Obsessive Compulsive Disorder: Theory, Research, and Treatment

By Ross G. Menzies; Padmal De Silva | Go to book overview

Chapter 10
PRIMARY OBSESSIONAL
SLOWNESS

Stanley Rachman


INTRODUCTION

Primary obsessional slowness (POS) is a compulsive disorder in which the affected person carries out simple everyday tasks, mainly self-care tasks such as washing and dressing, in an exceedingly meticulous, precise, unvarying manner and sequence. As a result, they take an inordinate amount of time to complete these tasks. It can take between 2 and 6 hours to get prepared in the morning.

The disorder is termed ‘primary obsessional slowness’ because the slowness is not, as in other types of OCD, secondary to another type of compulsion, such as checking (Rachman, 1974). In other types of compulsions the slowness, if any, is the result of repeatedly carrying out the same action. For example, such persons are slow to leave the house because they repeatedly return to check that each and every electrical device is unplugged, that all the doors and windows are tightly shut, and so forth. Some patients whose main disorder is POS may also display some slowness that is secondary to checking. Lucid case illustrations are provided by Bennun (1980), Bilsbury & Morley (1979) and Clark et al. (1982) and textbook descriptions are given in Gelder et al. (1983), Kendell & Zealley (1983) and Marks (1981). A recent report of cases, which also gives long-term data, is provided by Takeuchi et al. (1997). Further cases have been described by Takeuchi et al. (2001).


NATURE OF THE PROBLEM

The case of a 38-year-old man who suffered from a chronic and severe obsessional disorder provides an illustration of the nature of the problem. At the start of treatment he was taking approximately 3 hours each morning

Obsessive-Compulsive Disorder: Theory, Research and Treatment.

Edited by Ross G. Menzies and Padmal de Silva. © 2003 John Wiley & Sons, Ltd.

-181-

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