Film at the end of this post.

The manifestation of overwhelming obsessions, whether thoughts or actions, and compulsions is called Obsessive-Compulsive Disorder (OCD); classically defined as an anxiety disorder characterized by unwanted and repetitive thoughts and/or actions. OCD is classified as an anxiety disorder, psychological disorders characterized by distressing persistent anxiety or maladaptive behaviors that reduce anxiety. A simple crooked painting on the wall can be the equivalent to a giant elephant in the corner. Where a normal individual may be obsessed with why the elephant is there and how they can get rid of it, an OC sufferer can not rest until the frame is straight. 1 in 50 adults in the United States suffer from OCD, while many more hide their disorder because they believe they will be labeled as socially unacceptable, or they are uneducated on what they’re experiencing. It’s hard to understand what someone with OCD is experiencing; they are troubled with obsessive thoughts that are uncontrollable.

OCD usually becomes visible in males at the ages of 6 to 15 and females in their late teens and early twenties. OCD usually does not appear after the age of 25 unless the patient is predisposed and goes through a traumatic event. There are many different types of OCD, which does not always come in pairs of obsessions and compulsions. OCD can be diagnosed if only one obsession or compulsion is expressed. Typical OCD types are sufferers who obsessive over washing, cleaning, hoarding, checking, scrupulosity, and aggression. Examples of manifesting OCD symptoms are irrational checking of door locks, washing hands, or obsession with symmetry. Though these are typical symptoms, OCD can also manifest as thoughts of offending a higher power resulting in repetitive praying and confessing.

The history of OCD can be traced back for centuries to early religious and Greek writings. Some believe that in 14th, 15th, and 16th centuries OCD was erroneously viewed as possession by the devil and resulted in many exorcisms. Early focus on OCD centered on scrupulosity (religious themed) and mainly studied by monks, philosophers, and priests. Richard Baxter (1600) and John Baptist Scaramelli (1753) wrote extensive advice articles on not fighting obsessive thoughts. In the nineteenth and twentieth centuries, Pierre Janet was the first psychiatrist to address OCD. As Janet’s work was published in 1903, Sigmund Freud’s writings on psychoanalysis became popular. Because of Freud’s theories, OCD therapy was set back 50 years. Since 1960, psychologists are making positive strides in OCD therapy and medicine.

There is not yet a cure for OCD, but there are a few theories being researched. Some researchers accept that the causes of OCD are abnormalities in the brain’s neurotransmitters. Researchers have found some evidence that OCD could be a result of a genetic mutation in the human serotonin transporter gene. There may also be size abnormalities in the brain structure. New DNA studies point to possible genetic markers for OCD on chromosomes 1, 3, 7, 6, and 15. Still, other researchers have traced a connection between OCD and contracting strep throat as a child. Research suggests that strep throat infections may result in the development of antibodies that attack the basal ganglia (an area in the brain that is associated with OCD). This theory is referred to as PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Strep). Although, OCD is not a result of childhood trauma or experiences as Freud suggested, prevailing thought is that OCD is a combination of both nature and nurture.

Treatment of OCD can vary, although OCD cannot be cured. A psychologist’s goal for OCD patients is to teach them to learn how to cope with their disability. Psychiatrists can prescribe medicine for OCD. Like most disorders, OCD should be treated with a combination of therapy and medicine. Two highly popular methods of therapy are Cognitive Behavioral Therapy and Systematic Desensitization. Cognitive Behavioral Therapy is an integrated therapy that combines cognitive therapy (changing self-defeating thinking) with behavioral therapy (changing behavior). Systematic Desensitization is a type of counter conditioning that associates a pleasant relaxed state with gradually increasing anxiety-triggering stimuli, commonly used to treat phobias. There is not a set medication to treat OCD. Medications that were developed for depression have had positive affects on OCD patients. In extreme cases, surgery has been an option (a very dangerous one) for OCD patients. Common surgical procedures are capsulotomy and anterior cingulotomy. The goals for the surgeries are to alleviate symptoms of OCD and decrease a patient’s need for medicine. Both surgeries involve changes to the limbic system using high frequency radio waves or thin wires.

In my short movie, Rituals, I follow a fictional character, named Sarah, who suffers from OCD, but has not been diagnosed. I focused on an undiagnosed OCD person, because I think it’s important for the audience to understand how scary OCD can be for someone who doesn’t really understand what he or she is going through. Sarah is 22, a common age when OC symptoms begin to surface. Rituals briefly follows her morning obsessions and compulsions and her constant struggles with her own thoughts and actions. Sarah’s obsessions and compulsions manifest in counting, checking, washing, cleaning, and straightening. I tried to demonstrate Sarah’s anxiety from the moment she wakes up until the moment she leaves, then comes back into the house, because she feels like she didn’t do something right.

After approximately one or two weeks of extensive research on OCD (including reading several websites, a book on OCD, and questioning friends who suffer from OCD), I wrote out all the information to be used for scripting on note cards. Then, Leigh’s (the actress who played Sarah) actions were scripted by storyboard on my bulletin board. It took around three hours to shoot (not including a trip to Walgreens to get cereal, milk, and orange juice). I shot roughly an hour and thirty minutes of film (including scenes from different angles, mistakes, etc). It took around three days to edit for consistency and a day to edit in information.

Resources

• McGrath, PhD, Patrick, The OCD Answer Book, Sourcebooks, Inc.: Naperville Illinois, 2007
• Hemley, MD, David, “It’s a Brain Thing: OCD”, Youtube.com, August 26, 2006, http://www.youtube.com/watch?v=Sy8rTbxQB08.
• Hendrick, MD, Victoria, “What is Obsessive Compulsive Disorder?”, Seekwellness.com, National Institute of Mental Health, http://www.seekwellness.com/conditions/mental/obsessive-compulsive-disorder.html.
• McInvale, Liz, “The Face of OCD”, abcnews.com, April 10, 2006, http://www.abcnews.go.com/GMA/story?id=1821331&page=1.
• Healthboards.com, .