Obsessive compulsive disorder/OCD
What inspired me to write this lens
''Hello, I'm glad that something like this exists and I hope you will help at least a little. I am aware that I have psychological problems, but I don't know how to get rid of them. Last year I went to a psychologist, but only for a couple of times because I could no longer pay privately, and in our state services just say 'you're ok, nothing is wrong with you', so we're going in a circle, and mentally I'm feeling worse every day. In fact 10 years ago I started with obsessive-compulsive actions, and with time they developed even more. It's all such a terrible burden for me, I managed to remove some of these actions, but there are still quite a few. In addition, my head is full of silly thoughts, paranoia that don't allow me ti function normally. It's simply unbelievable that in my head can't appear any nice thoughts. When I think about the future I don't see anything good and then I start to panic, I start to shake, crazy thoughts are becoming worse and worse, and I am slipping into a state from which I don't know how to get out. I tried with relaxation teas that have helped me a little in the beginning, I even took Persen, but not regularly, and now I drink some pills - Yang elixir that are for calming, but there isn't any special effect. I want to know if there is any way for me to get back to normal and if you think there is, please let me know. I really need help, because I am afraid I will lose my mind. Thank you in advance'' - when I read this I decided to write a lens about this disorder. I was deeply touched with a situation in which this woman is, a desperate call for help. For some time I thought I had this disorder, so I read a lot of things about this topic. Eventually I found out that I was perfectly fine. Sometimes your mind plays some dangerous games with you.
WHAT IS OCD? - Classificatons and basics
OCD is a disorder which by modern classifications fall into the category of anxiety disorders (neuroses). Basis of OCD are repetitive obsessive thoughts and/or compulsive (compulsory) acts and intense feeling of anxiety. OCD can be treated with psychotherapy and adequate remedies. People with OCD are quite aware that there is no logic in what they are doing, but if they don't do their coercive actions, they get a strong sense of fear, anxiety, excitement, they have a feeling that something bad will happen. It is important to emphasize that these actions don't have a purpose for solving specific problems or experiencing pleasure. Most of these actions are are action of counting, hand washing, checking locks, the repetition of certain words and the like. Some say that OCD can start with some childhood experiences, perhaps in combination with a genetic predisposition. But whatever the cause, one thing is clear : there is no use of saying to people who suffer from OCD to stop washing something or checking. It's not only about the strength of will. Results show that medications help to a large number of OCD patients, but these drugs only calm the patient, relax him, they don't remove the main problem that has deep roots. Another approach consists in the fact that the patient is put in the situation that scares him and then it's tried to prevent the usual reaction. For example, a person who has washing habits, would be forced to hold in their hands something dirty, and then that person wouldn't be allowed to wash it. Of course, such a method can't heal no one overnight. But, some believe that accompanied by persistence, it can bring relief.
Some great books about OCD!
What do you think?
Maybe there is someone around you with similar symptoms, would you support them or judge them?
Do you know anyone who is suffering from OCD?
Yes, I do.
SUPERSTITIONS AND DISORDERS - Do they get us confused?
Most of us have some tiny little rituals which we actually don't need at all and we are aware of that. Some feel the need to always go the same route to work, drink coffee at the same place, wear the same shirt when going to important meetings. Even as a little girl I was surprised to my grandmother because she always reminded me not to cross my fingers, just a handful over fist (fist over fist). About the bread on the table, never to be standing upside down, but rounded up the crust. Prior to departure you shouldn't pass in front, but behind the car. There are unusual everyday actions, some of them we are aware of some of them we aren't. Some people fall into superstition, and others in learned procedures.
We all have a need for more self-control. However, when thoughts become more intense and gripping, when we are engulfed beyond our will and control, when our habits turn into exhausting rituals so that we could release tension or anxiety, then something serious happens. We can suspect that OCD happens.
Even at the beginning of the 17th century, Shakespeare describes Lady Macbeth who is a literary example of compulsive hand washing.
