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In general, when real life delivers a crisis, persons with anxiety
disorders, and specifically those with OCD, tend to manage these
crises somewhat more effectively than the population at large. The
very nature of Obsessive Compulsive Disorder is the mind's relentless
and endless effort to process and prepare for the most extreme nightmarish
scenarios. The anxious mind compels people to mentally anticipate
the worst possible scenario and not the negative outcomes which
life typically delivers. Our usual world predominantly delivers
circumstances to us which don't come close to matching the level
of negativity that people with OCD consistently prepare themselves
for.
Subsequent to the September 11th tragedy, it has been my observation
that the general public is reacting in a more exaggerated way than
would a person with OCD. The general public has been hit by this
real life crisis in a way that's caught them completely unprepared.
So now, for those who do not have OCD, white powder, possibly representing
bio terror, low flying planes, and being above the tenth floor of
any building, presents an association of their own vulnerability
to the extreme of terror. In contrast, persons with OCD tend to
be biochemically fixated, on the theme of their previous condition
prior to September 11th. For example, their neuro-chemistry could
be a lot more distressed about the potential of suffocating their
own child, or of possibly being gay, than with managing the ambiguities
of white powder or low flying planes.
There is, however, a segment of the OCD population which will be
noticeably more affected by these events, as will be the anxiety
disordered population in general. Persons with OCD who suffer from
contamination concerns are going to be more prone to cleaning off
all dust particles or to hypervigilance about hand washing, and
might consider buying protective devices such as gas masks or antibiotics.
Persons who have a fear of flying will tend to have their condition
exacerbated by the ambiguities of those who are concerned about
crashing, as opposed to those who are more concerned about having
panic attacks on board in flight.
An interesting phenomenon took place for many of my OCD patients
in the weeks following the September 11th tragedy. Specifically,
there was a very dramatic and evident trend characterized by a direct
relationship between the degree of patient progress and the proportion
of time spent processing the way in which this tragedy has affected
them or the world. Those persons who have not yet received the benefit
of behavior therapy have tended to either ignore, or devote no more
than five minutes of session time processing the tragedy and instead
devote the entirety of their therapy sessions to the ongoing process
of their therapeutic agenda. This reflects the intense and overwhelming
need experienced by the OCD sufferer to find relief from the urgent
dilemma created by their obsessional focus.
A recent theme, and I think a very relevant concern, for a number
of my patients who are more of the obsessional nature, is the threat
of what might be termed "blood lust." There is a tendency
for humans to find a sense of exhilaration or excitement at the
idea of going past a car accident and seeing some unknown horror.
It is also the case that some people become excited by the prospect
of the death toll being exorbitantly high or find a thrill in watching
and re-watching the inconceivable sight of the World Trade Center
buildings collapsing. For those persons with the purely obsessional
type of OCD, who are concerned about their own righteousness of
character, this human tendency to be attracted to horror provides
a fairly new spike theme. This spike involves believing that one
has a personal defect in character as indicated by their interest
in watching programs, like CNN, which provide one with sights and
information on crises, new traumas and human suffering. It is important
to understand that this appeal of the morose is basic human nature.
We tend to be somewhat disappointed on an emotional level (not necessarily
on a cognitive level) when we hear that a hurricane veered off course
and is not going to kill hundreds of people in low-lying areas in
our neighborhood.
It is important to understand that we all found a certain fascination
in watching the World Trade Center buildings collapse or in fathoming
what it might be like to have been on those planes that slammed
into the building. From a therapeutic viewpoint, it is important
for us to let go of finding an answer as to whether or not this
basic thrill, this basic tendency for humans to find fascination
and appeal in the potential horrific suffering of others is indicative
of severe psychopathology. This fascination is not in fact related
to a character deficit, but is indicative of nothing more than our
basic human curiosity. Specifically, we are better off not seeking
answers to such questions, but rather should accept the sometimes
surprising complexities of being human.
The tragedy of the September 11th disaster has unfortunately created
an opportunity for all of us in the general public to experience
the preoccupation, anxiety, and torment related to the uncertainty
of the future that OCD sufferers live with consistently until their
disorder is appropriately and effectively treated.
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