"We walk in circles, so limited by our own anxieties that we can no longer distinguish between true and false . . ."             . . . Ingmar Bergman

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Maria* had to check the stove, the locks, and the iron multiple times before leaving the house. The amount of time she spent checking increased from ten minutes to an hour or an hour and a half. She was usually late for work and occasionally missed appointments because of this behavior.

Melvin Udall*, played by Jack Nicholson in the recent film, "As Good As It Gets", performs a number of rituals which include turning each lock on his door five times, avoiding all cracks and lines on sidewalks and floors, and washing his hands repeatedly using a new bar of soap with each wash and then discarding it. Melvin's behaviors were disruptive to others as well as to himself in restaurants as well as in interpersonal relationships.

Robert* had boxes of flyers and notices that had arrived in the mail over the past two years. He was unable to throw them away because the information they contained might be of use some day. Robert's behaviors were a source of contention between him and his wife.

Sarah* had repeated intrusive thoughts about harming her daughter although she had never been violent before and she and her husband were thrilled after five years of waiting to finally have the little girl they had wanted so badly. The thoughts became so upsetting to Sarah that she did not want to care for her baby and became severely depressed.

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Maria, Robert, Sarah -- and Melvin Udall -- were all suffering from Obsesive Compulsive Disorder, orOCD. We all have concerns and routines or particular ways in which we do certain things, like the times we eat or the routes we take to work or the way we fold our clothes. When these behaviors ritualistic, however, or thoughts become persistent and bothersome, we move into the realm of obsessive thinking and/or compulsive behavior, strong indicators of OCD.
Maria, Robert, Sarah -- and Melvin Udall all achieved significant relief of symptoms within one to two years of treatment. All of these patients required medication and cognitive-behavioral therapy with emphasis on exposure-desensitization. At follow-up, Maria and Robert were doing well without medication or ongoing therapy. Sarah was discharged from therapy, but continued on meds. Melvin Udall got Helen Hunt and Jack Nicholson won an Academy Award.