Mr. Kaplowitz, have you not read the latest on OCD research? It is, in fact, a neurological disorder, not a disorder of control. Perhaps you’re confusing it with OCPD — that’s on axis II — it’s called, Obsessive Compulsive Personality Disorder, and is characterized by an obsession with rules, feeling that you know the right or wrong way to do things, and a desire to control one’s own and others’ behaviors; this is ego-syntonic, meaning that it fits with the person’s style. OCD, however, is extremely ego-dystonic, meaning that it’s uncontrollable, a nightmare for anyone who suffers from it.
How the heck did you get your masters degree and pass the licensing exam, Mr. Kaplowitz?, with your rudimentary base of knowledge? Get your facts straight.

OCD is a neurological disorder. Many people struggle with shame so intense it’s difficult for them to let people know the so-called “crazy” thoughts they have — for fear people will think they’re psychotic, which they are not. It does emerge first in boys, but there are an equal number of men and women (adults) who experience OCD. It is a terrible disorder, and can be very isolating. Thank goodness for the shows which often depict the worst case scenarios — but put a message out to the public that this exists. It often feels uncontrollable — that you can’t stop the thoughts. There’s also a type called, “Pure O,” which is strictly thoughts — no rituals — and therefore, more easily mistaken or misdiagnosed as GAD (Generalized Anxiety Disorder), or as Panic Disorder. The distinction is that the thoughts run in a circuit, and often follow a similar theme (such as, “I’m going to hurt people I love,” or, “I’ve done something terribly wrong.”).
For those of you who suffer with OCD, a type of Cognitive-Behavioral therapy called Exposure with Response Prevention is the treatment of choice, and involves having you perform a dreaded behavior or think a dreaded thought for a minimum of 30 minutes without doing the rituals or asking for reassurance — behaviors which distract you from experiencing your fear WITHOUT the dreaded fear coming true.
It’s powerful and it does work. There’s a 99-100% success rate. Some people also take a high dose of antidepressants such as Celexa or Prozac, along with therapy designed to help decrease reactions to thoughts. No other therapy (including body oriented therapies/somatic therapies) has been shown by extensive research studies to offer the same relief. Two authors I’d highly recommend are Jeffrey Schwartz (Brain Lock) and Lee Baer (The Imp of the Mind) — specifically for Pure O type. These are excellent books, which really demystify this difficult disorder. If you see a therapist, the therapist should be specially trained in OCD (in Exposure and Response Prevention), otherwise, you end up with therapists with misperceptions.

Most importantly, it’s important to know that OCD is not the person’s fault. It’s not caused by trauma. It’s not caused by stubbornness or rigidity in personality. It’s caused by a malfunction between the caudate nucleus, (the motor strip in the brain, which encourages action; it’s the “I must do something about this,” part of the brain, and the anterior cingulate gyrus which helps people to know right from wrong. Basically, there is more activity in these areas on SPECT scans (see Daniel Amen’s books), which increases questioning, fears, and actions to quell the fears.

OCD is a difficult disorder, but one, with the right treatment, that can be greatly relieved. To those out there who have it: You are not alone. And, you are not crazy. The thoughts may feel crazy at times, but you can find help and feel better. :)