Monk's OCD: Fact or fiction?

The brilliant, quirky inspector of the television series Monk has Obsessive Compulsive Disorder (OCD). His condition makes his life very difficult, but helps him to be meticulous in his job and spot details which all others seem to miss.

Actor Tony Shalhoub won the Emmy Award for outstanding lead actor in a comedy for his work on the series. But does the series give an accurate portrayal of OCD? Or have the facts about the condition been distorted to make for good television?

OCD, an anxiety disorder which affects between 1% and 3.3% of people, is characterised by obsessions and compulsions. Obsessions are persistent "self-generated" thoughts, impulses or images that you are unable to control or prevent. People realise these obsessions are senseless but are unable to suppress or ignore them.

Compulsions are repetitive, ritualistic behaviours or mental acts a person may perform in an attempt to reduce the distress. Common compulsions include washing or cleaning repeatedly, or checking repeatedly that doors are locked or an electrical appliance has been turned off.

Monk appears to have a mixed bag of several compulsions and obsessions. He worries excessively about dirt and germs, is preoccupied with symmetry, order and cleanliness, and worries about safety issues. He washes and cleans compulsively, and performs a series of steps in an exact order or repeats them until he feels they are done perfectly. He orders, arranges and counts objects over and over again. To top it all, his obsessions are so extreme that they border on paranoia.

In real life, OCD sufferers seldom present with such a wide array of symptoms. OCD does cause marked distress to the individual and is one of the most disabling psychiatric conditions. But people are usually fixated on one primary obsession and/or compulsion.

More harm than good?
Mental illness is still misunderstood and highly stigmatised. For many people the media is the only or primary source of information about mental illness. This is why it is vital that people are given correct information.

Experts are divided on the issue of whether or not the Monk series did more harm than good. Some reckon that it misinformed people about OCD. Others believe that although the depiction of the disease was not always accurate, it helped to make people aware of OCD.

Those who supported the series argued that it didn’t pretend to be educational. As is the case with all comedy characters, Monk's character traits and quirks are amplified and exaggerated. The show managed to entertain without making fun of Monk and others with OCD – or only very gentle fun. The viewer develops empathy for Monk and gets some idea as to the devastating impact such a disorder can have on a person’s life. - Ilse Pauw (Clinical psychologist) and Olivia Rose-Innes, Health24, November 2005

Read more:
A-Z of Obsessive Compulsive Disorder

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