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Compulsive Slowness: A Curious Manifestation of Obsessive Compulsive Disorder (OCD)
By: Dr. Michael A. Gallo, Psy.D.
It has been noted that some individuals who have problems with OCD experience a problem with excessive slowness. By compulsive slowness we refer to a symptom that is marked by completing many tasks in a exceedingly slow, methodical and fastidious manner. For example, a person may reach carefully into their purse or wallet and, in virtual “slow-motion” remove a credit card in order to make a payment at the store. Another individual may write a letter so slowly, concentrating carefully on each stroke of the pen, that it requires extraordinary time to complete. A third person may chew each mouthful of food with great deliberation before swallowing, thus taking very long to complete a meal. Compulsive slowness can also be seen in speech, reading, listening to words or sounds and even during the process of thinking. For example, one person might speak a sentence very slowly and carefully, taking an inordinate amount of time to complete a communication. Reading written words very slowly would entail focusing on each and every word on the page for a much longer period of time than is necessary for the brain to recognize its meaning. Moreover, one can become conditioned to “think” slowly, dragging out every cognition or thought for a prolonged period.
Each of these phenomena share one thing in common; i.e., the process of behavior or cognition is grossly delayed and slowed compared to the average or normative time needed to complete the task efficiently. At first glance it might seem that an individual exhibiting these symptoms could be experiencing some type of neurological impairment, i.e., actual structural damage to the brain itself. In actuality, compulsive slowness can be a relatively common symptom in OCD. We must remember that OCD consists of two primary symptoms: obsessions and compulsions. Obsessions are the intrusive, anxiety-provoking thoughts which initiate the OC process. Obsessions create anxiety in an individual, who then tries to look for a means of reducing the distress. The individual inadvertently stumbles upon the idea of creating compulsive behaviors as a means of eradicating the anxiety caused by the obsessive thoughts. Compulsions are well intentioned, but ultimately futile, counterproductive attempts at relieving anxiety caused by obsessions. We are all familiar with a very common obsession, which focuses on the concept of doubt. Did I really lock the door? Did I throw away an important piece of paper? Did I say something inappropriate? Etc, etc. The compulsion associated with doubt is usually excessive checking. We go back and check again and again, thus ineffectually attempting to alleviate the doubt that we made an error which might result in some negative event.
Compulsive slowness can often be a means of checking or being certain that something has been done properly. It is similar to compulsive avoidance in that this action is designed to preclude the occurrence of an obsession before it actually surfaces. Compulsive slowness, like compulsive avoidance, is intended as a preventative, pre-emptive measure. One assumes this line of reasoning: “If I do this task slowly and meticulously enough I can not possibly make a mistake.” Unfortunately, as with all compulsions, slowness is a trap in disguise. A person can never be completely reassured that moving slowly enough will eliminate all possibility of making a mistake. Moreover, the compulsive slowness can create incredible interference in a person’s life. Even simple tasks become extremely difficult to complete and the person can not accomplish what they would like. This in turn may lead to frustration, low self-esteem and depression.
Fortunately, compulsive slowness does respond to treatment. Anti-obsessional medications can play an important role. Most importantly, this symptom responds quite well to the creative and skilled application of cognitive behavioral therapy, particularly a modified version of the well-known intervention, exposure and response prevention. “Slow motion” behavior and thinking need not become a way of life for the person with OCD. One can expect to take their life back from this debilitating condition. Specialized treatment with an experienced, skilled professional, emotional support and hard work on the part of the patient can make problematic slowness a thing of the past.
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