All of these people are suffering from Obsessive-Compulsive Disorder (OCD), an emotionally crippling sickness that afflicts up to six million Americans. Cleaning, counting, washing, avoiding, checking-these are some of the pointless rituals that sufferers are powerless to stop. Now a distinguished psychiatrist and expert on OCD reveals exciting breakthroughs in diagnosis, succesful new behaviorist therapies and drug treatments, as well as lists of resources and references. Drawing on the extraordinary experiences of her patients, Dr. Judith Rapoport unravels the mysteries surrounding this irrational disorder . . . and provides prescriptions for action that promise hope and help.

Dr. Judith L. Rapoport is Chief of the child Psychiatry Branch at the National Institute of Mental Health. A graduate of Swarthmore College and Harvard Mediacl School, she has been the recipient of the Outstanding Service Award from the U.S. Public Health Service and the Ittleson Prize in Child Psychiatry from the American Psychiatric Association. She lives with her family in Washington D.C.

Acknowledgments Introduction

Part I: The Patients Speak: Parents 1. The Auto Accident That Never Was 2. Rituals and Contaminations: Zach and His Family

Part II: The Patients Speak: Children 3. Paul: Stuck in the Doorway 4. Arnie: The Paper Route 5. Morris: Mr. Clean

Part III: A Doctor's Perspective 6. The Boy Who Couldn't Stop Washing 7. The Doubting Disease 8. Is OCD a Brain Disease? 9. Unlearning to Understand 10. Anafranil: A Wonder Drug? 11. David's Drug Odyssey 12. How Sweet It Is! 13. The Hidden 14. No Joke 15. The Music Goes 'Round and 'Round 16. My Mind on My Mind 17. Over and Over Again 18. The Secret Life of a Street Person 19. Count Me Out 20. Love Story 21. AIDS: The New Obsession 22. The Hair-Pulling Women 23. Innocent Sinners 24. A Thousand Commitments to God

Part IV: On the Boundaries 25. The Obsessionality of Everyday Life 26. Knock Wood 27. Grooming and Nesting 28. I Can't Get You Out of My Mind 29. Free Will and the Uncertainty of Knowing

Part V: Do You Have Obsessive-Compulsive Disorder? 30. Making the Diagnosis 31. What to Do If You Have Obsessive-Compulsive Disorder

Epilogue Appendix: The Religious Perspective References and Suggested Reading Index