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 Universitys 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
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 were not supposed to do. But why doesnt
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 cant get rid of these
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 persons 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 dont 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? Thats
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 dont try at all, youll soon forget about
it and start thinking about something else.
Steketees lecture, given on September 27, was this years John
Hans Low-Beer Memorial Lecture. It was presented by AMI-Quebec (Alliance
for the Mentally Ill) and the Psychology Department.