Treatment of obsessive-compulsive disorder (OCD) in Moscow, getting rid of obsessive-compulsive disorder in children, symptoms of OCD

Obsessive-compulsive disorder (abbreviated as OCD) is a disease that is accompanied by a number of unpleasant psychological symptoms. The main manifestation of the disease is obsessive thoughts, actions, memories, to get rid of which you need to follow a certain ritual.

OCD is considered a non-dangerous disorder; it does not pose a threat to others. However, this disease can be very unpleasant for the patient and his loved ones. Modern psychotherapeutic and pharmacological treatment methods make it possible to completely eliminate the pathology or stop all unpleasant symptoms and restore a normal standard of living. The main thing is to seek help from specialists in time.

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Causes and prerequisites for the development of the disease

There are a number of factors that can trigger the development of this mental disorder:

hereditary predisposition;
certain character traits;
mental traumas that have not been properly processed;
long stay in a traumatic situation.

As for heredity, a predisposition to certain mental disorders can be inherited, as can certain personality traits that, under unfavorable conditions, lead to the development of OCD. Also, the development of the disease can be facilitated by a certain pattern of behavior in traumatic situations, established in childhood.

Obsessive-compulsive disorder can be triggered by mental trauma or painful memories of it that do not let go of the patient. Mental exhaustion due to prolonged periods of stress also increases the risk of OCD. And, of course, personality traits and individual behavior patterns play a decisive role.

How to get rid

It should be understood that OCD treatment will be successful only with a systematic approach. It is necessary to try to use a large number of methods, and not focus on one thing. When a person makes efforts in the struggle for his own peace and security, he inevitably wins. You need to be brave, enterprising, and not be afraid to be disappointed in your own eyes or extremely surprise those around you. So how to treat this syndrome? There are several components to take into account.

Age limits

They definitely need to be taken into account. Otherwise, the chances of a full recovery are reduced. A competent approach ensures that we hit the target one hundred percent and create an awareness of how external events are related to our internal messages. In children, OCD often occurs due to recent severe stress. They need to feel the support of their parents, to understand that they are protected. In adolescents, the disorder is caused by the inability to establish themselves among their peers. It is necessary to work with self-esteem and a sense of self-worth. In adults, obsessions are often associated with lack of fulfillment. You will need to reconsider family relationships and career achievements.

Analysis of the situation

Each case must be processed separately. This will give you the opportunity to examine the smallest details and gain confidence in your own ability to cope with aggravating circumstances. An analysis of the situation must always be carried out; this action will never be superfluous. As a result, it will become clear what paradigms you were guided by before, and what the main mistake was.

Gradual injection method

When it becomes scary and all sorts of horrors are imagined, you need to try to bring the situation to the point of absurdity. How to do it? You need to catch yourself in an anxious experience and try to consciously intensify it. Imagine the most terrible pictures until the bubble woven from the phobia bursts. Then you will probably want to laugh, and an additional resource will appear to overcome the obstacle. The gradual escalation method is wonderful because it helps bring our unconscious into the work. As a result of completing the task, the energy of fear is gradually exhausted due to the fact that it is used in an intensified form.

Cognitive behavioral therapy

Another effective method with a strong effect. A person gradually understands what is really happening to him and begins to think in a different direction. Cognitive behavioral therapy is aimed at creating a significant change in the way we perceive reality. Where previously there were only fears and doubts, faith and hope appear. Very little time passes and a person begins to think about himself from a completely different perspective.

Medications

They should only be used in exceptional cases. Medicines should be taken wisely and never exceed the dosage. Follow the doctor's recommendations, then there is nothing to fear. There are often cases when people, being in a painful internal search, decide to turn to specialists. And this is the right decision. There is no need to fight the terrible inner beast alone; it is always better to act according to a proven scheme. Medications will help you not fall into despair and hold out until your inner core strengthens. But you can’t start taking any medications on your own. Such experiments can end very badly.

Thus, obsessive-compulsive disorder is a serious problem that requires a responsible and disciplined approach. It is necessary not only to gather inner strength, but also to act, despite the difficult circumstances. If you cannot cope with the problem on your own, it is recommended to seek help from the community of psychologists and rehabilitation specialists of Irakli Pozharisky. Consulting a specialist will help you understand a complex issue and outline ways out of a personal crisis.

