Dear Therapist:

I am a tenth grade Rebbe in a local mesivta. I am concerned that one of the bochurim in my shiur may have OCD. He is a very good bochur and does very well, but is shy and seems very anxious about his grades. I noticed recently that he spends a very long time putting on ( and taking off) his teffilin. At least 10 minutes. He is constantly adjusting them during davening. He also takes a very long time davening. How do I know the difference between dikduk bamitzvos and unhealthy behavior?

Response:

OCD (Obsessive-Compulsive Disorder) is basically comprised of two aspects: obsession and compulsion.  Although some people have obsessive thoughts without compulsive behavior, the two often go together.  Until recently, OCD was classified as an anxiety disorder.  Indeed obsessive thoughts are often caused by, and in turn cause, much anxiety in people who suffer from this disorder.

Since OCD is largely diagnosed based on a person’s thoughts, ascertaining whether someone in fact has OCD (or another disorder) should not be based simply on observable behavior.  A few of the criteria for OCD are that the thoughts are intrusive and unwanted, that the person feels driven to the behavior, and that the actions are aimed at eliminating or reducing anxiety.

One person might simply feel very strongly about davening and tefillin, and wants to fulfill them on a higher level.  If there is no anxiety related to this, and the person can easily abstain from the action if he wants to (as when he has a pressing appointment), this is likely fine.  Another person can feel the need to do the very same action in the very same way to reduce anxiety based around his obsessive thoughts. 

In order to get a sense of what the case is in your situation, you might want to speak with the bochur to find out whether his thoughts about davening and tefillin are appropriate, and whether his actions are based on anxiety and an attempt to reduce it, or based on a healthy deliberate decision to be careful about these particular mitzvos.  If it becomes clear that he has a problem, you can try to help him to acknowledge that his thoughts and actions are hurtful to him.  The earlier that he goes for help, the more likely that treatment will be relatively short and effective.

-Yehuda Lieberman, LCSW

  psychotherapist in private practice

 Brooklyn, NY

 author of Self-Esteem: A Primer

 www.ylcsw.com / 718-258-5317

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