Psychology

Obsessive compulsive disorder (OCD) is an emotional and mental disorder whereby an individual suffers from obsessive thoughts (unwanted thoughts) coupled with compulsive tendencies. Some patients experience a stream of negative repetitive thoughts (Aardema and OConnor,2007).For instance, in a case study concerning a 38-year old lady known as Maria, obsession is characterized by a stream of negative repetitive thoughts about dirt or germs. This makes her develop fear of any contamination and compels her to react compulsively by carrying out physical actions that reduce her mental anxiety. Maria therefore keeps on washing her hands, brushing her teeth, scrubbing clean floors and demanding that her family members to take bath repeatedly. Although OCD is considered to be caused by biological and genetic factors, it can be caused by environmental influences. Environmental influences factors affect how people develop biologically, psychologically and socially. Various aspects of environment at such as allergies, use of drugs or alcohol and toxins can lead to learned behavior that encourages development of the obsessive compulsive disorder.

Discussion
Environmental Influences on OCD
The obsessive compulsive disorder is considered to be a physical and biological disease. Chemical imbalances in the brain lead to the development of OCD. The various parts of the brain that are associated with the disorder include striatum, cingulated gyrus and the orbit frontal cortex. Although some studies in the past have failed to link OCD to genetic factors, some studies have shown that the disorder may be influenced by genetic factors. For example, a case study  investigating OCD in a 38-year old  lady known as Maria indicated that her close family members had  behaviors deviating from normal behaviour.While her mother is superstitious, her  son has a ADHD disorder and  her daughter   has  a habit of cutting herself. Another study that implied that OCD may be influenced by genetic factors involved close family members of an OCD patient. They were found   to have less grey matter in the brain and this was linked to the suppressing responses witnessed in individuals suffering from the disorder. One environmental factor that has been linked to the OCD is an individuals life experiences. For example, during development, children adopt certain behaviors or attitudes in response to the kind of environment they grow up in. For example, a child  who receives  an inordinate emphasis about cleanliness when growing up  can develop an obsession about staying clean and this can cause compulsive behaviour.Obsessions cause overwhelming anxiety  due to the  disturbing  behavior that  individuals suffering from OCD  fail to suppress (Durand and Barlow,2007).Beliefs and attitudes  in a society  can interact  with behavior to trigger  the development of OCD.Based on the traditional and cultural beliefs in a given society, individuals can develop unwanted ideas or impulses towards certain issues and this can lead  to obsession and compulsive behaviour.For instance, a person may be obsessed that heshe has a terrible illness or may fear that a loved one may be harmed .Response to such fear can trigger  compulsive behaviour.Environmental  influences such as family conflicts, problems in interpersonal relationships and  alcohol or drug use may give rise to internal strife personal problems that can increase the risk of one developing OCD.Learned behavior  patterns  can develop due to the environment one grew up in. Family history, pregnancy and stress also increase ones risk of developing OCD.

Ones response  to beliefs attitudes and certain behavior    makes people to resort  to repetitive behaviour.Furthemore,anger and resentment by family members towards an individual who suffers from obsessive compulsive disorder increases OCD behaviour.Researchers consider environmental stress to be a major  factor in the development of the disorder.Because ones personal problems are attributed to the occurrences around himher, environmental factors that lead to learned behavior to deal with problems promote the development of OCD .People with OCD    are deeply  committed to their patterns and beliefs hence they become entrenched in dysfunctional beliefs (Rapoport, 1989).Common rituals carried out by individuals with OCD include hoarding, ordering and perfectionism. In the case study about Maria who has an obsession of repeatedly thinking about dirt, her behavior of scrubbing floors, washing hands and brushing teeth is an example of perfectionism rituals.

Treatment of Obsessive Compulsive Disorder
Psychosocial approaches are the most   methods of treatment of OCD.They include psychotherapy, group counseling, support groups, cognitive therapy, behavioural therapy, hypnotism, relaxation techniques and biofeedback. The cognitive behavioral therapy is considered to be one  the most effective form of treatment.Behavioural therapy is effective  when the patients are taught exposure and response prevention (ERP) techniques. This assists the patients to deal with obsessions and compulsions without engaging in some rituals. For example, patients who may fear germs of dirt can be taught how to overcome the disorder by touching garbage and then refraining from washing their hands. This is meant to reduce anxiety that leads to an obsession and compulsions and encourages one to resist intense urge to go through a compulsion. Medical treatments are used together with psychosocial approaches to effectively treat the disorder. Medical treatments aim at having the level of serotonin in the brain increased. Examples of medication that is used to treat the disorder include Anafril and SSRI.Group therapy and supportive counseling are very beneficial in the treatment of the disorder. In cognitive therapy, patients are allowed to interpret their obsessions. When patients can explain how their beliefsattitudes lead to their compulsive behaviour, their attitudes can be challenged such that an activity that they interpret as high risk is no longer a high risk activity. Cognitive  therapy helps patients  to re-evaluate their beliefs  about their engagement in a compulsive behaviour.They therefore work towards eliminating such behavior thought record can be used in cognitive therapy.

Psychotherapy is highly recommended as the first form of treatment in children. Cognitive behavioral therapy is effective because the small steps that   are taken are able to effectively address the issue of obsession. The therapy alters behavior and change thought patterns in patients (National Institute of Mental Health. How to Get Help for Anxiety Disorders, 2010).Group programs provide OCD patients with an opportunity to learn about themselves when they listen to the experiences of other patients who are also receiving OCD treatment. As a result, they acquire new skills and receive to deal with to the disorder. Group therapy also decreases feelings of isolation in patients. Supportive counseling helps patients to understand the disorder and also motivates the family members to offer great support to the patients. Stress management and relaxation techniques can help patients deal with anxiety disorders (Null, 2006).Relaxation techniques include muscle relaxation and meditation.  Biofeedback is used to treat OCD and is effective   when combined with other methods such as the cognitive behavioral therapy. It is a natural form of treatment whereby through an EEG-biofeedback, a neurofeeback is used to create a directed mental force which is mediated through the frontal cortex. It acts as a buffer to the pathological brain circuit that triggers obsessions and compulsive behaviour.When this is repeated, the OCD-related symptoms subside. Hypnotism is another method of treatment. In this case, a certified mental health professional known as a hypotherapist guides a patient to overcome thoughts and emotions that cause the disorder. Hypnosis blocks thoughts and emotions by changing the patients attitude that contributes to the disorder. The analysis and suggestion therapies are the two forms of therapies that can be used .If one was required to devise a treatment plan for OCD, a plan that puts more emphasis on psychosocial treatment would be more effective. Psychosocial approaches change an individuals thoughts and perceptions and this is vital in addressing the problem.

However, medical treatment should complement psychotherapy treatment. Research has shown that cognitive behavioral therapy which is one of the forms of psychotherapy is one of the most effective in treating OCD.It is important that  medical personnel understand  each case of OCD so that the best method of treatment is used.

Conclusion
Obsessive compulsive disorder is a mental and emotional disorder whereby individuals engage in unwanted thoughts and repetitive behaviour.For a long time, the disorder was believed to be caused by environmental influences but recent studies have shown that the disorder is caused by chemical imbalances in the brain. Various psychosocial approaches together with medical treatments are used to treat OCD.Although some approaches are more effective in treating the disorder than others, combining some approaches can increase the success of treating the disorder.