OCD is an acronym for Obsessive-Compulsive Disorder, in which people have recurring, unwanted thoughts, ideas or sensations (obsessions) that make them feel driven to do something repetitively (compulsions). It entails a recurrent repetition of actions (ritual) that start from precise thoughts and they successively become a behavioural pattern over time.
OCD is due to genetic and hereditary factors while the causes are chemical, structural and functional abnormalities in the brain.
In Spanish, the same acronym (OCD) is spelled TOC, Trastorno obsesivo-compulsivo. And TOC TOC is also the title of a brilliant, entertaining and insightful Spanish film written and directed by Spanish film director and scriptwriter Vicente Villanueva in 2017.
In this compelling and absolutely delightful plot, a heterogeneous group composed of six peculiar people suffering from different OCD meet at Dr Palomero’s medical practice in Madrid, Spain.
Federico, an interesting man in his sixties, has Tourette Syndrome (TS), a condition of the nervous system that causes people to have “tics”. The exact cause of Tourette syndrome isn’t known, and there is no cure or therapy for it. It’s a complex disorder likely caused by a combination of inherited (genetic) and environmental factors. Chemicals in the brain that transmit nerve impulses (neurotransmitters), including dopamine and serotonin, might play a role. Not only Federico has “tics” but he also curses a lot whenever an attack strikes him.
Blanca is a sophisticated elegant woman in her thirties who is apparently flawless and impeccable till someone or something bumps into her. She suffers from a type of OCD connected with preventive ritual or ritual of purification… from viruses, fungi, bacteria that increase exponentially her already high anxiety levels. Her rituals are focused on washing hands repeatedly and cleaning objects, surfaces and whatever she might touch or sit on.
Emilio is a smart playful and alert taxi driver in his late thirties who counts just everything that stimulates his curious mind: all the images, cars, stairs, and whatever he sees or imagines becomes a number, therefore it can be counted, numbered, multiplied or divided.
Arithmomania is a mental disorder that may be seen as an expression of obsessive-compulsive disorder (OCD). Individuals suffering from this disorder have a strong need to count their actions or objects in their surroundings. More often, counting is a compulsive behaviour, meaning that it is in response to an obsession that creates anxiety. The obsessive concern might be that something bad will happen to themselves or to someone they care about.
Ana María is a rather conservative middle-class woman from a Catholic upbringing in her fifties who is obsessed with control. In fact, she repeatedly controls everything in her house before leaving: she spends endless time checking everything and after getting out of her house, she continues to think obsessively whether she turned off the stove, closed the sink, windows, cookies jars, and so on. Very devoted to God, Holy Mary and Jesus Christ, she always signs herself three times with the sign of the cross… and all this ritual ad infinitum.
Otto is a designer in his late twenties. A brilliant, handsome, well-organized and very dynamic guy till he needs to confront stripes. To avoid any sort of stripes on the pavement or on any other surface, he improvises himself as a skilled acrobat… besides his phobia to cross stripes, he has a repulsion for disorder and everything he thinks or does is aligned with symmetry that in his eyes is a synonym of perfection. His life is quite complicated: he is well aware that his phobias are preventing him from having a healthy relationship except with his mother.
Lili is a young and successful fitness trainer who repeats every word she hears or sentence she pronounces or others utter twice… this compulsive disorder started manifesting after her father passed away… her ritual is connected to her dad’s death because she is afraid to die.
They should all have a session with Dr Palomero that same day, but they find out that everyone has the same schedule: 4:30 pm. Tiffany, Dr Palomero’s apparently rigid and sarcastic assistant, warns them that because of the new software that replaced her reliable good old Excel, the schedules have been mistaken. In fact, every patient should be received separately throughout the afternoon.
In addition, Dr Palomero is currently stuck in London. His flight back to Madrid is delayed due to critical weather forecasts, and Tiffany doesn’t know when his flight will actually land.
