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Tag: OCD

August 29, 2016

If you suffer from obsessive compulsive disorder, (OCD) and you are experiencing difficulty in getting yourself to adapt healthier behaviors in your life, there are no easy solutions. However, there is a solution, the solution is three part, defining what the problematic behavior is and picking an alternative and healthier behavior, understanding the genesis of the problematic behavior and learning and practicing how to get past your difficult emotions so you can practice your new behavior.

Defining what the problem is.

Let’s say you have a ritual with touching door knobs three times before entering any room. This is a problematic behavior because it is an oddity and people around you are bound to notice. Furthermore, the stressful urge that pushes you to engage in this behavior puts you in an anxious and stressful mood any time you enter any room, especially a room with a person or persons that you are required to engage with. Furthermore, it is also problematic as the obsession with performing this ritual prevents you from being present with others. So it stands to reason that the solution for this problem would be the opposite of what you are doing which would be two part, first that you no longer go through the awkward ritual of touching door knobs three times before you enter any room. Secondly, that you relive yourself from the strong mental urges to engage in such a ritual.

Understanding the Genesis of the problem.

From my experience in treating obsessive compulsive disorders, a commonality is usually a stressful childhood. The sufferer’s childhood was either blatantly abusive, such as physical abuse or covertly abusive, such as emotional abuse. Usually when someone suffering from OCD or any other type of mental health issues insists that they had a great childhood, they often will immediately contradict themselves in reporting on stories and experiences that the average person would consider to be terrible. Regardless, when an adult or child is chronically exposed to a stressful situation for which they lack the cognitive skills to properly address, the consequence that follows is usually the development of some type of mental health illness. Clinical evidence of this can be attributed to a research study where University of Berkeley researches showed that chronic exposure to stress leads to long term changes in the brain which the researches argue predisposes people to mental illness. Regardless, from a place of understanding and forgiveness, it is beneficial to explore any and all past traumas, big and small and understand how they have shaped you and influenced your problematic behaviors.

Practicing how to get past your difficult emotions.

So now you have defined what the problematic behavior is, and you have successfully explored how you came about developing this maladaptive behavior, there remains one major problem. This problem is getting past your strong urges and feelings of anxiety to engage in the problematic behavior in this first place. OCD is the result of brain damage, primarily to the basal ganglia. While biological infections have been known to cause damage to the basal ganglia, a common cause for such a damage would be atypical neurological wiring. Such atypical wiring can be attributed how a person lacking the cognitive skills to deal with a prolonged stressful situation, adapts with unhealthy behaviors which work in the short term.

A good example would be learning to read others for signs of anger, irritation or moodiness. This leads to a belief fallacy that the person can control others based on their astute observations of others and it also leads to an underdevelopment in assertiveness skills, in which the person unintentionally recreates familial stress in their lives by walking on egg shells around others and getting into personal relationships with difficult people. In most cases, people who suffer from OCD report a false feeling of having control over the situation when they engage in their rituals.

Regardless, having become armed with the knowledge of how their daily behavior influences their neurological wiring, most suffers from OCD become motivated towards practicing their alternative and desired behavior in response to emotional urges to engages in old rituals. For best results I would recommend OCD suffers to work with an experienced cognitive behavioral therapist.

Ugo is a psychotherapist and owner of Road 2 Resolutions PLLC.

August 8, 2016

“The whole is greater than the sum of its parts.”
― Aristotle

It is not uncommon for me to run into a potential client who is seeking to change a detrimental habit. The habit can range anywhere from issues with procrastination to substance abuse. In the process of gathering more information from the client. I encounter a pattern of unhealthy thinking and behaving that is prevalent in all areas of the clients’ life.

Upon bringing this to the attention of the client, I receive a response that the only thing he or she wants to work on is changing the specific habit they complained about, and nothing else. Well, this is a problem, because everything about us is interwoven. This means that while we are working on cognitive strategies to change thoughts and behaviors regarding the identified behavior, the client continues to engage in his established pattern of thinking and behaving in other areas of his life, which only reinforces the bad habit he wants to change.

The idea that we can departmentalize our behaviors is a misunderstanding, A misunderstanding because some people experience significant success in some areas of their lives than other areas of their lives. The simple reason for this is because in the areas they have experienced more success, they invested more time. Regardless, if you are experiencing negative consequences due to chronic detrimental behavior you engage in, it is based on your mindset, or simply put, an unhealthy mindset you adhere to. This means that for people who struggle with unhealthy behaviors, while simultaneously experiencing success in another area of their life, then they have experienced that success in spite of their unhealthy mindset. Furthermore, in the absence of the identified unhealthy mindset, they would achieve even more success in the area or areas they are already excelling in.

