Table of Contents
Behaviour is considered abnormal if:
It is harmful to the individual, and they hurt themselves while behaving in that way. Or it’s maladaptive. It is unusual, and only a few people in the society behaving in that particular manner, It hinders the individual from performing their daily activities thus becoming unproductive, Its harmful to those around the individual, like excessive drinking, could make those around the individual suffer when it is abused. These are criterions offered by the psychologists to help us understand abnormal behaviour, in order to effectively treat them.
There are man approaches to understanding abnormal behaviour, as it is not possible to treat it if not correctly diagnosed. The most common explanations or approaches to understanding abnormal behaviour are medical approach, psychodynamics approach, behavioural approach, human existential approach, socio-cultural approach, and the biological approach. Obsessive compulsive behaviour is a maladaptive way of behaving as it prevents a person from achieving their potential or carry out their normal daily activities, and in the extreme case, the individual may harm him/herself for the embarrassments they feel for behaving “weirdly” or having intrusive thoughts. There are many psychological disorders categorised as abnormal especially when the individual looses control over them. The most ones are Post Traumatic stress disorder which is a chronic and prolonged state of relieving traumatic thoughts for over six months. An individual who has gone through a traumatic situation keeps relieving the situation, and as a result develops syndromes that are avoidant towards stimuli similar to the traumatic situation. Other abnormal behaviours are the eating disorders, sleeping disorders, panic attacks, obsessive compulsive disorder, manic episodes, generalised anxiety disorders, phobias, etc.
Obsessive compulsive disorder, commonly noted OCD, is a psychological disorder that manifests itself in physical activities.
OCD is a type of anxiety disorder which is characterized by patients having uncontrollable and intrusive thoughts that result in repetitive and ritualised behaviour. The repetitive rituals are aimed at reducing the anxiety an individual feels a person suffering from Obsessive compulsive disorder could suffer from other anxiety disorders like Generalised anxiety disorder, panic attacks, avoidance behaviours, major depression, and other associated symptoms, occurring simultaneously with the Obsessive compulsive disorder (Oliwenstein, 2004).
Compulsions could be mental and behavioural. With mental compulsions, the individual keeps repeating words or saying specific words that do not make sense, over and over again, or having obsessive thoughts about a particular thing, while behavioural compulsions are the physical activities the individual feels compelled to perform in order to relieve anxiety. Compulsion is defined as the over tendency for an individual to desire to do something/ or is a behaviour or a ritual that an individual may feel overly driven and tempted to do over and over again. Compulsions are performed in an attempt to diminish the obsessions that the individual feels but in contrast, the compulsive behaviours cause more anxieties and become more demanding, to the point an individual losses total control of them, leading to involuntary movements and vocalizations.
Obsession refers to images, thoughts, or impulses that occur involuntarily, and are so uncontrollable, that they seem to replay in an individual’s mind. Common obsessions include obsession with contamination, somatic concerns, sexual content, and the need for symmetry,(wanting perfection or a specific way of doing things)).certain obsessions are related and directly associated with specific rituals like: sexual obsession is related to performing regular checks, symmetry obsession related with organisation and order rituals, while obsession with contamination is consistent with washing rituals.
It is important to note that not everyone who finds them doing things repetitively or having obsessive thought is said to be suffering from this disorder. It is normal to have such thoughts, but the individual should be able to control them and prevent them from acting normally. However, Obsessive compulsive disorder is associated with a personality disorder, Obsessive compulsive personality disorder, in which an individual feels compelled to constantly behave in ways relating to the intrusive thoughts, they could become perfectionists, or extremely clean. Not everyone suffering from OCD will develop the personality disorder, though it is most likely that a person with that personality disorder experiences those compulsions and obsessions.
Those having such behaviours should not be disregarded or termed as exaggerated fears about things. Some therapists and counsellors suspect some variables like relationships, financial or academic concerns could cause it. The victim’s distress arises when they realise that their obsessions are irrational, excessive and inappropriate. Therefore family members or those dealing with the victims should be careful not to disregard or speak negatively about the situation. The patients normally feel ashamed or embarrassed and strive to hide their behaviours which make it worse. When the compulsions become phobic, they could prevent daily activity performance, and if coupled with emotional distress, the patient’s ability to perform daily tasks is completely interfered with.