Symptoms and manifestations

Typically, the first signs of the disease appear in adolescence or young adulthood (sometimes, some signs appear in childhood). Then the first obsessive actions and thoughts appear. At the same time, the patient is aware that his actions and thoughts are illogical and have little connection with reality.

Obsessive-compulsive disorder has two main components: obsessive thoughts and compulsive actions. They are inextricably linked in the patient's mind.

Obsessive thoughts are images, thoughts, impressions, urges or memories that arise against the patient’s will and cause serious discomfort. The patient tries to resist them, avoid their appearance or block, which is difficult. But obsessive thoughts arise again and prevent you from concentrating on anything else. They can range from simply unpleasant or strange to frightening.

Treatment of Panic Attacks and OCD

Hello! My name is Dmitry Komarov. I provide private psychotherapy for anxiety disorders in Moscow. My specialty is the treatment of obsessive-compulsive disorder (OCD) and panic attacks. These conditions, on the one hand, tend to have a protracted course in the absence of adequate treatment, on the other hand, they respond well to psychotherapeutic correction. At the same time, it is possible to cope with them on your own, having mastered certain skills of working with your consciousness and thoughts. Therefore, my task is to teach you in the process of psychotherapy methods of preventing panic attacks and obsessions. This method of work, when the client begins to destroy his fears on his own, can significantly reduce the duration of treatment to several weeks.

My basic principles of work: attentive attitude towards the client, complete confidentiality, emphasis on non-drug treatment methods.

The first step to freedom from the disease is to seek qualified help from a specialist.

What is the treatment for anxiety?

By the word “treatment” I mean psychotherapy, that is, a non-drug way to alleviate your condition. You may be prescribed some medications, but taking medications is only an ADDITION to psychotherapy. Neither panic attacks, nor OCD, nor social phobia, nor depression can be cured using purely pharmacological methods.

Physiological processes in the brain are arranged in such a way that the positive effect of medications is realized only during their administration. Unfortunately, a significant proportion of patients experience disease relapses after discontinuation of medications.

What is psychotherapy?

Therapy consists of several elements, each of which has a healing effect:

1) The actual conversation . For anyone whose mind is filled with anxiety and doubt, the ability to talk about their experiences provides significant relief. When you put anxiety into words, part of the anxiety leaves you. Being able to talk freely about your problems is especially important for people with OCD (particularly those with violent or sexual compulsions). You can be sure that any of your thoughts will be accepted by me without judgment and with full understanding.

2) The second component of psychotherapy is an explanation of the mechanism of the appearance of fear and obsessive thoughts . For a person who is in the midst of a panic, it is very difficult to independently understand what he is really afraid of, where the fear comes from, and whether it is really real. Knowing the laws of the physiology of anxiety and the principles of the psyche, I will explain to you why there is a feeling of lack of air, whether it is possible to “go crazy” from fear, whether it is possible to faint, whether rapid heartbeat and increased blood pressure are dangerous. To successfully combat obsessive-compulsive disorder, a person needs to receive clarification about whether it is possible to prevent the appearance of obsessive thoughts, whether rituals help cope with the disease, and how regular attempts to get reassurance from relatives affect OCD.

3) At a certain stage of therapy, the third component becomes necessary - behavioral tasks . After all, it is one thing to receive assurance from a doctor that it is impossible to die from panic, and another thing to be convinced of this from your own experience. You can receive assurances about the safety of unpleasant sensations in the body an infinite number of times, but still continue to doubt and be afraid. In order to gain confidence in this knowledge, sooner or later it will be necessary to begin to purposefully immerse yourself in situations that provoke fear.

Obsessions

Intrusive thoughts vary from patient to patient. Currently, the following classification of obsessive thoughts is accepted:

doubts;
fears;
contrasting obsessions.

Doubts are characterized by constant thoughts about some action that has already been completed. The patient doubts whether he closed the door, turned off the gas, or paid for the phone. The peculiarity of such thoughts is that they return again after rechecking. The patient does not calm down and may approach the already closed door many times a day. It is interesting that normally, such doubts can arise in everyone; the problem appears when they become disturbing, illogical and intrusive.

