The entity known as 'obsessive-compulsive disorder' is actually not one but many entities grouped within a single category.
Within this category are housed compulsions of various degrees of severity as well as ideational patterns that range from a small, insignificant thought that repeats itself often and at inappropriate times, to large, full-blown obsessive delusions that border on psychoses.
The root cause of obsessive compulsive disorders, therefore, cannot be singled out as one, but rather falls into a range of causes that relate to each other yet differ in their point of origin. For example, the compulsion of hand-washing that is relatively common in today's culture, used to have other features in centuries past. Today, this symptom is frequently an attempt to regulate the anxiety that occurs in relation to feeling that one's life is out of control and that there is no way to remedy the situation. Efforts at regulating a single habit or compulsion are often, at their root, efforts to regain a sense of balance and of sanity, and to replace the fear of things escalating to a point of crisis, with a sense of being able to handle things.
Hand-washing is just one of many examples of compulsions that have to do with the separation of an individual's psychic center from its true relationship with their emotional and physical life, so that the person no longer feels at the center of that life, but rather at the mercy of large forces that can sweep through it and sabotage their best efforts and intentions. These forces are often perceived as nameless and faceless, but exist with a sense of impending crisis or doom and color the perception of the world.
By contrast, such things as obsessive fantasies about a particular person or situation that repeat themselves with great frequency, interfering with the normal flow of mental activity that is ordinarily part of a day, often have their root in the perception of the world as dangerous or very risky in terms of what is possible, and are efforts to create an ideological alternative which is wish-satisfying, that is, which grants one the feeling, however temporary, that things would be alright if the fantasy were fulfilled. Since the fantasy is not often fulfillable in real-life terms, satisfaction on the mental level is sought as a substitute.
The separation between self and world that underlies many obsessive-compulsive disorders can arise from a variety of causes - a shock to one's life such as a sudden loss or tragedy that is difficult to assimilate; a change of fortune or of relationship that involves losing something highly valued that was perceived as an essential part of one's identity; a set of circumstances or conditions that give rise to intense fear or terror, irrespective of their cause. Each of these can lead to the development of obsessive-compulsive symptoms and each can be remedied by restoring the relationship of self to world in such a way that the self feels safe and in the center of their world once again.
The spiritual underpinnings of obsessive-compulsive behavior are those which arise out of a separation between the embodied self and the deeper spiritual matrix in which that self lives. The physical self, feeling itself to be alone and unprotected in the world, lets go of the idea that there is anywhere or anyone to turn to who can meet the present need for greater security. This perceived absence includes relationships with others but also the relationship with God. Many who develop compulsive habits are creating their own world of security as an alternative - a world which does not involve others - a world which can become more and more regulated by efforts at minute manipulation of details.
The impaired relationship context of those suffering from obsessive-compulsive disorders needs to be restored on both the emotional and spiritual levels. Where an absence of safety has been the predominant feeling, trust needs to take its place. Where a sense of isolation has been experienced, one needs to be led gently back into the context of group alignment. These transitions, in themselves, will not alter the symptom picture, but they will create the restorative context in which further change can take place.
Similarly, re-acquaintance with one's spiritual underpinnings can bring a deeper sense of safety and security for those who are open to it. Often, however, turning to God is the most difficult thing for one preoccupied with obsessions, since the mental world that has been created is both insular and self-contained, and since fear can prevent even the desire for escape from that world.
Nevertheless, for those who seek an exit from their own self-imposed mental prisons, re-introducing a relationship with the Divine and the development of a regular spiritual practice of meditation and alignment will, over time, undercut the attachments to a particular thought or behavior pattern as a way of regulating one's safety in the world.
The inner isolation that severe obsessive or compulsive symptoms create can be very painful, even if part of a self-constructed inner world. Gentleness and a loving approach that invites one to leave the self-imposed prison are best, for these will support the underlying motivation to find a different resolution to the problems at hand.
In its most potent capacity, spiritual light of sufficient intensity can work miracles with obsessive-compulsive disorders, cutting through all the fear and isolation that are at the foundation of the disorder, and infusing a truth that simultaneously conveys love, safety, and a sense of all being well with the world. In the absence of light of this intensity, the slower path will lead to the same goal, but will just take a longer period of time.
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