A man who suffered from fears of contamination from AIDS felt a drop in his eye as he looked up while passing under a building. He became obsessed that the drop was actually from someone spitting out of a window who had AIDS. He felt compelled to go to every office on the 16 floors of that side of the building and ask if anyone had spit out the window.[pic]
This man, diagnosed as having obsessive-compulsive disorder, shows the driven quality of the thoughts and rituals seen in people with this condition. While the specific features of the condition vary from case to case, they have in common recurrent obsessions or compulsions that are severe enough to be time consuming (that is, they take more than one hour a day) or cause marked distress or significant impairment. Obsessive people are unable to get an idea out of their minds (for example, they are preoccupied by sexual, aggressive, or religious thoughts); compulsive people feel compelled to perform a particular act or series of acts over and over again (repetitive hand washing or stepping on cracks in the sidewalk, for example).
Obsessions usually involve doubt, hesitation, fear of contamination, or fear of one’s own aggression. The most common forms of compulsive behavior are counting, ordering, checking, touching, and washing. A few victims of obsessive-compulsive disorder have purely mental rituals; for example, to ward off the obsessional thought or impulse they might recite a series of magic words or numbers. About 25 percent of people with an obsessive-compulsive disorder have intrusive thoughts but do not act on them. The rest are both obsessive and compulsive; compulsive behavior without obsessional thoughts is rare (Skodol, 1989).
Compulsive rituals may become elaborate patterns of behavior that include many activities. For example, a man requires that his furniture never be left an inch out of place, and feels a need to dress and undress, brush his teeth, and use the... [continues]
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