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Calgary Health Region / Dr. Gene Flessati / Breakfast Televion Interviews

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PSYCHOLOGY DEPARTMENT (Adult)

 

Dr. Gene Flessati

Dr. Gene Flessati is a Clinical Psychologist who works in an outpatient mentalhealth clinic in the Calgary Health Region. His clinical interests include anxiety and mood disorders, health psychology, relationship issues, psychological resilience, and the promotion of psychological health and well-being.

At Issue: Obsessive Compulsive Disorder

 

Q: What is Obsessive Compulsive Disorder?

A: Individuals with Obsessive Compulsive Disorder (OCD) experience obsessions and/or rituals – usually both. Obsessions are thoughts, images or impulses that are highly disturbing to the person. For example, a mom may have images of stabbing her newborn, or a man may have thoughts that he got AIDS from a doorknob. People with OCD experience these obsessions repeatedly – sometimes hundreds of times each day. Obsessions are not simply worries. The person with obsessions is haunted by these thoughts, they occur over and over, and he fights to resist them. The more upset a person is by certain thoughts and the more he tries to get them out of his mind, the stronger they become. Usually, people with OCD also engage in rituals to cope with these obsessive thoughts.

Rituals are thoughts or behaviours that follow obsessions, with the goal of undoing the obsession or helping the person to feel safe. So, the mom who experiences images of stabbing her newborn may lock up all the knives, repeatedly check her baby for stab wounds, and repeatedly say to herself, “I love my baby. I’d never hurt him.” The man who is concerned that he will get AIDS from a doorknob may wear gloves, avoid touching doorknobs or shaking hands with others, and will repeatedly disinfect his hands with bleach.

OCD symptoms can vary from mild to very severe.

Q: How common is OCD?

A: Although we used to think that OCD was rare, we now know that it is a relatively common problem. About 2 per cent of individuals will develop OCD at one point in their life. People usually develop OCD in late adolescence or their early 20s. However, it can also develop in childhood. Although twice as many boys as girls develop the disorder, more women than men develop OCD. Without treatment, OCD can become a chronic problem. Fortunately, effective treatments are available.

Q: Why do people develop OCD?

A: We have some ideas about how OCD develops, but do not yet have all the answers. Biological and psychological factors are both important. In general, individuals who are prone to anxiety are more likely to develop OCD. As well, having certain experiences in childhood seems to make it more likely that OCD will develop. For example, individuals with OCD are more likely to have rigid, perfectionistic standards for themselves than individuals without OCD. These standards possibly developed as a result of pressure from parents or teachers to be perfect and well behaved at all times.

Individuals with OCD are fearful of their obsessive thoughts. The person tries to cope with these thoughts by engaging in rituals in order to try and feel safe and more in control. These rituals reduce anxiety in the short term, as they give the person the illusion of safety and control, but they also maintain the fear, as the person becomes more and more convinced that doing the rituals is the only way that he can feel safe.

Q: Are there effective treatments for OCD?

A: There are two effective treatments for OCD. Medications that increase the amount of serotonin (a brain chemical), are somewhat effective in reducing OCD symptoms. These medications help many people with OCD. Although these medications often decrease the person’s symptoms, they do not usually eliminate the problem. The most effective treatment for many people who have OCD is a specific type of psychological treatment called Exposure and Response Prevention. This treatment involves two key components:

* Exposure: The person repeatedly confronts whatever he is fearful of. So, for example, a man with obsessions about germs would touch doorknobs and other objects that feel contaminated.

* Response prevention: After the person confronts what he is frightened of, he remains exposed to the feared object without doing his rituals. So, for example, the man with fears about germs would not wash his hands for several hours after he touched doorknobs and other objects that he thought were contaminated.

Over time, the person discovers that the object or situation is not dangerous, and that his anxiety will decrease even if he does not engage in his rituals. As he realizes that he is not in danger, his obsessions and urges to do his rituals will decrease.

Many studies indicate that most individuals who stick with this type of treatment are much improved.

This treatment is time consuming and stressful, but it works!

Q: What should you do if you think you have OCD?

A: It is important to discuss your concerns with your family physician and consider seeing a clinical psychologist who has experience treating OCD. Although individuals with severe OCD usually need professional guidance from a psychologist or other mental health professional familiar with OCD, individuals with mild OCD may be able to set up their own treatment plan. Stop Obsessing is an excellent self-help book that describes a self-directed treatment plan for OCD. It is written by Edna Foa and Reid Wilson (2001). Dr. Wilson also has a comprehensive website (www.anxieties.com) that has a great deal of information on OCD and other anxiety problems. Both the Canadian Psychological Association and the American Psychological Association are excellent sources of information on OCD and many other psychological issues.

Useful Links:

Prepared by: Department of Psychology, Rehabilitation & Specialized Clinical Services, Southeast Community Portfolio, Calgary Health Region
 

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