CASE STUDY

Ms. A, a 30 year old housewife, sought psychological assistance as a result of the mounting
distress she experienced. Her formative years were characterized by exceptional academic
achievements and early perfectionistic tendencies, earning praises from her parents. However,
the course of Ms. A's mental wellbeing took a turn during her late teens when she began
grappling with distressing intrusive thoughts related to contamination and harm. These thoughts
gained prominence and intensity after her marriage at the age of 24, manifesting as an
overwhelming fear of contamination, particularly concerning germs and bacteria. As Ms. A
navigated the landscape of married life, her distress manifested in the development of elaborate
planned rituals. These included meticulous cleaning and disinfecting practices, coupled with an
avoidance of public spaces. Notably, this behavior extended beyond self-preservation to an
obsessive concern for her child's cleanliness. Ms. A devoted a substantial amount of time to
cleaning the floors meticulously, driven by an intense desire to safeguard her child from potential
harm.

Despite possessing a high level of insight into the irrationality of her distress, Ms. A found
herself ensnared in the challenging web of compulsive behaviors. The urge to engage in these
activities proved formidable, leading to a perpetuating cycle of heightened distress

Diagnosis: Obsessive-Compulsive Disorder (OCD), 300.3 (F42)

WELLS MODEL FOR OCD

Trigger

Onset of distressing intrusive thoughts related to contamination and harm during Ms. A's
late teens and Escalation of these thoughts after marriage at the age of 24, with a specific focus on
fear of contamination, particularly germs and bacteria.
Meta Belief

Early perfectionistic tendencies and high academic achievements in childhood may

contribute to the belief that maintaining high standards is essential for well-being.

Appraisal of Intrusion

Cognitive Appraisal Stage, The emergence of obsessions intensifies as Ms. A's thoughts
become more distressing, impacting daily functioning and overall well-being.

Belief About Ritual

Compulsive cleaning and disinfecting rituals, along with avoidance of public places, are
adopted as strategies to cope with the perceived threats.

Behavioral Response

Extensive and meticulous cleaning rituals to ensure personal and environmental

cleanliness. Avoidance of public places, reflecting a behavioral response to minimize exposure to
perceived contaminants.

Extended Behaviors Impacting Parenting

Compulsive behaviors extend to ensure the safety of Ms. A's child, involving prolonged
cleaning activities to prevent potential harm.

Emotions

Heightened distress and anxiety in response to intrusive thoughts and the perceived need
to engage in compulsive behaviors. Struggle to resist the urge to perform rituals leads to a cyclical
pattern of distress and compulsive responses.