A person suffering from obsessive compulsive disorder is likely to do the following:
- Involve in repetitive washing or cleaning for fear of contaminations.
- Perform repeated checks like if the door is closed, they would go back to check again and again if it is properly closed.
- Hoarding: They would have a fear of throwing out used personal items, and keep collecting and storing useless things.
- Be obsessed with religiosity, pray constantly, and fear that they would be punished if they don’t.
- Constantly arrange and fix things, even when they are in order, and feel tempted to correct any minor mistake that could be overlooked.
- Perform regular checks on loved ones, to ensure they are safe.
To offer the differentiation between the two (obsessions and compulsions), below are differentiating categories, as used in psychology:
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Common obsession patterns as observed in a clinical setting.
- A person experiences an exaggerated feeling of being contaminated with everyday items or contact pf people.
- They have nagging doubt that door locks or windows are left unlocked promoting insecurity.
- Experiment excessive concerns that a stove or similar appliances are left on.
- Have overwhelming urge to arrange objects in a certain order.
- Extreme fear of doing same things that maybe violent, immoral or sexually inappropriate.
Common compulsions patterns
- Repeated and excessive hand washing, and sometimes with the use of an antibacterial soaps, to avoid contaminations.
- Frequent checking of knobs, locks or switches.
- Unnecessary fixing of doors or things than do not require fixing.
- Hoarding used things like newspapers or newsletters.
The DSM-IV (Diagnostic and Statistical Manual for mental disorder, edition 4), which is published by the American Psychiatric Association places Obsessive compulsive disorder in Axis 1, as a clinical disorder. The DSM IV provides classifications for mental disorders, arranged into axes (Comer, 2009).
Causes of Obsessive compulsive disorder
There are certain causes of this anxiety disorder, including psychological and biological factors. However, the causes are generally described below:
- Chemical and brain dysfunctions. Serotin is highly associated with obsessive compulsive disorder. It is a neurotransmitter allowing communication between nerve cells. Research shows that Serotin influences biological processes like moods, aggression, appetite, pain, and sleep. It also connects to nerve cells in the, brain, causing many responses. When Serotin is attached to brain receptors, it could cause OCD, affecting mostly the orbital cortex, the Basal ganglia and the Thalamus. When anxiety rises in such an individual, the brain fails to function correctly, leading to the disorder.
- Biological /genetics. An individual would contract OCD if He/She has family members with obsessive compulsive disorders or other disorders associated with OCD like excessive concerns for minor details, hypochondria, bulimia nervosa, or sleep disorders. Inheritance is not conclusive, but there are studies to show that there are links between the two. Research shows that up to thirty percent of teenagers suffering from this disorder have family members with OCD or its symptoms. Other studies also show that if the disorder developed during adulthood, there are slim chances of a person’s children contracting it, as compared to the risks involved if the person contracted the disorder during childhood. There are other studies that suggest a two to eight percent chance of a child getting obsessive compulsive disorder if only one parent has it, or has a family history with it.
- Infections. Streplococcol infection is linked to Obsessive compulsive disorder. It is an infection of the throat, which sometimes the body confuses with healthy cells, leading to cellular damage. Children suffering from “Strep throat” infection could also develop Obsessive compulsive disorder.
- Depression. People with depression have a chance of developing OCD, while those with OCD will most likely develop depression.
- Psychodynamics. Psychodynamics theory suggests that early developmental and unconscious disturbances are highly associated with obsessive compulsive disorder. As an individual develops the part of the mind responsible for controlling thoughts and the one responsible for reasoning could conflict, raising instability in children, hence mental problems in later life.
- Social factors. This anxiety disorder is greatly influenced by Guilt and shame, brought about by our social structures, relationships and interactions. In an attempt to meet social standards, one could become psychotic due to the social presumes, leading to anxiety disorders like OCD.
