Whenever my children travel, I always make sure to tell them to “have a safe trip.” Before my husband goes to sleep at night, he makes it a point to be sure all of our doors are locked. A basketball player insists on reciting a specific prayer before each game, and a runner wears her lucky running shoes every time she competes. Do any of these behaviors seem abnormal to you? Probably not.
In this study on ritualistic behavior, researchers concluded that repetitive behavior, especially ritualistic-like behavior, is a common human (and animal) occurrence. This behavior is thought to have evolved as a means to induce calm and alleviate stress. Rituals provide us with the illusion that we are in control of a situation that is really out of our control.
Hmm, sounds a lot like obsessive-compulsive disorder, doesn’t it? While the researchers acknowledge a behavioral link between “normal” human rituals and OCD, they bring up a very important difference: Those with OCD continually wrestle with the feeling of incompleteness, never truly convinced that their task has been completed. Doubt always manifests itself and fuels the fire of OCD.
In general, people with OCD are also more rigid in their adherence to rituals than those without the disorder. As Dr. Jonathan Grayson tells us, “Consistency is the measure of severity, the more consistent you are, the worse your OCD is.” In other words, the more tied you are to your rituals, the more your OCD is controlling you. For example, if for whatever reason I’m not able to tell my children to “have a safe trip,” I might feel a bit uneasy for a minute or two, but I won’t dwell on it and I will still be able to move on with my day. However, someone with OCD with this same ritual might become distraught if not able to perform it and might possibly develop other rituals to “make sure” everything will be okay. For example, he or she might feel compelled to repeat “Everything will be fine” a certain number of times to quell the anxiety felt until the children in question return home safely. These are two very different reactions and it’s not difficult to see how the second scenario could snowball out of control and lead to hours and hours of compulsions.
I believe it is important to remember that the thoughts and rituals of those with OCD are often no different from those who do not have the disorder. Many people don’t realize this. What is different is the severity of these obsessions and compulsions, as well as the importance placed on them by the person with obsessive-compulsive disorder. Back to our example above. If I’m not able to say “have a safe trip” to my children for whatever reason, I might be annoyed or upset over the situation but my feelings would pass quickly. Someone with OCD, however, might think, “What’s wrong with me? What kind of mother forgets or doesn’t make it a priority to tell her children to have a safe trip? Now they might get hurt and it will be all my fault. What a horrible person I am.” It’s easy to see how these thoughts can become obsessions with lives of their own and rituals become compulsions that overtake the OCD sufferer’s life.
Why does this happen? While researchers continue to try to unlock the mysteries of OCD, the good news is we don’t have to understand where OCD comes from to treat it properly. Exposure and response prevention (ERP) therapy teaches those with obsessive-compulsive disorder how to best deal with their intense thoughts and rituals, so they can regain control of their lives.