Nikola Tesla, the famous inventor, used to count his steps while walking (I do this), he used to calculate the volume content of the plate of soup, a cup of coffee and a piece of food otherwise he wouldn't have enjoyed the meal. All his repeated actions or operations had to be divisible by three. If it happened to make a mistake he would come back to the beginning, even if it took him a few hours. There is no indication that Tesla was involved in psychotherapeutic treatment, although it is known from literature that he had great problems with his obsessions.
In the last two decades there has been significant progress in understanding the pathogenesis of OCD. New biological models in the etiology of OCD have resulted in the development of more effective strategies of treatment for people who suffer from this disorder.
The first symptoms, I am talking about here, emerge in adolescence or early adulthood, it is rarely encountered before it passes around 7 years from first symptoms until the person with a problem seeks help. The beginning can be inconspicuous, followed by a chronic and progressive development of symptoms. Some people get sudden onset of symptoms, which is most commonly associated with some triggering factor ( stressful events, pregnancy, loss of a close family member, etc. ).
WHAT ARE OBSESSIONS?
Obsessions are disturbing thoughts, ideas or images that seem meaningless, but which continue to occur and are held in person's head, against her will. Such thoughts can be very distressing, and people are trying to suppress or ignore them with the idea that ''they need to stop''. The person realizes that obsessions are a product of the mind and not imposed from outside. They recognize their irrational thoughts and pictures, trying to suppress them, but they continue to ''jump in'' and take place in the head for hours, days, weeks or longer.
HERE ARE SOME OBSESSIVE CONTENTS :
- Obsessions about dirt and pollution, accumulation and preservation
- Obsession with sexual content (thoughts about sex that person considers inappropriate and unacceptable)
- Ritual repetition (repeating the same questions, the same words, actions ... )
- Religious obsessions (excessive concerns about morality, good and evil, thoughts repetition about sins)
- Obsession with aggressive content (repetition of disturbing scenes of violence, fear of expressing some aggressive ideas, irrational fear that the person has hurt somebody)
- Superstitions obsessions (belief that some numbers and actions are lucky or unlucky)
- Obsessive need for order and symmetry (putting things in right angles, matching in the same shades of one color ...)
WHAT ARE COMPULSIONS?
Compulsions are repetitive behaviors or mental rituals performed by a person in order to reduce the anxiety produced by the obsessions. For example, you can check the door again and again to make sure you locked it, you can take a bath for hours to ensure that you don't get infected. Sometimes obsessions without compulsions arise, for example, a person has a fear of hurting someone, but that thought isn't accompanied by compulsion. Here are some more examples of compulsions : counting compulsions - it means that you have to count to certain number or to repeat a word for a certain number of times, and that reduces anxiety. In the basis of this disfunctional feeling is a thought ''that something bad will happen to me or someone close to me''. There is also compulsive overeating and many others.
Although there is awareness that these rituals are meaningless, you can't stop them because it will increase anxiety regarding obsession. It is important to know if you have OCD, this is not a sure sign that you are starting to lose your mind. I understand that you are upset by the fact that you can't control all of them, but I wonder what does for you mean the possibility to live your whole life with these constraints and these compulsions.
OCD falls under the category of anxiety disorders. Current clinical experience suggest that the combination of pharmaco therapy and cognitive-behavioral therapy is the treatment of choice for this disorder. REBT (Rational-emotive-behavioral-therapy) has attracted attention as an effective method for the treatment of OCD. With the help of REBT, clients learn to change irrational false-belief system, especially the demand for security, control and perfectionism.
COGNITIVE BEHAVIORAL THERAPY - CBT - WHAT IS CBT?
Cognitive behavioral therapy is a psychotherapeutic direction which puts the emphasis on the importance of what thinking has in what we feel and how we behave. Our feelings and behaviors are directly influenced by our thinking.
If you are experiencing unhealthy emotions such as depression, anxiety or anger and if you behave disfunctional (withdrawal into yourselves or violent reactions), we can identify the thoughts that cause our feelings and behaviors, and we can teach how to replace our thoughts with ones that will lead toward healthier emotions and more functional behavior.