- Traumatic brain injuries. Motor car accidents and serious falls could lead to brain injuries, causing cognitive problems, leaving an individual to develop symptoms related to Obsessive compulsive disorder.
- Stress. Extreme stressful situations could trigger this disorder as the individual becomes overly worried and anxious about the future.
- Environmental stressors like divorce, sexual or drug abuse, loosing a job, moving a house, death or other stressors.
To treat obsessive compulsive disorder, it should be correctly diagnosed and understood, so as to offer effective treatment. Therefore we look at the approaches of understanding and treating abnormal behaviour to offer understanding of why an individual would become obsessed with particular thoughts (Harris, 2005).
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Psychodynamics theory: Based on the theory of Sigmund Freud psychoanalysis, psychodynamics explain that an individual’s well being depends on the sequential developments from childhood to adult hood. As an individual develops they go through developmental stages that see determines their personality in future. Success of one stage depends on success of the previous stage. In an attempt to develop personality, an individual usually has internal conflicts between the id, the ego and the super ego. Therefore in the explanation of abnormal behaviour, psychodynamics explain that abnormal behaviour develops as a result of improper relationship between the id, the ego and the super ego, and poor development that leads to fixation.
The latter explains more of personality disorders, while the former explains the psychological disorders. An individual later develops defence mechanisms to fight off frustrations caused by the internal conflicts, or to deal with personality issues. These defence mechanism could make the person behave in an unusual way as they try to repress uncomfortable feelings. To effectively treat a psychological disorder occurring because of this, the psychiatrist should identify the defence mechanism involved in it, and help an individual overcome heir fear. The common way of doing this is through free association, where the patient is helped to face their fears, in a controlled environment (Coon & Mitterer, 2007).
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Medical approach understands abnormal behaviour as a medical problem. If an individual is involved in an accident that tampers with the brain or parts of the brain, the individual could end up behaving unusually, if not properly treated. Medical approach there relies on the use of drugs or medication to help patients overcome psychological disorder, like in the case of OCD; pharmacotherapy is common, especially when combined with psychotherapy.
Behavioural approach: Behaviourists argue that abnormal behaviour, just like any other behaviour, is learned through interaction in the environment, and it can also be unlearned. In an attempt to cope with situation in our local environments, we normally learn certain behaviours that offer relief’s to our “suffering”, and if this continues, we end up behaving that way for a long time. This, they called; Conditioning, and it can be negative or positive. Negative conditioning is when maladaptive ways of learning are rewarded, making the organism to accept it as the good way of behaving. In the case of OCD, the individual could have started having simple thoughts that could relieve anxiety whenever they felt anxious, and with time, since these thoughts helped, they became “addicted” to them till they could no longer resist having them, and ended up “acting” them out. To treat OCD using the behaviourist approach is to help the individual “unlearn” those compulsions and intrusive thoughts. To treat his, the individual is encouraged to acquire other relaxation techniques like yoga. If learned and monitored closely, the patient will effectively learn to adopt the positive techniques and avoid compulsions that hinder their healing process.
Chemical and neurotransmitters explanations: Abnormal behaviour can occur as a result of brain interactions with chemical substances that help in transmission of information between the body and the brain. The chemical substances are called neuron transmitters. Treatment for this kind of cause of abnormality could be medication that inhibits certain kinds of transmissions to the brain.
Socio-cultural approach: This explains the social and cultural factors that influence abnormal behaviours. We develop abnormal behaviours due to the social and cultural pressure exerted on us by the society’s we live in. Since society has demands and standards of behaviour that it expects us to meet, those who fail to meet certain standards may go through extreme stress, leading to abnormality. Helping an individual deal with certain environmental stressors effectively could be helpful in treating this kind of abnormality. Getting support from family members, friends and the community is also helpful (Hyman & Pedrick, 2008).
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Biological approach suggests that much of the abnormality we experience is as a result of biological attachments. Genetical explanations suggest that those with family members suffering from abnormal behaviours have high chances of behaving abnormally as they inherit it from their family/ parents.
