Fighting Fear

Confronting phobias and other fears

The Survival Advantage of OCD: a Tale of Edna

Edna, the cavewoman, knew what she was talking about.

Bernie and Charlie, the cavemen, were both friends even though Bernie was a worrier and Charlie was relaxed. Charlie slept outside the cave on humid nights where he could look at the stars and listen to the crickets. He hummed a lot. Bernie, on the other hand, was always alert to the dangers of sleeping out of doors: bugs, snakes, and the possible return of the saber-toothed tiger. He slept inside the cave towards the back where he could get some warning if Charlie began to scream. Even then, Bernie didn’t feel entirely safe. He thought that big rock that jutted out of the ceiling might fall if there was too much rain and block the entrance to the cave. You could never tell about that kind of thing. There was a flash flood last year that washed away all the clothing and smoked bear meat he had saved up for his retirement.

Edna, Bernie’s cousin, had obsessive-compulsive disorder, although nobody called it that back then. Bernie worried about anything, but Edna was a specialist. These are some of the things Edna worried about:

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  1. Whether what was left of that big fish was still good enough to eat. She would smell it first one way, then the other, then all around. And then she would smell it again, making sure she didn’t miss any smelly part.
  2. She worried that she hadn’t cleaned up enough after the flood, even though the flood had happened last year, and she had already cleaned the cave over and over. She was afraid of mold. Especially because the cave was so humid.
  3. She was worried that the fire would go out at night or, on the other hand, that it might burn too brightly and use up too much wood. The fire had to be just right. She checked it every night, circling the fire first one way and then the other, then three more times all round, just to be sure.
  4. Whenever she touched something that was brown, or looked a little brown, she washed her hands just in case the dog had done something there, even though the dog hung out mostly by the garbage dump. She washed her hands over and over again. Even if she just saw something that was brown, she washed her hands.
  5. Every night she counted her children to make sure none of them were missing. This took a long time since she could only count to three, and then she would have to start all over again.

Charlie would watch her from outside the cave while he was chewing on a leaf and say to himself, “That woman is an idiot.”

Even Bernie, who worried about lots of things, especially lightning, thought Edna was an idiot.

But there was one thing about Edna. She had more than three children, an extra three, at least; and all of them had survived after being born healthy! That wasn’t as many children as some of the old women in the tribe who were over thirty and had too many children to count. (They could only count one, two, three, many.) But those other women had lost a lot of their children, and Edna hadn’t. (I don’t mean the children were actually lost. I meant they died, sometimes as soon as they were born.) Edna knew something that even a lot of the women alive now have forgotten, or never knew in the first place: You have to be especially careful when you’re pregnant!

  1. When she was pregnant, which was most of the time, she washed her hands more than usual. She didn’t know anything about germs, but she knew about the mold; and she thought the mold could get inside her and hurt the baby.

We now know that women who get sick in the first trimester of pregnancy have a higher incidence of miscarriage. If they get an infection during the second trimester, the child who will be born three months later has a heightened risk of developing schizophrenia in later life. Not that Edna knew anything about schizophrenia. Even Bernie, the worrier, didn’t know about schizophrenia.

  1. Edna knew enough to stay away from sick people when she was pregnant.
  2. She stayed away from the back of the cave when it got too smoky.
  3. She never drank any of the fermented berry juice that made everyone laugh and dance around the fire. She stayed away from those mushrooms that Charley liked to eat.
  4. She never took drugs when she was pregnant. They had drugs back then that came from plants. Most of them were laxatives.

Nowadays we have many more drugs; and women who are pregnant should stay away from as many of them as possible. Depressed women, who seem to need to be on anti-depressants all the time do not need to be on them during a pregnancy, in my experience. At least, they should try coming off them and see if they really do need them.

  1. Edna tried to eat an exactly normal diet when she was pregnant—no strange animals or fish that she hadn’t eaten before. If there was some food that was doubtful she would try it out on the dog first; but even then she wouldn’t eat it. After all, the dog was used to living on garbage. If she did eat something weird by mistake, she would try to throw it up—which wasn’t hard because she was throwing up a lot of the time anyway.

In short, Edna and her children had a survival advantage because she had OCD. And that’s why we still have people with OCD around today.

Having OCD pays off when you’re pregnant. As long as you don’t get carried away.  (c) Fredric Neuman Follow Dr. Neuman's blog at fredricneumanmd.com/blog

Fredric Neuman, M.D. is the Director of the Anxiety and Phobia Center at White Plains Hospital.

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