Episode 117: Obsessive Compulsive Disorder – An Interview with Bobbi

What is it like to live with OCD?

Listen to this interview with Bobbi, a young woman who deals with Obsessive-Compulsive Disorder every day and you’ll get a much better understanding of what OCD is like. You have probably heard of the term OCD and perhaps you’ve seen shows like Monk or you’ve seen characters on TV and in the movies who show symptoms of obsessional thoughts or compulsive behaviors and perhaps you’ve wondered yourself about some of your own thoughts and behaviors. Learn more about OCD in this episode of The Psych Files.


Resources on Obsessive Compulsive Disorder

  • Definition of OCD (Wikipedia): Obsessive–compulsive disorder (OCD) is a mental disorder characterized by intrusive thoughts that produce anxiety, by repetitive behaviors aimed at reducing anxiety, or by combinations of such thoughts (obsessions) and behaviors (compulsions). The symptoms of this anxiety disorder range from repetitive hand-washing and extensive hoarding to preoccupation with sexual, religious, or aggressive impulses. These symptoms can be alienating and time-consuming, and often cause severe emotional and economic loss. The acts of those who have OCD may appear paranoid and come across to others as psychotic. However, except in some severe cases, OCD sufferers generally recognize their thoughts and subsequent actions as irrational, and they may become further distressed by this realization.

    OCD is the fourth most common mental disorder and is diagnosed nearly as often as asthma and diabetes mellitus. In the United States, one in 50 adults has OCD. The phrase "obsessive–compulsive" has become part of the English lexicon, and is often used in an informal or caricatured manner to describe someone who is meticulous, perfectionistic, absorbed in a cause, or otherwise fixated on something or someone. Although these signs may be present in OCD, a person who exhibits them does not necessarily have OCD, and may instead have obsessive–compulsive personality disorder (OCPD) or some other condition, such as an autism spectrum disorder. The symptoms of OCD can range from difficulty with odd numbers to nervous habits such as opening a door and closing it a certain number of times before one leaves it either open or shut.

  • Exposure and response prevention (ERP) is a treatment method available from behavioral psychologists and cognitive-behavioral therapists for a variety of anxiety disorders, especially Obsessive Compulsive Disorder. It is an example of an Exposure Therapy.

    The method is predicated on the idea that a therapeutic effect is achieved as subjects confront their fears and discontinue their escape response. An example would be of a person who repeatedly checks light switches to make sure they’re turned off. They would carry out a program of exposure to their feared stimulus (leaving lights switched on) while refusing to engage in any safety behaviors. It differs from Exposure Therapy for phobia in that the resolution to refrain from the avoidance response is to be maintained at all times and not just during specific practice sessions. Thus, not only does the subject experience habituation to the feared stimulus, they also practice a fear-incompatible behavioral response to the stimulus. While this type of therapy typically causes some short-term anxiety, this facilitates long-term reduction in obsessive and compulsive symptoms.


    Resources on OCD

    Neurological Connections between OCD and the Left VentroLateral PreFrontal Cortex

    • Sex Differences in Neural Responses to Disgusting Visual Stimuli: Implications for Disgust-Related Psychiatric Disorders,
      Xavier Caseras, David Mataix-Cols, Suk Kyoon An, Natalia S. Lawrence, Anne Speckens, Vincent Giampietro, Michael J. Brammer, Mary L. Phillips
      Biological Psychiatry – 1 September 2007 (Vol. 62, Issue 5, Pages 464-471
    • Mataix-Cols D, An SK, Lawrence NS, Caseras X, Speckens A, Giampietro V,
      Brammer MJ, Phillips ML (2008) Individual differences in disgust sensitivity modulate neural responses to aversive/disgusting stimuli. Eur Journal of Neuroscience 27:3050–3058.

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Comments

  1. Bebe says

    Andrea Fay Friedman has a sense of humor about her disability.

    There are other mental disorders that are displayed in the media. A big one is the US of Tara, a woman and her family learning to cope with DID with humor and hope.

    And on the other hand, there are plenty of disorders that are not in mainstream media, so it could be argued that OCD gets more attention and people are more likely to be more empathetic to persons with that particular disorder.

  2. Fabrice says

    Michael,

    I listen to your podcast (quite religiously, I might add), and today, I was listening to this episode on a stereo headset. As it turns out, when you cut over to your phone conversation with Bobbi, my brain went crazy listening to each side on the conversation in a different ear. In fact, it felt so distracting for the conversation to be switching back and forth from left to right that I had a difficult time paying attention.

    Perhaps another interesting brain artifact to research…

    –F.

  3. Michael says

    Fabrice: you must have been one of the first people to download the episode. Another listener got in touch with me about how distracting it was to have me in one ear and Bobbi in another. I usually create mono audio files, but I forgot to at first with this one. I corrected. However, I like your idea about a possible episode here….:)

  4. Bonnie says

    I have been thoroughly enjoying your podcast–thank you for putting it together! Just a comment about something Bobbi said about TV shows not making fun other syndromes, such as autism, like they do OCD. It brought to mind the regular character on the comedy Boston Legal. He was a lawyer with Aspergers syndrome. He was portrayed as very quirky, sensitive and very effective as a lawyer. All wrapped in the comedic sense of the program. I must admit it raised my awareness of Aspergers and that people with it can be very functional. Since then, I have been drawn to read books by Temple Grandin.

  5. says

    You two wonder why OCD is okay to make fun of compared to other disorders, but I doubt the existence of the phenomenon you’re trying to explain.

