Tabitha thought that once she got married her almost irrational fears would subside and she would no longer do some of her “odd” behaviors. Much to her discouragement, however, they did not. Instead, she noticed that she was only getting worse. She was so afraid of losing her husband that she would take three, hour-long showers a day, apply and reapply her make-up several times, and refused to let him see her naked. Fearful of her new house burning down, she checked and rechecked every single door, window, outlet, and appliance three times before leaving the house. Terrified that her husband would think of her as a slob, she cleaned the house daily with hot water and bleach at night instead of going to bed at a reasonable time.
All of these rituals were doing considerable damage to their relationship. At first, her husband tried to soothe her fears, but when nothing changed his concern turned to anger. This intensified Tabitha’s reaction and resulted in even more obsessive and compulsive behavior. Unsure of how to get out of the situation, Tabitha reached out for help from a therapist.
Obsessive-compulsive disorder (OCD) is characterized by the presence of obsessive and/or compulsive behavior, thoughts, and/or actions that take a considerable amount of time, are ritualistic, interfere with normal functioning, and/or cause relationship distress. It is a coping mechanism that has gone awry that naturally kicks in to soothe and diminish excessive fear or worry. While Tabitha knew her behaviors were “odd”, she was unaware of the underlying disorder. This checklist was used to determine the other areas of her life were OCD was present.
- Are you obsessively afraid of and therefore avoid being contaminated by bodily secretions, dirt, germs, sticky things, animals, and/or sick people?
- Do you obsessively and/or compulsively hoard, save or collect items worrying that they will be thrown away, destroyed or needed in the future?
- Do you obsessively and/or compulsively put things in order, have a need for symmetry, align items, arrange items, and/or organize regularly?
- Do you have obsessive religious fears or worries of saying the wrong thing, being punished, and/or dwell on religious images?
- Do you obsessively fear that you have an illness, are getting sick, and/or worry about your appearance in front of others?
- Do you have aggressive obsessions of harming yourself and/or others either impulsively or accidentally?
- Do you have obsessive unwanted sexual thoughts of performing acts, molestations, and/or violent behaviors?
- Are you obsessive and/or compulsive about specific numbers, have superstitious fears, and/or superstitious beliefs that prevent you from doing or saying things?
- Are you obsessive about volume, loud noises, textures on skin and in food, tags on clothing, strong smells, chewing loudly, and/or bright lights?
- Do you compulsively eat a certain way or order, touching others, rubbing items, and/or pick things up from the floor?
- Do you obsessively worry about losing things, making mistakes, saying the wrong thing, and/or remembering insignificant things?
- Do you compulsively hand wash, shower several times a day or for long periods of time, have ritualistic grooming habits, and/or wear gloves to avoid contamination?
- Do you compulsively clean the house, do laundry, use excessive bleach, have cleaning rituals, and/or avoid objects or places that could be contaminated?
- Do you compulsively check things over and over such as doors, windows, appliances, blood pressure, appearance and/or vehicle?
- Are you compulsively checking that you did not harm others, yourself, make a mistake, and/or do something that causes harm in the future?
- Do you compulsively read and reread things and/or write and rewrite things fearing that you didn’t understand and/or miscommunicated?
- Do you compulsively go in and out of doorways several times, repeat routine activities, do activities a certain number of times, and/or count insignificant items?
- Do you obsessively need the reassurance of others after it has already been given and/or compulsively confess to things already confessed?
- Do you have ritualistic routines for getting dressed and/or leaving the house that requires an excessive amount of time?
- Do you compulsively pick at your skin, pull hair from any part of your body, and/or pick at blemishes, scratches, or bites?
Tabitha and her therapist utilized the list to identify which behaviors were most troubling. Then, one behavior at a time was tackled along with the underlying fear until Tabitha’s OCD was hardly noticeable. During the process, Tabitha learned new, less time consuming, coping mechanisms and improved her relationship with her husband.