Cognitive behavioral psychotherapy with Obsessive-compulsive disorder. A modern approach.


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Obsessive-compulsive disorder (OCD) is a number of disorders, the leading emotion is anxiety. The client with OCD is concerned about repeated images or thoughts (obsessions), for example, about the possibility of Contracting a deadly virus, on possible errors and misconduct etc. of the Person with OCD feels an overwhelming urge to perform certain actions (compulsive), which help to neutralize unpleasant images – obsessive hand-washing, various rituals of verification.

the Scheme of development of OCD: 1) the appearance of certain thoughts "from nowhere"; 2) the feeling that these thoughts are alien, nasty , unpleasant; 3) the urge to suppress or get rid of them; 4) the simultaneous urge to "tame" these thoughts with a certain compulsive behavior.

Examples of obsessive thoughts:

  1. You are in danger of becoming infected.
  2. You did not notice the error.
  3. You unwittingly hurt someone.
  4. do You have something unfinished.
  5. You need some way to arrange things.
  6. now You say something inappropriate.

the Target of cognitive-behavioral psychotherapy for OCD is anxiety. One and the same person may experience the symptoms of the various anxiety disorders, for example, a person with OCD may occasionally experience panic attacks. Anxiety spoils life by creating artificial limitations in a variety of areas. It does not allow people to effectively work, communicate, travel or to maintain a stable relationship. Someone has to behave very strange, to avoid certain people, places, and activities – such as driving, travel on airplanes, subways, or use of elevators.

Where does anxiety? Anxiety is an integral part of our biological heritage. Before to a greater extent anxiety helps us to survive. For example, anxiety in open spaces led to a more cautious behavior, helping to avoid predators. In today's world there are so many dangers as before, so intense fear often does not help, but hinder.

Absolutely get rid of this emotions is impossible and not necessary. You need to look at anxiety not as an enemy but as an ally with whom you can harmoniously coexist.

most Often, clients suffering from OCD are asked to relieve their obsessive thoughts, the cause of which is anxiety. The goal of CBT when OCD does not relieve the customer from the obsessive thoughts and get rid of the desire to be free of these thoughts. The adoption of Intrusive thoughts helps cure OCD.

Algorithm with OCD

In General, this method is called exposure therapy, so we're looking for background information about the circumstances in which arose the disorder, and instead of avoiding disturbing images, and unpleasant situations, the client will consciously to meet them.

  1. Define what it is afraid of the client.

the Client needs to list and write a list of your obsessions. Next, list what will happen for the client, if you do not try to control them.

2. Description of protective and avoiding behaviour (rituals).

Obsessive acts resorted to by customers in order to hold back alarm.

3. The formulation of the motivation to change.

the customer determines the benefits that will result from the improvement of his condition.

4. Changing attitudes to obsessive-compulsive disorder.

requires that the client realized that suppress thoughts – is ineffective! Thoughts becomes greater. Also there is a common misconception that thoughts can affect reality and radically change it. Thoughts can't change reality! you Should let the thoughts flow calmly, gradually redirecting them to other objects. Robert Leahy in his book "Freedom from anxiety" offers to submit to Intrusive thoughts in the form of silly characters, accompanying them throughout the day.

5. To build a hierarchy of fears.

to Allocate in order of frightening thoughts, images from least to most depressing.

6. Evaluation of the rationality of fear.

Logical argument is completely rid of fear, but it is useful to dismantle the fears from a rational point of view. For this it is necessary to ask the client the question: "How would a rational person – someone else, not you, assess what is happening?".

7. Fear in the imagination.

At this stage, we use a hierarchy of fears of the client in order to proceed with the imaginary exposure therapy. You need to start with the weakest level of subjective discomfort fears. Therapy is to keep the image that causes fear in the mind within 10 minutes. Then you can increase the amount of time spent on this exercise. As practice shows, first, the intensity of fear increases, then begin to decline.

8. Practice facing your fear in real life.

9. Peredergivali long-term strategy.

to Completely get rid of obsessive thoughts is difficult, but possible to get out from under their power, to live a full and meaningful life.

Victory over OCD is based on the change of thinking for which the brain was programmed by the evolution and stipulation. From "Recognize, catastrophizing, control and avoid the" we need to move to a new set of rules really working: to evaluate, to organize, to let go, to accept.

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