, or stick shift, they would have no idea what to do.
Operating manual transmission can be awkward and aggravating. It is time-consuming and frustrating. However, after practice, the shifting of the gears demands less concentration and effort. Eventually the shifting of the gears becomes second nature. I am a veteran stick-shift operator. I now am able to operate manual transmission with the same amount of comfort and lack of attention as I get with an automatic transmission. I feel that operating with the stick is even preferable to driving an automatic. It allows the driver a greater feeling of control. It offers “oneness” with the car and the road.
There is a parallel between mastering a stick shift and mastering mental health. Successful mastery of both involves: Identifying and learning from someone who knows what to do. Giving up the old, familiar ways and embracing the change. Letting the mind do its unconscious work of learning and improving by trial and error. Persevering and persisting through failure after failure. Enjoying the little successes as they come. And concentrating attention on what was happening and being done when things were going right.
The clutch and the gearshift need to be identified and mastered when driving a standard transmission. The OCD sufferer needs to identify thoughts, triggers, obsessions and compulsions. They must grab hold of them. They must manipulate them through trial and error with perseverance to be able to break through and thrive.