The Illusion of Control by martin mascio

the illusion of control

Obsessive Compulsive Disorder t h e i l l u s i o n o f c o n t ro l “The essential feature of this disorder is recurrent obsessions or compulsions sufficiently severe to cause marked distress, be time-consuming, or significantly interfere with the person’s normal routine, occupational functioning, or usual social activities or relationships with others.”6 People that have Obsessive-compulsive disorder not only affect themselves but also the people around them. There are many different physical acts or mental situations a person with OCD puts themselves through. These physical situations are mainly comprised of recurring rituals that one does everyday in order to avoid perceived disaster. The interesting thing about OCD, however, is that sufferers of the disorder are very aware of their actions, but don’t think them out of the ordinary. People that have Obsessive-Compulsive Disorder are living a life of imprisonment, built upon the illusion of control.3

It is important to understand the nature of the two main features of OCD. The obsession refers to the ideas, and compulsion to the actions urged. The themes of the compulsions are usually concerned with fear of dirt and contamination (which may enforce, for example, cleansing rituals) improper sexual conduct, or violent actions that are often obscene or sacrilegious. The theme of the obsession may, however, be some anxiety-laden idea, a religious thought, or preoccupation with fear of religious faith. The patient is disturbed by it for a number of reasons. Although he is aware that the thoughts and urges to action emanate from his own mind, he finds them strange, irrational, and morbid. By applying his own will he can bring them under control for a while hence the “illusion of control”2 but he is unable to prevent their recurrence. Any attempt to confront and expunge them in their entirety generates anxiety. He has to, therefore, to settle for a compromise, which results in periodic relief. This, however, is interrupted by inevitable recurrence of painful ideas, perpetuating the cycle of obsession.3

8:00 a m

times

m o r e m i n ut e s . g o d da m n a l a r m . o k ,

do t h at r i g ht

123

times

123

no didn’t

g o d i h at e t h i s w h y do i do t h i s ? o k , o k , g o d i j u st wa n n a s l e e p . o k h av e to ta k e a s how e r a n d g o to wo r k . w h y a r e m y

s l i p p e rs m ov e d ? t h i s i s n ’ t r i g ht , e v e ry t h i n g i s m e s s e d u p , s l i p p e rs o n , ro b e

123

o n , t u r n o n l i g ht

jesus

123

n o , n o , n o n ot r i g ht

o k , da m n i ’ m a l r e a dy g o n n a b e l at e .

123

u p dow n

the illusion of control

Obsessions s i x m a i n bas i c t y p e s o f o c d “Obsessions are persistent ideas, thoughts, impulses, or images that are experienced, at least initially, as intrusive and senseless—for example, a parent having repeated impulses to kill a loved child, or a religious person having recurrent blasphemous thoughts. The person attempts to ignore or suppress such thoughts or impulses or to neutralize them with some other thought or action. The person recognizes that the obsessions are the product of his or her mind, and are not imposed from without (as in the delusion of thought insertion).” 9 There are six main basic types of OCD. There are checkers who live with an excessive, irrational sense of being held responsible for possible dangers and catastrophes that may befall others as a result of the checkers’ imperfect actions. They feel compelled to repeatedly check objects such as doors, locks, and the off settings on household appliances to feel assured they’ve averted potential disasters they might have caused had they not checked.

Washer and cleaners have obsessions about the possibility of contamination by dirt, germs, viruses, or foreign substances. They live with the constant dread of either being harmed or causing harm to others by the actions of those agents of contamination. Orderers feel they must arrange certain items in a particular, exact, or perfect way. They become extremely distressed if their things are moved, touched, or rearranged. Pure obsessionals experience unwanted, intrusive, horrific thoughts and images of causing danger or harm to others. Instead of behavioral rituals, many engage in repetitive thoughts, such as counting, praying, or repeating certain words, to counteract their anxious thoughts. They may also mentally review situations obsessively to ward off doubt and relieve anxiety. Hoarders collect insignificant items and have difficulty throwing away things that most people would consider junk. People with scrupulosity obsess about religious or moral issues. Their compulsions may involve prayer and seeking reassurance from others regarding their moral purity.7

8:10 a m

minutes to leave. they are still all sleeping, it’s freezing, shower on, still not

hot enough, o k , toot h b ru s h e s , o k , o k t h e y ’ r e c o r r e c t n ow , m y fa m i ly ’ l l b e

o k , a n d wo n ’ t h av e s o m et h i n g t e r r i b l e h a p p e n to t h e m .

this water is warm enough . is everyone still ok ? they should be , let me check , ok he â&#x20AC;&#x2122; s still sleeping . anthony ? anthony ?

