The 
Big Picture

Why study what it’s like to have OCD at work? Why is it important?

Adults with disabilities face specific and difficult challenges in the workplace, including gaining and maintaining employment (Lindsay, 2010). Employees with hidden disabilities such as OCD additionally take on the hurdles of disclosure and accommodations. In a study investigating the knowledge and perspectives of human resource workers across various organizations, Weber, Davis, and Sebastian (2002) found that there were four primary issues concerning mental health: underreporting of mental health disabilities (workers are reluctant to request accommodations), the impact of demographic differences on mental health (older workers rather than younger workers; female rather than male are more likely to report a mental illness), misreporting of mental health disabilities (HR workers feeling like they had to diagnose a problem), and the impact of the environment on mental health (robust economy lead organizations to hire those they normally wouldn’t). In fact, many industries don’t tend to be very accommodating for people with hidden illnesses (Beretz, 2003).

One vastly under-researched hidden disability in the field of organizational communication is obsessive-compulsive disorder (OCD). OCD is defined as a “neuropsychiatric disorder characterized by obsessions or compulsions (or both) that are distressing, time-consuming, or substantially impairing” (Grant, 2014, p. 646). For someone with OCD, these obsessions (unwanted, intrusive thoughts and fears) and compulsions (rituals to ease the anxiety produced by the obsessions) are incredibly distressing and “substantially interfere with normal functioning” (Abramowitz, Taylor, & McKay, 2009, p. 491). The most common manifestations of OCD involve washing (hands or otherwise), obsessing, hoarding, ordering, checking, and mental neutralizing (Foa et al., 2002). OCD is usually measured using the Y-BOCS, that is, the Yale-Brown Obsessive Compulsive Scale, which indicates the severity of an individual’s OCD. Typical treatment for OCD includes a combination of medication and cognitive-behavioral therapy (Marques, et al., 2010), specifically a therapy called Exposure and Response Prevention therapy (ERP). Treatment levels can range from occasional therapy sessions and no medication to full-time residential and inpatient treatment along with multiple medications, some of which are covered by various insurance plans.

OCD brings along with it many specific problems when it comes to employment; adults with OCD often have trouble finding and keeping jobs (Neal-Barnett & Mendelson, 2003), which can lead to a better quality of life (Remmerswaal, Batelaan, Smit, van Oppen, & van Balkom, 2016). First, it is difficult for an individual with OCD to find a job that is congruent with his or her particular symptoms. For example, Gunnar Rolland, a man whose OCD symptoms included needing to repeat things over and over, found he could not function in his desired career, engineering, because he had to re-read the pages of his textbooks so many times that he couldn’t finish an assignment (Chorley, in press). He settled on a career in construction, which was still not suited to his needs, as he would repeat lifting heavy boulders three or four times as his colleagues lifted them just once. Gunnar might have benefitted from a guided career program that would have helped him find a career that was congruent with his symptoms as well as met his career goals. Second, it is essential that individuals with OCD practice ERP therapy in all aspects of their life, including work. Individuals with OCD could benefit from skills training as it pertains to incorporating ERP therapy into their daily work life. For example, an employee with a hand-washing compulsion could be coached to practice resisting his or her compulsions while doing their daily work tasks. This would help them manage their symptoms while succeeding at work. Finally, it is difficult to know exactly what disability accommodations to request at work, as the process of disability disclosure to an organization is a problematic and legally complicated communicative phenomenon that requires special navigation skills and knowledge. Overall, OCD presents unique and challenging struggles to the suffering individual in the workplace that may be addressed using a vocational intervention in intensive treatment (Norberg, Calamari, Cohen, & Riemann, 2008).

The research being done here seeks to investigate exactly what it is that adults with severe OCD need to succeed in the workplace: what type of career guidance, what kind of accommodations, various positive working environments, incorporating therapy into the workplace, etc. The results will then inform a vocational intervention curriculum that will be made available to OCD treatment facilities, helping individuals with OCD find and keep employment while finding fulfilment in their work.

 

References

Abramowitz, J. S., Taylor, S., & McKay, D. (2009). Obsessive-compulsive disorder. Lancet, 374, 491-499.

Beretz, E. M. (2003). Hidden disability and the academic career. Academe, 89, 50-55.

Chorley, S. K. (in press). Norwegian magic: Finding help and healing from obsessive-compulsive disorder from an innovative approach. In J. Sørnes, L. Browning, & F. Fjelldal-Soelberg (Eds.), High north stories of pleasure, pain, relaxation, and structure in a time of transition.

Foa, E. B., Huppert, J. D., Leiberg, S., Langner, R., Kichic, R., Hajcak, G., et al. (2002). The Obsessive–Compulsive Inventory: Development and validation of a short version. Psychological Assessment, 14, 485–496.

Grant, J. E. (2014). Obsessive-compulsive disorder. The New England Journal of Medicine, 371, 646-653.

Lindsay, S. (2010). Discrimination and other barriers to employment for teens and young adults with disabilities. Disability and Rehabilitation, 1-11.

Marques, L., LeBlanc, N. J., Weingarden, H. M., Timpano, K. R., Jenike, M., & Wilhelm, S. (2010). Barriers to treatment and service utilization in an internet sample of individuals with obsessive-compulsive symptoms. Depression and Anxiety, 27, 470-475.

Neal-Barnett, A. & Mendelson, L. L. (2003). Obsessive compulsive disorder in the workplace. Women and Therapy, 26, 169-178.

Norberg, M. M., Calamari, J. E., Cohen, R. J., & Riemann, B. C. (2008). Quality of life in obsessive-compulsive disorder: An evaluation of impairment and preliminary analysis of the ameliorating effects of treatment. Depression and Anxiety, 25, 248-259.

Remmerswaal, K. C. P., Batelaan, N. M., Smit, J.H., van Oppen, P., & van Balkom, A. J. L. M. (2016). Quality of life and relationship satisfaction of patients with obsessive compulsive disorder. Journal of Obsessive-Compulsive and Related Disorders, 11, 56-62.

Weber, P. S., Davis, E., & Sebastian, R. J. (2002). Mental health and the ADA: A focus group discussion with human resource practitioners. Employee Responsibilities and Rights Journal, 14, 45-55.