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Traditionally, obsessive compulsive disorder has been seen as a neurotic disorder. As such, it has often been classified with anxiety states and phobias. It has also been referred to by other names such as obsessive-compulsive neurosis, obsessive-compulsive illness or simply as a compulsive disorder. Individuals suffering from this problem exhibit considerable distress and normally have a feeling of being helpless victims. As compared to psychotic illnesses, neurotic disorders are seen to be less disabling and handicapping. However, severe obsessive-compulsive disorder may lead to major incapacitation adversely affecting the life of the victims.
Generally speaking, neurotic disorders are relatively minor psychiatric illnesses. The patient is normally aware that he or she has a problem. He has a relatively intact contact with the outside world. In contrast, psychotic patients lack the insight that they are suffering from any problem and their contact with the outside world is normally impaired severely. Obsessive-compulsive disorder is classified as an anxiety disorder within the current psychiatric thinking. When an individual exhibits or complains about obsession or compulsion or both to the extent that his normal everyday functioning are interfered with, he may be described as suffering from obsessive-compulsion disorder. This is normally the basis upon which diagnosis is made.
American’s Psychiatric Association’s ‘Diagnostic and Statistical Manual’ and the World Health Organization’s ‘International Classification of Diseases, 10th revision recognize the core symptoms of Obsessive Compulsive Disorder to be obsession and/or compulsions. Obsessions are defined as those undesired images, ideas or impulses that enter an individual’s mind repeatedly (Fineberg et al 2001). Even though they are held to be initiated by the individual, they are normally distressing and egodystonic. Compulsions on the other hand are those recurring stereotyped behaviors or mental dispositions that are driven by rules and must be rigidly applied. They are not essentially enjoyable and do not lead to the completion of any useful task. They can either be linked to to obsessional thoughts or not.
As had been stated, an individual may be said to be suffering from obsessive-compulsive disorder when he either displays obsession or compulsion or even both. However, it is not the obsessions or the compulsions that really matters but how they influence the individual’s life. As such, obsession-compulsion disorder has to do with how much of an individual’s life is affected by the condition. Within the general population, obsession and compulsion are normal phenomena. There are individuals who experience obsession and compulsion but have never seen the point of seeking medical attention as they never see them as posing any serious threat to their well being. Numerous research have found that four fifth of the general population admit that they have one form of obsession or another (Silva et al 2004).
These obsessions are not different from those of patients who normally seek medication. The differences are however quantitative. There is less frequency of obsession in non-patients and the distress they suffer as a result of them is often less severe. A large percentage of individuals considered normal also suffer from compulsions. For instance, a man who goes to check if he has actually locked the door even after locking it barely five minutes ago. Such an instance will barely be described as a condition that needs help. There are also other individuals who have minor compulsive rituals such as arranging the desk in a given way. Research show that such compulsions are common in the general population (Vitkus, 1999).
There are questions as to whether an individual’s degree of distressed is being caused by obsessions and/ or compulsions or whether it is their functioning that is severely affected. One apparent fact is that if the problem is severe, then it will ultimately lead to much distress and subsequently interfere with their lives. An individual may not suffer from much distress by having an unwanted thought once in a while. However, if this were to happen more that ten times an hour, then it would undoubtedly lead to much distress. Quite a number of patients opt to go to the hospitals after the problem has progressed to high levels. As such, they only realize they have a problem after it dawns on them that they can no longer carry out normal functioning.
There is evidence that suggest that the symptoms of obsession-compulsive disorder can be reduced by specific pharmacologic agents in many patients. Evidence also indicate that that behavioral techniques of response prevention and techniques of exposure are effective. The integration of phamacotherapy and behavioral treatment increases the chances of the patient recovering even though complete cure often occurs infrequently. The majority of patients under the mentioned methods of treatments can lead relatively normal lives. In other words, they can be in a position to function normally within the family and the society and even work (Keith et al, 1996)
However, there is no evidence to suggest that traditional psychodynamic psychotherapy is effective in treating the condition. There is also no evidence to suggest that psychoanalysis is also effective in treating the condition. However, there are clinicians who employ psychotherapy frequently as an alternative to more specific treatment to help curb other problems that the patients may be having. Majority of patients are normally opposed to psychodynamic treatments and psychoanalysis especially after failing to note any improvement in their conditions after years of experience with them. They however come to realize that it actually has a place in the plan for treatment for those patients interested in exploring their thought patterns after successful medication.
Silva & Rachman (2004) Obsessive-compulsive Disorder: The Facts. Oxford University Press
Fineberg, Marazziti, Stein (2001) Obsessive Compulsive Disorder. Informa Health Care
Keith & Louis (1996) Value of Psychiatric Treatment: A Practical Guide. Diane Publishing Co.
Vitkus, J. (1999) Abnormal Psychology, Fifth Edition. Boston: McGraw Hill