This interview illustrates someone who struggles with Obsessive Compulsive Disorder. The client, Chuck is very candid about how he describes himself as “obsessive compulsive.” He acknowledges that his behavior is irrational but he cannot seem to stop. Pay particular attention to how Chuck describes his plans for a vacation.
Obsessive Compulsive Disorder is evident by:
Obsessions – recurrent thoughts, images, or impulses that cause anxiety,
Compulsions – repetitive behaviors that are designed to reduce anxiety and must be rigidly followed
A combination of obsessions and compulsions
Client feels driven to perform compulsions. Which:
•Are time consuming
•Interfere with normal routine
•Client recognizes thought/behaviors as being unreasonable
Use the below set of questions as a guide, as you view the video:
1.Chuck clearly describes how his thoughts and behaviors influenced his planning for a vacation. What impact do you think his obsessive thoughts and compulsive behaviors have on his daily life?
2.Chuck talks about having obsessive thoughts for a very long time. Do you think he sees any “strengths” in how he has managed to cope with the diagnosis of OCD?
Therapist: Thanks for agreeing to come here and talk with us. I know you’re having some pain from your back.
Chuck: Uh huh.
Therapist: Do you have any other kind of symptoms that are troubling you right now?
Chuck: Ah, I’m a little bit obsessive compulsive. Sometimes the obsessive part is a little difficult to deal with.
Therapist: Can you tell me what you mean by obsessive compulsive?
Chuck: The obsessive part, I’ll get a thought in my head and I cannot put it out. It’s just there all the time. I think about it when I got to bed. I think about it when I get up. It’s just hard sometimes to put thoughts to rest.
Therapist: And are there any specific thoughts that are common ones for you? That repeat themselves?
Chuck: Not particularly. An example, when I went on vacation I had to leave my pets with some friends and I obsessed about it, constantly. Should I be doing this? Should I be doing that? Will everything be okay? Maybe I should put them in a kennel? Maybe I should take them over to my friend’s house, let him watch them there? Just constantly it was on my mind.
Therapist: So it’s uncomfortable for you when that happens?
Therapist: And about how much of the time would you say you have thoughts like that that are in your head that you wish weren’t there?
Chuck: Pretty much all the time.
Therapist: Okay. Are there ever activities that you need to do as a result of having the thoughts in your head?
Chuck: I’m a checker. I have to check things. You know, like when I went on vacation and I left my pets at home, it took me two hours to get out of the house to leave. I had to check the stove. I had to check the windows. I had to check the cages, make sure everything was okay. Then I had to go back and start over again
Therapist: So the thoughts would be there and in order to appease the thoughts, if you will, you had to go back and check things over and over again?
Therapist: Okay. Do you have to allow yourself extra time?
Chuck: Yeah. I have to allow myself in the mornings about ten minutes. I don’t cook so it’s kind of ironic that I have to check the stove every morning because I never cook. But I have to check the stove. I’m a smoker so I have to check and make sure I haven’t left any cigarettes anywhere around burning. That’s not real rational either because I only smoke in the bathroom, but I still have to check. Like I say, I have my pets. I have to check their cages, make sure they’re not out. I have this obsessive thought that one day my bird is going to get out of its cage and it’s going to be out in the hallway when I get home from work because I didn’t check to make sure that it was in there; they’re not always really rational.
Therapist: And the thoughts that you have are they your thoughts? Are thy coming from inside your own head? Are they your own thoughts?
Therapist: They’re your own thoughts, but they’re repetitive and they bother you and if you could stop them you would.
Therapist: Do you have any anxiety symptoms at those times, such as a pounding heart, palpitations, shortness of breath?
Therapist: Are you somebody in general who has anxiety symptoms?
Chuck: I get a little stressed out yeah, but I think when I get more stressed the obsessions become more intense.
Therapist: Have you ever been depressed before this time?
Chuck: Ah, I haven’t been in treatment for the last two years, but before that I was in therapy for about seven years.
Therapist: Okay and when you were depressed, what symptoms did you have?
Chuck: Crying spells, hopelessness, helplessness that I couldn’t change situations, suicidal thoughts sometimes.
Therapist: And how long did those symptoms last?
Chuck: A lot of them lasted a long time. Actually for most of my adult life I think that I was depressed and had a lot of those symptoms, but didn’t really seek help until about seven years ago.
Therapist: And now during that time when you were having depressions, were you also having the obsessions and the compulsions?
Chuck: Uh huh.
Therapist: Okay and which ones started first?
Chuck: I don’t know. It’s like they’ve always been there.
Therapist: Both the depression and the obsessions and compulsions have been there as long as you can remember?
Chuck: As long as I can remember, yeah.
Therapist: Back to childhood?
Chuck: Uh huh.
Therapist: And right now you said currently you’re not depressed.
Chuck: No. currently I’m not depressed. Seven years of drugs and psychotherapy kind of helped.
Therapist: How long has it been since you’ve been depressed?
Chuck: I’ll have one or two days I might get down, but it’s not that overwhelming sense of hopelessness and helplessness. I haven’t had that for over two years now.
Therapist: And the obsession and compulsions have been somewhat alleviated, but really only to a minor extent.
Chuck: Yeah. They’re just kind of there and like I say kind of depends upon the situation, my stress level, you know, what’s going on. But, you know, I pretty much learned to live with it.
Now that you have viewed the video of Chuck, answer the following questions.
Chuck talks about having obsessive thought for a very long time. Do you think he sees any “strengths” in how he has managed to cope with the diagnosis of OCD?