Are your fears and superstitious actions ordinary or a symptom of a medical disorder?
By Benjamin Deu, MA, LMHC, Seattle Christian Counseling
References “Psychoanalytic Diagnosis, Second Edition: Understanding Personality Structure in the Clinical Process” by Nancy McWilliams
Most people have a pretty terrible understanding of obsessive-compulsion. You say the acronym O.C.D. and people imagine someone frantically washing their hands of dirt that’s not there. It’s much more nuanced than that.
And some people demonstrate only one symptom, but many demonstrate both. Common examples of obsession are workaholics and people with “Type A” personalities. People who may be considered “stereotypical” compulsive sufferers (people who repeat actions a specific number of times, etc) are almost always aware their actions are irrational; they just can’t help doing them.
“[Obsessives] are self-reliant and conscientious… They look constantly for ways to help people listen better, resolve conflict, and find win-win opportunities. They buy self-improvement books… and they like to focus on continuous improvement at work because it fits in with their sense of moral improvement.” (Michael Maccoby)
While obsessive and compulsive behavior often work together, that’s not always the case. Some people who tend to be active thinkers– philosophy professors often fit this criteria– may be obsessive but not compulsive. Their behavior isn’t like typical daydreaming. They spend a lot of time considering contentious issues and pitting ideas against one another. Look at ancient philosophers. They spent all day, every day thinking about and commenting on near-unanswerable questions. Most people don’t do that.
However, unlike compulsive people, obsessive people feel no need to act upon what they’re thinking. (290) Their personality is characterized by persistent, unwanted thoughts. People with obsessive character structures have been described as obstinate, orderly, punctual, meticulous, frugal, inflexible, inclined to intellectualism and hair-splitting discussion, and persistent even in the face of insurmountable obstacles. Does any of this sound familiar? “They are generally dependable and reliable and have high standards and ethical values.” (291) They’re driven by an internal, often unattainable, standard of excellence.
Because they can’t live up to their own standards, people with obsession struggle with shame. They usually try to cope with it by boxing up their unwanted thoughts through rationalization, moralization, compartmentalization, and intellectualization. Because emotions make them feel inadequate, they often combat them with anger. They may displace anger from its original source and focus it on a “legitimate” target so they don’t have to feel ashamed about getting upset. (293) Because they fend off or cover up their emotions, people with obsession have trouble dealing with or expressing them in a healthy way.
But you can’t approach everything with cool logic. For those who have seen the new Star Trek movie, you’ll remember when Spock tries to be a good, emotionless, logical Vulcan and ignore how he feels after watching his mother die and his planet implode. He represses his feelings and, instead, focuses on his duties as acting captain. But he wouldn’t even be able to run a lemonade stand well after that kind of trauma. And the movie shows the consequences of him trying to.
I Just Can’t Decide
Not only do people with obsession struggle to express emotions, they also often struggle to make decisions. Their fear of failure paralyzes them between options. They vacillate between both, running through every possibility, and inevitably refusing to choose because they don’t want to incur the shame of making the wrong choice. McWilliams gave the example of a pregnant patient who lined up two obstetricians with opposing viewpoints and dragged out her decision-making for so long she eventually went into labor and had to be taken to the nearest hospital and attended by whichever resident was on duty.
People with compulsion also avoid the shame of making decisions, but do so by avoiding debating altogether and instead rush headlong into an option. One example may be hopping into bed with people any time a situation becomes sexually charged. Unlike people with obsessive behavior, strictly compulsive people do not mull things over incessantly. They prefer hands-on activities (such as craftwork) that don’t require them to think much. And what characterizes the actions as “compulsive” is not that they’re harmful or helpful, it’s that they’re irresistible. “Florence Nightingale was probably compulsively helpful; Jon Stewart may be compulsively funny. People rarely come to treatment for their compulsivity if it works on their behalf, but they do come with related problems.” (295)
However, compulsive people are not the only ones who perform rituals they know have no legitimate influence on the outcome of something. Just about everyone has been compulsive at some point– pre-game rituals for athletes, knocking wood when someone says something optimistic, or putting “just one more” quarter into a slot machine. (301) The basic motivation behind the behavior is to keep something bad from happening (“undoing”), such as a woman with a compulsive personality who feels compelled to tap her door handle three times before getting in the car to avoid a wreck.
Why Do You See Them Together?
While obsession and compulsion do not always occur together, it is common because the actions are often an attempt to deal with the thoughts. It’s a struggle for control. Sufferers try to “control” their unwanted thoughts by doing things that are supposed to prove them wrong and make them go away. You can see real-life examples of this on A&E’s “Obsessed” which is available instant on Netflix. It documents the struggles of people trying to get help for their OCD. One episode focuses on Karen who, after years in an abusive relationship, is terrified of death. The anxiety created by spending years afraid her partner might harm her have mutated into a constant, all-consuming terror. She’s convinced someone will jump out of the shadows and kill her, another driver will careen out of control and hit her car, or (because she lives in California) an earthquake will swallow her. She repeatedly checks closets in her apartment and under her bed, certain someone has gotten in since she last checked. She knows it’s extremely unlikely someone has snuck in, but her fears are too strong to be conquered with logic. She has no choice but to act.
Christian Counseling for Obsessive or Compulsive Behavior
People with OCD do not have to live this way. And please don’t despair; thinking your thought life is a sign of weak faith. Yes, scripture repeatedly exhorts believers not to worry and to trust the Lord, but people with OCD have a medical condition that goes beyond ordinary nerves. Still, God would not have inspired verses such as Matt. 6:27, 31 and Phil 4:6 if he wanted you to live in fear.
If any of this article sounds familiar, whether to you or someone you know, don’t struggle alone. Get in touch with a professional Christian counselor who can help. They assist people struggling with OCD by digging down to the root of what causes the overwhelming thoughts and helping sufferers learn to manage them. They’ll use research-based treatment and the hope of God’s healing power to lift the oppression of unwanted thoughts and compulsions to help you find freedom from fear. The Lord can give you rest. (Matt. 11:28)
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