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Monday, June 6, 2011

OCD in the Media

Jeff Szymansk, PhD

By Jeff Szymanski, PhD

There were a lot of reality shows in the media last year about obsessive-compulsive disorder (OCD) and hoarding.  These joined the ranks of portrayals of OCD in movies and on television.  In fact, last year at the International OCD Foundation, we were repeatedly asked about our thoughts about how OCD and OCD treatment was portrayed in reality shows.

I”m often asked, “Did you think the show portrayed…

  • Individuals with OCD in a way that seemed respectful and not exploitative (i.e., they don’t spend the bulk of the show focusing on how bizarre the symptoms are)?
  • The treatments as prescribed, that people in fact do respond to the treatment and get better, and they emphasized the need for follow up maintenance of any gains the participants might have during the course of the show?
  • The treatment in a way that doesn’t scare people away from wanting to get therapy?”

When it comes to scripted television shows and movies, in many cases, OCD is portrayed as an eccentricity and not truly an anxiety disorder.  However, I came into work last week to a dozen emails from various people about how the television show Glee was depicting a character with OCD.  I went back and watched the show and was surprised at how well they captured it.  Emma Pillsbury, the high school counselor, has contamination-related OCD.  In one scene she is shown washing each grape individually before eating it.  Her belief was that if she did not wash the grapes in this particular way she would get sick.  Though she herself is a counselor, she is shown struggling with the reality of what her OCD is costing her and that without treatment, it is getting worse.

Eventually finding her way to a therapist, she spends the first 48 minutes of the 50-minute session wiping down the chair she is supposed to be sitting in.  For the last few minutes of her session, the therapist engages Emma in a discussion about why and how treatment might be of help to her.  The therapist mentions medication and behavior therapy.  These are, in fact, the two “first-line” treatments for OCD.  You almost never hear that talked about in popular media!

Other ways they got it right? Emma says things I’ve heard during initial treatment sessions with individuals with OCD:

  • “I don’t want to lay on a couch.”
  • “I don’t want to pop pills to be someone others want me to be.”
  • “This is just how I am.”

I am regularly struck as a therapist myself how many times I have had discussions with significantly unhappy people who, when faced with the prospect of change, even when it is change for the better, become overwhelmed with the thought of doing something new and different, and instead choose the known and familiar (even if it does feel terrible).  In these cases, individuals sometimes refuse treatment.

When I have come across this, I have to remember to find that place in myself where I recognize the need for change in some parts of my life but still fight it.  As such, the therapist’s parting comment to Emma caught my attention: “Your illness is not who you are supposed to be, it’s keeping you from who you are supposed to be.” This is the message I would most want viewers to take away from the portrayal of an individual struggling with OCD.

Posted by: WebMD Blogs at 8:04 am