Compulsiveness relates to control

Last week I discussed obsessive-compulsive disorders with a focus on obsessions that have been labeled “being trapped by thoughts.” Compulsive behavior, on the other hand, relates to control. Ironically, the more compulsive the behavior, the more out of control the person feels.

Most of us are somewhat compulsive and if you know individuals who seem to be compulsively neat you usually find they have areas in their lives that give way to normal chaos. Perhaps it’s an overstuffed closet where things are simply thrown in a chaotic fashion or drawers in a chest so jammed to the brim they resemble a mini-flea market.

People who exhibit pathologically compulsive behaviors exhibit repetitive, purposeful and intentional behaviors that are performed in response to an obsession according to certain rules or in a stereotyped fashion. The behaviors developed because the individual is attempting to neutralize or prevent certain events or situations that have become dreaded or feared. Interestingly, the compulsive behavior is often not connected with the behavior it is designed to neutralize or prevent. If it does relate in some way, it is generally excessive and beyond the point of realistic need.

The most common compulsive behaviors usually involve a form of counting, checking or cleaning. They do not involve any sense of gratification – only a terrible sense of, “I’ve got to do it.” Compulsive behaviors frequently begin as simply anxiety reducers, a hobby or a pastime, then develop into a passion and finally a compulsion covering up the underlying problem.

Many health authorities feel compulsive personalities develop in an attempt to protect one’s self-esteem. In the fast-paced society we live in, feelings of helplessness frequently develop, leading to a feeling of needing to control one’s self and others. Repetitive hand washers or shower takers, stove checkers and individuals who feel the need to count to certain numbers are examples.

Famous individuals such as the writer Samuel Johnson and the other scientist Charles Darwin are said to have suffered from OCD. Some psycho-historians believe that women in Salem, Mass., were burned as witches because of ritualistic behavior resulting from OCD. A recent best seller, The boy Who Couldn’t Stop Watching, details OCD in contemporary fashion.

Current treatments for OCD range from medication to behavior modification or a combination of the two. Some specialists advocate a psychological technique known as “implosion” in which patients are forced to confront their fear head on.

One who fears contamination of germs might be given the task of wearing his clothes day after day without washing them or be denied a shower for up to a week. This massive exposure to the feared stimulus increases the fear for a while. But the fear soon subsides and researchers claim a success rate of 65 to 70 percent.

The OCD Foundation in New Haven, Conn., is a clearing house for information on this disorder. With professional help, OCD is treatable.

Copyright c 1990 Harold H. LeCrone, Jr., Ph.D.