Obsessive compulsive disorder, although it is a disease that has existed since the history of humanity, it first started to be mentioned in the mid-1800s. Obsessive-compulsive disorder is a mental illness that occurs as a result of intrusive, inappropriate, obsessive thoughts that cause significant anxiety and distress, and the behaviors that develop with these thoughts to a level that affects daily life, even vital activities and routines. Obsession, which means obsessive thoughts and impulses, and compulsion behaviors, which mean repetitive behaviors or mental acts that the person cannot stop from doing, form the disease.
Although OCD usually starts in adolescence and between the ages of 20-30, it can be seen at any age, including preschool children. Although it starts at an earlier age in men, it is more common in women in general.
The Turkish word for obsession is "obsession". An obsession is a thought, impulse or image (phantasy, imagination, mental picture) alien to the self that is recurrent, persistent, causing anxiety (distress, anxiety) and comes undesirably. Words such as doubt, apprehension, doubt are used in daily language for obsession. “What if I left the door open?”, “I wonder if my hand is infected with a germ?” etc. Thoughts are examples of obsessions. Obsessions occur in three basic forms:
1- Obsessive thought (obsessive thoughts that are stubbornly disturbing the person)
2- Obsessive image (visual or vivid experiences that disturb the person)
3- Obsessive impulse (urges that force the person to undesirable behavior)
Contagion obsession: It is the most common type of obsession in various studies. Its incidence in OCD patients is 45-55%. This obsession is caused by factors such as dirt, germs and dust of the person's body and clothes; It is the obsessions about contagion with chemicals, detergents, poisons, urine, stool and other bodily secretions and the behaviors they do to relieve the distress caused by these obsessions. People with contagion obsessions may have compulsive behaviors such as excessive cleaning and avoiding environments that may contaminate germs. They may also exhibit avoidance behaviors such as a. People with this type of obsession experience intense feelings of shame and disgust along with anxiety.
Doubtful obsession: It is the most common type of obsession after contamination. People with this obsession are unsure of what they are doing. Since objects such as gas stove, door, lock may be left open, the person should not use an iron, etc. They suspect that the plugs of electrical appliances may be stuck in the socket (Doubtful obsession) and need to check again and again to be sure (Control compulsion) and keeps their minds busy. In such obsessions, there is a concern that the person or others will be harmed by the act or negligence. The emotion experienced is more of fault and guilt. Controlling these obsessions is followed by compulsions.
Aggression obsession: Contains thoughts about harming one's self or others. Its prevalence among obsessions is 20%. People with this type of obsession ask, “Will I commit suicide?”, “What if I stab my child?” etc. they have such thoughts. To combat these obsessions, compulsive behaviors such as staying away from objects that can be used as an attack tool such as knives and scissors, staying away from high places, and staying away from loved ones can be displayed.
Sexual obsessions: Okb Its prevalence is 26%. These are obsessions with a sexual content towards himself or others, in a way that he does not fit himself, his age, and his place in society. They mostly occur when the person has sexual relations with their same sex or with their children. Such obsessions are accompanied by compulsions to control and wash. Feelings such as shame, guilt, and sin can be experienced intensely.
Religious obsession: Having thoughts that are perceived as unacceptable against religious and moral values (God, prophet, etc.). A person cannot stop himself from thinking obsessive thoughts with religious content in a way that is completely opposite to his beliefs and views and in a way that causes intense distress.
The prevalence may vary according to the culture. Its prevalence among OCD patients in Turkey varies between 42%.
Symmetry order obsession: Everything is regular, eatable in place etc. considerations of necessity. Correcting these obsessions, putting them in order, etc. may be accompanied by compulsive behaviors. The need for symmetry and orderliness prevails throughout one's entire life. Morning preparation of people with this type of obsession can take a very long time.
Somatic obsession: It occurs in the form of overthinking with life-threatening diseases such as cancer. Fear of being sick is an intense emotion. People may be overly concerned with various methods (having an examination, controlling blood pressure, etc.) to protect themselves from diseases.
Obsessions of hoarding and hiding: obsessions related to keeping things that have no material or moral value for oneself.
Other obsessions: Need to know and remember, fear of saying certain things, fear of not saying the right things, fear of losing something, lucky and unlucky numbers, colors with special meaning, etc. There are also obsessions.
The Turkish equivalent of compulsion is “compulsion”. Compulsiveness is repetitive behaviors or mental acts that are performed to combat the disturbances of obsessions. Controlling the door to an overwhelming degree against the possibility of leaving it open and washing hands against the possibility of contamination are compulsive behaviors developed against obsessive thoughts.
The main purpose of compulsions is to reduce the distress caused by obsessions. However, although they provide temporary relief at first, they are the biggest factor in the continuation of OCD in the long run. Some of the compulsions are visible behaviors (such as washing hands) while others are mental behaviors (such as counting).
Compulsions to touch
From time to time, some OCD patients feel the need to touch an item they care about before performing certain behaviors.
Counting compulsions
Some OCD patients act in counting behavior if they do any daily activity without counting to a certain number, thinking that it will not be a coincidence.
Compulsions to collect and store: S� It is the most common type of compulsion. The person can accumulate / hide even the items that will not be necessary with the thought of "may be necessary in the future." Some obsessions do not create compulsions. The obsessive compulsive disorder patient knows that his thoughts and behaviors are absurd and unnecessary; but he can't stop himself from doing them.
When you read the examples above, you should think of “being clean, organized and organized; What's the harm in checking doors and windows for security purposes, should these be considered a disease?" thoughts can pass. Of course, we do these behaviors in our daily lives and should not be counted as a disease.
These thoughts are not in the dimension of illness unless they affect daily routines. For it to be a disease, it must be at a level that limits and impairs daily functions. For example, if a housewife is clean and tidy, it is not naturally considered a disease, but if she is cleaning almost every day, every hour of the day and cannot spare enough time for her children to raise them in a healthy way, it should be considered a disease. For security reasons, it may not be strange for a person to be sure that the windows of the car are closed and the doors are locked, but it is a situation that should be considered when checking the windows and doors by repeatedly leaving the house or turning back on the road.
If we look at the treatment method, as Holistic Psychotherapy, we do not look at OCD from a single dimension. For OCD to occur in a person, many events from the past to the present have to accumulate and progress. The person's family relationships, relationships with friends and school life can be the time period when these events occur. These factors should be evaluated separately and a process is run to completely eliminate them by using different intervention techniques. Applications made only to eliminate the symptoms bring a superficial result and show itself with a different obsession. These repetitive processes tire the person a lot and cause them to lose hope for a complete recovery. Therefore, with superficial, non-functional therapies moment should not be lost. What is healthier is to look at the symptom holistically.
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