What Causes Obsession, Compulsions

 Vijai P.Sharma, Ph.D. Clinical Psychologist

This is the fifth article in a series of eight on obsessive-compulsive disorder.

Unwanted thoughts can lead to unwanted behaviors, thus forming a vicious cycle.  It is obvious that obsessions cause compulsions, but we don't know what causes obsessions.

Generally, one in six OCD suffers gets progressively worse while some outgrow the symptoms without any treatment.  Some have "episodes" without any symptoms between episodes.  No one really knows what causes obsessive-compulsive disorder, and no one can predict who will get it.

Does OCD originate in the sexual and angry impulses in childhood?  Are our fears determined by the way we think?  Do certain beliefs and thoughts result in obsessive thinking and compulsive rituals?  We have theories to speculate about the causes and studies that tell us that some things go with OCD some of the time. Including:

Stress - OCD generally waxes and wanes in life and stress can exacerbate or trigger the OCD symptoms for the very first time.  Stress makes us all more vulnerable to fears and therefore to OCD.  School or work problems, divorce in the family, the death of a loved one, illness, accidents or other major life changes can trigger or worsen the OCD symptoms in children and adults.  In women, the onset of OCD can also be brought about by pregnancy, childbirth or abortion, especially in the form of obsessional fears about the baby.

Brain dysfunction - The observation that in some cases OCD begins after encephalitis, head trauma or some other brain disorder led experts to believe that brain abnormalities such as in the frontal lobes and basal ganglia may cause OCD.  When we perform an action, parts of our brains give us feedback so we can stop ourselves from doing it again.  When specific parts of the brain are destroyed, rats go on eating, hoarding or copulating endlessly as if they just cannot reach satiety or don't how to stop.  It is believed that the brain receives feedback that an activity is just performed. So it can order the body not to repeat the action.  According to the brain defect theory, OCD occurs because something goes wrong with the brain's feedback loop.

Another brain defect theory concerns defective memory.  OCD sufferers, doubting their memory, continually check and recheck "forgotten" actions.  Is it a disorder of memory?  Memory of an OCD individual when compared with non-OCD individuals seems to be equally good, if not better.  I think that OCD sufferers lack confidence in their memories.  They don't have defective memories.

Genetics - Twenty-five percent to 30 percent of OCD sufferers come from families in which other family members also have OCD.  Does a child in such a family merely copy the symptoms of his parents or grandparents?  Not likely, because symptoms may differ between generations.  For example, father may be a "checker" and child may be a "contamination."  Most experts now believe we can inherit a tendency to develop OCD under certain conditions. 

Brain chemicals - Our brain is a chemical factory; it produces 200 different neurotransmitters (brain chemicals).  Serotonin is one of them.  According to serotonin theory, OCD patients have some levels or in their responsiveness to serotonin.

Learned behavior  Some say that if a child is taught that he or she will go to hell for thinking (bad) thought, he or she may be predisposed to fear and develop compulsions to reduce those fears when bad thoughts occur.  OCD sufferers tend to be more religious, though not all religious people have OCD.  Strict toilet training and rigid upbringing was once wrongly thought to be the basis of OCD.

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Copyright 1996, Mind Publications 


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