Specifically, we’re referring to the category of emotional disorders known as Impulse Control Disorders. The similarity to OCD is seen in the fact that impulse control disorders, like OCD, are repetitive and very difficult for the person to bring under control. Furthermore, like OCD, they greatly disrupt and impair the sufferers’ lives.

However, Impulse Control Disorders also differ from OCD in important ways. Impulse Control Disorders, unlike OCD, often do not cause a great deal of distress to the person who has them—that is, unless or until legal authorities are called in.

Furthermore, distress, anxiety and upset do not play a very large role in most Impulse Control Disorders. In fact, many of those with Impulse Control Disorders actually report feeling pleasure from their behaviors even though their lives are impaired by them.

Some of the major types of Impulse Control Disorders include:

• Pyromania: People with this problem find themselves irresistibly drawn to setting fires. They aren’t out to make money as arsonists are; rather, they set fires for the excitement of it. Unfortunately, for those afflicted with this problem, law enforcement agencies consider their behavior on a par with arsonists; in other words, they don’t cut them a lot of slack.

• Kleptomania: These folks find themselves stealing repeatedly, yet they rarely need the things they steal. Rather, they feel tension prior to stealing and great pleasure and excitement when executing the theft. Later, they may feel remorse, but it such remorse fails to stop their behavior. As you can imagine, more than a few of these people eventually wind up in jail.

• Pathological Gambling: Not just anyone qualifies as a pathological gambler and thus have an Impulse Control Disorder. Only those who gamble themselves into serious problems financially over and over again receive this label. These folks sometimes even steal or engage in other illegal behavior just to keep their habit going. They may “know” what they are doing is a problem, but report feeling unable to stop.

• Intermittent Explosive Disorder: People with this problem report feeling unable to put the brakes on repeated episodes of aggression. They often harm property as well as people. When they feel the impulse to be aggressive, they say they “can’t help themselves.” Again, law enforcement agencies, not surprisingly, see their behavior differently.

• Compulsive Buying: Though not officially recognized as an Impulse Control Disorder in the current version of professionals’ diagnostic manual, people with this problem look very much like those with other Impulsive Control Disorders. They can’t stop themselves from buying “stuff” that is frequently completely unnecessary. They do so to the extent that their finances end up in ruins. They feel great when they buy something, but that feeling is fleeting and often replaced by guilt and shame. In spite of those feelings, they continue the cycle repeatedly.

• Trichotillomania: This is a common problem and involves repetitive, irresistible urges to pull out strands of hair. Sometimes Trichotillomania results in bald patches or even complete baldness. People with this problem often report feeling some pleasure from pulling hairs, whereas others say their main motivation is a reduction in anxiety or distress.

Treatment of Impulse Control Disorders has lagged behind the treatment of many other emotional disorders such as depression, anxiety, and obsessive compulsive disorder. There are some indications that treatments such as Habit Reversal Training may have value for Trichotillomania. However, most of the Impulse Control Disorders beg for more research on potential treatments.

Of course, even if we had a plethora of effective treatments, there’s still the problem that most of those with Impulse Control Disorders aren’t all that interested in getting help. Sigh.

There’s no reason to think you have a serious problem. In fact, if you saw your face and body as totally, wonderfully, gorgeous and without flaws, many people would think you were narcissistic.

But there’s a problem called Body Dysmorphic Disorder (BDD) that takes normal, minor dissatisfactions to a level that lies far outside the range of normal. People with BDD have heart-rending distortions of their own bodies. They obsess and feel anguish about one or more perceived bodily flaws.

More often than not, they view these imperfections as grotesque. Some typical concerns of those with BDD include worries about having:

• A forehead that seems too small or too large

• A slightly crooked nose

• A chin that feels too large or too small

• A penis that’s seemingly too short or too narrow

• Slight discolorations of the skin

• Ears that don’t look quite right to the person

• Crow’s feet

Those with BDD often shift their concerns from one imagined defect to another over time. You might review the list of supposed defects above as trivial concerns. But people with BDD seriously believe that their bodies are painfully deformed, blemished, or disfigured. But a hallmark of the disorder is that other people rarely see them that way; in fact, other people often do not even perceive anything at all as wrong with the actual appearance of those with BDD.

Yet when people with BDD worry about these issues, they sometimes engage in a host of rituals or compulsive behaviors in order to feel better. Unfortunately, they feel better only for a brief time.

