The truth is that the symptoms, i.e. the behavioural part of an obsessional condition are very often exaggerations of otherwise normal or adapted traits of behaviour. Indeed, it is this fact alone that increases the likelihood that we will all experience some kind and degree of such a condition at some point in our lives. Not infrequently, the behaviour element of obsessional – compulsive behaviour has its beginnings in early childhood training/experience. This is especially true where the entrenchment of such patterns of behaviour have been unduly enforced (not uncommonly by an overbearing and/or over-methodical parent or elder).

Perhaps you can now see from the above that such rituals are ways of controlling anxiety. This is why people who have experienced – often some very mild and probably temporary affliction of the kind at sometime in their past – find that at times of high anxiety, as when experiencing a serious illness etc. they developed what now amounts to a problem. I have known patients who have reported returning to check that a door has been locked at night over and over again, or who have been driven to distraction by the mental sound of a particular tune, going round and round in their head.

Where the condition is deeply entrenched to a point of interference in everyday life and of being disruptive in a major way, then specialist help should certainly be promptly sought. However, in my own experience of patients and the like, the symptoms, i.e. the seemingly endless return and demand of the particular piece of behaviour or thought (or whatever it is), is likely to diminish and fade in relation and proportion to the reduction of the anxiety being experienced. By this means control can be established once more.

So much then for my review in these letters of “anxiety state”: what it is and how it is managed. I do hope that you have found them informative, helpful and – where appropriate – reassuring. Please do also remember that more often than not, help is very near to hand, although admittedly you may sometimes have to be rather pro-active in seeking it out. In my next letter we shall focus our interest on human depression; what it is (and is not); how to recognize it from the distinctive symptoms that it is known to elicit and how to apply self-management strategies/when to seek professional help from the GP/consultant or whoever.