    You seem to take characters straightening pictures on the wall as making fun of OCD, but you don’t count mild versions of other disorders as evidence of making fun of those disorders.

    For example, (in the media) if someone is sad all the time, would you count that as making fun of depression?

    If someone keeps taking things the wrong way, does that count as making fun of paranoia?

    If someone is always happy, is that making fun of mania?

    If they eat a lot, does that mean they’re making fun of an eating disorder?

    My point is that if you look at most character traits in fiction, the extreme of that trait is probably a disorder in the DSM.

    So when you say there is a bias regarding OCD, make sure you’re being fair.

    Could it be that your interviewee was suffering from the availability heuristic?

  6. Michael says

    Interesting comment Jim. The difference I think between the examples you provide and what we’re thinking about is that the name of the disorder, OCD, is often mentioned directly. For example, in the (now quite old) example from Saturday Night Live, the skits were identified as “The Obsessive Compulsive Fishman”, “The Obsessive Compulsive Chef”, etc. I doubt there are are comedy skits in which the main character is clearly identified as suffering from depression or anorexia.

  7. Svitlana says

    Hi, I wanted to share what I experienced with my disorder.
    I had tough upbringing: constant grounding for any little thing, step dad yelled at me for everything. I think that contributed to what I experienced.
    I started feeling that I had to touch the door nob certain way, and if I wouldn’t do it- something bad would happen, like I would get yelled at really bad was the most common thought. So I kept touching door nobs like 20 times until it felt right. Also, I kept turning circles. I felt that if I turn around, then I have to turn back to ‘unturn’, or something bad would happen. Those thought were hunting me for about a year and each time I felt there was something wrong with. I didn’t share with my family because I thought they wouldn’t believe me. I knew something was really really wrong, so I decided to stop on my own. It was very hard because each time I didn’t comply with the feeling I had- I had this feeling of horror coming over me. However I tried to deny that feeling, and finally I concurred it after couple of months. It comes back sometimes with various thoughts, but I deny it at the same time I feel it.
    That’s a brief description there.
    Now that I moved to USA and I read so many things about OCD, I finally realised- I had it! And I am so glad that I was able to overcome it without even knowing what it was.

  8. Michael says

    Svitlana: fascinating story. I appreciate you sharing it. I’m sorry that you’re upbringing was so tough. The way you describe how your OCD developed is both sad and fascinating. I’m glad to hear that you overcame it. Very inspiring. Again, thank you for sharing your experience.

  9. says

    Thank you and it’s OK, I know I cannot change my family and learned to live with that. I’m very glad that something pushed me to change, otherwise who knows where would I be today.

  10. Rachael says

    I think I probably have OCD. I do like things to be ordered and I would prefer things to be in even numbers, but I don’t care to the extent that it gets in the way of my functioning, unless I let it. I actually tend to avoid cleaning because to some extent I am ok so long as I’m not thinking about it. But when I’m at a close proximity to dust and mess I don’t dare breath. Also when I do start cleaning and organizing I tend to get carried away, and then having things ordered comes into play. Last time I dusted the mantelpiece I had to remove all the ornaments from it obviously, but when I was putting everything back I realized there was one centre item (vase of flowers), but 5 other things to go on, so one side would be uneven. It really got to me, so I moved the extra item to another room.
    My problem is mostly germs, I wash my hands at least 10-20 times a day, I think this may be routed from when I was a child, I used to suck my thumb and my mother, in an attempt to discourage me would warn me of all the germs on my hands. And to this day I am very cautious about touching dirty things with my fingers, especially my left thumb (the one I used to suck) even though I stopped years ago. What do you think, could that be a possibility?
    Because I wash my hands so much I have grown very particular of the soap I use. I only like to use the same kind of soap. When I know I will be staying over night somewhere I will take a spare bar of soap for me to use. I don’t really know the logic behind this, I have just always used this particular brand of soap and like the smell of it. When I use other soaps, which I do occasionally I just don’t feel as comfortable. What do you think about that?
    I think the main problem with my “OCD” (inverted commas because I haven’t actually been diagnosed with it) is a fear of meat, raw and cooked. It just seems so disgusting to me, imagining putting the flesh of a dead animal in my mouth, imagining it’s human, and raw. The last time I touched raw meat was a couple years ago now, my father had to literally make me pick up a piece of raw bacon. I did so, but cried because it felt so wrong, and I washed my hands for 10 minutes. But I don’t know what has caused this fear. I am just very cautious of the germs one can get from raw meat, and used to be worried whether or not the meat I was eating was cooked properly or not.
    Would you say I had OCD? It doesn’t get in the way of my life particularly, except the meat issue which frustrates my parents endlessly. They see my reluctance to do the washing up (in that disgusting water) without gloves or touch the inside of the warm, moist dishwasher full of germs and food waste without washing my hands after as being overly precious, and get quite angry. I’m interested in what you think, the way I have explained it here, reading over it, makes it seem far worse than it actually is.
    Thank you for the interesting article.

  11. Haydn says

    Great interview. First, I wanted to tell you that I could not bring up the podcast about response prevention as the link went to the behaviortherapist site but I could not find the podcast you referenced. Second, to Jim Davies’ post: Jim, you raise an interesting point but you’ve overlooking the fact that people are laughing (or finding humorous) the Monk-type characters on TV whereas they are not finding humor in the depressed, etc people on TV. I think the reason it seems ok to make fun of OCD in the media is that the people just seem a little odd and seem to function well (like Monk); people don’t see the distress that OCD sufferers feel.

  12. Dennis says

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