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Informative Speech: The Bully inside our Minds

Helen Borges

I. Introduction

A. Attention Getter: Imagine having a bully, who does nothing but harass you at every opportunity. Imagine this bully makes you do embarrassing, and sometimes even dangerous things, and leaves you to be held responsible for the outcomes.  Now imagine this bully is always with you, every single second, of every single minute, of every single day, not even leaving you in control of your own thoughts.   Well, many of you may not experience such extreme bullying, but according to the Stanford School of Medicine website, last updated in 2014 , 1 in every 40 adults and 1 in every 200 children in the U.S. have to deal with such bully on a daily basis.  This bully’s name is Obsessive Compulsive Disorder, or OCD

B. Background and Audience Relevance: OCD is a disorder that has a neurobiological basis, and according to the World Health Organization, OCD is one of the top 20 causes of illness-related disability, worldwide, for individuals between 15 and 44 years of age. Although OCD is a serious, debilitating disorder, it seems like not enough people know about. For that reason, I believe it is important to become educated about the disorder.

C. Speaker Credibility:   While studying psychology, I learned a lot about Obsessive Compulsive Disorder.   OCD can be very debilitating, and in my opinion, not enough awareness is raised toward the disorder.     

D.  Thesis: OCD is a very debilitating disorder, and for that reason it is extremely important to raise awareness about it.

E. Preview of Main Points:  In this speech, you will learn about OCD as it is defined by the DSM-5 as well a theory of how an obsessive compulsive brain works.  Second, we will examine the current treatments being offered for the disorder.  Finally, we will discuss the impact OCD has in the lives of the people who suffer from it and why it is so important to know more about it.

Transition to First Main Point: To get started, let’s examine what exactly is OCD.

II. Main point 1:  Many people have heard about OCD at some point, but very few have an understanding of what it actually is.

Sub-point 1:  Under the fourth edition of The Diagnostic and Statistical Manual of Mental Disorders, published in 2000 and also known as the DSM-IV, OCD was grouped with the Anxiety disorders. Everyone experiences anxiety at times; it’s completely normal. Anxiety disorders, however, are different. They can cause such distress that it interferes with a person's ability to function normally.  When anxiety progresses and becomes severe to the point where it affects normal functioning, it is an anxiety disorder.  There are several types of anxiety disorders, including Social Anxiety, PTSD, and until 2013, OCD.  In 2013, with the release of the DSM-5, OCD was included in a newly created category, named Obsessive Compulsive and Related Disorders.  

Sub Point 2:  OCD consists of obsessions -- persistent thoughts experienced as inappropriate or intrusive and that cause anxiety and distress -- and compulsions -- Repetitive behaviors or mental acts that are carried out to reduce the anxiety or distress caused by those obsessions.   Well, that’s what OCD looks like, but what “is” OCD?  In a contribution made to the website About.com in 2012, Dr. Owen Kelly , who has done extensive research on anxiety disorders, research on the biological causes of OCD have focused on a circuit in the brain which regulates basic aspects of behavior, such as sexuality, aggression, etc. When this circuit starts working, these impulses are brought to your attention and cause you to address the impulse by performing a certain behavior.  For example, after using the restroom, you may begin to wash your hands to remove any harmful germs you may have encountered. Once you have performed the appropriate behavior -- in this case, washing your hands -- the impulse from this brain circuit diminishes and you stop washing your hands and go about your day…  Unless you have OCD.  It has been suggested that the obsessive compulsive brain circuit is hyperactive, causing it to be increasingly difficult for these impulses to be ignored. For instance, an obsessive compulsive brain may not be able to ignore the intrusive thoughts of contamination after leaving the restroom, leading the OCD sufferer to repeatedly wash their hands in order to get rid of those intrusive thoughts. Fear of contamination is not the only OCD behavior. In a personal interview I conducted on Feb 18th 2014 with Jorge Zuniga , who worked in a mental care hospital for 3 years and is currently a graduate student in the psychology department here at Mason, he shares some of the common OC behaviors he has dealt with during his experience, which include: Counting, checking, and obsession with symmetry, among others.

Transition:  Now that you know a little more about what OCD is, I will second talk about what are the possible causes for it and what are the resources currently are being used in the treatment of OCD.

III. Main Point 2: According to an article from Behavior Therapy by psychology professor Jonathan Abramowitz , there are two empirically supported approaches to the treatment of OCD and related disorders: cognitive–behavioral psychological treatment and pharmacotherapy.

Sub Point 1: One of the most common methods used in the treatment of OCD is CBT, or Cognitive behavioral therapy. Counselor Rachel Kaplan explained in a paper she wrote for Bryn Mawr College in 1992 that the way cognitive behavioral therapy works is basically by changing the feelings and thinking of an OC person by exposing them to their feared situation and blocking the obsessive behavior. An example of that is: A patient going through CBT who has an irrational fear of contamination may be asked to shake somebody’s hand, or touch a door handle – which is the exposure part. This is done because, according to researchers, the anxiety experienced by the patient should decrease after repeated exposure to the source of that anxiety. Then, they will be urged to go a few minutes, or sometimes a few hour without washing their hands. Blocking the compulsive behavior does cause anxiety in the beginning, but after a while the compulsive behaviors should decrease.

