Chapter 13.

Introduction

Student Video Activities for Abnormal Psychology
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The Impact of Obsessions and Compulsions

Author: Ronald J. Comer, Princeton University

Photo Credit: Fancy Collection/SuperStock

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13.1 The Impact of Obsessions and Compulsions

This video focuses on the numerous and intense symptoms of a woman with obsessive-compulsive disorder. Her obsessive fears and compulsive behaviors are tied in particular to her young son and to her concerns for his safety from contamination. The video shows the woman carrying out extreme, ritualized behavior. She discusses the negative impact her compulsions have had on her life and her ability to parent her child.

The Impact of Obsessions and Compulsions

Her obsessions center around her baby son, Jake.

When I come to stop signs, I have to look at him while I'm stationary, for fear that someone's going to come up and take him-- you know, open the door. I have to start the car before I take my eyes off him. Ah! When I'm moving, I figure nobody can get to him.

Stephanie's protective maternal instincts have gone into overdrive. It's a form of OCD that sometimes afflicts new mothers.

Do you like it? Don't like it. Don't like it. Just doesn't like. OK.

OK. To set this trap, I'm going to use a video cassette, which I shall lean against the door. Then I'm going to take this pen and line it up along the green rectangle. And I'm going to point this napkin so the edge, if you follow it with your eye, matches up with the corner of my wall.

Stephanie fears that someone might kidnap Jake, even when she's at home with the doors locked and the alarm on.

I'm not sure if somebody might have gotten in the house while I wasn't here, so I'll set a trap. I will set things up at a certain angle, that if they're moved, I'll know it. It's so pathetic.

Go for a walk.

Stephanie knows her thoughts are irrational, but they're beyond her control. Protecting Jake from every conceivable danger makes life hard.

OK. Get your stick.

When I can't take my eyes of Jake, it's literal. I stare at him. If I glance away, even like this, it's a chance for something to happen. He has to be in front of me, so that I can see him the entire time, so that if somebody walks by, I know that they aren't going to bump him, spit on him, grab him, touch him, inject him with something, whatever, take him.

Like many people with obsessive-compulsive disorder, Stephanie also has a fear of contamination. She avoids litter or spots on the pavement in case the wheels of the buggy touch something deadly. Passersby pose a double threat. They could kidnap Jake or contaminate him.

Just need to make sure nobody was near him. Cigarette. If I looked away, I'll have to turn my stroller around, look behind me to see if anybody was in the area. But then I worry that maybe I took my eyes off him while I was checking to see if anybody was behind us. So I'll turn back around, and then I'll turn back around the other way. And I'll just spin around in circles until I feel relatively sure that it's OK.

Sometimes it's hard for me to go for a walk, because I can never get home, because I'm constantly having to turn around and go the other way because there's somebody coming. If somebody's walking towards me, then I get frantic.

No, that's-- please keep him on a leash.

And it's a fear of never knowing if he was contaminated. It's like I'll never know if that person who walked by touched him. And that will eat away at me.

Before Jake was born, Stephanie was diagnosed as having OCD. Her obsessional fear of contamination leads to compulsive rituals, which she uses to manage her anxiety.

When I am going to interact with Jake in some way, I have to be certain my hands have been just cleaned. And they have to be scoured clean.

The urge to perform these compulsions is so strong that in this half hour, Stephanie washed her hands 22 times.

It's torturous. I wash my hands continuously. I know. I try to stop myself. But it's almost like my feet begin moving for the sink. And I'm trying to tell myself not to do it, but I'm desperate, and I have to.

And the washing ritual is complex and has to be performed absolutely correctly three times.

I have to lather up my hands completely, drawing my fingers through my other hand. The water has to be as hot as it can be. I start with my forefinger and scrape under my left thumb. And then I switch to my thumbnail and go to my forefinger, the middle finger, ring finger, and then I get to the pinkie. And I switch to this hand. I go back and forth several times.

And that just gets the first layer of contamination off. Because I still feel, since I scraped under my nails, that it's somewhere on me. So I have to get another pump and do it all over again. And this is really the one that I feel cleans me, because now my nails are clean and now I'm just going to scrub my hands.

And then I have to do a finishing rinse. This is the part that's hard, because the water's really hot, burning. But sometimes I keep my hands under there just to feel better. And then I get my towel. And I will be careful not to touch the garbage when I put this in. So I have to-- ow! And it touched my hand, so I'm back.

But it dries your hands out, and your hands crack. And then it gets to the point where I can't close them more than this, because the knuckles will crack open and bleed.

It's always been there. It's been noticeable, but it's been manageable. We could joke about it. We could kid her about it. We could do things to set her off. But it wasn't issue until Jake was born, our son Jake. Since then, it's been uncontrollable.

Stephanie is desperate to start treatment, as she realizes the real danger to her son comes from her obsessions.

I'm extremely worried about the effect this is having on Jake. I'm so desperate to take good care of him, and the OCD has a negative effect on him. On his dresser is the soap pump. He puts his hand at it and rubs his hands together. He was doing that at one year old. And that struck me, that I need to do something. Because no one-year-old should be pretending to wash. That was the first thing he pretended to do, was wash his hands.

13.2 Check Your Understanding

Question 13.1

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Correct!
Incorrect.

Question 13.2

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Correct!
Incorrect.

Question 13.3

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Correct!
Incorrect.

Question 13.4

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Correct!
Incorrect.

13.3 Activity Completed!

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