â&#x20AC;&#x2030;what

time are you getting up ? damn kid never answers me . ok , pants on , t - shirt on , and socks , these are clean ok .

the illusion of control

Compulsions a b st r ac t a n d o b j e c t r e l at e d â&#x20AC;&#x153;Compulsions are repetitive, purposeful, and intentional behaviors that are performed in response to an obsession. The behavior is designed to neutralize or to prevent discomfort or some dreaded event or situation. The act is performed with a sense of subjective compulsion that is coupled with a desire to resist the compulsion (at least initially). The person recognizes that his or her behavior is excessive or unreasonable and does not derive pleasure form carrying out the activity, although it provides a release of tension.â&#x20AC;?6 It is also common for doubt to enter ones mind as an obstructive element in the patientâ&#x20AC;&#x2122;s mental activities and conduct. For instance, while driving a car he may feel compelled to retrace his journey to banish the doubt that he may have injured or killed someone and left a bloodstained body on the road.3

There may be a preoccupation with numbers, leading the patient to a ritual assembly of a sequence of numbers derived from a chosen starting number expanded until figures cover all the pages of a large exercise book. Books, papers, pictures, and furniture may have to be in a special position, generally of a geometrical regularity or symmetry, and bouts of anger may be provoked if they are moved from a selected site. Bizarre and imaginary dangers may form the theme. A patient may be afraid of handling any piece of string, however short, lest he strangle himself with it. A girl may be unable to travel in public lest when she casts her gaze at male travelers she is accused to be focusing on their genital organs.8

8:31 a m

â&#x20AC;&#x153;Fear periodically

deranged me and took control of my actions.” — Joel Magarey

1234567

o k h e ’ s g et t i n g u p , s ho e s o n n ow , wo r k at

9:30

h at e e v e n n u m b e rs .

w h y do i do t h i s ? e v e ryo n e w i l l b e o k . a l r i g ht t i m e to g o , wa l l et , c i ga r et t e s ,

123 1 2 3 4 5 6 7 8 9 10 11 12 2 15 123 4567

k e ys , ba d g e , h av e to t u r n t h e l o c k r i g ht

da m n it ’ s c o l d

out s i d e .

ba d n u m b e r , n e e d to ta k e

e x t r a st e p s ,

o k t h at ’ s a g oo d

n u m b e r . i wa n t a c i ga r et t e , l i g ht e r wo n ’ t l i g ht , p i e c e o f s h it

o k t h at ’ s a g oo d n u m b e r , t h i s i s g oo d o k .

t u r n s i g n a l o n , h av e t o c o u n t t o

1 2 3 4 5 6 7 8 9 10 11

9:15 a m

a n t ho n y s hou l d b e at wo r k d i d s o m et h i n g ba d h a p p e n ; h e s hou l d b e o k ?

19 19 19 19 19 19 47 47 47 47 47 47 47 ,

o k o k h e s hou l d b e f i n e .

c a l m down he’s fine

it’s just like everyday he’s fine. da m n it i a lways g et st u c k w it h b r a k e jo b s , s hou l d ta k e ,

hou rs ba d n u m b e r i l l g et it do n e i n

t h e n e v e ry t h i n g ’ l l b e

o k , w h e r e i s s h e ? i s s h e ho m e s h e ’ s n ot a n s w e r i n g , i s s o m et h i n g w ro n g ?

