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 

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