:artist::artist:Obsessive-Compulsive
Disorder- OCD.
A mysterious horror story with a hope for a happy ending.

OCD has nowadays got into the highlight after many centuries of ignorance about this subject and deliberate reluctance to recognize and address this problem in the Soviet and post Soviet psychiatry. Why have people finally started to approach this problem and explore avenues for its solution? It has cost mankind many lost and unidentified talents. How many “girls” and boys have been “interrupted” (allusion to the famous movie” Girl Interrupted”)? How many people are still suffering due to the doctors’ malpractice of having avoided or underestimated this severe, painful and devastating personality disorder?
It was in early sixties, these psychedelic years, when the term “borderline personality disorder” showed up in the West. In the Soviet psychiatry, however, the doctors and scientists had neglected this disease as being the Western “novelty” which was not to be considered by the Soviet nation.
Later in the seventies, however the Soviet school of psychiatry acknowledged this disorder as a slight “functional “disorder termed very lightly and evasively as “neuroses”. Since the Soviet people were not supposed to be sensitive and reflective but determined to achieve one common goal – building the material and technical foundation for “communism”, neuroses were not to be considered as anything serious fraught with performance impairments. People, who addressed neurologists for help, any psychiatric counseling being considered hereby very shameful, embarrassing and compromising were recommended to “take themselves into their own hands” or drink valerian mixture before sleep.
The parents, who were confused, embarrassed and frightened by their children’s “strange” behaviors, where reprimanded by those doctors for having spoiled them by having brought them up as “lazy brats” (avoidant anxiety, behaviors) “obnoxious” ( oppositional behaviors caused by obsessions, and panic), “ undisciplined” (tardiness, procrastination, school dropping due to compulsive episodes and cycles).
In retrospect, looking back at my years of “secret and covert” sufferings of which none of my best friends, colleagues and even my loved ones could have ever suspected, I am now asking myself: “Am I really so misfortunate to have been born at the wrong time and the wrong ideological place? With all the discoveries and knowledge of today how could I have retorted to my child doctor who labeled me as spoiled and lazy? What arguments could I have brought up to my elementary school teachers and principals who made me lose my face before my classmates for having submitted “dirty” papers full of smudges (compulsive writing)?
Whom should I hold accountable or sue for my “interrupted” childhood and life? Had I been given a chance to face my unyielding educators now over all those “vulnerable green years,” I think I would have briefed them on the following.

What is OCD?
OCD stands for Obsessive-Compulsive Disorder. A very simple description of OCD is that it is a condition in which an individual experiences recurrent obsessions and/or compulsions. Obsessions are defined as repetitive thoughts, ideas, or impulses that an individual experiences as inappropriate, intrusive, and unwanted. Compulsions are defined as repetitive behaviors that an individual feels driven to perform in an effort to avoid or decrease the anxiety created by obsessions.
In OCD, obsessions are not just exaggerated fears about real-life situations, and usually are not directly connected to commonplace problems such as normal relationship, academic, or financial concerns. In fact, the individual with OCD is quite often very distressed precisely because he or she recognizes that the thoughts are excessive, irrational and/or inappropriate. Compulsions may appear in various forms, including recurrent observable behaviors such as hand washing, repetitive “mental compulsions” such as praying rituals, or avoidant behaviors that have an almost phobic quality. Often, these obsessions and compulsions are a source of considerable shame and embarrassment, leading the individual to go to great lengths to hide his or her symptoms. The obsessions and compulsions can be extremely time-consuming, often taking up many hours of a person’s day. As a result, OCD frequently causes significant emotional distress, and may greatly interfere with academic and professional functioning, as well as interpersonal relationships.
What is the nature/ etiology of OCD? Is it only environmental disorder due to “ill breeding?”

It is said that communication between the front part of the brain and the deeper parts of the brain are unable to communicate and trigger reactions properly. As a result, it causes one to think that there is a loss of control over certain fears. The chemical messenger that is said to be lacking in most cases is serotonin. This, as well as several other environmental and behavioral reasons are said to be part of the effect of obsessive-compulsive behavior.

What Does Obsessive-Compulsive Disorder Look Like in Children and Adolescents?

