by Sylvain Comeau

Obsessions, compulsions — it seems as though everyone has one in our neurotic age, but Gail Steketee, professor and chair of the clinical practice department at Boston University’s School of Social Work, cleared up myths about obsessive-compulsive disorder (OCD) in the annual Low-Beer Memorial Lecture.

OCD could happen to almost anyone, but as Steketee made clear, understanding its origins could help people prevent obsessions from taking root.

“OCD is a serious problem affecting approximately one in every 40 people. It is found in nearly every country and every culture, with only minor variations.”

The disorder usually begins with what are called “intrusive thoughts,” disturbing but essentially harmless ideas and mental images that ordinary people experience but usually dismiss. Some of the more exotic include thoughts about violent acts during sex, an impulse to jump off a train platform, or imagining yourself robbing a bank.

“These thoughts and images occur in approximately 90 per cent of the population. Even ordinary people have weird thoughts from time to time, and it is more unusual not to have these ideas than to have them. Perhaps our brains our hardwired to think up these ideas as part of its job, to monitor our behaviour, and to keep us in line so we behave appropriately in various situations and roles.”

The unpleasant emotional reaction to intrusive thoughts could then be a reminder of what we’re not supposed to do. But why doesn’t everyone develop OCD?

“The main difference seems to be that people with OCD experience more discomfort when these intrusive thoughts occur and they have a harder time dismissing them. They are more upset and can’t get rid of these thoughts.”

Compulsions often follow as a strategy for coping with obsessions. “Compulsions are behaviours designed to neutralize or prevent discomfort or prevent some dreaded event. But the compulsion itself can be a cause of distress and disruption in the person’s daily life.”

Most people prevent that vicious circle from getting started because they never give much credence to intrusive thoughts, dismissing them as mental flotsam. “Most people just say ‘Where did that come from?’ and forget about it. But people who develop OCD tend to think that if they have bad thoughts, that makes them a bad person.”

Genetic predisposition, environmental factors such as a strict (especially religious) upbringing, and cultural influences such as information from the workplace, the media and religious teachings could lead someone to take intrusive thoughts too seriously. Endless handwashing, one of the most common compulsions, could be prompted by public health campaigns. Steketee displayed a poster that detailed 10 different directions for washing your hands; it was spotted in the bathroom of an OCD clinic.

Steketee also pointed out that trying too hard to get rid of intrusive thoughts may only reinforce them. Most people don’t worry about the party-crashers in their minds, which makes it easier to forget about them. Steketee proposed a simple exercise to illustrate.

“What if I asked you to visualize a picture of a polar bear? That’s easy enough. Then, what if I asked you not to visualize that polar bear once for 10 minutes. The harder you try, the more likely you are to think about it. But if you don’t try at all, you’ll soon forget about it and start thinking about something else.”

Steketee’s lecture, given on September 27, was this year’s John Hans Low-Beer Memorial Lecture. It was presented by AMI-Quebec (Alliance for the Mentally Ill) and the Psychology Department.