Some of the compulsions include seeking plastic surgery (often many times), asking others for reassurance about their appearance, checking their “defects” in the mirror over and over again, seeing dermatologists excessively and requesting numerous procedures, wearing gobs of makeup to hide their presumed defects, picking at imagined skin imperfections and thereby causing irritations and scars, wearing clothing designed to hide their presumed deformity, extensive body building, steroid injections, supplements, and hormones to build body mass, and on and on.

If you think that BDD sounds a lot like obsessive compulsive disorder, you’re right. BDD has a lot in common with OCD. However, there are a few differences. For example, unlike OCD, those with BDD are more often depressed; they often have less insight into their problem than people with OCD, and some of the compulsions associated with BDD don’t occur as often as the compulsions of people who have OCD.

For example, you don’t exactly have plastic surgery a hundred times a day in the way that someone with contamination OCD might wash their hands that often. But trust me, some people with BDD do seek and obtain an astonishingly large number of plastic surgeries over time—and each time they think “this” surgery will finally be the one that corrects the problem, but it never seems to work out as planned. So they have another plastic surgery and then another.

So BDD does look a lot like OCD. And in actuality, whether or not BDD should truly be called a disorder that’s different from OCD or simply a subtype of OCD is an open question. We can think of arguments for both sides of that issue.

The bottom line is that if you or someone you know has BDD, get help. BDD is a serious problem that disrupts lives, ruins relationships, and sometimes leads to depression and even suicide.

Man with broken nose photo available from Shutterstock.

For example, a man with OCD might have an obsessive thought that a doorknob is contaminated and the thought of touching the doorknob causes him great anxiety. He takes a spray bottle of disinfectant and sprays the doorknob, which decreases his decreases. Then he reaches for a Kleenex to give him a barrier from any possible remaining germs. He feels relieved. And that momentary relief feels pretty good; well, that is until the next doorknob appears.

The pattern repeats: an obsessive thought, an overestimation of danger or risk, increased anxiety, a compulsive action, and then feelings of relief provided by the compulsive action.

OCD also involves thoughts.  For some people with OCD, their obsessions and compulsions are more in their heads than in their guts. Consider a woman feels compelled to count everything she sees—ceiling tiles, stairs, books on a shelf, you name it; she counts it. But she actually reports feeling not particularly anxious at all. It’s just that she feels things aren’t “right” if she doesn’t count everything imaginable. Her feelings are more about distress over things being out of order rather than anxiety.

OCD can also show up primarily in behaviors. For example, a man might feel a driven need to go through doorways in a particular manner. Until he gets it “right,” he can’t let himself continue on his way. He can’t come up with any particular thoughts about why he needs to go through doors in this way; he just feels he must. And that feeling of having things be “just so” isn’t exactly the same thing as anxiety.

As these examples illustrate, OCD manifests itself in many widely differing forms. The prominent feature(s) may involve anxiety, thoughts, behaviors, urges, or distress. Although OCD is currently considered a type of Anxiety Disorder, many professionals believe it deserves its own separate diagnostic category. In part, that’s because much of the urges and distress brought on by OCD just don’t look like classical anxiety.

The take home message is that this is a fascinating, yet quite complex disorder. If you “think” you may have OCD, consider seeking professional consultation. This is one problem that you don’t want to self diagnose. The good news is that treatments for OCD work very well.

Anxious man photo available from Shutterstock.

Of course we wondered if we could have done something to prevent this malady from occurring. When we saw our doctor, he suggested that we might have gotten our flu shots too early this year (apparently, they reformulate the shots as the year goes on). Of course, he said we had no way of knowing that and, no, he wasn’t recommending that we start getting two flu shots a year.

Maybe we didn’t wash our hands often enough. Or maybe we weren’t sufficiently attentive to getting enough sleep every night. Or maybe we spent too much time around crowds at the mall. Maybe…YIKES! Stop it!

We could see ourselves starting to fall into classic health anxiety so we rethought our concerns a bit. In doing so, we realized that we usually engage in most of the truly important behaviors for reducing health risks—we don’t smoke, we keep our weight under control, we have a good diet, we exercise and so on.

Worrying about people’s sneezes, washing hands excessively, avoiding crowds, etc, do little to nothing to actually prevent most cases of the flu. But they can cause stress and take up a lot of time if you let such worries spin out of control.

How about you? Do you let health worries dominate your life or is your health anxiety a normal, subclinical concern? Here’s a list of some questions to ask yourself in order to answer that question:

• Do you spend an hour or more most days worrying about your health?

• Do you frequently ask other people to reassure you about your health status?

• Do you take precautions against contact with germs that most people don’t (e.g., using Kleenex to open doorknobs)?

