Interview with Silvia García Graullera: the keys to understanding OCD

Psychologist Silvia García Graullera talks about her experience treating cases of OCD.

Obsessive-Compulsive Disorder (OCD) is a psychological disorder that is very sensitive to changes in the context in which the person who develops it lives.

That is why, in the current pandemic crisis situation, there are many people who suffer especially due to OCD and who need professional help.

In order to understand what are the key aspects of Obsessive-Compulsive Disorder during the coronavirus pandemic, on this occasion we interviewed Silvia García Graullera, a psychologist with a lot of experience offering treatment for people with OCD.

OCD in times of the coronavirus: interview with Silvia García Graullera

Silvia García Graullera is part of the management team of the psychotherapy center PSICIA, located in Madrid. On this occasion she talks to us about the main characteristics of OCD, and how it can affect us during the pandemic.

As you see it, what is Obsessive-Compulsive Disorder, beyond the definitions that appear in the diagnostic manuals?

OCD is an anxiety disorder, generally quite disabling, characterized by the presence of intrusive thoughts and compulsions. Obsessions are persistent and involuntary ideas or thoughts that "invade" the person's mind and provoke great anxiety. To reduce this discomfort, the person seeks to suppress or alleviate these thoughts through other behaviors, called compulsions.

A typical example in the case of checks can be the following obsessive thought: "if I don't check that I have turned off and unplugged everything before leaving the house, I may cause a fire, burn down the building and kill many people because of me...". The compulsions will consist of checking the ceramic hob several times, unplugging all electrical appliances, touching the iron to see if it is cold, even taking photos to be able to make sure when leaving the house... and so on and so forth...

No matter how much you check, you will feel a momentary relief, but soon you will again be assailed by the doubt: "What if I haven't checked it? -"What if I didn't check properly... what if I didn't unplug the toaster...? No matter how much you check, you are never satisfied, and each time you feel the need to expand all the rituals.

The person with OCD, although they recognize that their thoughts and compulsions are irrational and exaggerated, cannot avoid them, generating much suffering and interference in their lives.

What are the types of OCD that you see most often in consultation? Which ones are most often seen because of the COVID-19 crisis?

The types of OCD are very varied and can change in the same person over the years. Those related to testing and contagion are very common. Currently, with the COVID-19 crisis, the cases of OCD related to this subject have skyrocketed and they do not have to be new cases, but sometimes they are of people who in their day could have had an obsession related to the contagion of AIDS and later with mad cow disease and then with Ebola.

Other typical cases are the imperious need to have everything in order and symmetrical, the obsessions related to the possibility of being able to attack someone (ex. The Obsessive-Compulsive Disorder is a disorder in which the person cannot approach a knife because the thought of attacking a family member comes to mind), religious obsessions and conscience scruples, obsession with the possibility of natural catastrophes, wars, attacks, etc.

How does Obsessive-Compulsive Disorder begin to develop, in the stages when it is not yet a problem? In your experience, are people with OCD slow to realize that something is wrong?

Obsessive-Compulsive Disorder usually manifests in adolescence or early adulthood. At the beginning, people know that something is wrong, and they usually live it with a lot of fear, since both because of the content of the thoughts (generally very absurd) and because of the imperious need to neutralize them, they have the feeling of "going crazy".

At first they often hide it out of fear and embarrassment, but once the diagnosis is established and they get to talk about it with a professional, they are relieved to know that their disorder has a name and that it can be fixed.

Is it common for the family to blame the person with OCD for, in theory, not wanting to stop performing these rituals? In these cases, what is done in terms of psychological intervention?

Families are often quite puzzled by this disorder, and feel quite helpless. At the beginning they usually react badly and there are often conflicts over the management of the rituals. After some time, and faced with the impossibility of managing the situation, they usually end up giving in and we see how many families end up living under the rules of OCD.

It is essential to involve the family or partner in the psychological intervention, in order to provide them with guidelines so that they can help in the patient's treatment.

Is there a specific case of a patient with OCD that, as a professional, you remember with great satisfaction because of the results achieved in therapy?

Actually, we see a lot of cases and people who are totally limited in their daily life. Whenever a patient is discharged and moves on to the follow-up phase, it is a great satisfaction. In fact, when we do group therapies with people with OCD, former patients who have already solved their problem, often offer to help and collaborate in these therapies with other OCD patients. This factor is usually a great help, as it is very motivating to see how others have gone through the same thing and have managed to overcome it.