Cognitive-behavioral therapy for OCD

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OCD stands for obsessive-compulsive disorder. If you are at all irrational fears and a small fraction of the probability of occurrence of frightening events are still very afraid of something from the following list – that you infect that someone will penetrate into your home causing a gas explosion or fire that you make a mistake in operation, incorrectly read or say the word, cause harm to friends or strangers, go crazy, become unworthy person, will be something not so perfect as before (and the list is non-exhaustive) - and seriously restrict their freedom infinite control over the external environment and yourself, you have OCD.

As the name implies, OCD – a combination of obsessions and compulsi. Obsessions, in human terms – obsessive thoughts. It is a very unpleasant unwelcome judgments or images associated with what he wants to avoid people – but the more he tries to get rid of these thoughts, the more Intrusive they become. Compulsie – certain rituals to control itself, and reality that bring about temporary relief, “prove” that there is no danger, and allowing for a bit to get rid of obsessive thoughts. A large part compulsi be rechecking (valves for water and gas, locks, appliances, pockets, symptoms, status, close, documents, pronunciation of words, correct perception, places where could be done “bad” act), “cleansing” actions (washing hands and body, cleaning the room and clothes, drink, drugs), control of thinking and feelings (suppression of thoughts, shifting attention, the repetition of the opposite thoughts, “scan” of the body), search of razobizhenny (request that someone else made a check or assured that there's no threat), avoidance (defined “threat” activities, certain people, places where can happen “bad”), magical rituals (religious and personal rituals, that some supernatural way can protect from danger).

a Few simple examples. Ilya is afraid that could become a homosexual: in order to ensure that men don't attract him, he, looking on them, constantly scans your body and thoughts – not have arisen if he had any feelings to see if he has excitement in his chest and erection, if not flashed in his mind any images of a homosexual nature – naturally, such attention he creates a frightening sensations and images and realizes with horror, that “finds” signs of homosexuality. Irina haunted by thoughts that she was passing by the roadway, could someone push under the car and push these memories out of memory to make sure it is not, it needs three times to return to the road and each time to be repeated three times “my eyes don't see the ambulance, police and body”, and sometimes she asks her husband to double-check, did not disappoint in her eyes – the ritual and the need to walk the yards take her a lot of time and harmful to social life, because, among other things, she is constantly late for work. Oleg to leave the house require at least an hour: he needs to check several times whether the screw closed water and gas, disconnected the electrical appliances, locked the door – in every second case on the way to work, he begins to doubt whether there is enough clear he remembers about performing one of the checks, and comes back to double check. All these cases have one thing in common: people recognize that 99 % nothing is going to happen, but thinking about that remaining 1% is so firmly sit in the head and through the simple “might” cause such intense anxiety that does not remain anything else how to surrender and to carry out the verification. Gradually, the doubts become more frequent and Intrusive, and have to recheck many times that interfere with work, family life and sense of well-being – that is how OCD develops.

OCD is based on the error, zakradyvayuschayasya in the human perception process of their own thinking, when he gives his thoughts too much importance. It can be a mixture of thoughts and reality – “if I thought about it, then it will happen or has happened or is the place to be” a mixture of thought and action – “you think about it, means the desire to do it or is equal to the part”. So thoughts become obsessive – the person with OCD himself makes them so.

OCD affects about 0.7% of the population. Among them many famous people. Fear of catching germs from other people and the door handles suffer Donald trump and Cameron Diaz. Actress Charlize Theron has admitted that rechecks several times, even in the middle of the night, correctly laid out the things in the cupboard. Singer Katy Perry has obsessive thoughts about my teeth and cleans them five or six times a day, sometimes spending up to an hour. Actor Leonardo DiCaprio can't overcome his haunting childhood rituals-take place several times in the door and avoid stepping on a crack on the pavement. This experience has allowed him to play brilliantly OCD in the movie ‘Aviator’, which tells about the life of another famous person suffering from this disorder – Howard Hughes. In the film there is a very revealing scene where Hughes performed by DiCaprio repeats these words to achieve their correct pronunciation. So if you think you have OCD, do not be afraid. This is a fairly common problem and it is solved cognitive-behavioral therapy (CBT).

the Basic idea of CBT for OCD is this: the rituals, bringing short relief to long term support belief in obsessive thoughts. This relationship is based on a simple logic: cross-checking, cleaning or avoidance has led to the fact that nothing bad happened, so rituals help, but danger really exists. A person needs to experience through contact with the “threat” without the use of life-saving ritual and make sure that, first, nothing happened and, second, unbearable anxiety – only the first overreaction that fades after some time spent next to the “danger”. And if a frightening stimulus ceases to cause anxiety, and thoughts of him no longer be perceived as special and stop being obsessive.

Method of placement of a person in a situation that he fears is called exposure – and this is the Central and most effective method of CBT for OCD. Despite the fact that the customer has to go through a few unpleasant minutes of being next to a frightening stimulus, the effect is worth it. After a series of successful exhibitions OCD recedes in a few days.

Examples of exposure include contact with the “dirty” surfaces without washing hands when the fear of infection, the care of the house, not locking the door, with the fear to forget to turn the key in the lock, finding a knife in hand next to your loved ones with the fear of losing control and killing them, the delivery of the report without rechecking mistakes in fear of making a typo, viewing a horror movie with the fear to go mad at the sight of the possessed.

As a rule when we first met with the method of exposure clients with OCD experience a very strong emotion. A high percentage of loss of therapy from fear of passing exposure. That is why it is not applied immediately. CBT for OCD includes and other methods aimed at rethinking and management of Intrusive thoughts. Only when a person is ready for the exposure, but the sooner the better, begins its application – first with the lightest and moderately alarming exercises with the support of the therapist, and then, complicating the tasks according to the degree of anxiety and transferring them in independent work of the client. The result is the contact of man with the frightening situations and the development of his “immune” to them.

Returning to the examples, we can summarize that the outcome of exposure therapy for Elijah may be relaxed dealing with men without the “scan” himself on the subject of homosexuality, for Irina – walking on any sidewalk, not looking back to search for “his victim” and for Oleg – leaving home, leaving off appliances and do not turn off gas and water. All three are now free in their thoughts, the movements and owning your own time and can live a quiet full life.


2019-04-22
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