The chain of misfortune, or about obsessions and compulsions in the neurosis of obsessions

In the past, chains of happiness were much more spectacular than they are today: you would copy a letter with carbon paper, make ten children you know miserable with a copy, and then get twenty postcards from all over the country. But most importantly, it avoided the series of misfortunes mentioned in the spine-chilling appendix at the end of the letter: for example, Juan, a XNUMX-year-old from Puerto Rico, did not forward the chain of happiness and after a week the alligator bit off his two legs and his arm. Polish children could not afford it!

Such a seemingly harmless market with fate has its own dangerous type: obsessive-compulsive disorder.

I think, so I suffer

OCD is classified as an anxiety disorder, which means that it is based on anxiety and the goal is to get rid of it. The patient performs a series of unnecessary and abstract activities, often forming whole rituals that are to disenchant a bad thought (obsession) or prevent something bad from happening: illness, accident, death, separation. It works in a similar way to the aforementioned chain of happiness, the patient thinks that if he does not climb onto a broken paving slab, wash his hands eight times and finger all the books on the third shelf from the bottom of the bookshelf every hour, his family will be healthy and will not happen to her. misfortune.

As the name suggests, it is made up of obsessions and compulsions, not necessarily in perfect proportions. There are cases of OCD with a predominance of obsessive thoughts, and there are cases where intrusive behavior predominates.

Obsession is an intrusive and undesirable thought, impulse, image or concept that arises independently of our will and cannot be replaced by another thought or displaced from our mind. It is believed that obsessions most often relate to a few specific topics, boiled down to the following slogans: hygiene, religion, sex, violence; eg a patient endlessly analyzes situations in which, in his opinion, he could become infected with a serious disease, e.g. HIV. Even if he hasn’t had risky sex, he thinks the germs might be on the doorknob of the grocery store. During prayer, he cannot concentrate, because he imagines, for example, saints having sex or, worse, himself in such a situation. This awakens him a great deal of guilt and a desire to redeem himself. While he is waiting for the train, the thought of shoving someone under an oncoming locomotive appears in his head. The mother can feel the impulse to push the stroller with the baby off the steps of the overpass.

These obsessive, the more unpleasant the life, the less manageable thoughts make a person doubt his mental sanity, fear that he has gone mad, has been possessed or poses a real threat to other people, although it has not yet happened that he is sick with He realized these impulses. The consequence of the emergence of obsessions are compulsions, i.e. behaviors that lead to a specific compensation for bad thoughts or to eliminate the danger.

Just in case

Compulsion is an activity that must be done, otherwise the anxiety felt by the obsessive person reaches an unbearable level. The mechanism is simple: the sick person is afraid that something bad will happen if they do not do something. The risk is high, so he does what his mind tells him. The repertoire of compulsions is almost limitless, but the most common ones include obsessive hand washing, sometimes even skin tearing, manic cleaning and cleaning, counting your steps in your mind, passing cars or touching specific objects in specific sequences, arranging objects in a certain order, walking the same side of the sidewalk, avoiding cracked paving stones or going home repeatedly to make sure the gas in the stove is turned off and the front door is locked. Importantly, the patient is fully aware of the fact that the compulsion to perform these activities is imposed on himself (this awareness distinguishes obsessions and compulsions from psychotic delusions) and that it is completely irrational. However, the risk of deviating from the ritual is high. If there is an opportunity to prevent a tragedy, it must be seized. And the more a person is afraid, the more frequently he performs his rituals and continues to enrich them.

Does it seem to make no sense? And remember how many times we have littered our friends’ e-mail inbox with a silly letter, because failure to send it to fifteen people within a quarter of an hour was supposed to bring us misfortune? Bet that we thought then that what was harmful to us, just in case? How many times did we catch a button when we saw a chimney sweep? Just in case, of course. How many times have we kicked someone’s butt before the exam? Luckily. And for all … Magical and unjustified rituals have always accompanied people, in obsessive-compulsive disorder they simply grow to a size that prevents normal life. That is why therapy is so important.

Doctor Alicja Rutkowska-Suchorska, a specialist psychiatrist and certified psychotherapist, defines the therapy of obsessive compulsive disorder as a two-pronged, combining psychotherapy with pharmacology. The most commonly used is CBT, i.e. cognitive-behavioral therapy, the purpose of which is to identify and then extinguish erroneous beliefs and cause-effect relationships (it is not washing your hands twenty times an hour that nothing wrong has happened) and reducing the number and severity of intrusive behavior or rituals.

It is estimated that about 4% of the population suffer from obsessive-compulsive disorder (no data is available on how many film heroes suffered from this ailment, however, some consolation for those struggling with obsessive compulsions may be the fact that neither Jack Nicholson nor Mark Kondrat were avoided by them. ). In our increasingly computerized, logical, and almost completely understood world, this disorder is a negative triumph of magical thinking and the eternal ritualization of life. However, as long as, just in case, we attach new links to the chains of (un) happiness, the belief that compulsion has the power of an amulet will remain in us.

Text: Julia Wolin

Doctor Alicja Rutkowska-Suchorska, a specialist psychiatrist and certified psychotherapist, specializes in the treatment of this disease. We invite you to read the interview on obsessive compulsive disorder.

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