Suddenly, when each one of them manifests their OCD an intertwined sequence of apparently random actions, words, behaviours and sentences through the six patients’ interactions creates a new unexpected and hilarious situation. The initial unpleasant feeling they have in finding out about each other’s condition turns into a rather riveting disclosure of a potential solution for everyone. The time elapsed along their waiting offers them a more comfortable space where they can put off their masks. They then start challenging themselves and the others about their own OCD and the others’. In an effort to kill the time productively, Otto – whose real name is Manolo – decides to reproduce through an exercise a previous therapy session he witnessed.
For three minutes, each member of their group has to control their own pulsions, rituals, compelling phobias so that they will feel reassured and on their way to a possible foreseeable solution. They try, I mean, they really try. One by one, they all challenge their phobias but it seems hopeless eventually. None of them proved they could successfully manage and control their OCD. When Emilio is about to leave the group upon his personal failure, Federico reminds him that during a short time he wasn’t able to count the exact number Ana María signed herself with the sign of the cross or how much Federico cursed and how many bad words he uttered in the last hour.
Lili realises that also Blanca forgot her OCD compulsive behaviours: while focused on helping Ana María, Blanca touched her and went down on her knees without thinking about hygiene.
Each one of them reveals to the other ones that in a short moment they were unaware of their OCD because their attention was put elsewhere. The focus was on what was happening and not on their thoughts. This unexpected discovery brings a new awareness in every member of the group, empowered by the hope to improve their exhausting condition.
While Tiffany tries to stop them from going home, they all get out of the medical practice feeling empowered and hopeful. Lili takes a shot of them all and creates an instant social media group: “TOC TOC”.
Dr Palomero didn’t arrive on time, and because of his delay, the group was able to discover a self-help therapy based on reciprocal support.
How the film ends leaves a happy and pleasant smile on every viewer’s face. Intelligence wins in this engaging plot filled with a sense of humour and a good dosage of self-determination.
In real life, there are ways to handle, manage and treat OCD.
In fact, people suffering from OCD feel often very uneasy and embarrassed about their symptoms and the fact that others can realise how odd or absurd they can look. In order to hide them, they act as if they were “normal” and in doing so, they put great effort into looking ordinary. Before the disorder is identified and treated, sometimes successfully and sometimes not, families may become deeply involved in the sufferer’s rituals, which can cause distress and disruption to family members.
The two main treatments for OCD are psychotherapy and medications. Oftentimes, the best and most effective treatment encompasses a combination of both.
Treatment for OCD may include:
• Psychological treatments such as cognitive behaviour therapy;
• Anxiety management techniques;
• Support groups and education;
• Medications.
Psychological treatment such as Cognitive Behaviour Therapy (CBT) can improve symptoms, and this improvement is often maintained in the long term. CBT aims to change patterns of thinking, beliefs and behaviours that may trigger anxiety and obsessive-compulsive symptoms. This therapy uses education to promote control over symptoms. The education includes information that helps to expose myths about the causes of OCD.
Part of the therapy involves gradually exposing the person to situations that trigger their obsessions and, at the same time, helping them to reduce their compulsions and avoidance behaviours. This process is gradual and usually begins with less feared situations. The exposure tasks and prevention of compulsions are repeated daily and consistently until anxiety decreases. Over time, this allows the person to rebuild trust in their capacity to manage and function, even with anxiety. This process is known as exposure and response prevention (ERP).
ERP is visually perfectly described in TOC TOC where each member of the group pushes others to challenge their own limits.
Being a light comedy, based on the theatrical play by French playwright Laurent Baffie, this film explores a heavy and dramatic topic in a lighthearted and pleasant way.
The accuracy of medical research is suggested by a subtle dialogue while a captivating atmosphere keeps the audience hooked till the final credits, enriched by the already masterful performances of well-established and sublime Spanish actors among which stands out Alexandra Jiménez, Paco Léon, Rossy de Palma, Inma Cuevas and an entertaining Oscar Martínez a bit over the top.