107 107 107 107 107

s h e m u st b e s l e e p i n g .

w h y a m i do i n g t h i s ? g o d i wa n t it to sto p , b ut

it ’ s

w ro n g i k n ow i ’ m n ot c o n t ro l l i n g a n y t h i n g .

the illusion of control

Recurring Rituals stag e s a n d e f f e c t s Many of the compulsions associated with this disorder are derived directly from a patient’s obsessions. An overall ritual, done in several stages, which are all precisely defined, determines cleansing rituals and multiple baths. Dressing in the morning has to be undertaken in a specific manner from the feet upwards, and similar checks must be made to supervise each step before retiring for the night. There may be a compulsory round of the house to ensure that all windows and doors are closed and locked. The accountant or bookkeeper may have to check and recheck each column of figures, and repeated cleansing procedures may have to be undertaken after each excretory function.4 The inability to feel certainty that any of the ritualistic routines have been undertaken thoroughly, and endless rechecking which may occupy most of the day, is partly responsible for the slowness of the obsessive-compulsive person in getting anything done. The expression, ‘folie à doute’ has emerged in the French language to describe these activities.5

There is evidence of heredity factors and also environmental exposure as casual factors. Minorities of those with OCD have a family history of this condition. Part of the reason that OCD patients have trouble accomplishing tasks quickly is that they are unable to feel comfortable if they do not complete their rituals or compulsions. Exposure to parents who have suffered from this form of neurotic disorder can be a factor in the patient’s illness. It however has not been determined what proportion of this hazard in the patient’s life stems from hereditary factors. No single gene has been isolated as being responsible, but evidence that parental traits play a part in shaping the obsessivecompulsive condition, or obsessive personality in patients, is more firmly established.3

5:00 p m

“… unable to feel comfortable

if they do not complete their rituals or compulsions.” — Richard Gregory

43 43 43

where is he?

h e ’ s g et t i n g out o f wo r k , a n s w e r t h e p ho n e . o h g o d , m u st b e o n t h e t r a i n ,

5:40 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 43 c a l l h e r , n ot ho m e y et , t h e t i m e i s n ’ t r i g ht it ’ s

pm is he ok?

d i d h e m a k e it ho m e ?

w h e r e i s h e ? a n s w e r t h e p ho n e , h e a lways do e s t h i s to m e .

h e k n ow s i ’ m s i c k . c a l l aga i n , o f c ou rs e h e ’ s ho m e o k .

i f i do n â&#x20AC;&#x2122; t b r e a k i c a n g et ho m e b e f o r e

12:0

w i l l b e f i n e , w h y ? w h y do i do w h at i f s o m e o n e b ro k e i n ? d i d t h e y l o c k t h e

15 15 15 15 53 8

i s p u n i s h i n g m e . sto p it ! o k ga i n c o n t ro l ,

a m o k g oo d wo n â&#x20AC;&#x2122; t b r e a k , e v e ryo n e

t h i s to m ys e l f i k n ow it â&#x20AC;&#x2122; s st u p i d . g o d i h at e t h i s s h it , doo rs ? l et m e c h e c k , a n s w e r da m n it ,

15 15 15 3 53 83 53 83 83 ,

w h y do e s s h e n ot t e l l m e ? s h e

11:30 p m

123123123123 ,

t i m e to g et e v e ry t h i n g tog et h e r . w h e r e i s m y w r e n c h o k , o k f ou n d it , o p e n

12345 123 123 1 2 3 4 5 6 7 8 9 10 11 123 4 5 6 7 8 9 10 11 1 2 3 1 2 3 123 123 ,

close open close open close

n e e d to t u r n t h e h e at o n

e v e ry t h i n g â&#x20AC;&#x2122; s i n o r d e r .

o k g oo d ,

n o n ot r i g ht

n e e d to g et ho m e

i n t i m e , h av e to st r a i g ht e n e v e ry t h i n g out . s o t i r e d o f t h i s ,

o k e - b r a k e o n , a r e t h e y h e r e ? t h e y s hou l d b e ?

ok, ok

12:30

a m l ac e ov e r l ac e , p ut t h e m u n d e r t h e ta b l e o k t h at â&#x20AC;&#x2122; s

f i n e t h e y â&#x20AC;&#x2122; r e i n p l ac e . wa l l et , c i ga r et t e s i n o r d e r o k , o k t i m e to g et c h a n g e d .

