Just Checking: Scenes From the Life of an Obsessive-Compulsive

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Just Checking by Emily Colas [1] is an account of her experience with obsessive-compulsive disorder. Divided into four sections, Colas provides snapshots of her life in a journal like manner. The text conveys her emotions regarding the disease throughout her entire life including her childhood and her role as a mother herself.

Contents

Overview

Just Checking: scenes from the life of an obsessive-compulsive was written by Emily Colas in the year 1998. Separated into four parts, Emily Colas provides snapshots of her daily life and the struggles that she faces as a result of her disorder: obsessive-compulsive disorder. The anecdotes of her life are written in a journal-like manner. The entries cover all aspects of her life from her cheating college boyfriend, to her family life and raising her two children, and to her interaction with friends. Throughout all of the excerpts Emily Cola’s frantic worries are evident, especially her constant fear of contracting diseases from the most common daily interactions with other humans. Colas’ most evident worry is that she will instantaneously contract a disease from the most minuscule sample of blood. When strangers, including the babysitter of her children, enter her home she becomes obsessed with every possible chance that they may infect her home. Therefore, Colas’ developed a system of checkpoints so she could determine whether or not the bathroom was used, a drawer opened, or anything touched. As the book proceeds the narrator begins to deal with her illness and she struggles to get better. Her marriage fell apart as a result of her disorder and she and her husband divorced. Eventually, after Colas’ married life disintegrated, she decided to take action and get help for her disorder. The narrative covers the stress that her condition placed on her family. A family member's negative response to the person's disorder can increase the OCD behavior. [2] Colas started taking medication and made the conscious effort to stop obsessing over unimportant matters. The last section of entries demonstrates a healthier and more controlled person and the reader sees a change in the narrator.

OCD in college students

In her narrative, Emily Colas covers her time as an obsessive-compulsive college student. She writes that she had a bad habit of using drugs. She was a consistent user until one evening she had a terrible experience. She decided that drugs were not for her and she felt that God had chosen another path for her. Once she stopped using drugs she developed "extreme and intrusive neurotic thoughts." Colas' condition is not uncommon in college students. OCD affects 5 of every 1,000 students. [3] Obsessive-compulsive disorder is a biological anxiety disorder that causes a person to obsess over worries or fears and perform rituals in order to satisfy the worries. [4] For many people Obsessive-Compulsive Disorder first surfaces during their college career. This is because individuals with the disorder may have had more control over their condition while living at home with a family. Symptoms may not have interfered with the person's life or the person may have merely been labeled a perfectionist. Stress and adjusting to a new environment does not cause OCD, it does however provide an opportunity for symptoms to emerge. Emily Colas writes of the difficulty she faced in college due to her disorder. She struggled socially, as she began dating. Colas had developed a fear of eating at restaurants because she worried she would be poisoned. Fears like this are common among people with OCD. There are many different steps a college student can take to deal with their disorder. University health centers are available on most campuses and help can be provided to those who think they may have OCD. Cognitive behavioral therapy accompanied by medication is the most common treatment for the disorder. Cognitive behavior therapists work with OCD patients to overcome their fears by talking them through the process of facing their fears. This method of treatment has proven to be the most effective. Although this method is extremely effective, patients should also stay away from certain over-the-counter drugs and caffeine. Meditation is also a healthy choice because it has a calming effect. [5] Colas' condition was not uncommon for college students and today there are several places for students to go to get help.

