OCD and the Big Picture

When my son Dan’s obsessive-compulsive disorder was severe, many of the manifestations of his illness were obvious and serious. When you’re in college, it’s pretty tough to hide not being able to put a morsel of food in your mouth, or not being able to walk from point A to point B. I am so thankful that Dan recovered from severe OCD and that it is now classified as mild. He is doing well.

But he still has OCD, and it affected his work throughout college. As I’ve discussed before, college accommodations for those with OCD can be a complicated matter, and schools in general have a long way to go in their understanding of how to help those students with the disorder. For Dan, his challenges were far more subtle now than when his OCD was severe, but they still hindered him. One of the main things he struggled with was the balance of details within the big picture.

Certainly, this issue is not limited to those with obsessive-compulsive disorder. People process information differently, and the index of learning styles developed by Richard Felder and Linda Silverman back in the 1980’s references the balance of details within the big picture. However, it is not unusual for those with OCD to have this tendency. When I think of it, it makes sense. Those with OCD are typically very detail oriented. Is the faucet completely turned off? That man touched his nose before he shook my hand – am I now contaminated? Those with OCD notice things that many people without the disorder overlook. It’s not surprising that they might have trouble balancing details within the big picture. At times, they are just putting too much focus on the wrong things.

Those who suffer from body dysmorphic disorder (BDD) serve as a good example of this. BDD is a disorder in which people misperceive themselves as disfigured and ugly, and it is closely associated with OCD. BDD sufferers are overly focused on details of their appearance. For example, a small mole on the face may be seen as a hideous disfigurement. Studies have shown that people with this disorder exhibit an abnormality in how visual information is processed (they have less brain activity when looking at the “big picture” as opposed to looking at details).

Whether this abnormality in visual processing is a cause of BDD or a result of having the disorder remains to be answered. The question we can answer now is how can we help those who have this very real problem of balancing details within the big picture? Therapy can help, and in the context of college, the answer for Dan was simple. Just informing his teachers of the issue and checking in regularly with them to make sure he was on the right track with assignments and projects was usually all that was needed. He would run into trouble if this issue was not addressed. Again, it comes down to raising awareness and educating others about OCD, and then working together to ensure success.