OCD through a Socio-Cultural Lens
What is Obsessive-Compulsive Disorder? Most of us are better conversant with the term OCD, aren’t we? Is it just about keeping your room spick and span and wanting things to be in order? Is it only about having a fear of germs and contamination, or is there something more to it? People more than often have this tendency to casually throw around the word OCD without knowing the depth and the nuances of the disorder.
Symptoms & Diagnosis
Obsessive-Compulsive Disorder is a mental disorder that causes repetitive sensations or unwanted thoughts (obsessions). Indulging in repetitive routine activities (compulsions) is another critical feature of this disorder. Negative thoughts, restlessness, doing things in a specific order for a particular number of times, being anxious about self and others, are just some of the symptoms of OCD. People diagnosed with OCD indulge themselves in these compulsions or rituals to relieve themselves of the distress and anxiety caused by recurring thoughts.
OCD can be diagnosed and assessed by taking into account the DSM-5 scale and ICD-11. The Yale-Brown Obsessive Compulsive Scale is another diagnostic scale to assess the severity of the OCD symptoms.
There are different perspectives to look OCD from, some say it’s genetic, some believe it’s because of cognitive and behavioral factors while some have a more humanistic approach. In reality, a combination of these factors can be the root cause of OCD. Let’s examine OCD through a socio-cultural lens.
Causes
Humans have always been social animals where the environment we live in affects our behavior, our thoughts, and our actions. The renowned social psychologist Albert Bandura has laid out the social learning theory where people get influenced by their observations and interactions in society. In that vein, people can be victims of OCD with no genetic mutation or cognitive damage prior. Having been around relatives or parents who have OCD can be influential and eventually result in the child having this disorder. The socio-cultural perspective is focused on Nurture in the 'Nature vs Nurture' debate. However, a significant study is yet to be done to conclude if OCD can be caused solely by environmental factors.
Certain cultures and religions demand this level of discipline from the members of their community which can be quite daunting and manifest OCD. However, there is yet some significant research to be done in this field, keeping in mind the nationality, sexual orientation, and more. The one fact that cannot be negated is that culture in terms of the difference in literacy, education, mindset, access to health, food does have some implications on OCD. The type of compulsions and rituals that a person participates in might be culture-specific, the nature of which might be quite similar. It also depends on person to person and their respective cultural background how they perceive this disorder. Their perceptions would also determine their actions and the severity of the symptoms. Superstitions, which are more than often associated with religion and culture, can also do the job of adding fuel to the fire. For example, having anxiety and distress because the person forgot to light the lamp in the morning.
Childhood trauma, emotional and physical abuse, strained relationships also trigger OCD and can negatively affect people already struggling with this disorder. This proves the viewpoint of many socio-cultural and ecological psychologists. OCD is hence, found to be triggered because of external stimulations. Having a person with OCD at home not only affects the person who has it but also affects the people that person interacts with daily. People having PTSD are also likely to have this disorder. Material hardship is another reason that could lead to the possible manifestation of OCD as it evokes feelings of anxiety and distress.
Treatment
Now that you know how OCD is also influenced by society and culture, let’s cut to the chase. Is OCD curable? Can the environment help treat an OCD patient as much as it can negatively affect it? The answer is to an extent, yes, the society and the people around the person with OCD can help reduce the compulsions through constant support and nurturing. Professional help and therapy are also helpful. Joining support groups and listening to the journeys of other people who've overcome OCD can be beneficial to quite an extent. It is also crucial that the immediate family and friends provide their utmost support throughout and do not reinforce the rituals in any way. The family members can themselves join support groups to understand the problem beyond the superficial level. The disorder is bound to take a toll on the family members as well, and they must understand the disorder themselves. The person can have marital problems because of insecurity, and an aversion to touch; therefore, their partner needs to be all the more caring and supportive.
According to some studies, it also depends on the socio-demographic conditions of the person in terms of access to help and getting the appropriate treatment. If parents and society shun the disorder or turn a blind eye then the symptoms may get worse. Family therapy is another way for the family members and the OCD patient to understand the disorder better and reduce family conflicts. Although majorly Cognitive Behavioral therapy and Exposure-Response Prevention therapy is the treatment many therapists and psychiatrists follow, group therapy and family therapy can also prove to be quite helpful. However, if the condition continues to worsen then medication and Deep Brain Stimulation are treatments adopted in some special cases.