The thoughts and behaviors associated with obsessive-compulsive disorder are often perplexing to parents, teachers and peers. Recognizing the symptoms of obsessive-compulsive disorder may be challenging, as the symptoms can easily be misinterpreted as willful disregard, oppositionality, or meaningless worry. In addition, children and adolescents may try to hide their symptoms or may not know how to express their underlying worries. Often, a parent or teacher only sees the end result of the symptom (hours in the bathroom, extended time alone in the bedroom, or tantrums when the child cannot do something his or her way. Children may be able to resist the obsessions and compulsions at school but not at home. Symptoms of obsessive-compulsive disorder at home are often more intrusive than at school. Life for the child and the family can become very stressful, and all family members including the child may feel powerless to change rigid patterns of behavior.
The symptoms may fluctuate, with more symptoms at stressful periods and fewer symptoms at other times. If left untreated, the condition may lead to considerable worry or limitations in other areas of the child’s life. Peer relationships, school functioning, and family functioning: all may suffer. Depression may develop. In some situations, in response to the extreme anxiety, social isolation, and limited activities, a child may develop thoughts of self-harm or not wanting to be alive.
Parents and educators, please try to conceive these very important points no matter how inconceivable or irrational it may seem! Don’t be too soon to say” rubbish’! You must control yourself and stop doing these “stupid, nonsensical” things!” They just can’t help it!!! And this helplessness with the alert criticism and shame towards these behaviors that the children feel compelled to “fulfill” makes them even more depressed and miserable!
• Children with OCD may have difficulty explaining unusual behavior as to what their worries are or why they feel compelled to repeat their behaviors.
• Children and adolescents are often ashamed of their worries or habits and will make great efforts to keep their thoughts or rituals a secret.
• Children with OCD may show vigorous resistance to stopping the obsessions or compulsions (for example, parental reassurance that the child will not become ill from touching an item, does not reassure the child). Frequently, children cannot ignore their symptoms and, instead, feel they must continue their rituals.
• Children with OCD may recognize that they think differently than others their age. Consequently, these children often have low self-esteem!
Children with OCD are aware of their “learning disability” because OCD affects in the first place their “proper” academic performance. In order to keep up with their peers and eventually meet these challenging academic tasks they need a different learning style of which fact if unidentified and unrecognized the teachers may be absolutely unaware and mistake them for bad performers, lacking basic skills (reading writing) and sometimes due to their “poor” academic track record” these children can be” rightly” qualified as retarded or just not smart. In fact, children with OCD may seem to have:
• Difficulty concentrating, which may affect many aspects of school activities, from following directions and completing assignments to paying attention in class. Concentration can be affected by persistent, repetitive thoughts that are not known to others. Finishing work in the appropriate time can be difficult, and just starting schoolwork can be difficult, too.
• Social isolation or withdrawal from interactions with peers
• Low self-esteem in social and academic activities
• Problem behaviors, such as fights or arguments, resulting from misunderstandings between the child and peers or staff. Unusual behaviors may be distressing to the child or peers and lead to clashes.
• Medication side effects that can interfere with school performance. Once a child is receiving medication treatment for OCD, the child should be monitored carefully for new mood changes or behaviors, which could potentially reflect medication side effects.
One of my doctors with the neurological background prescribed me tranquilizers when I was in the 6-7th grades. ( phenozepam, elenium, seduxen, In Israel their synonyms are voben and clonex) Can you imagine me fulfilling difficult and challenging school tasks and home tasks being drowsy and inhibited all the time? I had difficulties in concentration, memorizing textbooks, musical text as I also went to special musical school and my secondary school was one of the most renowned and well reputed schools in the city. It was a total hell for me to catch up with the class and try to save my face before my judgmental and very ambitious peers and very demanding and unbending teachers. It couldn’t even have occurred to them to conceive that it was not the academic disability or retardation but only learning difficulties, difficulties in finding out my coping tools. I just needed special or different learning conditions. Could I have confided in anyone if even the doctors looked down at me?
It is very characteristic for OCD people and children to be more successful in performing challenging tasks related to creativity, problem solving, exploration and dealing with abstract matters (analysis, synthesis hypothesizing, etc) than in dealing with basic, “simple”, technical tasks. That is why my “striking metamorphosis” in high school where neatness of written presentation was considered a lesser priority and the focus was shifted on the brain productive activity with a wider range of opportunities for self expression, exploration, presenting and defending your views and arguments, that is why “my sudden improvement” in all the subjects, including algebra and mathematic analysis, trigonometry, physics and chemistry was inexplicable for my ex elementary school teachers. From a “poor performer” I elementary and junior high school I turned out to be an outstanding” A” student in high school. I was an A student during all my University time of studies and post graduate studies as well. The teachers must have attributed these personal changes to family or peer pressure or to my growth factor getting more responsible and disciplined on the senior developmental stage. Nothing of the kind! My dear teachers! I haven’t changed. I still hate dealing with basics (adding and deducting sums, my handwriting is as horrendous as it has always been.) And I can’t do neat things with my hands and still have compulsive reading and writing episodes.