• Do your worries interfere with living a happy life?

If you discover that health anxiety interferes with your life, get help. You can overcome this problem by working on it. A good therapist can help you to see that most “over the top” strategies to keep you well (e.g., using hand sanitizer ten times a day), rarely accomplish their goal.

You can learn to stick to the basics for keeping yourself healthy. And you can learn that if you do get sick, you’re quite likely to cope with it just fine. People get sick all of the time and they generally get better and move on with their lives. You can do the same with a little help.

Sick woman photo available from Shutterstock.

For example, if you’re in the Boomer generation, you may remember walking or bicycling to school as early as the first or second grade. You don’t see much of that today. And if you took a bus to school, no adults stood around watching out for you.

Today, parents are much more cautious. That’s probably good—at least to a point. I guess I knew things had gone a bit too far when I saw an ad from the Internet the other day which proclaimed:

“Finally: a protective helmet for wobbly walkers and crawlers that’s cute and comfortable, too! This advanced baby helmet is made of high-tech foam that absorbs impacts and cushions falls, without bulky padding. Its breathable lining keeps little heads cool. Helmet adjusts to fit kids 8-20 months. Thanks to its adjustability and material, No-Shock adapts to the shape of your child’s head.”

Maybe you’ve seen the YouTube video that’s been circulating around about how invaluable these helmets can be. In the video, a toddler takes a tumble and clonks his head on the floor, but thanks to his helmet, no harm done! Fantastic isn’t it? What reasonable parent wouldn’t rush out to buy one of these helmets for their kids (intended for roughly the ages of 8 months and two years of age)?

But then again, why should we stop at the age of two? Perhaps everyone should wear helmets all of the time throughout their entire lives. I’m pretty certain that some injuries would be prevented if that were the case. I’m guessing not that many people would be interested in such lifelong helmet use.

But how about toddlers? Should they wear helmets? Personally, I think not. Life has inherent risks. If we start putting helmets on kids, I think we’re giving the wrong message: “The world is a scary place and you must be very, very careful at all times. Don’t take risks and don’t venture out.” Sounds a lot like a prescription for how to develop an anxiety disorder.

But maybe that’s just me. I wonder what your thoughts are concerning this latest trend in how to be a good parent.

p.s. Thanks to Lela Davidson for bringing this item to my attention!

Baby in helmet photo available from Shutterstock.

Many of the clients I see express the need to be perfect. They fear making mistakes and feel horrible when they mess up. Some of these folks even berate themselves for making trivial, largely inconsequential mistakes like parking a few inches over the line of a parking space or making a few typoss on a blog (NOTE TO EDITOR: please don’t correct my typos in today’s blog!).

Some clients with sever obsessive compulsive disorder rachet this concern up to the point that they spend hours reviewing everything they right to insure a complete absence of errors. Others re-read passages from books over and over again to be sure that they remember every single detail. Still others consume large blocks of time arranging everything in their closets in perfect alignment with identical  spacing between each item.

If you’re a perfectionist, I strongly recommend that you get a grip! Stop viewing all mistakes as terrible. I can guarantee you that I’ve learned more from making mistakes than I ever would have if I didn’t make them.

Furthermore, mistakes are simply part of being human. Frankly, I’m pretty sure that I wouldn’t even want a truly “perfect’ person to be my fiend. Think about it. Someone who always has perfect posture, perfect hair, perfect clothes, perfection diction. Yuck. Sounds like an atomitron to me (is that a word? I think not; who cares!). So if you want to quit letting your need for perfection stress you out, I have an exercise for you. Set aside a day for making as many mistakes as you possibly can. Consider:

• Parking over the line (but don’t do this one if it’s a very crowded parking lot with precious few spaces!)

• Go in the out door and visa versa.

• Make minor misspellings on non-critical papers.

• Forget to cross your t’s and dot your i’s.

• Wear one blue sock and one brown.

• Comb a few hairs to be out of place.

• Leave one button unbuttoned.

You get the idea. And obviously, it’s not a great idea to make all of these mistakes when they might really matter like during a job interview. Certainly you’d never want to make mistaeks in something as important as a blog, for example. But you might be surprised by how many places and ways you can make a bunch of mistakes in without serious consequences. Loosen up a little. You’ll be glad you did.

So when should you start? How about next Monday? Why Monday? No reason; it just sounded good in the title to me.

Oops road sign photo available from Shutterstock.