the illusion of control

Treatment t r a d it i o n a l a n d e x p l o r ato ry

The current treatment of Obsessive-Compulsive Disorder with drugs plays an important role, and has been shown to be effective in some 50-60 percent of cases, providing considerable relief and in many cases a complete remission from the attack. However, additional measures may be required. Supportive psychotherapy, based on exploration of the historical development of the patient and understanding of his personality and special needs, relieves symptoms and improves compliance. Behavioral therapy is of particular value in patients who cannot tolerate drugs, and in those who require treatment over long periods.3

Beyond the use of normal drug treatment and psychotherapy, advances on a wide front may pave the way for better treatments and a deeper understanding of the functional pathways in the brain, whose abnormal activity cause great emotional distress to both OCD sufferers and their companions. The complexities of the brain cause obsessions that seem fantastical, or compulsions that seem futile, to an outside observer. But these complexities, nonetheless, are physically concrete and therefore constitute an irrefutable reality for sufferers of OCD. The brain of a patient suffering from OCD must be handled delicatelyâ&#x20AC;&#x201D;but if it can be treated, and regain its normal functioning, there is nothing to prevent a healthy mental life and meaningful personal relationships.3

1:05 a m

â&#x20AC;&#x153;â&#x20AC;Ścomplexities of the brain cause obsessions that seem

fantastical, or compulsions that seem futile, to an outside observer.” — Richard Gregory

o k h av e to o r d e r t h e bat h roo m . o k , o k t h e s h e lv e s a r e r a z o rs t h e y â&#x20AC;&#x2122; r e n ot i n p l ac e o k t h e

â&#x20AC;&#x2030;f i n e ,

n o wa it h av e to f i x t h e

â&#x20AC;&#x2030;toot h b ru s h e s

a r e i n o r d e r . w h y do i do t h i s ?

s o t i r e d , a l a r m s et , wa it , i s e v e ry t h i n g l o c k e d n e e d s o t i r e d , h av e to m a k e s u r e

53 83 53 83 53 83 83 53 83 53 83 53

g o c h e c k . o k t h at ’ s f i n e .

e v e ryo n e

will sleep fine,

19 19 19

53 83 53 123 1 83 53 83 53 83 53 83 ok ok

more time and they’ll be ok,

the illusion of control

s ou rc e s 1. When Not in Control, People Imagine Order. National Public Radio (NPR): 28 November 2008. Radio. 17 Jan 2011.

6. “Obsessive Compulsive Disorder.” Diagnostic Criteria From DSM-IV-TR. American Psychiatric Association Print.

2. Taylor, Lucy. “The Tyranny Of Perfection.” Daily Mail 17 May 2010, Print.

7. Hyman, Bruce. The OCD Workbook. Second. Print. 8. Hyman, Bruce. Coping With OCD. 57. Print.

3. Gregory, Richard. “Obsessive Compulsive Disorder.” The Oxford Companion To The Mind. Second. 2. New York: Wiley-Interscience, Print. 4. Purdon, Christine. Overcoming Obsessive Thoughts : How To Gain Control Of Your OCD. 9-29. Print. 5. “People Who Can’t Let Go.” Haymarket Publishing Services. 01 March 2007: 44. Print.

9. “Obsessive Compulsive Disorder.” Diagnostic And Statistical Manual Of Mental Disorders. Third. Washington, DC: American Psychiatric Association, 1987. Print. 10. Magarey, Joel. “Daring to leave the dark cave of secret shame; Joel Magarey, a writer with much to hide, describes the consequences of publishing a tell-all memoir.” West Australian 6 Feb. 2010, Saturday: 40. Print.

c o l o p ho n This book was produced in partial fulfillment of the requirements of the Senior Studio in Graphic Design, College of Art and Design, The University of the Arts, Spring 2011.

Concept and design by Martin Mascio. Narrative written by Martin Mascio. Photography and image treatment by Martin Mascio.

Instructor: Jan C. Almquist, Adjunct Professor, Graphic Design

Dedicated to: My Family for always being there, and supporting my decisions.

Advising Editor and Guest Critic: Tim Appignami, Senior Lecturer, Liberal Arts

Special thanks to: All of my friends for their support during this process, and the graphic design faculty for teaching me how to think and see.

Professional Consultant and Guest Critic: Joel Katz, Joel Katz Design Associates Hans-U. Allemann