Ultimately, the ability to identify a need to change, and the preference to cherry pick what type of change will occur, is a primitive instinct. Meaning that we want to experience positive changes in our lives with little cost or sacrifice.

It is also important to note, that for those who embrace focusing on the whole versus the parts, the process of changing your entire life is counter intuitive in that you only focus on your mindset and become cognizant on when and how you practice change in all areas of your life.

 

Ugo is a psychotherapist and owner of Road 2 Resolutions PLLC.

May 29, 2013

Obsessive compulsive behaviors can be described as the repeated occurrence of intrusive thoughts (obsessions) followed by repeated attempts to rid one’s self of these thoughts through irrational behaviors (compulsions).

I had a client who had this rule, before leaving his home he would grip and release the door handle twelve times, before he was satisfied about two things.  First, that the house was truly secure and secondly that the house wouldn’t burn down. On the first day of our appointment he said to me,

“I don’t understand why I am like this, I had a good childhood and I have no problems with my life.” By now I can predict without fail that a new client whose has highlighted issues with obsessive compulsive behaviors on his or her intake sheet is going to tell me something like this.

Denial

I have found in my practice that most OCD clients are truly baffled by their obsessive thoughts and compulsive behaviors. Like the example statement written in the previous paragraph, most clients with OCD, will insist that they have no reason to be distressed, however upon further examination all sorts of traumatic stories come to the surface. Usually after the first time these revelations are made, I wait until the following session to bring to the client’s attention about how his or her revelation contradicted their initial statement that they have experienced no traumas in their past.

Clients are usually surprised and in agreement when I bring this to their attention. It’s not that they came to intentionally lie about their past, it’s that they have been conditioned to be in denial about their stories for a long time.

When people find themselves in emotionally painful situations they truly have no power over, if they are not afforded an outlet to express what they are experiencing, it’s not unusual for these people to develop maladaptive behaviors to feel like they have some type of control over their lives. These maladaptive behaviors can be a result of obsessive and plausible thoughts (touch the door knob twelve times to make sure it’s locked) to obsessive and irrational thoughts (wash your hands twenty times, counter clockwise  or else someone you love dies.)

Bringing OCD to an End

From my experience, the most effective strategy for helping clients end their traumatic experiences with OCD, is by helping them identify real life issues they have been hiding from. It could be issues with assertiveness from early life experiences with a controlling parent, to issues of codependency and abandonment from having been orphaned at an early age, and bounced around from one foster home to the other.

People will usually carry their denial of unresolved issues into all types of relationships in their adulthood. So for the guy, who felt bullied by his father and has a habit of washing his hands every five minutes for good luck, what happens when he is finally able to assertively ask his supervisor to stop sending him emails with prejudice jokes he finds offensive?

For the young lady who was bounced around from one foster home to the next from the age of two, what happens if she lets go of her fear of being abandoned and sets a firm boundary with her boyfriend about being sexually faithful, or she just decides to leave the relationship?

I have found that when people start addressing issues they have been too fearful or shamed to address, they forget about their obsessive thoughts and the compulsive behaviors cease.

From the first session to the identification of underlying issues, there are short term behavioral strategies that the client is introduced to, designed to end maladaptive habits along the way.

My favorite is to have clients identify the behaviors or habits they will like to end, and having them document the number of times they were triggered by the intrusive and obsessive thoughts while practiing to do nothing in response. This exercise helps the client develop emotional resiliency, where the client learns not to become behaviorally reactive to uncomfortable feelings.

For the more technological savvy clients, mobile apps like Habit Streak Pro, allows clients to track their daily progress to ceasing bad habits and practicing good habits for days in a row until the next session. The goal as with the previous example is to help the client develop emotional resiliency while underlying issues are being identified.

These behavioral strategies, are effective coping strategies for not responding to obsessive thoughts, but unless the true underlying issues are identified, the client will likely replace retired compulsive behaviors with new ones.

So what are your thoughts? All feedbacks are welcome in the comment section. Also, if you know anyone who might benefit from this information, please share this post with them.

Ugo is a psychotherapist and owner of Road 2 Resolutions PLLC, a professional counseling private practice.

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