Monthly Archives: August 2015

Unusual Obsessions and Compulsions

Over the years I’ve come across a lot of OCDs in the clinic, some have more “normal” rituals, such as hand washing, reassurance seeking etc. Most people “stick” to their rituals over the years, sometimes better, other times (especially when they’re under great pressure, or facing major life events or life transiting periods) worse. Many of them have more than one or two compulsions, but they usually have similar underlying causes (obsessions).

Recently I was introduced to this man in his mid 50s. He has a brother who suffers from chronic schizophrenia. He is quite a sensitive person, very easily upset by remarks from others. Initially he was having obsessional ruminations, but responded well to the SSRIs. Subsequently he had a relapse, and started to always feel agitated, wanting to hit people and things he see. This recurrence with violent contents stay with him for quite a few years, however, he managed to function and work.

Over the years he has seen many psychiatrist doctors but to no avail. Then he came back again, still feeling anxious he might do harm to himself or others. Few months ago when he came, the violent content subsided a little, but he is now having this urge to swallow little things (e.g. coins, keys etc). And another two weeks later, it became less about harming people, but he still wants to smash things, especially glasses, big or small, so when he notices others’ smartphones (glass screen!), he gets really anxious with the urge.

Then few days ago, he said he’s been struggling to ride his motorcycles, because he keeps imagining driver/rider coming out from another junction/corner and he accidentally hit them or get hit! So he literally slows down or even stops in every junction, and was almost hit by a car following him. “Yet I’ve to stop!” he added, even knowing he might get hit from the back.

I tried to sit down and think how they are all related, what the underlying obsession is? – “fear of harming self/others/things” is what I concluded. What say you?

 

Previous entries about “unusual” OCD:

Learn about this man’s obsession (to do with his toilet habit)

Compulsive Voyeurism 

Emotional Blackmailing

He is in his early 30s, was diagnosed with OCD over 10 years ago, when he was finishing high school and about to start college. He was doing very well academically, and in school he was very popular.

Since the diagnosis, he had tried to get a degree, but failed all his 6 attempts. His washing, checking, chanting, counting, all compulsions occupied almost all his time that he couldn’t attend class, sit for exam, or do anything else.

But he had a very supportive family, especially the mother and the sister. For the past few years, he had been staying home most of the time, so the mother cooks, washes, and prepares everything for him. Whereas the sister allows him to live in her house, and supports him financially. They also take turn to take him to see doctor.

Recently, the sister called up, saying that the patient is asking to enrol himself to a course again in either US or Canada. She had tried very hard to explain to patient that not just she has no money to support him, but also the fact that his illness wouldn’t allow him to complete the study. But the patient was very stubborn, for him, the only way out of his current life is to get a degree first (but not to conquer his OCD symptoms). He asked the sister to get a loan, borrow money, he doesn’t care what she does, but he must get to study (not locally, but overseas). He is the center of his life and all family members’ lives, they must obey to what he says.

The sister doesn’t know what to do. The family members know him well. When they refuse him, he will start screaming and shouting, until everyone in the building and nearby know it, as if the family is abusing him. And then the next stage, he would start saying that if he couldn’t go for study, he would just end his life. And yes, he’s done it before previously, taking pills excessively on one attempt and drinking insecticides on another.

No matter how hard they try, they couldn’t persuade him out of this idea of studying overseas. They can give him a chance this time, which is the 7th attempt to get a degree, but they also know how it’s going to end up and then another cycle starts again…

They can only accept to be blackmailed, continuously, endlessly… till the day they give up on him, or he finally has the courage and wisdom to have his OCD treated.