OCD
Obsessive Compulsive Disorder (OCD) is an anxiety disorder with two essential characteristics:
Recurrent and persistent thoughts, ideas, images and feelings that are perceived as intrusive and senseless (the obsessive component).
Repetitive ritualised behaviours which the individual feels compelled to carry out in order to prevent the obsessional thoughts and the associated discomfort (the compulsive component).
Attempts to resist the compulsive behaviour produce mounting tension and anxiety that is relieved by giving in to the compulsion.
The obsessional thoughts or compulsive behaviours are severe enough to be time consuming (more than 1 hour per day) or may cause significant distress or impairment to the individual’s normal way of life. Often the sufferer recognises that the obsessive-compulsive behaviour is excessive and unreasonable but feels powerless to stop it. The condition is often highly secretive and can remain hidden from even immediate members of the family.
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COMPULSIVE BEHAVIOUR
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Of the many compulsive behaviours that can be expressed with OCD the most common are considered to be:
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washing
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checking
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repeating
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ordering
Of these, washing or cleaning are the most prevalent and are characterised by:
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A fear and avoidance of contamination as well as elaborate washing, cleaning or decontamination rituals.
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Checking behaviours (the next most common) involve elaborate and repeated checking in order to prevent a perceived disaster or dreaded event from occurring. Behaviours that may be expressed include:
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Counting, touching objects in a certain way, repeating certain words, numbers or prayers, repeatedly checking that all light switches in the house are turned off.
Ordering involves:
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Compulsively arranging objects in a specific way according to some set of perceived rules.
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Compulsive self-mutilation such as biting the inside of the mouth, picking at spots and trichotillomania (hair pulling) are less common, but well documented (1).
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CAUSES OF OCD
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The exact of cause of OCD is not known. However, research has shown that OCD sufferers show abnormalities in the functioning of a variety of areas in the brain (2) – however from what we now know about neuroplasticity (the brain’s ability to rewire and restructure through learning) it may be possible for those areas to be modified. The scientific community is also split as to whether the differences in brain functioning is a cause or a result of OCD.
There may be also psychological causes. Studies highlight the link between traumatic experience, particularly in childhood, and the development of OCD (3). Whilst many sufferers experience depression the majority of experts believe that this is a result of OCD and not a cause, however if this is the case with your OCD, this will be part of the individualised approach that hypnotherapy takes and improving mood can be focused upon.
Genetic studies have shown a likelihood that OCD may be influenced by certain genes which could make a contribution to the risk of developing the disorder (4). However, recent discoveries, in what is known as epigenetics, makes it clear that our genetic inheritance is not fixed, as once thought, but is constantly adapting to new input.
Whatever the cause may be, my approach is to treat the individual and not the condition as such. Each individual is unique in their history and personality and my therapy style respects this and I therefore work with clients fitting the therapy to their needs and not a “one size fits all” approach.
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HYPNOTHERAPY FOR OCD
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One aspect of the psychological experience of OCD is what is known as dissociation. Many authorities report that there is a high level of dissociation present in individuals with OCD (5). Dissociation is one of the ways the mind copes with too much stress and finds an outlet by disconnecting from the world around you. Behaviour, which may have started off as a way to make you feel safe when anxious or stressed, can turn into unwanted obsessive compulsive behaviour. Some authorities have found that approaches – such as hypnotherapy – which emphasises treating the OCD behaviour as a dissociated aspect of personality are effective in resolving OCD (6).
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Hypnotherapy can also treat the stress, anxiety or trauma which may also have triggered the OCD and continues to aggravate the condition. For underlying trauma resolution The Rewind Technique or EMDR, both of which I employ in therapy, can resolve the traumatic incidents thus removing part of the psychological foundation of some OCD.
If you would like to discuss how hypnotherapy could play a part in your recovery from OCD, please do get in touch now.
REFERENCES:
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1. Andrews G, Creamer M, Crino R, Hunt C, Lampe L and Page A (2002) The Treatment of Anxiety Disorders: Clinician Guides and Patient Manuals Cambridge University Press
Heyman I, Mataix-Cole D and Fineberg NA (2006) Obsessive-Compulsive Disorder British Medical Journal 333(7565): 424-429
2. Fornaro M, Gabrielli F, Albano C, Fornaro S, Rizzato S, Mattei C, Solano P, Vinciguerra and Fornaro P (2009) Obssessive-compulsive disorder and related disorders: a comprehensive survey Annals of General Psychiatry 8(13)
3. Lochner C, Seedat S, Hemmings SM, kinnear CJ, Corfield VA, Niehaus DJ, Moolman-Smook JC and Stein DJ (2004) Dissociative experiences in obsessive-compulsive disorder and trichotillomania: clinical and genetic findings Comprehensive Psychiatry 45(5): 384-391
4. S Taylor (2012) Molecular genetics of obsessive compulsive disorder: a comprehensive meta-analysis of genetic association studies Molecular Psychiatry 18: 799-805
5. Rufer M, Fricke S, Held D, Cremer J and Hand I (2006) Dissociation and symptom dimensions of obsessive-compulsive disorder European Archives of Psychiatry and Clinical Neuroscience 256(3): 146-150
6. Andrews G, Creamer M, Crino R, Hunt C, Lampe L and Page A (2002) The Treatment of Anxiety Disorders: Clinician Guides and Patient Manuals Cambridge University Press
Frederick C (2007) Hypnotically facilitated treatment of obsessive-compulsive disorder: can it be evidence based? International journal of Clinical and Experimental Hypnosis 55(2): 189-20
Huynh ME, Vandvik IH and Diseth TH (2008) hypnotherapy in child psychiatry: the state of the art Clinical Child Psychology and Psychiatry 13(3): 377-393
Schruers K, Koning K, Luermans J, Haack MJ and Griez E (2005) Obsessive-compulsive disorder: a critical review of therapeutic perspectives Acta Psychiatrica Scandinavica 111(4): 261-271