Psychology Of Personality: The Case Of Mrs. C 160605

Psyc 62208221psychology Of Personalitythe Case Of Mrs C Is Excerp

Psyc 62208221psychology Of Personalitythe Case Of Mrs C Is Excerp

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The case of Mrs. C presents a comprehensive and complex illustration of severe obsessive-compulsive disorder (OCD) intertwined with additional psychological issues, family dynamics, and historical backgrounds. This analysis aims to explore Mrs. C’s psychological profile, the manifestation of her symptoms, potential diagnostic considerations, and suitable therapeutic approaches based on the case details provided.

Mrs. C, a 47-year-old woman, exhibits extensive OCD features, primarily compulsive washing, hoarding, and rituals centered on cleanliness and contamination fears. Her compulsive handwashing, occurring 25 to 30 times daily with rituals lasting up to two hours, reflects classic OCD symptoms involving contamination fears and the need for ritualistic behaviors to mitigate obsessional anxieties. Her rituals significantly impair her daily functioning, evident in her prolonged showers, which sometimes extend for hours, and her obsessive collection of unused items, such as towels and clothing, indicative of hoarding—a common comorbidity often associated with OCD (Mataix-Cols et al., 2009).

The household environment further exemplifies the severity of her condition. Mrs. C’s refusal to allow family members to wear underwear more than once, her avoidance of housework, and her extensive hoarding contribute to a dysfunctional domestic setting. Her inability to manage household cleaning exacerbates familial stress, leading her husband, George, to become impatient and overwhelmed, which highlights the relational disruptions typical in severe OCD cases (Steketee & Frost, 2002). Her behaviors around contamination extend into her appearance and social interactions, as she seldom dresses in new clothes, neglects personal grooming, and engages in public nudity within her home, eliciting embarrassment in her teenage sons, thus impacting family cohesion.

Mrs. C's obsession with pinworms, stemming from childhood exposure and subsequent fears of contamination, further complicates her OCD profile. Her fixation on avoiding infection leads to excessive boiling of household items and hypervigilance about hygiene, which persists even after the initial health threat has been eliminated (Abramowitz & Jacoby, 2015). Her preoccupation with cleanliness, coupled with her hoarding, suggests a profound difficulty in distinguishing between perceived contamination and actual health risks, a common challenge in OCD treatment.

Beyond OCD, Mrs. C presents with additional psychopathologies, including clinical depression, sexual arousal disorder (frigidity), and a history of suicidal gestures. Her depression may be reactive, stemming from her long-standing symptoms and familial disruptions, or part of a comorbid mood disorder often seen in chronic OCD sufferers (Taylor, 2011). Her sexual dysfunction, characterized by a lack of arousal and decreased intimacy with her husband, potentially results from her emotional withdrawal, compulsive rituals, and psychological stress, aligning with literature linking OCD with sexual difficulties (McCabe et al., 2010).

Her history reveals formative familial influences—strict, authoritarian father and a cold, compulsive mother—who modeled authoritarian control and emphasized cleanliness and disease avoidance. Such early environmental factors likely contributed to her developing OCD traits, aligning with the diathesis-stress model of OCD etiology, which emphasizes early vulnerability combined with stressors (Salkovskis, 1990). Her upbringing under rigid familial rules, along with her Catholic background fostering sexual repression, may have reinforced her OCD symptoms, especially contamination fears and compulsive washing, as ways to exert control and manage guilt or shame (Rachman, 2006).

Diagnostic considerations included differentiating severe OCD from schizophrenia or other psychotic disorders. Mrs. C’s psychological testing and previous evaluations consistently supported a nonpsychotic diagnosis, with no evidence of thought disorder. The imperative was to distinguish her compulsions and rituals from delusional beliefs, as misdiagnosis could lead to inappropriate treatments. The case supports an OCD diagnosis with comorbid depression and sexual dysfunction, while schizophrenia was explicitly ruled out based on clinical evaluations (Stein & Forde, 2011).

Therapeutically, treating Mrs. C’s severe OCD poses significant challenges. Cognitive-Behavioral Therapy (CBT), specifically Exposure and Response Prevention (ERP), is the gold standard for OCD treatment and involves gradual exposure to feared stimuli coupled with prevention of compulsive responses (Foa et al., 2005). Given her entrenched rituals and hoarding behavior, ERP would necessitate a highly individualized, systematic approach, possibly supplemented by pharmacotherapy with selective serotonin reuptake inhibitors (SSRIs), which have demonstrated efficacy in reducing OCD symptoms (Denys et al., 2010).

Family involvement is critical; educating her husband and children about OCD could mitigate familial tension and foster supportive environments essential for her recovery. Considering her comorbid depression, pharmacological intervention with antidepressants, alongside psychotherapy, may improve overall outcomes (Pauls et al., 2014). Addressing her sexual dysfunction may involve couples therapy and sex therapy to enhance intimacy and reduce shame or guilt associated with her condition (McCabe et al., 2010).

The case highlights the importance of understanding the complex interplay of genetic, environmental, and psychological factors influencing OCD. Early intervention, comprehensive treatment plans combining CBT, medication, and family support, and addressing associated disorders—depression, sexual dysfunction—are crucial for improving Mrs. C’s quality of life. Despite the severity of her symptoms, with persistent therapeutic efforts and multimodal interventions, recovery and symptom management are feasible, emphasizing the need for personalized, compassionate care for severe OCD cases (Rachman, 2006; Mataix-Cols et al., 2009).

References

  • Abramowitz, J. S., & Jacoby, R. J. (2015). Obsessive-compulsive disorder. The Lancet, 387(10020), 894-905.
  • Denys, D., Van Nieuwerburgh, F. C., & Westenberg, H. G. M. (2010). Pharmacotherapy of obsessive-compulsive disorder: Evidence-based review. Journal of Clinical Psychiatry, 71(1), 30-39.
  • Foa, E. B., Liebowitz, M. R., Kozak, M. J., et al. (2005). Randomized placebo-controlled trial of exposure and ritual prevention, clomipramine, and their combination in obsessive-compulsive disorder. Archives of General Psychiatry, 62(4), 363-372.
  • Mataix-Cols, D., et al. (2009). Hoarding, compulsive checking, and other compulsions in obsessive-compulsive disorder. Behavior Research and Therapy, 47(3), 187-194.
  • McCabe, R. E., et al. (2010). Sexual dysfunction in obsessive-compulsive disorder: A review. Journal of Anxiety Disorders, 24(4), 424-430.
  • Pauls, D., et al. (2014). Comorbidity of obsessive-compulsive disorder and major depression. Journal of Affective Disorders, 165, 8-14.
  • Rachman, S. (2006). Advances in the understanding and treatment of obsessive-compulsive disorder. Behaviour Research and Therapy, 44(12), 1895-1904.
  • Steketee, G., & Frost, R. (2002). Hoarding and its relation to obsessive-compulsive disorder. Journal of Anxiety Disorders, 16(3), 233-243.
  • Stein, D. J., & Forde, D. (2011). Obsessive-compulsive disorder: Clinical features and diagnosis. Psychiatric Clinics, 34(4), 819-832.
  • Taylor, S. (2011). Modeling the development of obsessive-compulsive disorder: A biopsychosocial approach. Journal of Clinical Psychology, 67(3), 236-248.

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