A Historical Overview
According to the Book of Proverbs, there is no new thing under the sun. OCD — although not known by that name before recent times — has been with us pretty much forever. It was documented as far back as the 1400s. In the 1600s, some people were known to have had what was called “religious melancholy.” While engaged in prayer or meditation, these individuals found their minds invaded by base or blasphemous thoughts, or they were tormented with doubt that they had said, perhaps, a “dirty” word in church.
Doctors and Scholars
One of the earliest famous persons to suffer from OCD was Dr. Samuel Johnson, a scholar, writer and Renaissance man of his day (the early to late 1700s). Johnson had what would today probably be known as a severe case (stories are told that he drank tea almost obsessively; various reports mention as many as 16 or even 25 cups at a sitting, or as many as 40 in a single day), and was subject to movement compulsions, among other kinds of unusual behaviors.
On rare occasions when he was asked about them, he blamed “bad habits.” He also apparently suffered most of his life from depression, another affliction common to people who have OCD. (In addition, he likely had Tourette's syndrome, which is now believed to be related to OCD.)
In the early 1800s, OCD was understood as a kind of partial insanity. (And you think you're afraid to tell anyone about your obsessions, compulsions, and phobias.) By mid-century, the condition received a lot more notice among psychologists, especially in France.
When Freudian theory came into general prominence in the nineteenth and early twentieth centuries, “neurosis” and other now-rather-quaint-sounding terms became the watchwords of their day. Virtually every personality quirk and “abnormal” behavior, it was believed, originated in the home, and was caused by the subject's parents (as well as sexual repression). In fact, truth be told, it was almost always the mother who was blamed for virtually any condition believed to have been psychologically based.
Sigmund Freud studied OCD, too. Although, much later, it would become plain that his “neurosis” theory of the condition was off the mark, he did help to bring OCD to greater prominence. “Obsessional neurosis” patients must have felt at least somewhat grateful to know that they weren't alone, even if the psychologists of their time blamed the condition on all kinds of things that really had nothing to do with it.
Freud wrote that he found the disorder to be among the most interesting he had studied, but he believed that it could not be cured. (In a manner of speaking, he was right. As of this writing, OCD does not have a “cure” per se — and, if it did, it would not be a psychologically but a physiologically based one. However, it can be managed very successfully, to the point that it no longer dominates one's life.)
Alert
Once you understand OCD as a brain disease or neurological condition, you'll realize — and can help others to realize — that your symptoms aren't just you “acting crazy.” OCD originates in the brain. Although types vary, its symptoms overall show remarkable consistency from one victim to the next!
Even after OCD became identified as such, it was believed, well into the twentieth century, to be a psychological illness. As recently as the 1980s, some texts still referred to it as “obsessive-compulsive neurosis.”
It wasn't until the mid-1980s that OCD began to be understood as a neurological disorder, and that CBT, the OC Foundation, and most OCD support organizations came into being. (You'll read about all of these.)
Modern Times — The Pioneers
Many doctors impressed the psychological community with their early work with OCD patients. Dr. Michael Jenike founded the first residential OCD treatment center in the United States, which he continues to run today, at McLean Hospital in Belmont, Massachusetts. Dr. Wayne Goodman founded Yale University School of Medicine's obsessive-compulsive disorders unit and was a principal creator of the Yale-Brown Obsessive-Compulsive Scale, or “Y-BOCS” as it is known, a tool that is still widely used to evaluate whether a person's symptoms fulfill the diagnostic criteria for OCD.
Did Lady Macbeth have OCD?
It would appear so. If the fictional character from Shakespeare's Macbeth (written and first performed in the early 1600s) had been a real woman and had lived in modern times, her need to wash her hands repeatedly for long periods, hoping to remove long-faded blood stains, certainly would have suggested OCD.
Dr. Edna Foa was among the first in this country to use a technique you will hear more about, called “exposure and response prevention” (exposing the patient to his feared thing or situation, then preventing him from performing his typical compulsion to relieve anxiety and keep his feared outcome from occurring). In some cases, the treatments appeared rather radical. But apparently, even the more extreme treatments enjoyed more success than had been expected, and the basic techniques are still used with success today.
Dr. Judith Rapoport did groundbreaking research into OCD. In the early 1990s, her bestselling book, The Boy Who Couldn't Stop Washing, finally made OCD known and understandable to the general public. The publicity surrounding the book was also responsible for countless numbers of children and adults finally being directed toward an accurate diagnosis and effective treatment.
In 1984, Lucinda Bassett, who had once suffered from a host of panic and anxiety problems, co-founded the Midwest Center for Stress and Anxiety. She later became a popular lecturer and wrote a brisk-selling book called From Panic to Power to help others overcome their fears. Her techniques are still being used and taught.
There have been many other excellent and dedicated researchers and doctors who've paved the way for OCD treatment, as well as a far greater understanding of the condition.
