Coming To Understand Obsession

Joanna, Intern

In The Thought that Counts: A Firsthand Account of One Teenager’s Experience with Obsessive-Compulsive Disorder, Jared Douglas Kant tells the story of how he was diagnosed with OCD at the age of 11 and dealt with the disease as an adolescent. Kant is a Clinical Research Assistant at the Massachusetts General Hospital Obsessive-Compulsive Disorder Clinic and Research Unit. Written alongside psychologist Martin Franklin Ph.D., Associate Professor of Clinical Psychology in Psychiatry, Department of Psychiatry, University of Pennsylvania School of Medicine, & Clinical Director, Center for the Treatment and Study of Anxiety, and science writer Linda Wasmer Andrews, a freelance health and psychology writer, The Thought that Counts serves as a guide for teenagers struggling with OCD and is part of the Adolescent Mental Health Initiative series created through a partnership with The Annenberg Foundation Trust at Sunnylands. In the following excerpt, Kant describes his new understanding of obsession in light of his struggles with OCD.

When I was younger, the word “obsession” made me think of infatuation. If a boy fell head over heels for a girl, spending an extraordinary amount of time and energy daydreaming about her and hanging on her every word, people would say, “He’s obsessed with that girl.” Naturally, it didn’t occur to me to use the same word to describe the peculiar thoughts I was having. But as I later realized, there’s a big difference between the everyday meaning of obsession and the scientific definition.

In scientific terms, an obsession is a recurring thought or mental image that seems intrusive and inappropriate, and that causes anxiety and distress. It’s different from simply being preoccupied with a cute classmate or a favorite hobby, because even after obsessive thoughts start causing serious problems, the person feels powerless to stop thinking them. At some point, the person realizes that the thoughts are controlling him or her instead of the other way around.

Obsessive thoughts aren’t just exaggerated worries about real-life concerns. Instead, they’re overblown fears and anxieties with little basis in reality. Yet once these thoughts push their way into someone’s mind, they refuse to leave no matter how hard the person tries to push them out.

Consider my obsession with images of disease, for instance. Flipping through magazines as a boy, I sometimes came across disturbing images of plague and pestilence, such as flies buzzing over open sores. When I saw such pictures, I carefully avoided touching them. Occasionally, though, I would make a mistake. My finger would drag across the ink on the page until it hit one of the infected people. Whenever this happened, I screamed inside. I ran to the bathroom, slathered myself in soap, and turned the hot water up to boil. I was steaming, and I must have looked like a lobster by the time I emerged from the bathroom.

My reaction to touching the images illustrates another critical point: Obsessive thoughts lead to intense anxiety about something bad or harmful that the person fears will occur. The anxiety is so strong that the person feels compelled to do something – anything – to get relief and ward off the feared consequence. That’s how compulsions, such as my excessive hand-washing, are born. From a scientific standpoint, then, a compulsion is a repeated act, either behavioral or mental, that a person feels driven to perform in response to an obsession, to keep something bad from happening or to reduce the associated distress.