CBT is a psychotherapy based on the cognitive model of emotional responses - it starts with the fact that our thoughts cause our feelings and behavior, not outside things like people, situations or events. CBT therapy has long-term effects - it is one of the fastest and most efficient therapies. The average number of meetings that the client has with the therapist is around 16. Other forms of psychotherapy, such as psychoanalysis for example, can last for years. CBT involves joint work of therapist and the client - a cognitive behavioral therapist helps the client to realize and achieve their life goals. The ultimate goal of psychotherapy is that the client becomes his own therapist and he learns to apply acquired knowledge and skills in daily life. Cognitive behavioral therapists have a specific agenda for each meeting with a client on the clients problem.
Given the fact that CBT is based on the idea that most of our emotional problems and behavior we learned during our life, it focuses on teaching clients how to unlearn the behavioral patterns that are not good for him. In this way, the therapist teaches the client how to build a healthier life philosophy and consistently with it to behave more functionally.
The CBT therapy gives clients homework assignments. The role of homework is that clients actively involve in the work on their own problems, that what they have learned in psychotherapy, use in daily life to train new ways of thinking and behavior that will lead them to the desired therapeutic goal.
REBT - Rational-emotive behavioral therapy
REBT is a type of cognitive-behavioral therapy, founded by American psychologist Dr. Albert Ellis. REBT is a psychotherapeutic approach to helping people change their unhealthy emotions and behavior by changing beliefs and attitudes that create unwanted psychological states (such as panic, depression, shame, guilt, anger, etc.). The process of change is educational, in the sense that enables patients to help themselves and learn how to be a therapist to themselves even when they stop going to therapy. In the process of teaching clients how to manage their thoughts, emotions and behaviors, REBT therapists use a number of psychotherapeutic techniques, including understanding of the philosophy of life of its clients, empathy and problem solving strategies.
In REBT's basis lies six basic principles :
- WE FEEL WHAT WE THINK - thinking is what mostly determine human emotions. The events themselves don't make us sad, angry or anxious, but what we tell ourselves about these events is introduced in our emotional states. For example : people who are socially anxious aren't upset about the behavior of others, but they are telling themselves that others will reject them, hurt or be mean to them, and that they can't stand their behavior.
- WE DISTURB OURSELVES WITH WRONG THINKING - our emotional problems are caused by dysfunctional thoughts like exaggeration, black and white thinking, rigid thinking, excessive generalization, jumping to conclusions, etc.
- CHANGING OUR THINKING WILL CHANGE OUR FEELINGS AND BEHAVIORS - since our thoughts are disturbing us, it is necessary to work on changing our beliefs about us, others and the world.
- IRRATIONAL BELIEFS HAVE A VARIETY OF CAUSES - although the environment, culture and genetics play a significant role in the development of irrational beliefs, we are the ones who have a tendency to disturb ourselves in different ways regarding various situations that are assessed as bad and dangerous.
- REBT CONSIDERS TO SEE DIFFERENT WAYS IN WHICH WE ARE DISTURBING OURSELVES WITH OUR BELIEFS - REBT teaches clients hot to uncover beliefs about themselves, others and the world that they have learned in the past, and to determine whether they are accurate and useful in the present.
- BELIEFS CAN BE CHANGED - since people are naturally inclined to develop irrational beliefs, changing beliefs is sometimes difficult and requires persistence, which is why REBT is very active and directive psychotherapy.
SCHWARTZ'S METHOD IN FOUR STEPS
Jeffrey M. Schwartz is the world's leading expert when it comes to obsessive-compulsive disorder (OCD) and its treatment. 4-step method was first brought up in his bestselling book "Brain Lock". If you have obsessive thoughts and compulsive (compulsive, compulsive) behavior, IT will help you a lot understanding of the significant advances in the treatment of obsessive-compulsive disorder (OCD). In the past 20 years, behavioral (behavior-behavior) therapy has proved very effective in the treatment of obsessive-compulsive disorder (OCD).