But that definition doesn’t quite fit what I mean by self-less (note I put in a hyphen to distinguish the term from selfless). I think people can and probably should have at least some concern for their own needs in terms of finances, relationships, security, and so on. And sometimes your own needs may even have to take precedence over the needs of others.

But people all too often seriously mess themselves up when they become overly concerned about themselves and their egos. They experience exquisite concerns with how they look, what they say, mistakes they make, who likes them and who doesn’t, et cetera.

People who worry a lot about their egos judge just about everything that they do. Their internal dialogues consist of an endless loop of self-hate and vitriol with thoughts such as “How could I be so stupid?,” “I hate myself,” “No one could be this dumb,” “I’ll never amount to anything,” “Nobody could ever like me,” and on and on. It’s pretty difficult to feel alright with thoughts like those.

But the alternative isn’t as simple as it seems. The solution does not come from merely trying to pump yourself up with positive self-affirmations like “I’m wonderful,” “I’m the best,” “I can do anything I put my mind to,” or “I’m number one.” The problem with that approach is that you still end up ceaselessly judging and evaluating everything that you do. And filling your mind with positive self-statements is likely to leave you feeling quite punctured and deflated whenever those positive thoughts are put into question by actual failures, mistakes, and difficulties.

Instead, the real solution comes from working on having less concern about your “self” and your ego. Try to stop judging everything you do and say. Let go of evaluating and criticizing your every move. Work on accepting who you are and what you do without giving yourself a rating.

An excellent exercise to show you how easily the mind engages in negative judging is to sit in a room and try criticizing every single item in the room—the chairs, the flooring, the ceiling, the art, everything. You’re likely to discover that even if you’d rather liked that room, it’s ridiculously easy for your mind to trash everything in it. That’s because most people’s minds are so accustomed to judging and evaluating.

So try working on letting go of the obsessive need to judge yourself. When you hear negative (or positive) thoughts about yourself in your mind, try responding to them by saying “I don’t need to evaluate myself. I want just to accept what is. Let it be.”

Dropping your ego and need to evaluate yourself takes time and effort. Old habits die hard. But the more you learn to take on a self-less attitude, the happier you’re likely to become.

Senior woman and helper photo available from Shutterstock.

Or then again, your mind might start focusing on thoughts about how horrible it would be to have a lousy night’s sleep. Such thoughts include:

1. Tomorrow’s an important day and if I don’t sleep, I’ll perform at a subpar level. That just isn’t acceptable.
2. I hate it when I sleep poorly.
3. I don’t know how I’ll get through the day.
4. There’s nothing worse than having to go through a whole work day after sleeping miserably the night before.
5. I’ll be a wreck tomorrow without a good night’s sleep.

Frankly, I agree; having a bad night’s sleep seriously simply sucks! But on the other hand, it isn’t a catastrophe like those thoughts suggest. Fact is, when you have catastrophic thoughts about not sleeping, you’re almost bound to remain awake because of the hyper-arousal such thoughts cause.

So instead, consider de-catastrophizing by:

• Reminding yourself that each and every time you have had a lousy night’s sleep, somehow, someway you still managed to trudge through the next day. Yes, you might not have felt great, but you got through it.

• Realize that few people on this planet have a great night’s sleep every single night. Poor sleep happens to almost everyone here and there. Worrying and catastrophizing just makes things worse.

• Try getting up if you can’t sleep and do some mindless chore. Doing a chore will take your mind off your catastrophic thinking and may even give you a sense of satisfaction from accomplishing at least one small item.

• Try concentrating solely on your breathing. Notice how the air feels as it comes through your nostrils, down your throat and into your lungs. In and out. In and out. This strategy takes a little practice, but you can gradually learn to clear your head of negative thinking if you focus on something else like the act of breathing.

Here are just a few other sleep tips for you to consider:

Make sure your room is dark. Put up blackout curtains if you need to. Darkness can help your brain set its clock and start releasing melatonin, a hormone that helps bring sleep on.

Make sure your room is a bit cool. Most people sleep better when the temperature is cool.

Make your room quiet if you can. If you live in a noisy area, try getting a fan or white noise generator to block out noxious noises.

Mattresses matter. If your mattress isn’t especially comfortable, splurge and get a good, comfortable one.

Finally, if your sleep problems are chronic in nature, consider seeing your physician. It could be that you’re suffering from depression which often disrupts sleep and that should be evaluated. You could also suffer from some other ailment such as sleep apnea that could be causing you problems. In other words, don’t continue to suffer from poor sleep one night after another. Do something about it and you’ll feel a whole lot better.

Sleepless woman photo available from Shutterstock.

