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Headline: Compulsion complexity
I’m sitting in one of the smaller classrooms in Tolman Hall for a psychology discussion section. A student
walks in, and the door swings shut behind her. I’m pretty sure the door didn’t close properly, so I get up
and make sure it did. I repeat this action for the next student who walks in.
The class begins and Mike Dolsen, my GSI, starts speaking about the paper that is due in a few weeks.
Just at that moment, a third student walks through the door. I jump up to go fix the door.
Two more students walk in. This time, Mike, who has been observing me, goes and shuts the door before I can get to it. Every time a student walks in after that, Mike makes sure the door is shut.
Obsessive-compulsive behaviors is one of the comorbidities that many people with autism — like me — have to deal with.
When most folks think of obsessive-compulsive behaviors, the first image that comes to their mind is of people washing their hands until they bleed. While compulsive behaviors don’t have to be that extreme, they can nevertheless be quite disruptive to the functioning of the person engaging in them.
Another example of this behavior in my case is how I react to the lint on people’s jackets. I am hard-pressed not to rapidly walk over and remove that piece of lint. Such an action of course would be viewed as highly inappropriate behavior, but all my thoughts are all aimed at that piece of lint.
Obsessions are the unwanted thoughts, and compulsions are the impulsive behaviors that occur in response to those thoughts. I, like many on the autism spectrum, have a laundry list of such obsessive-compulsive behaviors to suit every occasion.
As a small child, I used to line up all my toys and building blocks in a perfectly straight line. My line had to be in the precise sequence of red, blue, green and yellow, with the black and white ones at the end. My line would stretch right across the room.
The best way to tackle these compulsions is systematic repeated exposure in order to recondition your brain. It’s called exposure and response prevention. To tackle my lining-up behavior, my therapists would rearrange the color sequence or break my line, and I would not be allowed to go near to fix it.
It’s kind of like what Amy Farrah Fowler attempts to do with Sheldon Cooper’s compulsion in the TV series “The Big Bang Theory.” Sheldon can’t stand an incomplete sentence or task, so Amy makes Sheldon watch as she intentionally exposes him to incomplete songs, activities and sentences.
It’s terribly hard at first. Just like Sheldon, I would re-engage in the behaviors as soon as people’s backs were turned. Eventually, I came to accept that I should not obsessively engage in that specific behavior.
The support of therapists and people around me was important — they monitor me and helped me transition. My therapists would only allow me to engage in these behaviors a certain number of times in order to help me reduce and fade the behavior. For example, I would be allowed to close the door three times before I had to stop.
Compulsive behaviors, however, are much easier to quash when the behavior is directed at objects. The availability of an object can be externally manipulated by a therapist.
But it is harder to address behaviors that are more cerebral in nature or when the compulsion is in reaction to the behaviors of others in a public setting since we can’t control their behavior. People crossing their legs bothers me, but it’s inappropriate to attempt to straighten out their legs.
Engaging in these behaviors brings about a mixture of emotions. On one level, they are strangely comforting. It feels good to have something just right — a perfection of sorts. It’s the familiar sound of the click of the door as it shuts. It’s that jacket that’s untarnished by lint.
At the same time, these behaviors are highly annoying, irritating and exhausting. My brain is well aware of this second obsessive track. Each time I repetitively engage in these behaviors, part of my brain stands aside and exasperatedly remarks, “Really, you gotta be kidding me!” or “Here we go again!” But that compulsion just overrides over any logical or intelligent thought.
Increased anxiety is the end outcome as you struggle to cope with this set of conflicting emotions and this addiction. These parallel loops of anxiety may lead to other more dysfunctional autistic behaviors in turn, and even a meltdown.
It could well be that obsessive-compulsive behaviors are coping reactions by us autistics to the world of chaos around us. These behaviors give me a subconscious but misguided feeling of control over my body and environment. But pushing myself to not engage in these compulsions gives me the real power here.
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