Carolyn is a 36 year old homemaker. She spends most of her time at home cleaning, arranging, rearranging and washing hands repeatedly. She repeatedly arranges her bed to be neat. She folds her clothes so that they are perfectly symmetric. Shoes in the rack should be in line always. Her husband and kids are irritated by her excess cleanliness and there are constant conflicts between them. Carolyn becomes sad and distressed quite often whenever her husband asks her to stop cleaning and arranging.
These are typically referred to as obsessions and compulsions. Obsession is a repeated intrusive thought and compulsion is repeated act based on the obsession.
Carolyn has obsessions for cleanliness and symmetry and compulsions for washing. It is good to be clean and tidy but anything in excess is problematic. When in excess, it is termed as obsessive compulsive disorder or OCD in short. It has become quite a teenage trend in the recent past to use OCD as an adjective (like “I am so OCD about eating out today“, etc.). OCD is a serious disorder for many people out there and they need help. Please remember that, use of the term in inappropriate situations belittles the seriousness of the original problem.
A few tips to reduce the obsessions and compulsions and restore peace at Carolyn’s house.
Carolyn should be taught how to relax
It could be a simple breathing exercise, meditation, having her favorite drink etc. She should relax in order to de-stress herself regularly. She should exercise and eat healthy food.
Carolyn should use the 15-20 minute rule
If Carolyn gets an urge to clean her stove again which is already clean, she should postpone the cleaning for 15 or 20 minutes later. She should be able to control her thoughts of cleaning the stove for 15 minutes at least. Eventually, when she gets used to this behavior, she can increase the time period of postponing, for example after a few days she can comfortably postpone it to the next day. This would reduce her distress.
Carolyn should try to find out any other stressors troubling her
For example, she should openly talk to her spouse about their ongoing relationship regarding anything that is affecting her. Talking helps a lot.
Carolyn’s FAMILY SHOULD HELP HER
Carolyn’s spouse should realize that this behavior is not pleasant for Carolyn and she needs help in coming out of it instead of shouting at her and getting irritated. He or other family members should not scold or criticize her.
Carolyn should try to find out the reason of her cleaning
Carolyn has a fear of contamination, she dreads contamination. She should start imagining that she is not cleaning the house for a day and experience the anxiety. When the anxiety has slowly come down, realize that it is just your imaginary anxiety and fear, but factually, no contamination really occurred.
Carolyn should see the broader aspects of life
She should realize that she has not met her friends since a long time and arrange to meet them. She could also start with few of her hobbies yet again.
Carolyn should check whether she is sleeping well or not
Sometimes depressive symptoms like sadness, loss of interest and sleep disturbances can accompany obsessions and compulsions. It becomes important to identify them and treat them.
Carolyn can tell to herself, “My hands are not dirty, I have obsession that they are dirty”. She can relabel her feelings.
Carolyn can distract or refocus her attention on something else.
She can make a list of distraction things like watering plants, talking to the neighbor, etc and do those things whenever her urge to clean increases.
If symptoms are not under control, Carolyn should consult a mental health professional
- Based on severity, usually medications are prescribed to let go off Carolyn’s symptoms and reduce her anxiety.
- Exposure response prevention and cognitive therapy are the psychotherapies used by professionals to reduce the symptoms.