Taking Steps To Treat Obsessive Compulsive Disorder

BOSTON- In the U.S., an estimated one in 50 adults suffer from Obsessive Compulsive Disorder.  But 25 years ago, there were only a handful of doctors who specialized in OCD, an anxiety affliction in which people have unwanted and repeated thoughts that compel them to perform certain rituals, such as repeated hand washing.

Harvard Medical School professor of psychiatry Dr. Michael Jenike was one of those first doctors, and he pioneered treatments for the disorder. Since the 1970s, hundreds of doctors across the country have joined him and now work with OCD patients.

You get them to touch something they're afraid of. You gradually work your way up, and their brains learn that they don't have to be so fearful."

Harvard's Dr. Michael Jenike, on treating OCD

Jenike described an OCD patient named Ed Zine, who has since mostly recovered.

"Ed was pretty much 100 percent disabled for quite a few years when I first met him," Jenike told WBUR's Here & Now.

Jenike, who is also on the board of directors of the International OCD Foundation, said he recently had lunch with Zine's family. "He's doing great. He still has OCD symptoms," he said. "But overall his life has dramatically improved."

Speaking to WBUR's Here & Now in 2009, Zine described the typical thoughts that passed through his head while trying to do something as simple as eat pasta.

If a strand of pasta touches face, lip or chin and does
not go into mouth, gently try to grab strand with thumb and index
finger of other hand, letting fingers touch only pasta and not each
other. If fingers touch each, reverse entire process and start over.
Make sure fingers do not touch face or lips. If they do, start
touching and counting rituals ...

Zine is just one example of the many cases Jenike has treated.

"Some people fear contamination in the world, so they find someplace they feel is safe," he said. "Sometimes it's the bathroom ironically."

Jenike called the rituals, like hand washing or Zine's habit of counting in even numbers, "Valium for the thoughts."

He said that though everybody has a few of these quirks, if you have a severe case of OCD there's no mistaking it.

"You can't function, you can't go to work... you're terrified all the time," he said.

Jenike says it is possible to prevent OCD using behavioral therapy on those who may be genetically pre-disposed.

But for those who have already developed OCD, Jenike recommends Cognitive Behavioral Therapy, in which a doctor exposes a patient to his or her fears.

"You'll make a list of the kinds of things that set off their OCD, the kinds of things they avoid.  And then you start somewhere low down on the list and you get them to touch something they're afraid of. For instance if they're afraid of hospitals you get them to touch a magazine with a picture of a hospital," he said.

"And then they'll get anxious and they stay in that anxious state and they'll just come down.  And then when they can touch that and not get anxious... you actually have them walk by a hospital, and eventually go in a hospital," Jenike said. "So you gradually work your way up, and their brains learn that they don't have to be so fearful."

But Jenike stresses that this approach must be gradual and done with a skilled practitioner.

Report compiled by WBUR's Meena Ramayee and Jill Ryan.