How to define obsessive-compulsive disorders? How to recognize them? Understanding how they work How to treat them?
Definition of Obsessive Compulsive Disorder
Obsessive compulsive disorder is the overwhelming need to control reality that is expressed through a series of ritualistic actions and thoughts.
Their redundant repetition plays the role of reassuring the person that they are in control of what can happen or the effects of what has happened.
All this may seem absurd to an uninformed observer. But what emerges from a rational need for control can then become completely irrational.
It is the evolution from a healthy state to madness. It can insinuate itself into the mind in any way until it completely devours the reasonable.
The compulsion becomes inevitable, uncontrollable and ritualized when a stereotypical thought or action reassures or guarantees what is desired.
WHAT ARE THE SYMPTOMS OF OBSESSIVE COMPULSIVE DISORDER?
There is an obsessive thought, that something terribly bad, frightening, catastrophic might happen, that we might lose what we hold dear, etc., which activates the compulsion (the other symptom) set up to suppress the thought obsessive, which is like a woodworm that lives in our mind.
OCD can take many forms: Obsessive-compulsive disorder (OCD); Pure obsessions (pure O); Compulsive behaviors in children and adolescents; Dysmorphia (fear of one's own body); Hypochondria; Generalized anxiety and distress; Social phobia; Panic attacks; Phobias (various forms); Trichotillomania (hair pulling/tearing disorder); Self-harming behavior (cuts, scratches, burns, etc.); Internet addiction , online gaming, gambling, trading; substance addiction ; compulsive purchases; kleptomania; sexual fetishism; hoarding; various eating disorders , such as anorexia, hyperphagia, bulimia and vomiting syndrome.
Compulsions can take the form of: Behavioral rituals; Mental formulas; Magical rituals; Controls; Counting; Washes; Prayers; Medical checks
Obsessions, in general, can be fear-based or pleasure-based.
More specifically, obsessions can be: fear of harming others, especially loved ones; fear of being a pedophile, murderer or homosexual; fear of contamination; religious ideas, delusional thoughts; fear of illness.
On the other hand, pleasure-based obsessions are those that give rise to addictions to substances or substances without substances.
HOW DO OBSESSIVE COMPULSIVE DISORDERS DEVELOP?
We have identified 5 types of OCD or obsessive compulsive disorder and each of them explains how the disorder develops:
- The doubt that triggers the need for reassuring answers.
- The effects of a traumatic experience.
- Rituality which results from excess ideological rigidity, from adherence to a rigid morality or a superstitious belief.
- From the exasperation of rational reasoning which becomes irrational.
- Acts of healthy prevention carried out outside.
The doubt that triggers the need for reassuring answers
For example, the doubt of being infected or suffering from a disease can trigger the attempt to prevent infection by all means or to activate the disinfection mode to remedy what has happened.
Doubt triggers a system of reasonable preventive or restorative protections, but which, exacerbated, become irrational and imprisoning.
However, doubt can also be triggered to propitiate something positive in life: for example, on the day of the exam, I dress in a certain way and I do a certain route and it goes well, so the next time I repeat the same pattern and it goes well, so I think that for the next exam too, if I wear these clothes and do this route, things will go well.
Repetition of this scenario can become a constraint and if I do not perform this scenario I will be afraid of not passing the exam, but it is this thought (fear) that puts me at risk that the exam goes badly. In this case, I may perceive it as confirmation.
A causal association becomes causal. Although rationally one recognizes that the dress has nothing to do with the exam result, the irrational association prevails, so I will put into practice a series of actions and thoughts that work in my mind and for this I will repeat them, thus establishing a compulsion;
Rituality which results from an excess of ideological rigidity, or in the observance of a morality, or in a superstitious belief.
For example, I think I have sinned and I need to pray to make amends. This is a ritual of reparation : it is a kind of punishment with a religious basis. Or, I force myself to give up something I love so as not to succumb to temptation, but since it's difficult, I impose a preventative ritual on myself. For example, washing with cold water several times, repeating particularly difficult mental phrases, or, on an annual basis, we can activate propitiatory rituals such as doing morning prayer rituals so that the day goes well or so that my loved ones are well;
Exacerbation of rational reasoning processes which become irrational
For example, before making a decision, I must analyze all the possibilities so as not to make a mistake: it is reasonable, but in the extreme, I can no longer decide.
And if we have to make an immediate decision, we cannot, because we feel the need to check everything carefully beforehand, to analyze each variable.