Compulsions

Those with obsessive-compulsive disorder continually practice rituals or routines in order to satisfy their intrusive worries and fears. Emily Colas describes several routines that she completes daily in order to ensure that she does not contract a disease. Colas has a rather complex routine for taking out the garbage. She had her husband undergo an extensive procedure of taking out the trash to ensure that no germs entered her home. Colas also had a habit of double checking things. When putting on the dishwasher she would check several times to be certain that her cats were not inside the appliance. Eventually she started locking the cats in the bathroom when it was time to wash the dishes. Routines like Colas' are typical of OCD patients. These routines are meant to satisfy their worries and make the person feel better temporarily. Often the patients feel compelled to perform these rituals. A person's worries generally fit into three categories: overestimation of threat, intolerance of uncertainty, and the over-importance of one's thoughts and the desire to control these thoughts. [6] Common rituals or routines of OCD patients include excessive cleaning, checking locks, ordering or arranging items in a certain way, and saving or sometimes hoarding items. [7] These routines are exhausting for the person to keep up with and they only satisfy their worries temporarily.

Narrative medicine

Just Checking fits into the literary genre of narrative medicine. Rita Charon describes Narrative Medicine as "medicine practiced with the narrative competence to recognize, absorb, interpret, and be moved by the stories of illness." [8] The purpose of narrative medicine is to add a more meaningful component to sickness and disease. Emily Colas' literary work is an illness narrative because Colas describes her disorder with emotion. She covers all aspects of her life in regards to the disease through her narrative. She acknowledges the illness and releases her feelings towards her dysfunctional condition. Colas' narrative provides an outlet for her to discuss her disorder and reflect on her journey to recovery.

Related Research Articles

Anxiety disorder Cognitive disorder with an excessive, irrational dread of everyday situations

Anxiety disorders are a cluster of mental disorders characterized by significant and uncontrollable feelings of anxiety and fear such that a person's social, occupational, and personal function are significantly impaired. Anxiety may cause physical and cognitive symptoms, such as restlessness, irritability, easy fatiguability, difficulty concentrating, increased heart rate, chest pain, abdominal pain, and a variety of other symptoms that may vary based on the individual.

Hypochondriasis Medical condition

Hypochondriasis or hypochondria is a condition in which a person is excessively and unduly worried about having a serious illness. An old concept, the meaning of hypochondria has repeatedly changed. It has been claimed that this debilitating condition results from an inaccurate perception of the condition of body or mind despite the absence of an actual medical diagnosis. An individual with hypochondriasis is known as a hypochondriac. Hypochondriacs become unduly alarmed about any physical or psychological symptoms they detect, no matter how minor the symptom may be, and are convinced that they have, or are about to be diagnosed with, a serious illness.

Obsessive–compulsive personality disorder Personality disorder involving orderliness

Obsessive–compulsive personality disorder (OCPD) is a cluster C personality disorder marked by an excessive need for orderliness, neatness, and perfectionism. Symptoms are usually present by the time a person reaches adulthood, and are visible in a variety of situations. The cause of OCPD is thought to involve a combination of genetic and environmental factors, namely problems with attachment.

Scrupulosity is characterized by pathological guilt/anxiety about moral or religious issues. It is more commonly known as religious anxiety. It is personally distressing, objectively dysfunctional, and often accompanied by significant impairment in social functioning. It has not been proven to be an actual disorder by medical professionals, though it falls under the anxiety category. It is typically conceptualized as a moral or religious form of obsessive–compulsive disorder (OCD), The term is derived from the Latin scrupulum, a sharp stone, implying a stabbing pain on the conscience. Scrupulosity was formerly called scruples in religious contexts, but the word scruple now commonly refers to a troubling of the conscience rather than to the disorder.

Lovesickness refers to an affliction that can produce negative feelings when deeply in love, during the absence of a loved one or when love is unrequited. It has been considered a condition since the Middle Ages and symptoms that have remained consistent across time include a loss of appetite and insomnia.

An intrusive thought is an unwelcome, involuntary thought, image, or unpleasant idea that may become an obsession, is upsetting or distressing, and can feel difficult to manage or eliminate. When such thoughts are associated with obsessive-compulsive disorder (OCD), depression, body dysmorphic disorder (BDD), and sometimes attention-deficit hyperactivity disorder (ADHD), the thoughts may become paralyzing, anxiety-provoking, or persistent. Intrusive thoughts may also be associated with episodic memory, unwanted worries or memories from OCD, post-traumatic stress disorder, other anxiety disorders, eating disorders, or psychosis. Intrusive thoughts, urges, and images are of inappropriate things at inappropriate times, and generally have aggressive, sexual, or blasphemous themes.

