Obsessive Compulsive Disorders: Challenges and Solutions by Christian Komor

Author:Christian Komor
Language: eng
Format: mobi
Published: 2012-07-30T21:00:00+00:00

THE ONE SECOND RULE

 Though-action fusion versus delusion.

 The longer the thought is dwelled on, the more the brain says “Hey, this must be important! I will set aside lots of file space and focus on this more!”

 Secondary thought loops. (1) See knife in kitchen – (2) Unwanted thought of stabbing loved one– (3) “I must be a terrible, disgusting person to think such a thought” or (1) Thought of “I should have more friends” – (2) Tensing up and focusing inward (3) “ I won’t be OK until I have more friends.”

 Sometimes obsessions can be the result of difficulties with memory (e.g. obsessing about what signs say, or if the stove is turned off). Explore if this might be the case for the individual. If so, develop memory tools to assist the individual.

 Most obsessions have in them at least a potential kernel of reality.

Examples: Hurting child

Hearing being damaged by a loud noise Eyes damaged by sunlight

 Three general levels or types: Common, Global and Intrusive.

Common Obsessions are those that tend to pop up as part of daily living (“Did I just get glass in my eye from that jar that my spouse dropped in the other room when I was not even around?”) Similar to Type II Diabetes, Common Obsessions cause discomfort, but usually not disability and are usually manageable through obsession inoculation techniques.

Global Obsessions are those pervasive, consuming, life-infringing obsessions that are usually highly disturbing to the individual and make it difficult to function in work, relationships and self-care. Global Obsessions are often frightening and disturbing and many times center around such issues as religion, harming others, sexuality, bodily injury, or timeline distortions.

Intrusive Obsessions are less common and often very difficult to remove. Examples of Intrusive Obsessions include songs, noises, images, or phrases that replay over and over in the sufferer’s mind and seem impossible to shut off. It is as if the individual’s mind becomes caught in an endless feedback loop.

 Start the treatment process by writing down the obsessions in list form, rating their intensity, listing what comes before the obsession (“trigger”.) and what comes after the obsession (“neutralizing strategy”.)

 The second main task is to habituate to the obsession.

 Active treatment for obsessional OCD should not be attempted until the individual is fully committed to do whatever it takes to fight off the OCD.

 Unlike C-OCD, it is usually necessary to jump right into the worst of the obsessions and give them no quarter to escape and regroup.

 Defensive strategies, attempts to gain reassurance, or seeking comfort from the obsessions invariably causes them to escalate.

 Exposure and Response Prevention (ERP) behavioral treatment is like an immunization.

 It is also crucial to remember that:

o Obsession-based OCD takes six to twelve months or more to treat to any significant degree and

o The number of “hits” or attacks by the obsession (e.g. the frequency with which the obsession presents itself into consciousness) will almost always increase during the first weeks and months of treatment.

o Goal

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