Sub Point 2: Another very common method used to treat OCD is with medication. The most common type of medication used to treat OCD are SRIs, or Serotonin Reuptake Inhibitors. This type of medication increases the concentration of serotonin in the brain. It has been found that SRIs are very effective in treating OCD. When on this type of treatment, improvement was seen after 8-10 weeks, however, less than 20% of those treated with medication alone achieve full remission. For this reason, it is thought that combining medication and psychotherapy is the best way to treat OCD.

Transition:  Now that you have an idea of the possible causes and available treatment for OCD, I would finally like to talk about why it is important to know about OCD

IV. Main point 3:  Although OCD is a serious disorder, not enough people seek treatment for it.

Sub-point I:  According to the National Institute of Mental Health website , last updated in 2014, between 2 and 3 million adults in the United States currently have OCD, and surveys estimate that less than 10 % of those suffering are currently in treatment.   That means that more than 1 and a half million people are silent while being bullied by their own minds.  There is no way to know the exact reason for this, but my guess is that OCD, like many other mental disorders, is not taken as seriously as it should be.  You will never hear somebody saying “Well, if you don’t like having diabetes, then why don’t you just stop?”, but I can guarantee you that any given person who suffers from OCD has heard the “if you don’t like the rituals, then why don’t you just stop” nonsense at least once.  

Sub point II:  Living with OCD is certainly not easy.  I very often hear the term OCD being used casually to describe someone who is clean, or organized.  In the media, OCD is often portrayed as a personality quirk, and something not to be taken seriously.  To me, that may be one of the reasons why OCD isn’t taken as seriously as it should be.  OCD is a very distressing disorder, and if severe enough, may cause disability. For some people, washing their hands more than one hundred times a day is the absolute necessary in order for their obsession to be alleviated.  Just imagine the amount of energy it must take for them to manage the turmoil caused by their obsessions and compulsions while also being expected to function normally, and many times hide their OCD.  That is why I say that OCD is no laughing matter, and it certainly does not look like its glorified version, often portrayed by the media as a personality quirk.  It is serious disorder, which in its worst form kills.  According to cognitive-behavioral therapist Margaret Andover , recent prevalence rates suggest that suicidality is more common in OCD than previously though. In a scholarly article she wrote for Psychiatry Research in 2010, Andover explains that nearly 30% of individuals with a history of attempted suicide and 8% of those reporting suicidal ideation meet the diagnostic criteria for OCD specifically.  OCD is a serious disorder that should be given proper medical attention.  With the proper help and support, it becomes much easier for OCD sufferers manage their disorder.

III. Conclusion

A. Review Main Points:  In this speech, you learned about OCD as it is defined by the DSM-5 as well as a hypothesis of how an obsessive compulsive brain works. We also examined some of the current treatments being offered for the disorder.  Finally, we discussed what OCD looks for those who suffer from it and the impact it has not only in those people’s lives, but in the lives of everyone around them.  

B. Restate Thesis: By listening to this speech, you hopefully have a greater understanding of obsessive compulsive disorder, some of the treatments being offered, as well as what it looks like from the point of view of those who suffer from it.  

C. Memorable Closer:   As I’ve previously stated, this speech’s purpose is to educate you about OCD.  If you have OCD, you’re not alone.  If you know somebody who has it, make sure that you use the little bit of knowledge you’ve acquired through this speech to help them.  When I say help them, I don’t mean “treat them”, there are no psychologists here and no one expects any of you to have this responsibility.  When I say “help them”, I mean tell them that you know that battle is not easy, and that the best option is to seek help. If you have OCD, or know somebody who does, know that the battle against that bully is not an easy one, but with help, it can become much easier to take control and lead a normal life.  If you need help or know someone who does, there are many resources you can use.  GMU has a counseling center, and to learn more about it you can go to caps.gmu.edu. There is no reason to lose hope.  This battle can be won, and with proper treatment and support, victory is in the horizon.  

References

Abramowitz, J. S. Franklin , M. E. Kozak , M. J. Street , G. P. Foa , E. B. (2000). The effects of pretreatment depression on cognitive-behavioral treatment outcome in OCD clinic patients. Behavior Therapy, 31, 517-528. doi: 10.1016/S0005-7894(00)80028-3

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Andover, M. S. Gibb , B. E. (2010). Non-suicidal self-injury, attempted suicide, and suicidal intent among psychiatric inpatients. Psychiatry Research, 178, 101-105. doi: 10.1016/j.psychres.2010.03.01910.1016/j.psychres.2010.03.019.

Kaplan, R. (1998). Obsessive compulsive disorder. Retrieved from   http://serendip.brynmawr.edu/bb/neuro/neuro98/202s98-paper1/Kaplan.html

Kelly Ph.D, O. (2010, August). Obsessive-compulsive disorder. Retrieved from

http://ocd.about.com/od/causes/a/Causes_OCD.htm

Mateos, Jose (2006). Global burden of obsessive-compulsive disorder in the year 2000. Retrieved from www.who.int/healthinfo/statistics/bod_obsessivecompulsive.pdf

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