Anxiety Phobias Monk PDF

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Benchmark Anxiety and Phobias: Monk Hannah James Department of Behavioral Sciences, Grand Canyon University PSY-470: Abnormal Psychology Jimletta Vareene-Thomas January 30, 2022

2 Benchmark Anxiety and Phobias: Monk Throughout the history of television and movies, mental disorders have been portrayed many times and by many different characters. The Television show Monk starring Tony Shalhoub is no different, created in 2002 the show focuses on a retired detective, Adrian Monk, who uses his extreme OCD to help him solve criminal cases. The character is portrayed as a very intelligent person, however, he is often crippled by his obsessive compulsive disorder and relies on the help of his assistant to function in the world. The disorder portrayed in the show, OCD, is a disorder where the affected person has uncontrollable obsessive thoughts that cause them to do certain repeated behaviors, or compulsions, to relieve the thoughts (NIH, 2019). Monk is an accurate depiction of what OCD and extreme phobias are like, if he was real, he would be best treated by cognitive therapy to retrain the way he processes his intrusive thoughts. OCD and Stress Stress is something everyone deals with on a daily basis, it is a natural part of life, and the way people process events. For people diagnosed with obsessive compulsive disorder, stress can be a trigger for their obsessions or can cause them to be less equipped to manage the compulsions in a healthy way. Stress doesn’t directly cause OCD since it is a neurobiological disorder, however stress can set off or worsen OCD in a person. Stressful events that have been known to precipitate OCD are death of a loved one, marriage, divorce, moving, birth of a sibling, natural disasters, or in general any type of big life transition (ADAA, n.d.). This disorder is stress responsive, patients are usually dealing with the intrusive thoughts very frequently and daily stressors can exacerbate the obsessions, in turn causing even more stress “While obsessions are highly stressful and anxiogenic ideas, compulsive actions are usually perceived as stress relieving… this finding is in accordance with previous studies that reports that OCD patients

3 suffer significantly more stress by daily events” (Morgado et al., 2013). People dealing with this disorder find relief from their stress and obsessions through their compulsions, these compulsions are rituals that soothe the stress and can come in various forms. Stress and OCD, in general, go together in some form, and tend to be in a cycle of stressors and relief from the stressors. Monk’s Abnormal Behaviors The character Adrian Monk was very intelligent and talented at his career as a homicide detective with the San Francisco Police Department until the murder of his wife, Trudy. This traumatic event worsened his preexisting phobias and obsessive compulsive disorder severely. The intensity of the disorder resulted in Monk being suspended from the police force, however, since he was the best detective on the force, the police chief, and others, hire Monk as a private investigator and consultant. According to fan made sites, Mr. Monk has hundreds of phobias that he has his assistant, Natalie, keep a list of. In one episode titled “Mr. Monk and the Naked Man”, Monk claims to have 312 phobias ranging from a fear of aardvarks to a fear of Neil Diamond. His greatest and most common phobias include a fear of germs, needles, dentists, milk, death, snakes, lightning, mushrooms, heights, crowds, and elevators (Breckman and Zisk, 2002). Along with his many phobias, Monk also suffers with his extreme OCD that causes him to keep everything perfectly organized, avoid uneven things, compulsively touch objects, and to constantly wipe his hands with wet wipes. Adrian Monk performs many behaviors and compulsions that would be considered abnormal to the average person, as a result of his anxiety disorders. DMS and ICD

