Before falling asleep, Mathis, 12, checks a dozen times if her window is closed. Then he pulls his curtains, an operation that takes him a good quarter of an hour "because he can not stand any crease or interstice of light," says his mother. Finally comes the inspection under the bed, "two or three times, to be certain that no spider or other insect is there."
A routine that delays bedtime, but especially worries his parents terribly: "Initially, we thought he had a simple anxiety of the evening, he never liked going to sleep. But growing up all of this is growing. The psychiatrist we saw talked about OCD, "says Mathis's mother.
"We talk about OCD when rituals take more than an hour a day"
OCD for "obsessive-compulsive disorder", in other words, "acts that can not be prevented from being performed on pain of experiencing unbearable malaise", summarizes Lionel Dantin, psychiatrist in a hospital center and author of book Defeat the Knocks . For the latter, if we all sometimes resort to certain rituals, when these manias take "more than an hour a day" and become indispensable to the subject so that it calms down, then "we speak of Toc".
In other words, it is not pathological to have from time to time need to check two or three times that the front door is closed or that our phone is still in our bag. On the other hand, when whole sections of our existence are devoted to these "rituals" as Lionel Dantin defines them, it is time to consult. Especially since there are solutions.
Psychological but sometimes genetic causes
First of all, explains the psychiatrist, "we must try to understand where the OCD comes from". "Knowing that some have a genetic background. It is observed that a person with OCD is seven times more likely to have a parent who suffers from it. But TOCs can also be derived from childhood or symptoms expressing suffering due to trauma. This is for example the case for some women who wash their hands obsessively after a sexual assault or, less obvious, in response to a humiliation suffered. "
To reassure myself, I started to invent some magical thoughts
Armelle, 26, started developing TOCs after her high school diploma. "I was extremely stressed by this exam and to reassure myself, I started to invent some magical thoughts. If I read my class more than twenty times, I would be successful, if I had all my pens in my kit, and so on. The problem is that once I got my bac, I continued, for everything. And I find myself today with dozens of rituals to accomplish before starting my day: empty and fill my bag at least twice to be sure to have not forgotten anything, close, open, close my car, etc. I started a behavioral therapy because I see that in reality I'm wasting a lot of time and people are looking at me strangely. "
Treatments that vary according to the types of OCD
" The treatments differ depending on the type of OCD, " says Lionel Dantin. According to him, he can be classified into two broad categories.
- OCD based on sensation: "I wash my hands until I feel clean, I check several times that a valve is closed until I'm sure it does not drop etc. "
- And the OCD, which is based on repetition: "I draw the curtains three times, I wash myself five times, I spend four times my hand in my hair before speaking, etc." "
If the arsenal of exercises offered as part of a therapy is quite broad, it will vary depending on the type of ritual. "For example, details Lionel Dantin, take the case of a person whose TOC is to check that the tap is closed. His OCD breaks down into several actions. She closes the faucet, then she runs her hand under it to see if drops of water remain. Then she turns on her heels. She turns to look at the faucet again and make sure it does not leak. She says "it's good" in her head. Then finally she goes away. "
For this type of ritual, which he classifies in those related to a sensation, Lionel Dantin proposes to the patient "to suppress the last sequence", namely in this case, the sentence pronounced in his head, "it's good Which validates the action. If she succeeds, it will then take a second time without the last look at the tap after turning on her heels. And so on.
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Take control of the TOC so that it does not have too much influence
For a patient who needs to wash his hands three times, otherwise he can not go to work or move on, the method will be different. "In the context of CBT (Cognitive-Behavioral Therapy), it will be proposed to try to wash them only twice, then once. In an approach called "strategic therapy", I will suggest instead to choose between not performing this ritual at all or repeating it five times. The patient will wash his hands 15 times with each compulsion. This will make the ritual long and boring and thus erase the anxiolytic dimension. Above all, in deciding to change the frequency, one takes control of the OCD, which makes him lose his grip. "
Make the ritual long and boring to erase the anxiolytic dimension
Other exercises that the psychiatrist explains in his book include keeping a logbook of obsessive thoughts or repetitive acts, mindfulness sessions, and so on.
Methods that prove their effectiveness, assures Lionel Dantin, although it is not possible to speak of assured healing: "it is estimated that 25% hope for recovery, 50% a strong improvement in the medium term and 25% a failure of therapy. Little Mathis, after six months of weekly consultations, manages to lie down without paying attention to his curtains or to what is under his bed. "He sometimes has small relapses, but he is better," his mum rejoices.
