1 2 3 4 5 …..

 

1, 2, 3, 4, 5

Consultant Psychiatrist, Dr Thomas Lee

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“1, 2, 3, 4, 5. Once I caught a fish alive.

6, 7, 8, 9, 10. Then I let it go again.

Why did you let it go? Because it bit my finger so.

Which finger did it bite? This little finger on the right.”

This is not a simple nursery rhyme.

At least not to Danny (not his real name). It was a curse to him.

A song that returned to bite him again and again, since he was a teenager.

For whenever Danny needed to perform a particular ‘critical’ activity, he had to sing this nursery rhyme PERFECTLY without any errors before he could feel at complete ease to carry out that activity. For example, before he opened his car door or turned on the stove, he had to hum this nursery rhyme. If something went awry during the song — a word sung wrongly or pronounced unsatisfactorily, the tune went off slightly, the tempo was too fast or slow, or a stray thought popped into his mind — he had to repeat the song again until he got it PERFECTLY right. Most importantly, the volume of the numbers (1-2-3-4-5, 6-7-8-9-10) must be LOUDER than that of the words. So he must be sure to emphasize the numbers. And finally the finale — he had to wriggle his right little finger exactly 10 times at the end of the song.

Danny rarely got it right just once. Almost always, he had to repeat it several times before he was satisfied. This would usually take anywhere between 1 and 5 minutes before he could open his car door or turn on the stove.

 

 

Danny hated doing this. He knew it was absurd and nonsensical. But he felt totally helpless. He simply could not resist or fight it because he had this dreadful fear that some kind of disaster would befall him or his family if he did not sing it perfectly before each ‘critical’ activity. Such fears include serious vehicular accidents, explosion of stove, or some mishaps that could result in serious injuries or even death to him or his loved ones.

Imagine Danny’s life. Opening a car door and turning on the stove were only two examples of many ‘critical’ activities in his everyday life. His work was persistently hampered by this compulsion to hum the song before performing activities like switching on his desktop computer and opening his office door. It got worse over time. His life, work and relationships were mercilessly disrupted.

For Danny, life was a constant battle day and night as he struggled to fight the irrational thoughts in his head each day. Time seemed like an eternity as he wearily fought each skirmish alone and silently.

To the observer, Danny was an ineffective person who took longer than necessary to do anything. He was often observed to be distracted or staring blankly. Friends and colleagues avoided him. His superiors chastised him. Only his family stood by him ….. helplessly.

Danny suffered from a mental disorder known as Obsessive-Compulsive Disorder (OCD). A person with OCD has recurrent unwanted thoughts (obsessions) that generate intense fear, anxiety and worry. In order to eliminate such distressing thoughts, the person has to carry out specific actions in a rigid and ritualistic manner (compulsions). For Danny, the very fear of calamity befalling him and his loved ones (obsession) overpowered him to sing a perfect nursery rhyme (compulsion) resignedly so as to neutralize any possibility of a disaster. As a result, a person with OCD invariably suffers significant disruptions and impairments in most aspects of his or her life.

Obsessive-Compulsive Disorder is a treatable condition. A combination of medications and psychotherapy is the most effective way to alleviate the symptoms of OCD and to bring about recovery. Quality of life can improve. Life functions can be restored. For Danny, treatment gave him back his independence and freedom to live as normally as anyone else.

 

 

Consultant Psychiatrist, Dr Thomas Lee

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