Emily Colas is an American author. Her book Just Checking: Scenes From the Life of an Obsessive-Compulsive illustrates her struggle with obsessive-compulsive disorder (OCD), and the effects it had on her life and family. She lives in Los Angeles.

The obsessive–compulsive spectrum is a model of medical classification where various psychiatric, neurological and/or medical conditions are described as existing on a spectrum of conditions related to obsessive–compulsive disorder (OCD). "The disorders are thought to lie on a spectrum from impulsive to compulsive where impulsivity is said to persist due to deficits in the ability to inhibit repetitive behavior with known negative consequences, while compulsivity persists as a consequence of deficits in recognizing completion of tasks." OCD is a mental disorder characterized by obsessions and/or compulsions. An obsession is defined as "a recurring thought, image, or urge that the individual cannot control". Compulsion can be described as a "ritualistic behavior that the person feels compelled to perform". The model suggests that many conditions overlap with OCD in symptomatic profile, demographics, family history, neurobiology, comorbidity, clinical course and response to various pharmacotherapies. Conditions described as being on the spectrum are sometimes referred to as obsessive–compulsive spectrum disorders.

Sexual obsessions are persistent and unrelenting thoughts about sexual activity. In the context of obsessive-compulsive disorder (OCD), these are extremely common, and can become extremely debilitating, making the person ashamed of the symptoms and reluctant to seek help. A preoccupation with sexual matters, however, does not only occur as a symptom of OCD, they may be enjoyable in other contexts.

Compulsive behavior Habit and impulse disorder

Compulsive behavior is defined as performing an action persistently and repetitively without it necessarily leading to an actual reward or pleasure. Compulsive behaviors could be an attempt to make obsessions go away. The act is usually a small, restricted and repetitive behavior, yet not disturbing in a pathological way. Compulsive behaviors are a need to reduce apprehension caused by internal feelings' a person wants to abstain from or control. A major cause of the compulsive behaviors is said to be obsessive–compulsive disorder (OCD). "The main idea of compulsive behavior is that the likely excessive activity is not connected to the purpose to which it appears directed." Furthermore, there are many different types of compulsive behaviors including shopping, hoarding, eating, gambling, trichotillomania and picking skin, itching, checking, counting, washing, sex, and more. Also, there are cultural examples of compulsive behavior.

Exposure therapy is a technique in behavior therapy to treat anxiety disorders. Exposure therapy involves exposing the target patient to the anxiety source or its context without the intention to cause any danger. Doing so is thought to help them overcome their anxiety or distress. Procedurally, it is similar to the fear extinction paradigm developed for studying laboratory rodents. Numerous studies have demonstrated its effectiveness in the treatment of disorders such as generalized anxiety disorder, social anxiety disorder, obsessive-compulsive disorder, post-traumatic stress disorder (PTSD), and specific phobias.

Racing thoughts refers to the rapid thought patterns that often occur in manic, hypomanic, or mixed episodes. While racing thoughts are most commonly described in people with bipolar disorder and sleep apnea, they are also common with anxiety disorders, OCD, and other psychiatric disorders such as attention deficit hyperactivity disorder. Racing thoughts are also associated with sleep deprivation, hyperthyroidism and the use of amphetamines.

Primarily cognitive obsessive-compulsive disorder is a lesser-known form or manifestation of OCD. It is not a diagnosis in the DSM-5. For people with primarily obsessional OCD, there are fewer observable compulsions, compared to those commonly seen with the typical form of OCD. While ritualizing and neutralizing behaviors do take place, they are mostly cognitive in nature, involving mental avoidance and excessive rumination. Primarily obsessional OCD takes the form of intrusive thoughts of a distressing or violent nature.

