Summary
The Obsessive Compulsive Disorder is a type of anxiety disorder which is mainly associated with obsessions and compulsions in the patient’s mind. The obsessions that linger in the patients mind include thoughts, images and impulses that repeatedly preoccupy the mind and make the individual feel out of control. The patient on the other hand does not find the ideas pleasant but finds them intrusive and realizes that they do not make sense. Karen was obsessed with ideas that some calamities might have befallen her children. However, when the children came back home, she realizes that nothing had befell her children. She occasionally dreamt of some bad omen befalling the family but all this never came to be. The fact that obsessions do not really make sense in the real world is an important feature of the OCD that helps in bringing about a difference between the OCD and other non-OCD disorders. The obsessions are also accompanied by some forms of troubled feelings that usually take different forms like fear and anxiety. Karen also experienced some feelings of rituals which did not make sense in nay way. However, she continued observing them claiming that she felt more comfortable just observing them. The OCD disorder can also make the individual to be engaged in some specific behaviors of rituals so that the individual feels some feeling of relief. Karen frequently had this kind of feeling and felt more relieved when she thought about the rituals and the events that she kept imagining of to be taking place in her life. In order for a person to be diagnosed with OCD there are some specific attributes that such a person needs to depict like having obsession and compulsion. This can be best done by psychologist or a psychiatrist. When Karen had such disorders, she was advised by the family physician to see a psychologist. The socio-setting of the Karen’s childhood days also contributed towards the development of the OCD. Karen had the recurring memory of failing to completely confess her sins and had the feeling that a calamity would befell her, a belief she held on for a very long period of time. In order to improve the situation, Karen was introduced to training, parent education and a renewal relationship with the church. This played a very important role towards ensuring that her condition improved. Exposure and response prevention is another form that played a very important role towards ensuring that Karen’s condition improved greatly.
There are various symptoms that can be depicted by a person suffering from OCD. Most of the symptoms revolve around the two major conditions of obsession and compulsion. Karen depicted quite a number of symptoms among them, obsession thoughts whereby she kept on thinking and imagining that a serious accident had befell her children. She also had excessive worries on anything that took place and if any bad thing happened, she thought that it must have been a sign of bad omen and that a calamity was going to befall her children. Karen also had a variety of repetitive behavior and was very keen on the order and sequence of the actions she took believing that a given sequence could result into a given set of calamities befalling one of her children. When using the DSM-IV, each psychiatric diagnosis is organized into five different axes which are related to different situations of disorder or disability. The categorizations are done as follows: Axis I – V which had several different symptoms.
Diathesis-stress model is a psychological theory that is used to explain how people can end up suffering from mental disorders as a result of making assumptions that mental disorders are as a result of the interaction of both the genetic and the experience. In the Diathesis-stress model, two people can be born with OCD but depending on the conditions that they are exposed to, the disorder can either develop or become suppressed thus not developing. The development of the OCD therefore depends on both the environment and the genetic combination of a given individual. This kind of theory can be commonly applied to mental disorders and in some cases major depression and anxiety disorders. Karen also experienced OCD as a result of socio-setting especially when she was growing up as she had to live with the fear of continuously feeling that a calamity would befall her since she failed to confess all her sins. This can be categorized under the Diathesis-stress model as there is some kind of environmental and social setting that may have caused the propagation of the OCD. Most cases of OCD are propagated by the environmental conditions that different individuals are exposed to. Two people can be born with similar traits however, depending on the exposure that one is subjected to in terms of religion or environment, a person can either have the disorder suppressed or enhanced. Individuals are therefore encouraged to avoid conditions that could lead to the development of the disorder as the effects could be adverse. Karen experienced quite a number of stressful events like having to take care of her children who often gave her a lot of hard times. The children were not supportive and therefore contributed towards her situation getting even worse.
Karen being a Christian did not uphold the use of the contraceptives and therefore opted for the use of natural methods of controlling pregnancy. However, after sometime this became a problem and therefore restricted herself on when they would have a sexual intercourse. As time passed by Karen could have the urge for orgasmic moment and therefore resorted to masturbation which made her feel guiltier. Such thoughts disturbed Karen and are some of the major contributors towards the OCD she was experiencing. Her experience became even worse when her husband started staying at home during the day thus raising more fear for her children’s safety. This is also a case of OCD influenced by the environmental and social setting of the individual. When Karen was pregnant, she witnessed a very unfortunate accident at her neighbor’s place when the neighbor’s one-year child was accidentally run over by another child riding a bicycle. This occurrence traumatized Karen and it was at this point that she started having the feelings of anxiety and could not control what she kept on feeling. After her second pregnancy and moving into their new home, she started becoming distressed as she was missing some of her friends. The environment that Karen was exposed to also resulted into numerous thoughts lingering in her head thus the eruption of more severe thoughts that later resulted to her condition of OCD. In order to help in the treatment and control of Karen’s condition, the treatment goes beyond using drugs alone to control the situation. Karen’s behavior needs to be understood clearly and a solution sought. According to the therapist, Karen’s ritualistic behavior was one of the most difficult areas that needed to be controlled. Karen was involved to a very large extent in ritualistic events more than the social and religious activities that she got involved in during the previous days. The treatment that was sought in such a situation was one that involved the development of interpersonal skills that would give Karen more control of the environment around her. Further treatment to control the condition involved combining assertion training, parent education and renewed interest in the church activities in order to improve Karen’s condition. With time she was able to reduce her reliance and belief in her rituals and the situation improved further. Karen’s ritualistic behavior could therefore be directly addressed using the behavioral treatment method which is also known as exposure and response prevention which exposes the person to stimuli that provoke intense anxiety. After conducting several sessions to control Karen’s ritualistic behavior, it was possible to have the situation completely rectified.
In this case, I would give the individual a range of 61-70. This is because her condition is not so good to be awarded a higher value and at the same time, the condition has not moved beyond control. The individual can still register a comeback as she has realized most of her weaknesses and correcting the condition is not a very big problem. The condition can be easily solved by the engagement of a psychologist who can help the individual to become more responsible of her condition and work towards improving her condition. In order to correct the condition, the individual should be encouraged to avoid distressful moments and improve on the social aspect of life. Through socialization more relationships can be developed which on the other hand removes the boredom of the mind and later on help in involving the mind in more engaging activities hence the elimination of the OCD. The individual’s state cannot be said to be worse or bad but she is just having some mental disorders which can be easily solved through counseling or involving a counseling psychologist who can take the individual through the recovery process. The Multi-axial profile is as shown below:
i. Axis I – this category includes the clinical disorders, substance abuse disorders, learning and mental disorders. Karen had some form of this category of disorders as she was very anxious and depressed as a result of her condition.
ii. Axis II – this category consists of both the individual disorders and the intellectual disabilities. Karen depicted some form of personality disorders when she was completely obsessed with the occurrence of various calamities.
iii. Axis III – consists of various acute medical and physical orders. Karen on the other side did not have any of such disorders.
iv. Axis IV – consists of mainly the environmental and the social factors that contribute to the occurrence of various disorders. Most of the disorders experienced by Karen were as a result of the social and environmental exposure she had when she was a child. She failed to confess her sin and therefore had the mentality that a very big calamity would hit her and therefore lived with a lot of fear in her life.
v. Axis V – involves the GAF for the adults and the children GAS.
