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The link between cultural ritual and OCD

Cutural and religious rituals and many of the behaviours of Obsessive Compulsive Disorder (OCD) show striking similarities: washing, checking, repetition... is OCD a manifestation of a deep human need that has spun out of control?

Cultural and religious rituals show similarities to OCD

Rituals, religious or cultural, important to particular groups or populations, tend to involve similar sets or sequences of behaviour, and have striking similarities with the rituals followed by people with Obsessive Compulsive Disorder (OCD). That’s the observation of Siri Dulaney and Alan Page Fiske, two US anthropologists, in an already classic paper, published in 2009.

Studies quoted by Dulaney and Fiske have suggested different purposes and effects of ritual: it may affirm connection to a group or a family (baptism or other birth rites); it may mark a coming of age or a change of status (puberty ceremonies; marriage).

Boys of the Yao tribe in Malawi participating in initiation rites

Some studies have hypothesised effects on the brain of chanting or oft-repeated actions; there’s a suggestion that some sounds and movements create subtle vibrations that induce neurological experiences, then interpreted as a spiritual connection with the divine. Ritual can also impose order on a confusing or distressing world, and reduce anxiety as a result. There’s also a theory that ritual is related to play — and performed for its own enjoyable sake.

The precision of ritual

There are distinctive and similar aspects of ritual behaviours across cultures. For example, washing or the use of water as a symbol for cleansing power is very common. Rituals often follow precise and sometimes complex rules of action and timing, carried out to ward off something unpleasant happening — and sometimes, when the rules are not adhered to, the meaning of the ritual is changed or else made powerless.

“Rituals often involve washing and other forms of purification, orientation to thresholds and boundaries, and colors that have special significance. Rituals tend to involve precise spatial arrays and symmetrical patterns, stereotyped actions, repetitive sequences, rigidly scrupulous adherence to rules (and often the constant creation of new rules), and imperative measures to prevent harm and protect against imminent dangers. These features typify ritual, but they also define a psychiatric illness, obsessive compulsive disorder.”

As the authors write, these features are very often observed in obsessive compulsive disorder. Many people with OCD have a compulsion to wash or to clean. Their focus may often be on getting the sequence of behaviours ‘right’ — so the washing or cleaning must happen in exactly the same way each time, and if something interrupts the sequence then the whole thing may have to start again for it to ‘work’.

Tsukubai basins used for ritual washing in Japan

The psychological links

Way back at the beginning of the last century, Sigmund Freud noticed the links between ‘obsessive neurosis’ and religious ritual, and noted that breaking religious ritual and breaking the rules of a compulsion both created feelings of guilt. There were certain objects, and behaviours, in both religion and obsession which acquired a taboo status, which prevented them from being touched, or contemplated, or displaced.

Developing this insight, Dulaney and Fiske mine a huge collection of anthropological and ethnographic studies to show many more similarities, including the importance of significant colours, concern about bodily fluids, emphasis on certain words or names which must or must not be uttered…all present in some people with OCD.

However, there’s a big ‘but’ in all of this. The person with OCD does not want to feel compelled to engage in rituals. Life is a whole lot harder in many ways with OCD. They’re also more than aware of the bizarre nature of needing to wash their hands 50 times, or check locks and windows 20 times, or whatever other compulsion is dominant….and in fact they may well hide their rituals from other people.

Delaney and Fiske argue that the ‘drive’ to ritualise, either as a compulsion in OCD or as a feature of religion or culture, comes from the same psychological ‘place’ in the mind. The tendency to OCD seems heritable, as well, although it’s rare that the same compulsion occurs in parent and child — different objects or behaviours will emerge in each individual. For some of us, the desire for ritual goes into a ‘malfunction’ which shows up as OCD — but essentially, say the authors, and deep down, ritual is hardwired in the human species.

The House Partnership, 15th July 2014


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