Obsessive–compulsive disorder Disorder that involves repeated thoughts that make a person feel driven to do something

Obsessive–compulsive disorder (OCD) is a mental and behavioral disorder in which a person has intrusive thoughts and/or feels the need to perform certain routines repeatedly to an extent where it induces distress or impairs one's general functioning.

Stanley Jack Rachman was a psychologist and Professor Emeritus of the Department of Psychology at the University of British Columbia in Vancouver, British Columbia, Canada.

Thomas R. Insel American neuroscientist

Thomas Roland Insel is an American neuroscientist and psychiatrist who led the National Institute of Mental Health (NIMH) from 2002 until November 2015. Prior to becoming Director of NIMH, he was the founding Director of the Center for Behavioral Neuroscience at Emory University in Atlanta, Georgia. He is best known for research on oxytocin and vasopressin, two peptide hormones implicated in complex social behaviors, such as parental care and attachment. He announced on Sept. 15, 2015, that he was resigning as the director of the NIMH to join the Life Science division of Google X. On May 8, 2017, CNBC reported that he had left Verily Life Sciences. Insel is a Co-founder with Richard Klausner and Paul Dagum of a digital mental health company named "Mindstrong," a Bay-area startup. He has also co-founded NEST Health, NeuraWell Therapeutics, and Cortical Capital.

Susan Swedo is a researcher in the field of pediatrics and neuropsychiatry. Beginning in 1998, she was Chief of the Pediatrics & Developmental Neuroscience Branch at the US National Institute of Mental Health. In 1994, Swedo was lead author on a paper describing pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS), a controversial hypothesis proposing a link between Group A streptococcal infection in children and some rapid-onset cases of obsessive-compulsive disorder (OCD) or tic disorders such as Tourette syndrome. Swedo retired from the NIH in 2019, and serves on the PANDAS Physician Network.

The delayed-maturation theory of obsessive-compulsive disorder suggests that obsessive-compulsive disorder (OCD) can be caused by delayed maturation of the frontal striatal circuitry or parts of the brain that make up the frontal cortex, striatum, or integrating circuits. Some researchers suspect that variations in the volume of specific brain structures can be observed in children that have OCD. It has not been determined if delayed-maturation of this frontal circuitry contributes to the development of OCD or if OCD is the ailment that inhibits normal growth of structures in the frontal striatal, frontal cortex, or striatum. However, the use of neuroimaging has equipped researchers with evidence of some brain structures that are consistently less adequate and less matured in patients diagnosed with OCD in comparison to brains without OCD. More specifically, structures such as the caudate nucleus, volumes of gray matter, white matter, and the cingulate have been identified as being less developed in people with OCD in comparison to individuals that do not have OCD. However, the cortex volume of the operculum (brain) is larger and OCD patients are also reported to have larger temporal lobe volumes; which has been identified in some women patients with OCD. Further research is needed to determine the effect of these structural size differences on the onset and degree of OCD and the maturation of specific brain structures.

Judith L. Rapoport American psychiatrist

Judith L. Rapoport is an American psychiatrist. She is the chief of the Child Psychiatry Branch at the National Institute of Mental Health (NIMH), part of the National Institutes of Health (NIH) in Bethesda, Maryland.

Carolyn I. Rodriguez Puerto Rican psychiatrist, neuroscientist, and clinical researcher

Carolyn I. Rodriguez is a Puerto Rican psychiatrist, neuroscientist, and clinical researcher developing treatments for obsessive compulsive disorder as well as mapping circuit dysfunction in the human brain. Rodriguez holds appointments in both clinical and academic departments at Stanford University. Rodriguez is a Clinical Lab Director at the Stanford Center for Cognitive and Neurobiological Imaging, an associate professor and Associate Chair of Psychiatry and Behavioral Sciences, and a Director of several specialized translational research programs.

References

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