Human existentialists, argue that in an attempt to achieve, we could develop abnormal behaviours. In our desire to achieve certain goals in life, we go though a lot of stress to do that, for example we over study to pass exams in order to get better jobs, so as we do this, we could stress ourselves beyond limits, leading to abnormality. Also, frustrations could occur when these goals are blocked, and push us to abnormality. This theory suggests that we have needs that we desire to meet in order to feel actualised. As we strive to meet these needs, our efforts could be limited, causing frustrations that could result to abnormal behaviour (Butcher, Mineka & Hooley, 2007).
To summarize the above, Treatment of OCD can simply be generalised as follows:
- Pharmacotherapy: medication can be used to treat this disorder. Because of the linkage Serotin has with the disorder, drugs that inhibit reuptake of Serotin could be used to ensure treatment. The drug that could be used is the SSRIs (Selective Serotin Reuptake Inhibitors.) e.g. Paroxetin and Fluoxetine are common. Anti depressants could also be sued to bring the calming effect whenever a person feels anxious and unable to relax. The disadvantages of pharmacotherapy are that symptoms can return, and the patient relapses when medication is stopped.
- Highly structure psychological treatment like the ERP, “Exposure and Rituals Prevention”. A process where the patient is exposed to the sources of their obsessions then encouraged not to perform them. The rituals facilitate reality testing. With time and constant practice, the individual will be able to control the behaviours and cope with the intrusive thoughts.
- Combining medication and psychological treatments. This would be more effective than prescribing medication with no psychological; treatment.
- Psychosurgery. The surgery is a last resort when all the other techniques fail or the patient does not respond positively to other medication, as it is radical. Psychosurgery refers to “neurosurgery” for a psychological disorder. The common type of this surgery is cingulotomy, which is the removal of the cingulated cortex part of the brain. However, this surgery has serious risks on the individual as one’s personality could completely change after it, or the patient develops seizure.
- Cognitive therapy. The therapy is aimed at helping an individual lessen the overwhelming feeling of responsibility they feel towards others, and heal the thought process.
- Family therapy. Is aimed at promoting better understanding of the disorder so as to reduce more conflict, and offer patients with a form of support and love, to focus on healing. When family members are informed and educated about his disorder, they are better equipped at helping their fellow loved ones cope with the disorder in a peaceful environment, that promotes healing, rather than cause more harm by family divisions.
- Group therapy. Being part of a group would encourage patients to share and learn from people with similar situation. It also offers support to individuals, discuss coping skills, and give encouragement and emotional support, lessening feelings of isolation and that one is suffering alone.
- Self help strategies. A patient could educate him/herself about the disorder. Obtaining information and being knowledgeable about it could incorporate helpful habits and encouragement to overcome it. Some self help tips include reading OCD books, staying connected to family and friends, joining an OCD group, and practising relation techniques like Yoga, mediation, or deep bathing.
- Herbal treatments. Though prior assistance and testing could be required before using herbal treatment, there are some herbs that offer treatment for OCD. These herbs include John’s work, valerian recet, and Ginkgo Billoba
Obsessive compulsive disorder is a type of anxiety disorder, whose causes could be biological, social, psychological or other stressors. An individual suffering from OCD experiences intrusive thoughts and compulsive behaviours that could be shaming or embarrassing in public. The have a tendency to want things in order, excessive fear for contamination or hoarding. OCD is associated with other anxiety disorders like the Post Traumatic Stress disorder, generalised Anxiety attacks, panic attacks, sleep or eating disorder, stress, hypochondria, etc
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Treatment for obsessive compulsive disorder ranges fro psychological therapy, to medication, psychosurgery, for extreme OCD, group therapy, family therapy and herbal treatment. For effective treatment of abnormal behaviour, the physician must correctly diagnose the abnormality, and understand its root. This is done by the understanding of different approaches to abnormal psychology. These approaches include biological, behavioural, socio-cultural, medical, psychodynamics, chemical transmitters, human existentialist and environmental approach (Barlow & Durand, 2008).