To avoid mistakes, we become unable to act. This can happen before taking important action: to feel more confident, we repeat and check several times and end up not taking action. This can happen to the accountant before submitting his statements, to the surgeon before operating, etc. What is reasonable transforms and becomes unreasonable until it blocks;
Acts of healthy prevention carried out outside
In these cases, prevention turns into outright fear. For example, the mother who fears for her child's health by protecting him from situations she considers dangerous. For this reason, she prevents her child from being around other children, animals, from playing so as not to sweat, she forces him to wear heavy clothes, to eat certain foods or certain quantities of foods, etc. ; this mother, out of fear, will make her house a temple of cleanliness and everyone who enters it will have to sanitize themselves. Prevention turns into mania;
The effects of a traumatic experience
The person develops the series of thought-behaviors to protect themselves from undesirable and distressing events: this is the case of abused women. After a traumatic event, they wash at home in an exaggerated manner, as if they could cleanse themselves of what happened.
This can turn into an uncontrollable compulsion to act out, even when a man is just looking at her.
In this case, the ritual serves to calm the anxiety and anguish associated with feeling unclean, and even in these cases the rituals can be preventive or propitiatory in nature.
In summary, the types of compulsive rituals fall into three classes: preventive, propitiatory and restorative.
This classification allows us to understand how the disorder develops . Indeed, it is precisely the behaviors or thoughts that the subject implements to prevent, propitiate or repair which fuel the disorder.
HOW DOES THIS DISORDER WORK?
In general, people who suffer from this disorder tend to:
1) to avoid what scares him, what he feels the need to defend himself from, while confirming to himself the dangerousness of the situation he has avoided.
2) to want to reassure themselves by asking their loved ones for help. In this way, although he feels protected at first, he will later have confirmation of his inability to handle the situation alone, which will make the problem worse.
Although present, rare cases tend to alienate others because they do not trust them and perform their rituals in private, away from prying eyes.
3) set up ritualized sequences of sensations or digital actions to combat fear, or to manage the pleasure drive. Compulsive subjects systematically repeat these scripts as they serve their purpose.
There may be rituals of washing, disinfecting, checking, repeating mental formulas, counting, ordering, not throwing away, pulling out one's hair, torturing one's skin.
We may have rituals that must be performed rigorously and if the repetition fails, the person feels the need to start again.
What seems like a solution becomes a problem.
IS PHARMACOLOGICAL TREATMENT EFFECTIVE FOR THIS DISORDER?
Regarding pharmacological treatment, there is currently no real specific treatment for obsessive-compulsive disorders. In fact, this disorder is treated with a mixture of antidepressants, anxiolytics, antipsychotics and neuroleptics.
HOW DOES THE INTERVENTION WORK?
Since what seems to work ends up worsening the disorder to the point of invalidating it, the first thing to do is to stop what is not working.
Additionally, by understanding how it grows and how it feeds, its functioning can be undermined and lowered in a relatively short period of time.
The therapeutic intervention, which will be based on the logic of the problem itself, will consist of maneuvers capable of interrupting the vicious circles that fuel the problem.
However, when we apply our treatment protocols, which consist of maneuvers aimed at interrupting these vicious cycles, we must first take into account the resources and limitations of the person who asks us for help. Tactics and techniques must be created and adapted to the specific case.
They aim to modify dysfunctional actions or thoughts and to actually change the perception of things that lead to a pathological reaction.
Rituals can be performed to generate a specific feeling of pleasure or to reduce feelings such as fear or pain. This information is extremely important for the specialist, as it allows him to develop an effective intervention. Depending on the structure of the ritual, the most specific counter-ritual to prescribe is designed, adapted to the different compulsive symptomatologies.
Why is it that our young children, even as children, cannot seem to live without their cell phones?
From a young age we are oriented towards the use of technology and today the cell phone seems to be the easiest technological means of access. People are putting cell phones in their children's hands from a very young age. For example, to distract him when he needs to be fed, to silence him when he cries; later, to allow him to be in contact with his friends; or the parent puts the device back on so they can be more relaxed when the child starts to go out.
When it is not an adult who provides the cell phone, the young person also asks for it because he thinks that with the cell phone he will have more control over himself, over others or even over the world that surrounds him: he may believe that owning a smartphone and being constantly connected makes him smarter, faster, more comfortable, can make it more beautiful, more efficient and sooner, he can ask for it precisely with the intention to transgress certain prohibitions: these are just some of what we call self-illusions, that is to say what facilitates the shift into dependence on cell phones and the virtual world and/or 'Internet.
How can the Internet or a cell phone be addictive?
It seems that the neurochemical mechanisms involved in substance dependence are the same as those triggered by so-called non-substance addictions, that is, when one becomes dependent on technology, cell phones, the internet. and the web .
