Obsessions

The word “obsession” comes from the Latin word obsidere (“to besiege”) and
can be defined as a recurrent thought, impulse, idea, or image that is intrusive, disturbing, and senseless. Among the most common types are themes
of violence (for example, images of killing a loved one), contamination (for
example, thoughts of catching a disease from a doorknob), and personal injury
or harm (for example, impulses to leap from a bridge). Obsessional
doubting is also characteristic of most patients with obsessive-compulsive
disorder, which leads to indecisiveness in even the most simple matters such
as selecting a shirt to wear or deciding what to order at a restaurant. The basic
content of obsessive thinking distinguishes it from simple worrying.Worrying
involves thinking about an event or occurrence that may realistically result
in discomfort, embarrassment, or harm and has a probability of occurring;
obsessive thinking is typically recognized by the patient as being senseless
and not likely to occur. An example of a worry is thinking about an event
that possesses a strong likelihood of occurring, such as failing a test when
one has not studied. Repeatedly imagining that one might leap from the
third-floor classroom during the exam, a highly unlikely event, is considered
an obsession. Furthermore, because the obsessive-compulsive patient is
aware that these intrusive thoughts are senseless and continuously attempts
to rid the thought from his or her mind, obsessive thinking is not delusional
or psychotic in nature. Although both delusional and obsessive patients may
experience a similar thought (for example, that they have ingested tainted
food), the obsessive patient recognizes that the thought is unlikely and is a
product of his or her mind and struggles to get rid of the thought. The delusional
patient adheres to the belief with little to no struggle to test its validity. 578