A powerful poem is rapidly making the rounds via video. Neil Hilborn, who wrote it in 2011, calls it “OCD,” and the presentation of it below occurred this past June at the Rustbelt Regional Poetry Slam in Madison.
In case you’re wondering, Neil Hilburn has recently explained (source: The Huffington Post) that the tics are actually part of his intended performance; however, he also has them for real.
What’s the relationship between OCD and tics? Expert Charles S. Mansueto, Ph.D., offers a comprehensive article, “OCD and Tourette Syndrome: Re-Examining the Relationship,” on the International OCD Foundation website.
The following, from Mansueto’s article, is an intro toward understanding the distinction between these two diagnoses:
OCD is characterized by obsessions – frequent, unwanted, upsetting and maladaptive thoughts or images that a person can’t get out of his/her consciousness. These are often associated with ritualized overt or covert behaviors (compulsions) that the person feels compelled to perform in response to his/her obsessions. Typically, these are designed to reduce distress and/or to prevent a feared event. Tics are sudden, repetitive, stereotyped movements or phonic emissions that are usually seen as involuntary and are sometimes preceded by urges. Tics can occur in flurries and tend to wax and wane in severity and intensity over time. They can be simple – sudden, brief and meaningless (e.g., eye blinks, head jerks, facial grimaces, coughs, barks, snorts, etc.) or complex, slow, and more purposeful (e.g., smelling things, touching things, shouting obscenities, counting things, tracing objects, ‘evening up’ objects, and repeating heard words or phrases, etc.). Simple tics often appear first with complex tics developing later. Tourette Syndrome is diagnosed when multiple motor tics and one or more phonic tics are present during the course of the disorder.
Mansueto notes that the DSM-IV classifies OCD and tic disorders as separate entities, which remains true in the newer DSM-5 as well, though both OCD and tic disorders have now received updated placements. OCD now has its own listing, no longer under Anxiety Disorders, and Tourette Syndrome and other tic disorders are now listed as motor disorders under a neurodevelopmental category.
Although distinct from each other, OCD and Tourette Syndrome (TS) and other tic disorders (T) are viewed as having a connection, according to Mansueto:
The frequent concurrence of symptoms of both disorders in the same individual is one strong clue. Up to 60% of TS sufferers have been reported to have OCD symptoms, 50% of children with OCD are reported to have had tics, and 15% met criteria for TS. Also, evidence from family studies and lines of genetic research suggest that the disorders are etiologically linked.
Moreover, at the clinical level, distinguishing between OCD and T/TS symptoms can be difficult and at times impossible. Even seasoned experts can be hard put to distinguish complex tics from compulsions. This can present a significant dilemma for clinicians attempting to make a differential diagnosis (tic or compulsion?) under such circumstances. This is not a small point. Besides influencing treatment decisions, the diagnosis holds important implications for the predicted course of the patient’s disorder, the likely choice of treatment, and the expected prognosis for the individual.
OCDTypes.com looks like a good resource for descriptions of the various subcategories of OCD; it also includes related disorders such as hoarding, trichotillomania, and tic disorders.
Interested in seeing more of Neil Hilborn? He and a couple other poets—Dylan Garity and Hieu Nguyen—are involved in “The Good News Poetry Tour“—and they’re going back on the road this fall.