Stating that obsessive behaviors and thoughts, also referred to as Obsessive Compulsive Disorder (OCD), can affect an individual's quality of life, Psychiatrist Prof. Dr. Nevzat Tarhan notes that obsessions are more commonly seen in perfectionist individuals. Tarhan points out that these individuals cannot manage their attention and time, and emphasized that obsessive thoughts first appear as intrusive thoughts (vesvese). Prof. Dr. Nevzat Tarhan advised dealing with these newly emerging intrusive thoughts by shifting one's focus of attention.
To Cope with Intrusive Thoughts, the Focus of Attention Should Be Shifted
Üsküdar Üniversitesi Founding Rector, Psychiatrist Prof. Dr. Nevzat Tarhan, made evaluations regarding obsessive behaviors and their causes, which are referred to as Obsessive Compulsive Disorder (OCD).
Stating that obsessions, also referred to as OCD, are known as "vesvese" (intrusive thoughts/scruples) among the public, Prof. Dr. Nevzat Tarhan said, “Obsessions are seen in 2% of society, meaning we can say it's a condition affecting 2,000 people in a city of 100,000. We can say that the prevalence of these obsessions, which are at a pathological level, is not low.”
They Can Appear and Disappear During a Period of Life
Prof. Dr. Nevzat Tarhan noted that some obsessions that are not at a pathological level and do not require visiting a clinical physician can also be seen in about 13,000 to 30,000 out of 100,000 people, adding, “These can appear during a period in these individuals' lives and then pass.”
The Person Cannot Remove the Thought from Their Mind
Prof. Dr. Nevzat Tarhan noted that in obsessive behaviors, obsessive thoughts, and obsessions, the person cannot get rid of the thought from their mind even though they know it is absurd and meaningless. He said, “Even though the person knows this situation is irrational or not rational, they simply cannot get that thought out of their mind. That thought controls them. In fact, these individuals state that they feel as if there is a second person inside them. Their logic says 'Do it this way,' but a second person inside seems to be directing them, saying 'Do it like this.'”
Obsessive Individuals Forget the Main Purpose of Their Work
Prof. Dr. Nevzat Tarhan stated that individuals with obsessions and compulsions are perfectionist people with rigid standards. He said, “Underneath these obsessions are perfectionist personality traits. When a person starts a task, they choose details, make rules, lists, sequences, and such organizations and programs that they forget the initial purpose. They forget the main goal. They find themselves engrossed in other things. Forgetting their primary objective, they get lost and overwhelmed in those details.”
They Cannot Manage Attention and Time
Prof. Dr. Nevzat Tarhan noted that obsessive individuals cannot manage their attention and time. He said, “Let's say a person spent 8 hours arranging books. Now, normally, if this person is a librarian, arranging books for 8 hours a day is normal. This is not an obsession and is consistent with the principle of productivity. They are doing what their job requires. But if their job is not librarianship but teaching, meaning they spend hours just arranging books, neglecting their students and daily tasks, then they become ill. So, this is an obsession related to whether goal-oriented actions are consistent with parallel reason. The person is distressed when they don't do this. The person cannot fully explain their work productivity; it's unexplainable.”
There Are Many Types of Obsessions
Prof. Dr. Nevzat Tarhan stated that there are many types of obsessions, adding, “There are religious obsessions, sexual obsessions, and compulsions. Here, a person's obsessions cannot be explained by identifying with cultural and religious matters. There are cultural norms related to sexuality within religious and cultural standards. There are religious norms related to cleanliness. These are individuals who repeat all of these to an inexplicable degree. Normally, a person performing a religious act, if they learn that it has no religious equivalent, can correct this behavior, but individuals with Obsessive Compulsive Disorder (OCD) cannot correct it.”
I Am Perfect, So They Should Be Perfect Too…
Prof. Dr. Nevzat Tarhan stated that individuals with obsessions typically possess a “everyone should be like me” perfectionism. He said, “When these individuals do something, they think only they are perfect. At the same time, they believe everyone else should be as perfect as them. In the background of these individuals, in addition to perfectionism, there is hidden arrogance and hidden narcissism. It is difficult to live with such people. They immediately exclude others unless they conform to their conditions and opportunities. These individuals often become very lonely. Some can improve by experiencing the negative consequences of these behaviors. Being rigid and stubborn are also other characteristics of their personality.”
Prof. Dr. Nevzat Tarhan stated that individuals with obsessions have rigidity of thought and are very rigid and persistent in their behaviors. He said, “These individuals walk around with their hands in the air, claiming their hands are dirty. Or, if they have a symmetry obsession, they cannot speak to the person opposite them if something on the table is crooked. They cannot speak if a picture on the wall is askew. For people without obsessions, this is not an obstacle. However, these individuals feel an undeniable need to correct it. They feel as if a second person inside them wants them to correct it.”