Contrasting obsessions are unpleasant thoughts that seem disgusting, unnatural, and blasphemous to the patient. The most common images are the fear of harming yourself or loved ones. Sometimes patients are afraid to express an offensive thought or say or do something immoral. A separate category of contrasting phobias are obsessive thoughts of blasphemous content - offensive to the ideals of the patient (his worldview, religious self-awareness) - a special version of obsessions, usually arising in believers, pious people, manifested in painful thoughts and ideas for the patient, offensive and indecent in relation to God , Mother of God, Saints (most clergy of various denominations can determine when a parishioner’s “wrong thoughts” are sinful thoughts, and when they are a symptom of a mental disorder, and send them to a doctor and even bless them for treatment by a psychiatrist).

Another category is pollution obsessions. They are so widespread that they have received a special name. Fear of pollution is called mysophobia. The patient is afraid of getting infected, afraid of germs. To overcome his fear, he can wash his hands every hour and clean several times a day.

If obsessions become more complex, the patient begins to come up with actions and rituals aimed at calming down. After such a ritual he feels better. In the case of fear of contamination, this may be a fear of specific objects and places, or washing hands in a strictly defined sequence.

Cognitive behavioral psychotherapy for OCD

Treatment of OCD

Cognitive behavioral therapy is the gold standard treatment for obsessive-compulsive disorder. The main techniques of cognitive behavioral therapy for OCD are cognitive restructuring, exposure with response prevention (ERP) and metacognitive approach.

Exposure with response prevention (EPR) involves gradually confronting situations that trigger obsessions (obsessive thoughts) and compulsions (compulsive actions), coordinated with the patient, and initially accompanied by the therapist. During this exercise, the patient learns not to allow obsessions to arise in these situations. The exercise is initially accompanied by anxiety, but it is always kept at a level that is tolerable for the patient. As a rule, EPR is difficult to perform at the beginning of treatment, but then patients find that it is not as difficult and worrying as they thought. This gives confidence and allows you to gradually move on to more and more difficult situations.

Before starting EPR, the therapist and the patient make a list of his obsessions, ranking them from the least disturbing to the most difficult. Starting with simple obsessions, the patient learns anxiety control skills - he is convinced that anxiety gradually decreases and goes away, even if he does not perform rituals.

Cognitive restructuring helps identify persistent beliefs (“thinking errors”) that underlie anxiety. You can learn to recognize and correct these errors without resorting to compulsions (obsessive actions). For example, a new mother might think, “Should I stab my baby?” Most people can easily dismiss this thought in the spirit of “what a strange thought that just pops into my head.” However, if a person has the belief that one should attach great importance to one's own thoughts, or that thinking about something bad is as immoral as doing it, the reaction may be much more alarming: “If I think that way, I’m terrible.” mother! There's something wrong with me! However, research shows that trying to control or get rid of your own thoughts only leads to an increase in the frequency of fearful, shameful, or unpleasant thoughts. In this case, the following, carried out together with a psychotherapist, help:

realistic assessment of the chances of a frightening event occurring,
separation of self and painful thoughts,
reference to previous experience “I have never hurt anyone before;

"Research shows that patients with obsessive-compulsive disorder never commit violent acts that frighten them."

Thinking errors underlying obsessive-compulsive disorder:

Merger of thought and fact (event)

The belief that thinking about a certain event can cause that event and that it now needs to be prevented (example)

Merging thought and action

The belief that the thought of an action can cause a person to perform that action (“If I thought about it, I can do it”)
The belief that having a thought about a certain action increases the likelihood of doing it (example)
The belief that only bad people who are capable of such actions can have bad thoughts
The belief that thinking bad thoughts is as bad as doing them

Thought-object fusion - the belief that thoughts and feelings can be transmitted to inanimate objects (making them more “real”, more capable of causing harm) or damage objects

The belief that feelings of anxiety can be transferred to books, contaminating them. Now, when using books, the feeling of anxiety cannot be avoided.
The belief that the thought of his pedophilia while shaving has the power to be transmitted to the razor, so that the next act of shaving will increase the risk of becoming a pedophile.
digital superstitions (example)
belief in "unlucky" things

Metacognitive approach. As part of cognitive-behavioral psychotherapy for obsessive-compulsive disorder, so-called metacognitive techniques are also actively used, with the help of which the patient learns to emotionally distance himself from obsessions (obsessive thoughts) and observe them non-judgmentally. Therapeutic work focuses on changing the subjective perception of the significance of obsessions and the need to respond to them.

