Alumni newsmaker:
> > Steven J. Brodsky, AM'92, treats an obscure but significant disorder

Clinical psychologist Steven J. Brodsky, AM'92, knows quite a lot about Obsessive Compulsive Disorder (OCD). He knows that it affects about 6 million people in the U.S.-roughly two percent of the population-and that age 7 is the average age of onset. He also knows about one often undetected type of OCD, in which the symptoms of both compulsions and obsessions are tied to religion.

Brodsky, a staff psychotherapist at the Center for Cognitive-Behavioral Psychotherapy in Manhattan, has been treating patients with OCD, including those with religious manifestations, for six years. While obtaining his doctorate in psychology at Yeshiva University's Ferkauf Graduate School of Psychology, he worked in a clinic in a predominantly Jewish neighborhood in Brooklyn, NY, where he encountered patients with religious OCD and decided to make the disorder his specialization.

"I discovered over time that this was a bigger problem than a lot of people knew," says Brodsky. In recent years, however, the disorder has been receiving more public attention, and Brodsky himself has appeared in several New York-area newspapers to raise awareness.

General OCD cuts across all socioeconomic, gender, and racial lines. Nor, says Brodsky, do religious manifestations of OCD discriminate: he has treated Jewish, Christian, Muslim, and OCD sufferers of various other faiths.

Sometimes called by the clinical name "overscrupulosity," OCD is composed of two parts: the obsession and the compulsion. First, a person mulls over a worry or an anxiety triggered by a situation such as, in the religious manifestation, the slightest fleeting thought of a sin. As the person becomes obsessed with the worry, he or she tries to alleviate the awry thoughts by taking some type of action. In the religious cases, such action might involve repeatedly visiting the confessional booths or asking the rabbi for reassurance. Other examples offered by Brodsky include people who, when reciting a prayer, believe they have missed a word and so restart the prayer again and again, agonizing over every word until their recitation is perfected, or those who stop attending services because they are afraid of shouting blasphemies during worship.

In normal people, the action taken to counter a worrisome thought eases the anxiety, but in OCD patients, it creates a compulsive, vicious circle back to the anxiety. With religious OCD, however, the cycle may appear less serious, because others may misread the overscrupulosity for extreme religious devotion.

But, advises Brodsky, asking a simple question can uncover the problem:

"Ask the person, 'Do you think that this is really a serious concern, do you think it's a little overboard at all?'" he advises. "Very often, the person will acknowledge, 'I know it sounds silly, but I just can't help myself.'" If a person exhibits any of these symptoms of OCD, he strongly suggests referring the person for therapy.

Although the degree of severity for any type of OCD varies from mild to extreme, Brodsky warns that the disorder should not be taken lightly on any level. "If you can imagine what it would be like to feel that you don't have any control over your thoughts or actions, it's really enough to make you feel you're going crazy," he says. "A lot of people may resort to substance abuse or go psychotic or get depressed because they feel they're losing control of their lives. Some even kill themselves."

There is hope, however, even for the most serious cases. Cognitive behavioral psychotherapy cures about 80% of all OCD sufferers, general and religious, through step-by-step mental exercises that help patients gradually learn to tolerate anxieties. According to research, cognitive behavioral therapy offers more effective long-term results than medication or traditional psychotherapy, or both combined. Brodsky typically sees significant progress in about six months, depending on the severity of the case and the patient's motivation.

"They're no longer living in fear-many of them for the first time in their lives are enjoying life, saving their marriages and their jobs," he says. Most return to their religion with no relapses, which, according to Brodsky, is the most important part of the cure. "They're able to regain the sincere religious fulfillment they once enjoyed." --B.C.

Any questions for Steven Brodsky can be directed to sjbrodsky@aol.com.