Obsessive Compulsive Disorder
4 Steps in the Self-Treatment of OCD
Step 1: RELABEL
The critical first step is to learn to recognize obsessive thoughts and compulsive urges. You don’t want to do this in a merely superficial way; rather, you must work to gain a deep understanding that the feeling that is so bothersome at the moment is an obsessive feeling or a compulsive urge. To do so, it is important to increase your mindful awareness that these intrusive thoughts and urges are symptoms of a medical disorder. Recognize that the intrusive obsessive thoughts and urges are the RESULT OF OCD.
Step 2: REATTRIBUTE
The key to this approach to treating OCD can be summed up in one sentence: “It’s not me–it’s my OCD.” You are working toward a deep understanding of why the urge to check that lock or why the thought that “my hands are dirty” can be so powerful and overwhelming. If you know the thought makes no sense, why do you respond to it? Understanding why the thought is so strong and why it won’t go away is the key to increasing your willpower and enabling you to fight off the urge to wash or check. The goal is to learn to reattribute the intensity of the thought or urge to its real cause, to recognize that the feeling and the discomfort are due to a biochemical imbalance in the brain. It is OCD–a medical condition.
Step 3: REFOCUS
In refocusing, you have work to do: You must shift the gears yourself. With effort and focused mindfulness, you are going to do what the caudate nucleus normally does easily and automatically, which is to let you know when to switch to another behavior. Work around the OCD thoughts by focusing your attention on something else, at least for a few minutes: DO ANOTHER BEHAVIOR.
Step 4: REVALUE
Do not take the OCD thought at face value. It Is not significant in itself. You must use your knowledge that OCD symptoms are just meaningless signals, false messages from the brain, so you can refocus and shift gears. You must gather your mental resources, always keeping in mind, “It’s not me–it’s my OCD. It’s not me–it’s just my brain.” Although in the short run, you can’t change your feelings, you can change your behavior. By changing your behavior, you find that your feelings also change in time.
Source: Brain Lock, by Jeffrey Schwartz, MD., Regan Books, 1996.
Posted in Obsessive Compulsive Disorder
What to Expect in Obsessive Compulsive Disorder Treatment
When dealing with Obsessive Compulsive Disorder (OCD), it is important to find a therapist who has experience in the treatment of OCD. The recommended therapy for OCD is considered to be cognitive-behavioral therapy (CBT). While every therapist operates differently, below is a brief summary of what to expect during CBT treatment for OCD.
To start, you and your therapist do a comprehensive assessment, covering your history and other relevant concerns. You both agree you’re ready to start tackling your OCD so you examine your symptoms today.
Your therapist gives you your first assignment. She tells you, “over the next week, play detective. Look at your life as though a video camera were following you around. Record on a sheet all of your obsessive worries and notice exactly what you do in an attempt to make them go away.”
You and your therapist then begin preparations for the exposure and response prevention. Already you have your notes from your own detective work. Together you create a detailed inventory of all your obsessive thoughts, rituals and avoidance behaviors. Then you rank your compulsions by the degree of distress it causes you to experience the obsession and imagine not doing the desired ritual.
You and your therapist design your first exposure assignment. “You want to target a situation you really want to change,” she says. That will motivate you to do the hard work ERP demands of you. But you don’t want to pick something so overwhelming that you aren’t willing to do it.”
Homework will continue and increase in rates of exposure. Together you and your therapist will fine-tune your treatment plan to help you maintain your momentum and get the support you need.
Your success will motivate you as you continue to gain mastery over your OCD. The work is challenging and time consuming and you know you still have more work ahead of you, but your courage is bringing you a reward that is life-changing and indescribably sweet.
Source: OCD Treatment: Fighting Back By Laurie Krauth, MA, LLP Ann Arbor, Michigan, OCD Newsletter, Winter 2
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