In most cases, the frequency of cognitive behavioral therapy for OCD is 1 session per week, with specific tasks to be completed between sessions.

Some complex cases may require more frequent appointments or shorter hospital stays. Psychotherapy for OCD is long-term, but the first results can be noticeable after 3-5 sessions.

Most patients with obsessive-compulsive disorder have already tried to overcome compulsions on their own without success, and they find it difficult to imagine that cognitive behavioral therapy for OCD can help. However, studies show that with sufficient duration of a course of cognitive behavioral psychotherapy for OCD and regular homework, 85% of patients can completely control their symptoms. Dreams of what their life would be like without anxiety, with the free time now taken up by rituals, motivate many OCD patients to go through the difficult stages of treatment. During therapy, the patient and therapist not only get rid of obsessions, but also work to resume an active social life, find new hobbies, improve relationships with loved ones, return to work, and start their own family.

Treatment of OCD

Compulsive actions

These are actions that are stereotypically repeated and have no rational basis. From a logical point of view, it is impossible to explain why the patient needs compulsive actions. For the patient himself, they take on the character of protective rituals. If you follow certain actions, nothing bad will happen.

Such actions can range from touching hair to tics. It is noteworthy that during the adolescent development of the disease, it is tics that predominate. Initially, they may be mistaken by doctors for somatic dysfunctions, but they manifest themselves as a more complex set of movements.

Performing such actions may be accompanied by an unpleasant feeling: the patient understands that his actions are meaningless, but cannot stop. If the ritual is disrupted, the patient experiences severe discomfort and strives to continue performing it as soon as the opportunity arises.

You should not immediately diagnose OCD to everyone who has bad habits - biting their lip, straightening their bangs. They persecute many. The difference between a mentally healthy person is that with the proper level of self-control, he can refuse repetitive actions. Often he does not notice them until others point them out. A patient with OCD knows exactly what and how he does during compulsive actions. He cannot get rid of the habit himself without the help of a specialist.

It is important to differentiate OCD from other mental illnesses, including the more dangerous and serious schizophrenia. Therefore, if specific symptoms appear, it is important to consult a specialist for a diagnosis.

OCD can be treated well; a course of medications in combination with psychotherapy will help correct behavior and restore a normal rhythm of life.

Causes of the disease

The manifestation of the disease is expressed in persistent irrational thoughts, desires and uncontrollable, regularly repeated actions (obsessive-compulsive disorder). To know how to deal with obsessive-compulsive neurosis, the doctor needs to establish the cause of its occurrence. It is believed that hormonal disorders are to blame, which cause an increase in anxiety levels and affect the normal course of thought processes. Such a failure can be caused by genetic disorders (hereditary) or appear as a result of injury, infectious disease or stress (acquired). In adults, disorders can be either hereditary or acquired. According to the observations of doctors, the higher the intelligence and mental abilities of a person, the greater the likelihood of the disease occurring.

A special group are children. Obsessive-compulsive disorder in preschool children is most often hereditary. The danger is that it is difficult to identify at an early age. Often, parents do not notice any strange behavior in their child. The alarm begins to sound when the symptoms become pronounced and interfere with the child himself and those around him. Children with a family history of mental illness are at risk. Effective treatment of obsessive-compulsive disorder neurosis in children is only possible with timely consultation with a specialist.

Adolescence is no less dangerous. The body is in the process of growth, against the background of which immunity and the ability to fight infections decrease. The situation is aggravated by an unfavorable climate in the family. All this can become an impetus for the development of OCD. Parents should closely monitor the teenager's condition. Even with minor manifestations and symptoms, it is better to consult a psychiatrist. Practicing specialist I.G. Gernet (Moscow) will tell you how to get rid of obsessive-compulsive neurosis.