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Working with ocd- the case of majorie

Obsessive-Compulsive disorders Obsessive Compulsive disorder is an anxiety disorder where an individual experiences distressful and obsessive thoughts (thoughts, ideas that intrude the consciousness of a person and are repugnant, the thought form against the persons will and one tries to resist them) and behaviors or compulsions, a recurrent form of behavior carried out due to a strong urge of compulsion (Martin, Fiona & Richard, 2001). According to Freeman, the key element of OCD is the occurrence of recurrent thoughts that are accompanied by the urge of compulsion and inability to resist them. Obsessions such as, fear of germ or dirt contamination leads to compulsive ritualistic cleansing. Studies show that almost four million people suffer from OCD and nearly half of these people develop the disease before the age of 19.
Overview of Case
Marjorie is a 24-year-old, Caribbean American. She was born in West Indies, but her family immigrated into the US when she was four years old and later they acquired American citizenry. Marjorie is unmarried and has no children. She is employed temporary in her church. As a teenager, she started experiencing discomfort in touching things such as toilet seats, desk chairs, light switches or items that had public contact. As her condition accelerated, she found herself requiring to leave the workplace to go home and take a hot shower and change clothes. She cleans the house thoroughly several times in a week, washes her clothes on a daily basis and cleans her hand 20-30 times a day. When at home, she is so obsessed with her cleaning rituals that she baths for almost an hour several times in a day using three to four washcloths. She changes her clothes several times in a day and has a phobia of meeting new people for fear that they might contaminate her.
Marjorie, when growing up used to assist her mother clean the house. These actions drew favorable attention from her parents especially her father. When her father passed on, she missed the special mentions such that whenever she thought of her father she would feel anxious and would begin her cleaning rituals, this helped her feel connected to his memory and gave her a feeling of control over her life. Marjorie’s cleaning practices became more recurrent with her compulsive thoughts about feeling secure and in control. It drew the concern of both her siblings and employer especially due to her increased habit to leave mid shift that put her job on the line. When she visited a clinic she did not shake hands with the examiner. She was thin and anxious. She was examined using a general psychological assessment, The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). A psychiatrist, who diagnosed her with OCD, prescribed Zoloft® (a selective serotonin reuptake inhibitor, SSRI). She was taken through a cognitive behavior therapy (CBT) to address her condition.
Determining the direct cause of OCD is challenging for Psychiatrist, thus most look at OCD from a biological perspective i. e. heredity factors and the upbringing. The psychiatrist in Marjorie’s case started by speaking to her about her family and also psychological factors such as, the house should always be clean and if I do good factor people notice. OCD can also be attributed to the brain chemical serotonin. Though methods to measure serotonin have not been developed studies of the platelets, spinal fluid and effects of certain drugs have led scientist to conclude of a possible link of serotonin and OCD. Studies have also shown that parental training and approach to things may have an effect on the children. Such manners draw out rituals from the kids. OCD affects the carrier and those around them. They take over their being and activities that interfere with their co-existence with others.
Reference
Swinson R., Antony M., Richter M., (2001) Obsessive-Compulsive Disorder, Guilford press.
Rachman S., Silva de P., (2009) Obsessive-Compulsive Disorder, Oxford University press.
Lehman P. (2006), Psychotherapy in a Nutshell, Author house.

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