Schwartz technique is called response prevention, because it teaches people how to prevent compulsive reaction and how to replace it with new, more constructive behaviors. The basic idea of the method is that with understanding of the essence of thought and the need for coercive actions, a person learns how to cope with them, and anxiety caused by OCD. Managing fear consequently allows the control of behavior, or compulsions, in a new and more efficient way.
Four steps are :
1. RELABEL - A critical first step is learning how to recognize obsessive thoughts and compulsive urges in their very essence, o get a better insight into what is their purpose, what they actually are. he best ally in what would be the so-called "keeping a journal" or daily record , like : "This thought is an obsession, this urge is compulsive urge." This presents a certain challenge, but taking responsibility for what is happening to you is the first step in achieving the goal. The goal of the first step is to learn to correctly name the intrusive thoughts and urges as obsessions and compulsions, and to do it with confidence. ''I do not think my hands are dirty, but I have an obsession that says that my hands are dirty," "I do not have to wash them, but I have a compulsive need for hand washing."
2. REATTRIBUTE - After the first step, you should realize that you aren't your obsessive thoughts, nor your compulsive behavior. Your OCD is your problem, one that imprisons you live normally and happily. OCD is a type of fake messages and constraints, a problem that is just part of your personality, and can't be generalized to your personality as a whole. The goal is to learn to determine the real cause of the intensity of thoughts and compulsions, to recognize that the feelings and discomfort are caused by biochemical imbalance in the brain. OCD is a medical condition. Within the brain lies a structure called caudate nucleus. Scientists have studied the structure and it is believed that with the OCD's caudate nucleus isn't working well. Caudate nucleus is the place to filter very complex message that is produced in the anterior part of the brain that is used for thinking, planning, and understanding. Caudate nucleus and putamen are collectively called the striatum and they operate by providing a subtle transition from one action to another. With OCD is a problem in that subtle, efficient filtering and changing thoughts and behaviors interrupted by the failure in caudate nucleus as well. As a result of this accident, the front part of the brain becomes overactive and consumes too much energy. Probably for this reason, people with OCD start thinking that something is "wrong" with them. They feel like they have to invest a lot of effort for the dismissal activity, however positive news is that this can be fixed. Moreover, the people themselves may influence the repair of the defect. This step will also lead to the freedom of thoughts and compulsions, but it will greatly help because you will finally realize what the problem is, and you've just learned that this problem can rehabilitate themselves.
3. REFOCUS - Here the real work begins. It's all in persistent exercise, because like in other essential activities : ''NO PAIN, NO GAIN''. Mental exercise is like a physical. To refocus, you need to do the following - control your own actions. With the effort and attention, you will take over the role of what would caudate nucleus automatically do. The main thing is to understand when to stop with one action and start with another one. Every beginning is difficult. The idea of refocus is to work with your OCD thoughts and needs by switching attention to something else. For starters it is enough to focus on something else for a few minutes. Hobbies are very good for this exercise, especially if they involve both physical and mental engagement. When thoughts and compulsions occur, help yourself so that you will firmly say "I am experiencing my OCD problem, I am determined to replace it with another action." It is important to attempt to extend this new activity. In the beginning, it can be short, and should last for a few minutes. However, make sure that you do it for a period of fifteen minutes. In all of this a diary will help you - you can write down how successfully you resisted the actions, period of time when you did this, when you made a mistake and why. If you make a mistake, don't get discouraged. We all make mistakes, they are a part of life. The change is a process in which one has to be persistent.
4. REVALUE - In the previous steps you renamed the problem, understood its causes and decisively begun to resist. Persistence and perseverance are essential in the previous steps. As a result, you begin to observe the re-evaluation (in a new way that you evaluate and appraise your own problem). Think differently about your obsessive thoughts and compulsions. If you have adequately passed the first three steps, you are now in a state that attaches less importance to your OCD needs.