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The ‘Overactive Conscience’ Part 2 – Nature of the Problem

The people in the situations in the previous article are all in distress. In addition, at first glance, it appears that they are all trying to solve a spiritual problem. While it is true that these people are experiencing emotional and spiritual distress, this distress is a symptom of the problem and not the problem itself. These people are dealing with a mental disorder called Obsessive Compulsive Disorder (OCD).

At times, some of these symptoms may be caused by clinical depression. In addition, it is quite common for depression to occur along with OCD. Less commonly, these symptoms occur in individuals diagnosed with schizophrenia and related psychotic disorders.

Please remember that all of us may temporarily struggle with a spiritual issue and that going through such a struggle does not necessarily mean that a mental disorder is present. However, if you review the cases described above, you will find that the problems described were not simply “minor” or “passing” struggles. Rather, the issues described above caused intense distress and the individuals were unable to resolve the problems even though they all tried to find a way to deal with their anxiety.

OCD is a mental disorder that is characterized by obsessions and compulsions. The clinical term, obsession, means something completely different than the popular use of the term. The popular use of the word obsession means that someone really, really likes something, whereas the clinical use of the word obsession means almost the exact opposite.

Definition of Obsessions:

Recurrent and persistent thoughts, impulses, or images that are experienced as intrusive and inappropriate and that cause significant anxiety or distress. By definition obsessions are:

  • Intrusive – obsessions can occur at any time – usually at the exact time that the person does not want to be having those kinds of thoughts.
  • Recurrent/persistent – they keep coming back even when the person doesn’t want them
  • Distressing– obsessions are NOT pleasant and the person is distressed by them

Obsessions can take the form of:

  • Thoughts/Ideas – e.g., “I think I might have committed the unpardonable sin.”
  • Images – e.g., intrusive pictures of violent, sexual or blasphemous things.
  • Impulses – e.g., the feeling that one might say a cuss word out loud in church.

It is important to note that everyone has occasional obsessions. Yes, everyone. Research studies have repeatedly shown that occasional obsessions are part of the human experience and are “normal.” Research has shown that “normal” obsessions and “clinical” obsessions are the same in terms of content (e.g., fearing that a loved one will be in an accident, harming someone, etc.). However, when people without OCD experience an obsession, they are able to dismiss it and go on.

Conversely, individuals with OCD find obsessions difficult to dismiss, have significantly more obsessions, experience high levels of distress over the obsessions, spend much more time trying to sort out the significance of the obsessions, and engage in compulsive behaviors or mental acts to neutralize the feared outcome associated with the obsessions. The thoughts, impulses, or images are not simply excessive worries about real life problems. For example, a person in a difficult financial situation who is worrying about how she/he will pay for car repairs is an example of a real life problem and is not an obsession. The person attempts to ignore or suppress the thoughts, impulses, or images or to neutralize them with some other thought or action. The person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind (not imposed from without like when a schizophrenic hears voices).

Definition of Compulsions:

“Repetitive behaviors (e.g. hand washing, ordering, checking) or mental acts (e.g. praying, counting, repeating words silently) that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly.” “The behaviors/mental acts” are aimed at preventing or reducing distress, or preventing some dreaded event or situation. However, these behaviors/mental acts are either not connected in a realistic way with what they are designed to neutralize/prevent or are clearly excessive.”

Summary Point:

Simply put, obsessions are thoughts, images, or impulses that create anxiety/distress and compulsions are behaviors or mental acts that are done to prevent or reduce anxiety/distress.


BIBLIOGRAPHY
  1. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (Text Revision, 4th ed.). Washington, DC: Author.

To view the complete PDF of Understanding the ‘Overactive Conscience’, click here.