Obsessive-compulsive disorder is characterized by a patient’s obsessive, distressing, and intrusive thoughts leading to related compulsions done in an attempt to neutralize the obsessions.  Obsessive thoughts associated with obsessive-compulsive disorder are chronic in nature, and the patient clearly recognizes that the obsessional thoughts are a product of his or her own cognitive thought processes, and not from any outside influence.  The patient often recognizes that the obsessive and intrusive thoughts are not based on any sound logic.  Obsessive thoughts often lead to marked anxiety or distress.  To relieve the associated anxiety, the patient feels driven to perform some act or ritual in response to the obsession.  The disorder invariably leads to a diminished quality of life.

The obsessive-compulsive patient fully realizes that their obsessions and compulsions are unreasonable.  The patient often adapts rules that must be applied rigidly to any repetitive behavior or rituals used in response to the obsession.  These rules and rituals, which vary from patient to patient, evolve because of their anxiety decreasing effect.  The result, over time, is a rigid set of rules for creating order that are followed for the sole purpose of reducing anxiety.

Patients diagnosed with obsessive-compulsive disorder often experience very similar patterns of compulsive behavior resulting from the associated obsessions.  Repeated hand washing at regular intervals throughout the day, arranging objects at right angles, perfectly aligning objects in straight lines, counting steps to or from a destination, meticulously cleaning the home, and canceling out bad thoughts with good thoughts are a just few of the common patterns of behavior of the obsessive-compulsive patient.  Obsessive-compulsive disorder can also incorporate fears, such as the fear of contamination by sweat, urine, saliva, tears, or feces, resulting in the inability to use public restroom facilities.

Any compulsive actions performed because of obsessive-compulsive disorder are done for the reduction of anxiety.  Compulsive cleaning is one example of an activity commonly performed by sufferers of obsessive-compulsive disorder.  The act of cleaning is presumably done to create cleanliness of the surroundings and order in the environment.  Any microbiologist can inspect the newly cleaned environment of the obsessive-compulsive patient, and uncover any number of pathogens, including viruses, bacteria, mold, and other bugs.  The heating and air condition duct work remain uncleaned.  Mold or fungus most likely exists under the carpet or in hidden location.  Pathogens will be revealed in the refrigerator and on most every surface of the home.  Another compulsive behavior is to line objects up in straight lines and at right angles.  A physicist can come along and inspect the lined up objects with lasers and other highly technological measuring equipment and prove to the obsessive-compulsive patient that nothing is even remotely lined up.  Great disorder exists despite the efforts made by the obsessive-compulsive patient to create order.  None of this inspection and analysis, however, matters much to the obsessive-compulsive patient.  What is important to the obsessive-compulsive patient is that, in their own mind, they have created order to their own level of satisfaction.  In creating order, anxiety is temporarily reduced.  It is therefore the act of creating order that is the issue, not the actual level of order created.

Many different theories regarding the cause of obsessive-compulsive disorder exist.  The majority of research supports the belief that there is some type of abnormality in the serotonin system of the brain.  Environmental factors, as in many mental disorders, are reported to play a role.  The notion that environmental factors actually play a role in obsessive-compulsive disorder, however, is difficult to understand.  Neuropsychiatrists have identified certain regions of the brain associated with obsessive-compulsive disorder.  Aberrant activity of a wide variety of certain neurotransmitter receptor sites has been positively correlated with obsessive-compulsive disorder.  If any aberration of the brain or neurotransmitter system is involved in obsessive-compulsive disorder, it is more likely that the aberration occurs as a result of obsessive-compulsive disorder rather than actually being caused by the disorder.

The modern treatment protocol of obsessive-compulsive disorder fails to provide a cure.  When the treatment fails to provide a cure, it is likely that the cause of the disorder has not been found.  When the cause of the disorder is not addressed, any treatment offered is focused upon symptom suppression.  Symptom suppression through medication and behavior modification through psychological counseling does not address the true cause, and therefore cannot provide the cure.

Just what, then, is the cause of obsessive-compulsive disorder?  The classical medical modus operandi of complicating a disorder through classification and analysis ad infinitum has made it difficult to come to an understanding of what medicine is actually attempting to treat.  If the treatment consistently fails, the treatment is therefore inappropriate for the disease, and another treatment must be found.  Before the appropriate treatment can be found, the cause must be identified, In addition, the obsessive-compulsive patient must be able to accept the cause of their obsessive-compulsive behavior before any treatment will prove effective.