Computers- the breakthrough invention like SSRI drugs have facilitated my professional pursuit and thus have made me more adapted to life. I still struggle with compulsive reading in spite of the fact that I used to read and am reading tons of written items: fiction and specialized literature, press, documents, scientific articles but in a different way which is sometimes a challenge.
I wish SSRIs had been discovered 10-15 years back! I wish the knowledge of “special needs” students had been obtained and admitted 10-15 years ago and my teachers had been more educated, more open-minded, flexible and more sensitive to” special needs” children.
But I am not going to convert my academic paper into a rostrum from which I could cast my allegations towards the public health and education in the ex-Soviet Union. Although our pedagogical and medical sciences failed to meet my needs and help me cope with my problems I still owe my acknowledgement to my first English teacher who identified me as “a very gifted pupil with a rare gift for language learning”. My choice for my life long profession, career and modus vivendi was determined by my avoidant behavior – to avoid any situations where I failed and go for the situation where I excelled. Thus, language learning and then language teaching has become my best remedy which has helped me to replace my life full of sufferings and inner struggles into a life of a successful performer and highly reputed professional. I would like to remark, however, that my case is not a success story 100% since OCD, if not duly properly identified and addressed won’t go away. The symtopms persist to haunt you throughout your entire life. Symptoms may come and go, depending on the environmental and somatic factors ( stress exposure, infections, like colds and flu, exacerbating the OCD symptoms), Sometimes you seem to believe that you are free and you can keep that way for a considerable time frame ( long remissions), but sometimes when the OCD trigger is activated all of a sudden and often inadvertently you are again entrapped by a short or long relapse and you give in, feeling defeated and hopeless realizing that you will never break through and will have to be ever be“ alert” and in the stand-by mode for the rest of your life.
In reference to the above said and in the light of the new approaches to different learning I would suggest that further investigation and research into OCD and further elaboration of effective and efficient solutions( interventions and preventions) be done to deal with this severe learning and life impediment.
Finally, the scientists, especially our Western counterparts, are making big efforts to address this problem and they keep on coming up with new suggestions of ways how to collaboratively maximize and synergize the effect that their studies have discovered.
They are trying to tackle this problem from different perspectives: set up special foundations and communities geared towards solving this issue,
Besides the turnaround, revolutionary changes and achievements in the contemporary psychiatry and pharmacology (the new generation of antidepressants, SSRIs -Sensitive serotonin reuptake inhibitors, beta-blockers, and anxiety relievers), there have also appeared a number of innovative and effective approaches and methods in psychotherapy. The new Cognitive- behavioral approach is a psychotherapeutic technique whereby the patient cooperates with the doctor, rather than passively follow his prescriptions. The old and “traditional “method of psychotherapy (autogenic coaching) has proved totally ineffective and in some cases even counter-productive,
With regard to the school setting and OCD interventions at school the educators have come up with some workable tips for a classroom teacher that I wish had been implemented much, much earlier!
I wish the classroom teachers should have been able to do the following:

 Check in on arrival to see if the child can succeed in certain classes that day
 Allow more time to complete certain types of assignments
 Accommodate late arrival due to symptoms at home
 Offer strategies for the child to resist uncomfortable thoughts
 Allow the child to tape record homework if the child cannot touch writing materials
 Give the child a choice of projects if the child has difficulty beginning a task
 Suggest that the child change the sequence of homework problems or projects ( for example, if the child has fears related to odd-numbers, start with even-numbered problems )
 Adjust the homework load to prevent the child from becoming overwhelmed. Academic stressors, along with other stresses, aggravate symptoms.
 Anticipate issues such as school avoidance if there are unresolved social and/or academic problems )
 Be aware that transitions may be particularly difficult for the child. When a child with obsessive-compulsive disorder refuses to follow directions or do transition to the next task, for example, the reason may be anxiety rather than intentional oppositionality.
In other words studying the OCD issues for teachers and paying this issue a better attention, being more flexible and providing a supportive environment will be one the most valuable contributions for the children with OCD which together with other proper interventions will help the children to alleviate their suffering.