RESUMEN DE PROYECTOS

Being neat, tidy, orderly, organized, and following rules can be a blessing in many situations in life. But when these behaviors are carried to the extreme, they can become disruptive and take over a person’s life. When they do, it’s called obsessive-compulsive disorder (OCD).

Obsessions are recurring and persistent thoughts, impulses, or images that bring on intense anxiety. Examples include images or thoughts of harming someone, being contaminated with dirt or germs, or fearing you left your lights or stove on or your door unlocked. People typically experience these thoughts or images as intrusive (that is, happening despite efforts to resist them), unreasonable, and distressing. Obsessions can become so intense, so consuming, that some people spiral into a full-blown panic attack. This reaction is similar to that seen in panic disorder except that the phobic objects in OCD are thoughts or images rather than bodily sensations or changes.

Here’s a list of some common obsessions. As before, check (√) all items that apply to you: Thoughts that you might harm self or others



Violent or horrific images 

Fear of blurting out obscenities or insults 

Fear of acting on unwanted impulses (for example, to stab a friend) 

Fear of stealing things 

Fear of being responsible for something terrible happening (such as fire or burglary) 

Sexual thoughts, images, or urges 

Fear of acting on “forbidden” impulses (incest, homosexuality, aggressive sexual acts) 

Concern with sacrilege and blasphemy, right/wrong, or morality 

Concern that someone will have an accident unless things are in the right place 

Fear of saying certain things because they might come true 

Fear of losing things 

Intrusive (nonviolent) images, nonsense sounds, words, or music 

Concerns about dirt, germs, or bodily waste or secretions (urine, feces, saliva) 

Concern about getting ill from possible contaminants 

Concern about environmental contaminants (asbestos, radiation, toxic waste) 

Excessive concern with household items (cleansers, solvents) 

Excessive concern about animals (for example, insects) 

Compulsions are repeated ritualistic behaviors (for example, checking, hand washing) or mental acts (such as counting, praying). The purpose of performing rituals is to reduce anxiety and suppress or neutralize the disturbing intrusive thoughts or images. Attending to obsessions and ritualizing is enormously time consuming. And it puts so many constraints on life that people literally run out of time to do what they need to do. This cycle interferes with daily routines and social functioning. In extreme cases, hospitalization may be needed to break the cycle.

Here’s a partial list of common compulsions. As before, check (√) all behaviors that seem to apply to you:

Excessive/ritualized cleaning (hand washing, bathing, toothbrushing, grooming, toilet 

routine)

Excessive cleaning of household items or other inanimate objects 

Checking locks, stove, appliances, and so on 

Checking that you did not/will not harm others or yourself 

Checking that nothing terrible did/will happen 

Checking that you didn’t make a mistake 

Needing to repeat routine activities (jogging, going in/out door or up/down from chair, 

rereading, rewriting)

Compulsively collecting or not being able to get rid of useless objects (e.g., junk mail, old 

newspapers, garbage, and other useless objects such as Band-Aids, ear swabs, wrappers) Performing mental rituals (other than checking/counting)



Excessive list making 

Needing to tell, ask, or confess, or touch, tap, or rub 

Ritualized blinking or staring 

Ritualized eating behaviors 

Engaging in superstitious behaviors 

Compulsive hair pulling (top of head, eyelashes, eyebrows) 

Most people struggling with OCD realize that their rituals are excessive and unreasonable. Yet they continue to do them, chasing a sense of relief that comes about by struggling to neutralize unwanted thoughts and associated anxiety.

The problem is that rituals typically only reduce anxiety for a short while, and then anxiety and tension come right back. The same is true of the thoughts that trigger the anxiety in the first place. In fact, there’s mounting research evidence that attempts to suppress unwanted thoughts and images can actually backfire, setting people up to have the unwanted thoughts with increasing frequency and intensity (Hayes, Wilson, Gifford, Follette, & Strosahl, 1996; Wegner, 1994). This process keeps the vicious cycle going with OCD.

Ray is a forty-year-old office clerk who feels completely controlled by the endless cycle of recurring obsessions, anxiety, and compulsive washing.

Ray’s Story



For as long as I can remember I’ve been terrified of germs and the prospect of getting diseases. When I go to stores, I can’t even open the door myself. I have to stand outside and wait for someone to go in or come out and then I try to catch the door with my elbow. I can’t stand to even think about touching public property and wouldn’t ever leave the house without antibacterial hand gel. I can’t eat off plates or silverware at restaurants, so I never eat out with my friends. Even in my own house I eat off paper plates and use plastic silverware. My hands bleed because I wash them so much. I can’t sleep if I feel like I might have germs on me, and so I have to shower ten times before falling asleep. As much as I want to enjoy normal activities like everyone else, I can’t make the anxiety go away. My cleansing rituals are the only thing that helps, and then the anxiety comes right back again and again. Will it ever end?

Post-traumatic Stress Disorder

Post-traumatic stress disorder (PTSD) is a cluster of anxiety problems that can develop in the wake of a severe traumatic experience. Such experiences would produce intense fear, terror, and feelings of helplessness in anyone. Experiences like that include violent crimes against yourself or family members (such as rape and assault), combat situations (for instance, wounding of self and others, committing or witnessing atrocities), natural disasters (such as earthquakes or tornadoes), and accidents (such as car or plane crashes).

People suffering from PTSD may notice a number of changes after the traumatic event. Some changes affect how they experience their world. These altered experiences may take the form of seeing the world as a dangerous place, feeling emotionally numb, or feeling a sense of detachment from the self or surroundings—like an out-of-body experience. Other changes are more behavioral and may include being startled easily, scanning the environment for threat, and avoidance or escape. These changes tend to creep up on people over a period of several months after the traumatic event.