Prevention
OCD is a disorder that cannot be prevented; however, the intensity of the symptoms can surely be reduced. Suppressing the thoughts will only increase in severity and will do more harm than good. It is thus significant to seek professional help for reducing the severity of the symptoms. Early diagnosis can help manage the symptoms and thereby reduce the time the person battles with OCD.
Recent Research & Findings
An ANN(Artificial Neural Network) approach using the Y-BOCS scale hints at 'worth of family' as a factor in influencing OCD and increasing the severity of the symptoms (June 2020)
The 'worth of a person' in their family in terms of freedom to make decisions, the same importance as siblings are significant factors contributing to OCD. The more neglected or ignored an individual is, the more chances are of that person acquiring OCD.
Family Accommodation (FA) leads to increased distress and symptom severity (3rd January 2020)
Facilitating compulsive rituals, providing reassurance by the caregivers or family members of the OCD patient leads to increased anxiety and distress levels. Caregivers modify their own behavior at times, to relieve the OCD patient of distress by often reinforcing the compulsions. This can prove to be rather detrimental to the patient. FA is thus, termed as one of the worst treatment outcomes and has a strong relationship with symptom severity.
As the awareness about mental health and its issues is gaining momentum, people with mental and anxiety disorders are gradually getting more acceptance in society. However, it is still a long way to go before people start vocally addressing the issue. It is time that people start realizing how serious mental health is and that there is no coherent reason to undermine it. So the next time you see inaccurate representations of OCD in pop-culture (Monica Geller from Friends, Sheldon Cooper from Big Bang Theory), one can hope that you will be better equipped to have an informed opinion about the disorder and not jump to conclusions.
References:
https://beyondocd.org/information-for-parents/helping-a-child-who-has-ocd/parents-role-in-treatment
https://www.helpguide.org/articles/anxiety/obssessive-compulsive-disorder-ocd.htm
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5872369/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7327615/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6964456/
Understanding OCD using the socio-cultural approach has both positive and negative criticisms. One of the key strengths of this approach is that it directly impacts and influences issues regarding society, family and labels by combining all the factors together. It addresses labels on the basis of negative stereotyping and stress due to unsatisfied expectations. It helps understand extreme behavior and how it can be influenced by others or their situation. Due to the practical application and ecological validity, it has a higher probability of success.
ReplyDeleteBut it underestimates individual differences and may cause ethnocentricism due to different cultures and generalization. This approach is reductionist and unethical as the research is often conducted without participant consent and nurture doesn’t have enough research to prove causation of OCD. The socio-cultural theory was often used to treat OCD as the support of family increases likelihood of improvement but recent research says otherwise.
OCD may be treated and measured by measures DSM-5 and ICD-11, taken into consideration. In certain individuals, cases of OCD may exist, despite no history of genetic disorders or neurological impairments. Being around friends or parents who have OCD may be harmful and potentially result in a child developing this condition. The socio-cultural viewpoint centers on nurturing in the argument 'Nature vs Nurtured.' Nonetheless, a detailed analysis is yet to be carried out to suggest that OCD can not be triggered purely by external causes.
ReplyDeleteSocial cause or external environment play major role in a person's behavior. Therefore it is possible for OCD to originate from such situations. I agree that there is a lack of study under this aspect and wish for more research to be done under this field. An accurate study of OCD origin can help prevention of OCD that can be induced by environmental or social situations.
ReplyDeleteThe socio- cultural perspective is an important approach towards OCD. The socio- cultual aspects are as important and influential as the biological part of OCD. I feel that the socio- cultural values or rules can actually help in making a difference in the individual with used appropriately. The article was enjoyable and interesting to read and very easy to understand.
ReplyDeleteThe socio cultural perspective presents a logical argument, but fails to discuss its limitations that can be actually understood if other perspectives are taken into consideration. It says that the environment and type of people you are surrounded with affects behaviour and can even cause disorders like OCD even if you don't have any genetic/biological inheritance. What it fails to address is that there are individual differences in perceiving situations and environments, and so two people living in the same environment with same people around develop into two different individuals with different trade and mindsets, which could resonate with the environment or might be completely opposite.
ReplyDeleteWhat it essentially doing is, giving more preference to nurture over nature, when both could provide significant inputs, especially in a disorder like OCD.
Wow! This was so informative
ReplyDelete