I have seen many cases like N. During the five years I've been in practice. I sometimes picture these unfortunates as men and women being pecked to death by predatory birds. The birds are invisible - at least until a psychiatrist who is good, or lucky, or both, sprays them with his version of Luminol and shines the right light on them - but they are nevertheless very real. The wonder is that so many OCDs manage to live productive lives, just the same. They work, they eat (often not enough or too much, it's true), they go to movies, they make love to their girlfriends and boyfriends, their wives and husbands... And all the time those birds are there, clinging to them and pecking away little bits of flesh.