Educ. 5340-Diverse Families Final Paper

Obsessive Compulsive Disorder-My Friend Peg

People talk about their "special friends." I have special friends, too, but the words have taken on a whole new meaning since I have worked with the people at the REM Home. This is a home for the mentally-handicapped. Seventeen mentally-handicapped ladies gather to learn about healthy eating. I have enjoyed this group for more than two years. That was when I met Peg. The rural community couldn't believe I was going to such a place. They described the REM Home as a place for the crazy, insane, nuts, and loony people.

Rather then making assumptions, I started to give some monthly basic nutrition programs on healthy eating. I found the ladies to be caring and fun to be around. They do, however, exhibit a certain level of peculiarity as human beings. This uniqueness (or diversity) is what stimulated public reaction.

For research or investigation process for this paper, I conducted fifteen hours worth of personal interviews with Peg, my friend, and Sue, the caregiver at the home. The interview format was free flowing and without structure. Additional research on Obsessive Compulsive Disorder was conducted via the Web.

Peg's Story as told by Sue

Peg was extremely close to her parents. They did everything together. They worked, played, and enjoyed life. One week end her parents ended up in a fatal car accident involving a train and car. Peg was the survivor, but suffered much mentally. However, her life of terror was just beginning. She was an only child and was taken in by her elderly grandpa. Things were tense between the two individuals. After a year, Grandpa started abusing Peg. Peg became with drawn in school. She was very angry and would lash out at her friends. One evening, it was so bad her and grandpa; Peg went to the neighbors. The neighbors reported the situation. After many foster homes and schools, Peg ended up at the REM Home. Peg has more problems then OCD. Many conditions are hard to treat and maintain.

INTERVIEWING SUE

After a few months of presenting at the home, I asked Sue, the caregiver at the home about Peg's condition. Sue said that Peg has Obsessive Compulsive Disorder (OCD). OCD is an anxiety disorder characterized by an inability to resist or stop continuous abnormal thoughts or fears combined the ritualistic, repetitive and involuntary defense behavior.

She went on to say that the cause of this disorder is unknown. However, there are several psychological theories related to its cause. Major depression and organic brain syndrome may contribute to its onset.

There are two features of this disorder. "Obsession" is recurrent and persistent thoughts, ideas, or images invade the conscious awareness. Sue felt that Peg's thoughts would be of contamination and worry. Peg had lost her parents in the accident when she was eight years old. An elderly abusive grandpa raised Peg. The next feature,"compulsion," is an act the individual feels compelled to take in response to an obsession, even though it is senseless and tends to be repetitive. A great deal of anxiety is created if this compulsion is not performed. Sue explained that Peg's compulsion would be about contamination. Peg is always cleaning. Peg is cleaning counters, rearranging things, and washing hands. Sue said the compulsive obsession action temporarily relieves the anxiety; but the anxiety relief is short-lived, and the compulsion soon returns.

In talking with Sue, she said that Peg becomes very angry if the compulsive behavior is brought up in conversation. She does not realize that she is constantly moving things and cleaning.

OBSERVATION AND INTERVEIWING PEG When I first met Peg, she was busy and I asked what she was doing. She replied, "The table is dirty-can't you see the dirt on it?" I asked if she could sit down and talk with me, but she was too busy. She was complaining about the other people in the home that did not pick up their things.

I noticed that Peg had some tic (blinking in the eye and a shoulder that shrugs).

I interviewed Peg. She was busy cleaning and wiping off the table. I asked why she was doing that and she said that the other people in this home leave the place in such a mess. She said, "I have to work day and night to keep this place nice and clean."

Another time when I was at the REM Home, I was setting up my things. Peg said that she would wipe off the table. She was very insistent. As soon as I finished my presentation, Peg was cleaning the table again.

During my presentation on another occasion, Peg was sitting at the table and rearranging the materials that I was using. I am sure she never realized what she was doing.

On another occasion, Peg looked very nervous. I observed her talking to the caregiver. Peg came across as being stressed, pressured, and irritable. I overheard the caregiver tell her that I know you did not sleep well last night. Peg also complained of an upset stomach.

I noticed that Peg's hands were rough and red. The hands looked like they might hurt and be painful.

As I entered the home, Peg looked upset. After talking with her, I found out that she did not know that I was coming. Sue was sorry that this had happened and that this is a trait of a person with OCD. They like to stick to a schedule and do not care for changes.

RESEARCH FINDINGS ON THE WEB

There are very few people that have recovered from obsessive-compulsive disorder without treatment.

Research suggests that OCD involve problems in communication between the front part of the brain (the orbital cortex) and deeper structures (the basal ganglia). These brain structures use the chemical messenger serotonin. It is believed that insufficient levels of serotonin are prominently involved in OCD. Drugs that increase the brain concentration of serotonin often help improve OCD symptoms.

The most common themes of obsessions involve dirt and contamination, religion, aggression, sex and doubt. For example, a person with OCD may be preoccupied with visions of dirt and germs and may not be able to stop these disturbing thoughts. Another example would be a gentle, nonviolent person who experiences recurring thoughts of losing control. A person may realize that the obsessions are a product of his her own mind and attempts to suppress them or neutralize them with some other thought.

There are two main types of compulsions: overt, or behavioral, and covert. Common overt behavioral compulsions are cleaning and checking. An example of a compulsive cleaner would be someone who continuously scrubs everything in sight, including themselves. Examples of covert compulsions are mental strategies, such as thinking happy thought or visualizing certain images to neutralize distressing obsessions. Compulsions are performed in an attempt to relieve anxiety, though they have little effect on the person's anxious state.

No specific genes for OCD have yet been identified, but research suggests that genes do play a role in the development of the disorder in some cases. Childhood-onset OCD tends to run in families (sometimes in association with tic disorders). When a parent has OCD, there is a slightly increased risk that a child will develop OCD.

OCD is potentially devastating illness that can result in considerable social and economic disability for both afflicted patients and for their family members. OCD is usually treated with a combination of specific behavioral therapies, called exposure and response prevention, and medications. It is important to note that many psychoactive medications are not likely to help OCD symptoms, but that a number of particle effective drugs have now been carefully evaluated. The treatment, however, for most OCD patients should involve the combination of behavior therapy with medications.

The majority of the drugs that help OCD are classified as antidepressants. It is important to note that depression commonly results from the disability produced by OCD, and that doctors can treat both the OCD and depression with the same medication.

Some psychiatric conditions that frequently occur along with OCD are anxiety disorders, depression, disruptive behavior disorders, learning disorders, hair pulling, and body dysmorphic disorder (imagined ugliness).

OCD patients may also have tics (brief muscle jerks, such as repetitive eye blinks, nervous cough, or shoulder shrugs), there is now evidence that very low doses of neuroleptic drugs with an anti-depression medication may help OCD symptoms.

Some of the people with OCD tend to wash their hands a lot and their hands become raw and sore looking.

During my interview and observation process with Peg, I begin to understand her actions and thoughts. I told Peg that I really enjoyed her and liked visiting with her. She responded with a hug. I also told her that she is my special friend.

In teaching nutrition to Peg and her friends, I wondered if they were learning the basics of nutrition. It brought tears to my eyes the evening that my friend Peg led the group in a jingle that had been taught a few months before. I asked, "What does bread do." As they danced around they said-"Bread gives us energy."

I have learned a lot from my special friend, Peg. Her acts of kindness and caring are overwhelming. My level of understanding this type of diversity has increased greatly.

Ilene Sorensen

-- Anonymous, March 28, 2000