(bright music)
- There are four components to be diagnosed with OCD:
that you have the obsessions,
the intrusive thoughts and sensations
that are uncontrollable that you do not want;
the compulsive behaviors,
these are the safety mechanism,
the escape behaviors that you engage in
to help yourself feel safe;
and it has to take up a lot of time in a day,
at least one hour,
but that's still a lot of time
- Of course. - if you're doing it,
obsessing engaging in compulsive behaviors;
and then if it interferes with your daily functioning,
whether it's school, work, social activities,
family activities.
So, if you have four of those components, you have OCD.
Then the question is, how much does it interfere
with your daily functioning?
How much time does it take from your daily activities?
And there can be people who engage in obsessions
and compulsions for at least an hour a day
to those people who are stuck in obsessions
and compulsions for all of their waking moments.
- Wow!
The people who just have the obsessions,
those thoughts, those intrusive thoughts,
they don't have OCD
because they're not doing the compulsions
'cause they don't-- - Hmm.
- No? I'm wrong? Okay. - No, no, no, no, no, no, no.
There's actually a term it's called Pure O,
- Pure O? - which stands...
Yes, Pure O which stands for pure obsessional.
It's actually a misnomer because what we don't see
are the mental compulsions that the person is engaged in.
So we see or the person understands the obsessions
that they're experiencing,
however, with the fears that they have,
they're engaging in a lot of mental compulsions.
If you can imagine like a philosopher, right?
What does a philosopher want to do?
The fear is not getting at the truth.
- Then they want to figure out the truth?
- Figure out the truth. - Okay.
- And that is what a person with Pure O engages in.
They have whatever that fear is.
Okay, let's say the fear that the world is not really round
and they engage in mental compulsions,
whether it's thinking of a conversation that they've had
with their peers and their colleagues
or their thinking of an article that they read
or thinking back of a thought that they might've had.
They're constantly intellectualizing.
They're constantly repeating certain thoughts.
They're constantly trying to get at the truth.
They're trying get at certainty.
And remember, OCD is the disease of the doubt.
- Mm-hmm.
- And the reality is in life, there is no certainty.
However, a person with OCD is trying to obtain certainty
that doesn't exist.
- So, is it possible though,
that someone just has the thought and not the compulsion?
- It's really rare because... - Yeah.
- because the compulsion is also any type of escape
or safety behaviors, right?
So even a person with Pure O
what they would do is they might seek reassurance
from other people.
They might seek reassurance from their family members.
They might seek reassurance from the internet
with all the information on the internet these days.
They might avoid the situation that triggers the fear
or the uncertainty.
- So, let's just say,
"I got really mad at my landlord
"and I thought, 'You know what?
"'I'm going to burn this place down
- Okay. - "'cause I'm just so angry.'"
Now, I'm not gonna do that, but I had the thought.
That doesn't mean I have OCD,
- [Jenny] No.
- but what was my compulsion in that scenario?
- So a person with OCD would have a thought and think,
"Oh my goodness, what does that mean about me?
"Why would I have such a thought?
"Why would anyone have such a horrible thought?
"Am I a criminal?
"I must be a criminal if I'm going to have these thoughts."
And then they would fear acting out the thought.
So there's a term called thought-action fusion,
which is when a person believes that having a thought
is going to lead to an action,
and they tied the two together.
- I get it now.
- And you have to remember,
a thought is a thought is a thought is a thought.
It's just that.
Just because you have a thought doesn't necessarily mean
that you're going to act out a thought, right?
How many times have we had thoughts
of beating up our bosses?
- [Kyle] Of course.
- Or--
- I mean, not here at MedCircle.
(Jenny laughing)
I've never thought that.
I just wanna be very clear.
Yeah, yeah. - Sure or...
You know, kicking the ticket meter's butt.
- [Kyle] Right, yeah.
- Right? For giving me that ticket.
- [Kyle] Yeah.
- Just because you have to thought
doesn't necessarily mean that you're going to act out on it.
- [Kyle] Got it, got it.
- However, a person with OCD would believe
that having a thought means
they're going to act out the thought.
And what a horrible thing that would be
if I did such that thing.
- Mm-hmm.
In the series we did with Dr. Ramani on anxiety,
- Mm-hmm.
- she really dove deep into
how just changing our thought process
can help relieve a lot of this
anxious behavior. - Yes.
- And it's interesting, I'm hearing this and saying,
yes, changing our thought process
could change this behavior too,
but also understanding that they are only thoughts
- [Jenny] Yes, yes.
- is such a powerful thing
to understand - Right.
Absolutely. - for people who know someone
with OCD or have OCD themselves.
- And you know, I think that with people with OCD
and anxiety disorders,
it has to go beyond just the cognitive therapy part.
And the reason why being is,
people with OCD and anxiety,
they realize that their fears are irrational.
They realize that it's excessive
to be washing eight hours a day.
However, they can't help it.
- Right. - Because...
Just because they have the intellectual understanding,
doesn't translate to an emotional belief,
- Yes.
- and therefore, the behavior therapy part,
and this is cognitive behavior therapy.
The behavior therapy part is the more important component
for treatment because the behavior therapy
is what you do to confront the fears
that give you the feedback,
"Oh, this actually isn't so threatening."
- Nothing happened.
- Right? - Nothing bad happened.
Yeah, I'm thinking of all the parents watching this going,
"This is fine, but how do I know if my kid is acting out
"if they have ADHD, if they're just depressed,
"or if they have OCD."
- Right.
- I mean, what do you tell those parents?
- Well, first of all, you want to recognize some signs.
So, if a person, if your loved one
is stuck repeating certain behaviors,
if your loved one--
- Give me an example, though.
Give me an example in like an adolescent teen
or a child even younger.
- Okay.
Examples: going in and out of doors,
getting up and down off of chairs,
turning the stoves on and off, checking faucets,
washing to the point where their hands
are bloody and dry and chapped and cracked,
constantly asking for reassurance for certainty.
"Is this okay for me to touch?
"Is this knife okay to use?
"Is my food contaminated?
"Will I be hurt if I go to school?"
If they have a hard time sleeping,
because they are so stuck in their obsessive thoughts
that they can't sleep
because your body's natural fight or flight response
is heightened.
If they are the last to get out of the house in the morning
because they are stuck performing compulsive behaviors
and they're simply late.
They rather be late than to not engage
in their compulsive behaviors.
Have they started to avoid friends, avoid school,
avoid things that they used to enjoy
because of fear of embarrassment
or because they fear that they will get stuck in the ritual
while they are in public?
Are they more irritable?
Because again, your brain is like a plate.
If your plate is full of negative thoughts,
then you're not going to have space or tolerance
for anything else.
So are they more frustrated and irritable?
So those are just some of the signs
that parents and loved ones can recognize.
And if they do,
then they need to seek help.
Whether it's finding an OCD support group,
finding an expert who can treat the person.
Parents can always go
on the International OCD Foundation website
which is iocdf.org.
There is a therapist directory of experts
who can treat OCD.
There is also
the Anxiety and Depression Association of America
which is adaa.org that also has a therapist directory.
And as well, the abct.org
which is the Advancement of Behavioral
and Cognitive Therapy.
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