And then there’s the ever popular “Seriously?…Really?” I like that one a lot. Why? I really don’t know. It just conveys a tone that I like. Perhaps it’s my sarcastic streak. At any rate, I find myself wanting to say “Seriously?….Really?” pretty often when I confront the thoughts that constantly bombard the minds of people who have obsessive compulsive disorder (OCD).

I feel like saying that because people who have OCD really take their thoughts seriously. As in “really seriously.” Thus, they may have thoughts such as “I must have perfect thoughts about everyone I care about or something bad will happen to one of them,” or “If I have bad thoughts, it must mean that I am bad,” or “If I think about profanity in church, I must be a horrible, sinful person.”

What’s really interesting about OCD thoughts is that researchers have found that almost everyone has similar thoughts from time to time. In other words, the thoughts of those with OCD are virtually indistinguishable from those that people without OCD have. The key is that people without OCD simply don’t take such thoughts seriously. Really.

In other words, they notice these thoughts; they think the thoughts are sort of weird, but they don’t put much meaning into them. They don’t believe that thoughts cause things to happen in the world and essentially realize that “thoughts are just thoughts,” nothing more.

So if you have OCD and worry about the types of thoughts that run through your mind, try repeatedly telling yourself that “thoughts are just thoughts.” And “everyone has thoughts like these every now and then.” Finally, remind yourself that thoughts simply don’t cause things to happen in the outside world. LOOK: Thoughts exist in your mind, but they can’t reach out and do anything to anyone or anything—SERIOUSLY…REALLY!

Woman calling out photo available from Shutterstock.

The original idea behind BIP’s was grounded in something called learning theory. In brief, learning theory proposes that kids will do more of what they are rewarded for and less of what they aren’t. They’re also likely to engage in disruptive behaviors less often if those behaviors result in a loss of something the child likes or if the behavior is followed by a mildly unpleasant consequence.

However, some of the BIP’s that I’ve seen in recent years seem to have lost their original grounding in learning theory. The school girl I mentioned (we’ll call her Nicole) had been failing to follow rules, blurting out inappropriate comments in class, banging her head, arguing with the teacher, and sometimes trying to leave the classroom when she shouldn’t. Here are some relevant snippets from Nicole’s BIP:

• Let her be near the teacher whenever she wants if it’s not too disruptive

• Give her the choice of not standing in line if she doesn’t want to

• Allow her to choose to eat lunch with the teacher if she wants to

• Give her as many choices as possible within the teacher’s ability to tolerate doing so

• Reduce writing work and give Nicole the choice of any topic she wants

• Allow Nicole to go under the desk as a reward

• When problem behaviors occur, deliver consequences in a four part sequence

First: Remind Nicole about the reward system

Second: Give her choices of where to go

Third: Send her to the office

Fourth: Call her parents

What’s wrong with this plan? Why do I say it doesn’t appear to be grounded in solid learning theory? I could probably write a book explaining the problems with this BIP, but for my readers’ sake, I’ll boil it down to a few highlights.

First, the plan appears to be attempting to do everything possible in order to avoid frustrating Nicole. However, learning to tolerate frustration is one of the very things she needs to learn. Therefore, allowing her the option of not standing in line may temporarily avert frustration, but it’s likely to give Nicole the message that she can get out of anything she finds unpleasant (thus rewarding the opposite of frustration tolerance).

This same problem is evident in the reducing of writing and allowing Nicole as many choices as possible. Again, these strategies may help prevent a few outbursts in the short term, but Nicole will learn nothing about how to tolerate frustration, delay gratification, or persevere in the face of obstacles.

Second, when Nicole does misbehave, she’s given two consequences that could actually reward her for having engaged in problematic behavior (i.e., “reminding” her about the reward plan which gives her attention and giving her choices which lets her have her way). Only on her third offense is she sent to the office. And being sent to the office could be positive or negative depending upon what goes on in the office.

If office personnel aren’t careful, they could easily reinforce Nicole when she’s there. The same issue applies to calling her parents—this action could feel positive or negative to Nicole depending on how it’s handled.

Finally, and perhaps most importantly, the plan fails to clearly identify a set of target behaviors that teachers want to see Nicole engage in more frequently. Positive behaviors tend to crowd out negative, disruptive behaviors, but these were given short shrift in her plan.

I love BIP’s. They can do a world of good. But they can all too easily backfire if they aren’t carefully crafted and grounded in learning theory. You just can’t get kids to a better place by simply trying to steer them away from anything they might find frustrating or upsetting.

Young girl making a face photo available from Shutterstock.