The Thought of Harming Those Around May Emerge
Prof. Dr. Nevzat Tarhan stated that obsessions sometimes appear as intrusive thoughts. He said, “A person takes their child in their arms. While standing by the window, the thought suddenly comes to mind, 'What if I throw my child?' There is a fear of harming in these patients. They experience the fear of 'What if I throw my child?' Because they are afraid of throwing their child, they become engrossed in thoughts like 'Oh dear, what kind of person am I, how could I do this, how could I think this?' and start avoiding holding their child. If they believe the obsession, the obsession starts to control them, but if they don't believe the obsession, they say, 'I know myself. Why would I throw my child?' This is entirely an intrusive thought (vesvese).”
Intrusive Thoughts Should Not Be Magnified
Prof. Dr. Nevzat Tarhan noted that obsessions first begin with intrusive thoughts (vesvese) and said that these thoughts can disappear by shifting the focus of attention. Prof. Dr. Nevzat Tarhan stated, “In the initial period of obsession, intrusive thoughts first appear. A chemical response has not yet formed in the brain. They enter the kitchen; there are knives in the kitchen. A thought comes to their mind, 'What if these knives stab me?' If they could think 'Why would I do this?' and change the subject, they would escape this situation. However, if the person takes the matter seriously, feelings of guilt begin, such as 'What if I do it? Would I really do it? Is there such a person inside me?' Feelings of sinfulness begin, and they avoid that action. That is, they start not holding their child. They start not taking themselves into the kitchen. They fear new things. If a person amplifies some of their fears during the initial period, that is, when they are in the state of intrusive thoughts, they can turn it into an obsession. If they disregard it, this problem disappears.”
Focus of Attention Should Be Diverted
Prof. Dr. Nevzat Tarhan noted that a person can cope with and succeed in dealing with intrusive thoughts that arise in the initial period. He said, “This can happen to us during certain periods of our lives, especially regarding matters we care about. The person should immediately use the method of shifting their focus of attention. That's why these are called intrusive thoughts. Thoughts come without the person inviting them. This is quite natural. For example, our liver produces bile. What happens when the liver malfunctions? You get jaundice. Our brain also produces thoughts, emotions, and behaviors. Our brain is the organ of thought, emotion, and behavior. This part of the brain starts working automatically, distinct from the brain's entirety, and produces absurd, meaningless thoughts. The frontal lobe of the brain, on the other hand, needs to find a logical explanation, stating 'This thought that comes to mind is appropriate, that thought is not appropriate,' 'This is valid, that thought is not valid,' 'This is safe, that is not safe.'”
Prof. Dr. Nevzat Tarhan noted that the left brain performs thought reasoning, the right brain performs emotional reasoning, and the frontal lobe balances both. He said, “Individuals with obsessions need to gain the skill of using their frontal lobe. If these individuals learn to use their frontal lobe, they learn to manage themselves. In fact, the frontal lobe means 'human.' Our entire personality, our decision-making mechanism, operates in the frontal lobe.”
Childhood Traumas Can Lie at the Root of OCD
Prof. Dr. Nevzat Tarhan noted that childhood trauma is frequently encountered in OCD, especially in emotional obsessions. He said, “Especially in self-blaming individuals, the childhood trauma scale is examined. For example, is there sexual abuse? Is there emotional neglect and abuse? If so, there is a method to logically accept and manage these traumas. With that method, you may not solve the trauma, but you become able to manage it. You put it into a logical framework, encapsulate it, and place it in the brain. This is taught in treatment, but first, it is necessary to correct the disrupted chemical balance in the brain. This constitutes the first stage in treatment.”
They Confuse Material and Spiritual Cleanliness
Prof. Dr. Nevzat Tarhan noted that in OCD and obsessions, despite the person acknowledging it as absurd, they confuse material cleanliness with spiritual cleanliness. He stated that this affects the quality of life of these individuals, adding:
“Because the person felt guilt in the past, they perform material cleaning today to cleanse that spiritual impurity. That is, they spend 4 bottles of shampoo in the bathroom in one day. I know patients who spend 8 hours in the toilet. They wash their hands, then wait standing at the door, unable to leave and returning again. They even reportedly dismantle and wash doors at home. That is, they say they would put the armchair in the washing machine if they could. So, to eliminate that anxiety and fear inside them, they resort to cleaning behavior, but after a while, they become exhausted and fall into depression. They become unable to do anything anymore. The person who previously couldn't leave the bathroom can now not even bathe once a month; they are forced to do so.”
OCD and Obsessions Can Be Treated with New Methods
Prof. Dr. Nevzat Tarhan noted that treating OCD and obsessions was previously very difficult, but new methods emerging with new technologies are now being used. He said, “The thought-producing, decision-making regions of the brain can be identified. We know which lobe to target. Currently, there are magnetic therapies in our country. These are being applied. The disrupted network in the brain is restored with neuroplasticity. The person begins to manage their thoughts. Generally, their close environment offers advice to these individuals, but there is no improvement. In fact, the chemical communication in this person's brain is disrupted, the dopamine balance is disturbed. The treatment aims to eliminate these disruptions.”
Treatment Must Be Completed
Prof. Dr. Nevzat Tarhan noted that incomplete treatment leads to the chronicity of the disease. He said, “There is minimum treatment and optimum treatment, but if these individuals are in the final stage, they receive maximum treatment. At the highest level, medication alone is not sufficient. Classical, standard treatments are replaced by deep TMS treatment.”