Lyn, you mention PTSD so was there a specific incident or period in her life when this all started to get a malign grip on her?
I’m ‘mildly’ OCD myself, and I know that the ‘trauma’ that ‘kicked it off’ was losing my husband to late diagnosed cancer. Nor surprisingly, my OCD now takes the form of trying to keep all my family ‘safe’ from ‘unexpected disasters’.
I’ve never really studied OCD much (as I say, I’m pretty mild - it’s more irritating than anything)(though I have to be careful not to let it escalate ,and I have ‘good and bad’ days etc etc), but what strikes me is the following:
OCD is about trying to CONTROL an ‘uncontrollable and dangerous universe’. That certainly makes sense in my case - something ‘hideously bad’ happened (out of ‘nowhere’ it seemed) and showed how ‘dangerous’ life is.
Someone else I know of who has OCD is the brother of a younger sister who is severely brain damaged - the family’s entire life revolves around the poor sister (the mum has ballooned to the size of a house - another key ‘stress signal’!), and so the teenage boy is completely ‘powerless’ over his homelife and environment. Hence his OCD - an attempt to ‘control’ what he cannot control.
Fundamentally, I personally believe, we just as human beings have to learn to ‘live with danger’ - and take REASONABLE steps to minimise the danger. of course, with OCD, those steps are MAXIMISED! hence the endless rituaals - a hopeless attempt to make us safe, safe, safe, safe, safe… (in your daughter’s case, presumably ‘safe from infection’.)
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On a less personal basis, I watched, a while ago, a programme on TV about OCD, and two things stood out -
(1) OCD is a failure to reach closure. For example, for most of us, when we leave the house, we check the central heating is off, the garden door locked, the iron off, etc etc etc …and when we’ve done it, we ‘know’ we’ve done it, and so get ‘closure’ …and out of the house we go. BUT, with OCD we can’t achieve that closure. Performing the ‘rational’ safety check (turning off the central heating) does not ‘convince’ us that we actually have checked it - so we go and check it again… (eg, your daughter may wash her hands…which, for a rational person, sorts the ‘clean hands’ problem, but for OCD the gesture fails to convince, and so she washes them again, again, again, again… ie, no ‘closure’ is attained)
(2) if we ‘deny the urge’ then over time, it dissipates. The programme had someone who was ‘prevented’ from doing her ritual, and had to go for a walk for half an hour. After about twenty minutes the ‘urge to go back and repeat the ritual’ had left her…it took time, but it DID ‘dissipate’. So, as a therapeutic method (ie, delay and diversion’) this ‘may’ work.
finally, ther should be a lot on the Internet about OCD/PTSD and ‘germ-fear’ and how it is both coped with (ie, to diminish it - not to ‘endure’ it!) at a personal left AND what can be achieved by psychiatric help (or even pharmaceutical help to diminish the chronic anxiety that eats us up!).
Maybe your daughter will always be ‘prone’ to OCD etc, but she cannot be ‘left to endure it’ as it is for the rest of her life.