Hockenbury Discovering Psychology 5th txtbk

544 CHAPTER 13 Psychological DisorderscompulsionsRepetitive behaviors or mental acts that areperformed to prevent or reduce anxiety.A compulsion is a repetitive behavior that a person feels driven to perform. Typically,compulsions are ritual behaviors that must be carried out in a certain pattern orsequence. Compulsions may be overt physical behaviors, such as repeatedly washingyour hands, checking doors or windows, or entering and reentering a doorway untilyou walk through exactly in the middle. Or they may be covert mental behaviors, suchas counting or reciting certain phrases to yourself. But note that the person does notcompulsively wash his hands because he enjoys being clean. Rather, he washes hishands because to not do so causes extreme anxiety. If the person tries to resist performingthe ritual, unbearable tension, anxiety, and distress result (Mathews, 2009).Obsessions and compulsions tend to fall into a limited number of categories. Aboutthree-fourths of obsessive–compulsive patients suffer from multiple obsessions, andslightly more than half report more than one type of compulsion (Rasmussen & Eisen,1992). The most common obsessions and compulsions are shown in Table 13.3.Many people with obsessive–compulsive disorder have the irrational belief thatfailure to perform the ritual action will lead to a catastrophic or disastrous outcome(MacDonald & Davey, 2005). Recent research suggests that many people withOCD, especially those with checking or counting compulsions, are particularlyprone to superstitious or “magical” thinking (Einstein & Menzies, 2004). Eventhough the person knows that his obsessions are irrational or his compulsions absurd,he is unable to resist their force.People may experience either obsessions or compulsions. More commonly, obsessionsand compulsions are both present. Often, the obsessions and compulsionsare linked in some way. For example, a man who was obsessed with the idea that hemight have lost an important document felt compelled to pick up every scrap of paperhe saw on the street and in other public places.Other compulsions bear little logical relationship to the feared consequences. Forinstance, a woman believed that if she didn’t get dressed according to a strict pattern,her husband would die in an automobile accident. In all cases, people withobsessive–compulsive disorder feel that something terrible will happen if the compulsiveaction is left undone (Mathews, 2009).Table 13.3The Most Common Obsessions and CompulsionsObsessionContaminationPathological doubtViolent or sexualthoughtsDescriptionIrrational fear of contamination by dirt, germs, or other toxic substances.Typically accompanied by cleaning or washing compulsion.Feeling of uncertainty about having accomplished a simple task.Recurring fear that you have inadvertently harmed someone orviolated a law. Typically accompanied by checking compulsion.Fear that you have harmed or will harm another person or haveengaged or will engage in some sort of unacceptable behavior.May take the form of intrusive mental images or impulses.CompulsionWashingCheckingCountingSymmetry andprecisionDescriptionUrge to repeatedly wash yourself or clean your surroundings.Cleaning or washing may involve an elaborate, lengthy ritual.Often linked with contamination obsession.Checking repeatedly to make sure that a simple task has beenaccomplished. Typically occurs in association with pathologicaldoubt. Checking rituals may take hours.Need to engage in certain behaviors a specific number of times or tocount to a certain number before performing some action or task.Need for objects or actions to be perfectly symmetrical or in anexact order or position. Need to do or undo certain actions in anexact fashion.Source: Based on Rasmussen & Eisen (1992), Table 1, p. 745.