Obsessive-Compulsive Neurosis
Obsessions are composed· of persistent and repetitive inttusions of unwanted, irrational thought, often coming at an inappropriate time. They cannot be banished voluntarily. Petty worries are common examples-"Did I turn the car lights off?" "Did I turn off the stove?" Such persistent thoughts, even tunes that recur for no apparent reason, represent common mild obsessions. Quite common is the irritating TV commercial or jingle that persists in spite of efforts to banish it from memory.
The neurotic's obsessions are different. Not only are they more insistent, they are so disturbing that they interfere with the individual's adjustment. They are often psychologically painful, since they center on morbid thoughts of obscenity, murder, suicide, or death. In the extreme, these obsessive thoughts can disable the individual.
Compulsive symptoms, at a normal level, hit most people. Common examples include paying excessive attention to unimportant matters, fussy tidiness, and sometimes fastidious dress for oneself or children. A compulsion is an irresistible behavior pattern that"may or may not grow out of obsessive thoughts-the compelling urge to express oneself or to repeat some behavior over and over again. At the abnormal level, compulsions often take the form of rituals such as washing one's hands over and over again. Here the indivIdual en· gages in the behavior, unaware that it is an obsession. The compulsive act makes little or no sense to the individual intellectually, but if he or she does not perform it, intense anxiety results. In exaggerated form, compulsion reactions become manias. For example, we frequently hear of pyromania, the compulsion to set fires, and of kleptomania, the compulsion to steal.
Obsessive ideas and compulsive acts may occur separately, but usually the two are combined.
