In a previous post, I explained with the aid of a fictitious story how OCD can creep up on a person in the form of intense contamination fears, and washing compulsions as their consequence. ‘Washing’ is one of a group of outward symptoms of OCD. In a scientific article from 2006, the French researcher David Mataix-Cols and his group presented their version of what is now commonly called: the dimensions of OCD. I expressly write: their version, because there are others. This is due to the fact that mental disorders are entities on a scale, they are so to speak continuous, not exactly demarcated. They may even flow over into each other. Persons with OCD may exhibit thought patterns that are close to those of schizophrenia patients, and schizophrenia patients may display behaviour that is like that of OCD patients. That is why exact and unchanging definitions are hard, if not impossible, in disorders of our psyche (very simply put: an expert can’t open a patient’s skull and peep inside to see what is going on in his/hers mental life…). Boundaries are almost never clear.
To return to the definitions of Mataix-Cols et al: they allow for four distinct symptom dimensions, and one that is more of a hypothetical nature. These four are:
- symmetry and ordering
- contamination and washing (remember Iris?)
- aggression and checking
The more hypothetical dimension is that of:
- somatic/sexual/religious/mental rituals
This group of scientists also drew a nice diagram, to show the different dimensions, and also to make clear which dimensions may overlap in practice:
I hope that this picture, and the text below it, are speaking for themselves. Bear in mind that the overlaps shown in the diagram are relatively small, but that the subscript makes clear that in reality they are large. The authors no doubt did it this way to keep the picture as clear as possible.
Finally: terms like ‘aggressive’ and ‘sexual’ may cause some distress, and that is unnecessary. I will tell why: these words have a negative connotation when seen combined, and in the context of the everyday news, especially when one thinks of the yellow press. Here, their meaning has nothing to do with the criminal side of society. We are dealing with very human feelings, that may somehow be repressed, or hard to express properly. Moreover, OCD has repeatedly been described as the opposite to sociopathy, if put on the same scale. Patients with OCD usually have a tendency towards feeling guilty, and to be often concerned about the moral side of things. They overworry, and take great care not to hurt others. If you keep this in mind, then you will have a good grasp of the different dimensions of OCD, and their meaning in a clinical context.