However, there is a big difference between substance addictions and non-substance addictions; the latter are much more subtle and therefore more likely to creep in and create greater dependence; perhaps because they are still little studied and because the false belief that using a cell phone is a sign of intelligence or special intellectual abilities, etc.
But today, this idea is finally being called into question and more and more parents are paying attention to the use of these means by their children. When parents are confronted with the signs of their child's addiction (when they realize that their child is uncontrollable and/or aggressive), many are quick to call for help.
What are the signs of technology, internet or cell phone addiction?
Many people believe that it is the time spent online or on the phone that determines the presence of an addiction. We must put an end to this false myth! In fact, our research has shown that we become addicted primarily to how we use the media.
We can assume that a person becomes addicted when, instead of enjoying his children and wife, he prefers to use his cell phone or stay on the Internet to carry out his activities. Or, for example, when a young person does not go out with his friends to continue chatting with virtual friends. In short, when we prefer the virtual to the real.
The signs of abstinence appear after detachment from the virtual. There is then discomfort and confusion, change in eating habits, sleep-wake rhythm, lifestyle. Addiction affects relationships and performance at work, school, etc. It makes you agitated, emotionally unstable and aggressive, for example towards others, your parents and/or yourself.
But the definitive confirmation that we are in the presence of an addicted person is when all this disappears simply by resuming the use of a cell phone or connecting to the Internet to carry out their activities.
Is there a composite of the person addicted to the Internet?
Anyone can become addicted, regardless of age, gender, culture or any other factor. Laborit said that if you repeat yourself, even the least pleasant thing becomes pleasant, so you can become addicted.
It is obvious that people who take care of young people, because they are in the spotlight of parents, of teachers, of society which tries to protect them in every way possible, are more likely to be identified if they show signs of addiction. However, anyone can become addicted.
What are the most common addictions in which young and old can find themselves trapped?
Young people are most often victims of gambling, chat relationships, selfie mania, often staying online to follow influencers or to try to become one themselves.
Adults, on the other hand, can become dependent on the internet and/or their cell phone when they continue to work with their smartphone at home, in the car, at the beach, in the park, when they could be pass; when they settle for virtual relationships, virtual sex and/or porn as a substitute for real life; when they are convinced that to trade, they must be glued to all the stock exchanges day and night, because they can thus create economic and professional opportunities for themselves; when they try to stave off boredom or when they are deceived by the idea that they can get rich by playing online or gambling.
Unlike young people who, as we have said, are often observed by adults, the latter often feel less vulnerable; therefore, they rarely seek help explicitly or directly for the addiction, which they do not recognize among other things.
Typically, help is sought by others or by themselves when there is dissatisfaction on the part of a partner or employer, or when they themselves have a problem related to the anxiety, psychosomatic, social, therefore difficulties with those around them and perhaps for other ancona.
When can we say that a more or less young person is dependent on a cell phone or the internet?
A more or less young person is dependent on a cell phone or the Internet when he can no longer do without it. The path to addiction begins with usage (which involves using the media at will or the ability to autonomously control and limit oneself), then moves to abuse (i.e. when we use technological media or stay online when we could avoid it, or we use it excessively, which results in a reduction in our ability to control ourselves). When the abuse is prolonged and we completely lose control, when we are dominated and when we live almost exclusively according to the medium, we become addicted.
In short, when the person fails, or rather when they feel that they cannot give up.
What should you do when you realize that a loved one is dependent on their cell phone or the internet?
As I said before, the addicted person rarely asks for help.
In most cases, it is those close to them who directly experience the problem of the dependent loved one. This is why we intervene indirectly with the dependent person.
If the person seeking help is willing to cooperate, a strategy is first agreed upon to eliminate the side benefits that the addicted person has created over time.
When you are dependent, you can only follow the rules dictated by what you depend on.
At the mercy of an ever more pressing need, the employee, in addition to deceiving himself, manipulates others, is ready to risk his health, his affection, his freedom, his mental lucidity, his money, etc.
After the elimination of the advantages, the employee finds himself having to deal only with the disadvantages (anxiety, failures, guilt, feelings of helplessness, losses suffered, etc.). At this stage, he generally asks for help and intervention becomes direct.
The work we do uses the same logic as the problem, aiming to completely demolish the futile pleasure that fuels addiction, previously considered useful.
At the same time, the patient is led to experience pleasures which will become new and healthier needs: gradually, he will have experiences which will correct his bad habits and allow him to discover that useful and healthy pleasure can be found not by prohibitions or punishments, but taking into account the fact that prohibitions, impositions open the door to transgression. The wise Oscar Wilde, who lived his life in search of pleasure, making it a work of art, said: if I indulge in it, I can give it up, but if I don't indulge in it, it will become unspeakable.
Where to train in the systemic and strategic approach?
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