4 In the television series, Adrian Monk is diagnosed by his long-time psychiatrist Dr. Kroger, with obsessive compulsive disorder, as well as extreme phobias. Based on the International Classification of Diseases (ICD-10), Monk would be classified under chapter V, which is mental and behavioral disorders which includes codes F00 through F99. OCD, as well as phobic anxiety disorders, are listed under the category of Neurotic, stress-related and somatoform disorders, codes F40 through F48. Phobic and anxiety disorders are listed as code F40, and OCD is listed as F42. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) uses a similar coding method as the ICD-10, as a result, OCD is also listed as F42. In the DSM-5, the type of phobia and anxiety Monk exhibits would be classified as Specific Phobia and listed as code 300.29. the be classified under these certain codes the patient has to show symptoms that align with the symptoms listed in these manuals. For OCD this would be reoccurring obsessions, these obsessions may or may not be accompanied by compulsions (APA, 2018). For phobias, symptoms listed are intense fear and anxiety due to specific objects, events, or situations (APA, 2018). These coding systems are useful tools for diagnosing and classifying disorders. Psychological Model When it comes to applying a model to obsessive compulsive disorder, there is some discrepancy. Some believe that the behavioral model is the best theory to explain and treat OCD, while many others believe the cognitive model is the best approach for this disorder. In the case of Mr. Monk, the cognitive theory will be used to help explain the causes and symptoms of OCD. According to the cognitive model, OCD is believed to be a result of intrusive thoughts that have been made overly important by the patient “Everyone experiences intrusive thoughts from timeto-time. However, people with OCD often have an inflated sense of responsibility and misinterpret these thoughts” (OCD-UK, 2020). The misinterpreted thoughts are believed to lead

5 to the obsessions and then as a result, the compulsions. The basis of the cognitive theory really relies on the response intrusive thoughts and the reaction to them, some researchers believe that OCD could occur if intrusive thoughts were interpreted as that the person currently is, has been, or will be, responsible for harm, in harm’s way, or able to prevent harm (OCD-UK, 2020). Based in its theories, the cognitive method appears to be the best model for OCD. Treatment Plan There are many forms of treatment that are available and effective for obsessive compulsive disorder. Some of these treatments include behavioral therapy, habit reversal training, and exposure therapy. Based on the cognitive theory, the best treatment for OCD would be cognitive therapy, this therapy focuses on recognizing that the intrusive thoughts are not reality. This type of therapy deals with the misinterpreting of the negative thoughts and obsessions “Cognitive therapy focuses on the meanings we attach to certain experiences that we misinterpret” (ADAA, n.d.). This therapy is effective because it teaches patients to recognize which thoughts are accurate, and which thoughts they are making overly important or obsessing over, and then once they recognize the thought isn’t reality, they can better control the compulsions. Based in this, the character Monk would go to intensive cognitive therapy to reform the way he interprets his intrusive thoughts. This would help him to better cope and understand which thoughts are extreme and which are real. The character Adrian Monk is a good portrayal of what OCD and extreme phobias can be like. The intrusive thoughts he experiences are the cause of his unusual behaviors, but with cognitive therapy, which is based on the cognitive model theory, he could learn to cope with his disorders. OCD and phobias are not very commonly portrayed in media, the character of Monk provides necessary representation to those who are dealing with these types of disorders.

6 Reference:

ADAA. (n.d.). Treatments for OCD. Treatments for OCD | Anxiety and Depression Association of America, ADAA. Retrieved January 31, 2022, from https://adaa.org/understandinganxiety/obsessive-compulsive-disorder-ocd/treatments-for-ocd

APA. (2018). ICD diagnostic coding. https://www.apaservices.org. Retrieved January 31, 2022, from https://www.apaservices.org/practice/reimbursement/health-codes/icd-diagnostic

Breckman, A., & Zisk, R. (2002, July). Monk. whole, Toronto, Ontario; USA Network.

Morgado, P., Freitas, D., Bessa, J. M., Sousa, N., & Cerqueira, J. J. (2013). Perceived Stress in Obsessive-Compulsive Disorder is Related with Obsessive but Not Compulsive Symptoms. Frontiers in psychiatry, 4, 21. https://doi.org/10.3389/fpsyt.2013.00021

NIH. (2019). Obsessive-compulsive disorder. National Institute of Mental Health. Retrieved January 31, 2022, from https://www.nimh.nih.gov/health/topics/obsessive-compulsivedisorder-ocd

OCD-UK. (2020). OCDUK. Retrieved January 31, 2022, from https://www.ocduk.org/ocd/whatcauses-ocd/

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