Obsessive-Compulsive Disorder (OCD)
part 3

Compulsions are things that people do or acts they perform in their heads.  They are repetitive and senseless, just like obsessions.  In many people, the compulsion is linked to an obsession.  Here is the official definition.

1. Repetitive behaviors are mental acts that the person feels driven to perform in response to an obsession.

2. The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive.

The most common ones in pediatric OCD are: washing, repeating, checking and ordering.

Less common ones are rituals to protect themselves from bad things, counting, hoarding and slowness.

Sean's mother first started to wonder what was going on when Sean was spending so much time in the bathroom.  So one day she decided she had better found out.  While he was in there she quietly came up to the door and listened.  She heard water running.  She opened the door just a crack but could only see her son's hands in the wash basin, scrubbing and scrubbing.  She shut the door and waited.  A few moments later out he came, as if nothing was going on unusual.  She watched the bathroom door that day and made some notes.  Sean made 20 trips to the bathroom that day and none was less than 5 minutes.  So she showed him her notes.  At first he just screamed at her for bugging her.  Eventually, he started crying but all he could say was, " I just feel dirty all the time" I can't help it".

When Rob was 8, his mom was always reminding him to check the door, make sure he had his coat, and similar things.  Now Rob thinks to himself, "I think I have made up for that about 100 times worth now!"  When Rob goes out the door, he has to check just about everything.  Was his CD player turned off?  Did he turn off the lights?  Did he lock the door?  Did he accidentally turn the TV on?  Did he hang up the phone?  So, Rob is very anxious and worried that maybe the house may be broken into, or there might be a fire, or something, and goes back and does it again.  But by the time he is done checking the last thing, he wasn't absolutely sure he had checked the first thing.  The solution?  Rob doesn't leave home much, and when he does, he makes sure someone is there.  Once he is at school, he is mostly checking his pants.  He keeps wondering if maybe his fly is down.  So he checked it.  About every 30 seconds.

Everyone thought Robin was weird at school.  As soon as she came into a room she would walk down the desks and lightly touch every third one, or was it every other one?  Once she was seated, she would work, then touch, work, then touch.  There were round bolt heads that attached the desktop to the desk.  They stuck up a little bit off the top of the desk.  Robin felt like she had to touch them.  She half realized that everyone knew she was doing this, but she didn't want to say anything because then everyone would know she was crazy.  Why did she do it?  To keep from becoming a lesbian.  She knew this was stupid, but she couldn't help it.

Randy got up every morning at 6 am.  The bus did not come until almost 8:30, and he missed it about half the time.  His mom was always trying to get him to hurry.  Well, says Randy, you would take a long time, too, if you had to get ready perfectly each day.  What does that mean?  To start with, it means when you get out of bed, both feet touch the ground at exactly the same time.  It means you brush your teeth 30 times on the top and exactly 30 times on the bottom.  It means after you use the soap, you line it up perfectly parallel with the soap dispenser.  The order for taking a shower and combing your hair is as complicated as getting ready to fly a plane.  Every month it seemed there was one more thing that had to be done just right.  Once he was dressed, he was fine.  Randy finally got help because he was on the verge of being expelled.  No way was he going to change his clothes for Gym, shower, and put his clothes back on.  He didn't tell them why.

Erika started crying when she came home from a birthday party.  She was blowing up a balloon and then letting the air out so it would shoot all around the house.  She blew too hard and the balloon exploded.  It seemed as if Erika did, too.  An hour later she sort of explained to her Mom that she was crying because she couldn't "undo" the balloon.  All of a sudden, it all made sense in her mother's head.  That is what her daughter had been doing these last few months!  Erika would go in and out and in and out of her door.  She would only go one way through the doors in the house, so she was always going the longest way around.  Her mom thought it was just a game.  While she would talk on the phone she would carefully put her hand through the hole in the cord back and forth, plus a number of other things.  It turned out that the compulsions that her mother could see were just the tip of the iceberg.  There were many mental compulsions, too.  She would lie in bed wanting to go to sleep but couldn't until she could open this box in her mind and then shut it up just the same way.  Erika usually cried her self to sleep thinking that she was obviously going crazy.

At parent-teacher night Justin's teacher showed Justin's mom his work.  The teacher's question was, do you think he is doing this on purpose?  When you looked at Justin's papers, it looked like they had been either hit with a shot gun, or attacked by a very vicious eraser.  Almost everything had been erased over and over and over.  As a result, many places were erased through the paper.  Then it was folded and unfolded many times.  When Justin sat down to work, he worked hard, and became more and more frustrated.  However, when asked to do things orally, there was no problem.  The teacher suspected a learning problem and sent him to the resource teacher.  This is what finally convinced Justin to say what the problem was.  It wasn't that he couldn't write or print, he just couldn't get it perfect.  He knew that his first attempt was okay, but it wasn't perfect.  It made him so anxious to see that imperfect letter or number that he felt he had to fix it.  It turned out that at home, each sheet of homework consumed about 10 other sheets before he got it right.

Lots of children like to collect things, and now with recycling, it is even more common.  Mary started out that way and everyone at school was so happy to have her there.  Mary would pick up trash, wrappers, old milk cartons, and anything she saw.  She told the teachers she was bringing it home to go to their recycling.  When her father saw Mary coming each day after school, he counted to 10, said a prayer, and greeted her.

" Have any home work, Mary?"  Of course she did, but as she pulled the homework out of her pack, out came about a half a trash bag of garbage.

"Are you going to throw that junk out Mary?"  No, not right now, she might use it to make something later on and she wanted to make sure she had it sorted properly.  Mary's father knew what that meant.  It meant she would squirrel away that with the rest of her trash, or collections, all around their farm.

Mary and her Dad knew what was coming next, the showdown.  "Mary, you are not coming into this house until you let me have those things.  "After a lot of screaming and "you don't understand", Mary would give up her junk.  Each Friday Mary went to the school and cleaned out Mary's desk.  She never said she did it, and Mary was afraid to ask.