Re: again
Shelley Mellors
Sexual outrage and associated rituals
Sexual obsessions in OCD are unwanted thoughts, images or impulses which make you anxious or distressed every time they come into your mind. The are completely inconsistent with a person's true values and desires, and as a result they are often associated with high levels of shame and embarrassment in addition to anxiety or fear. Common examples include thoughts of molesting children, unwanted homosexual images, and impulses to inappropriately touch or stare at breasts or genital areas. Most people with this type of OCD respond to their thoughts by reminding themselves that they would never do such a thing, and by trying to avoid situations where the thoughts are likely to occur.
How common is OCD?
OCD can occur in both adults and children, with most people developing their first symptoms before the age of thirty. Boys usually show their first symptoms at a younger age than girls, so OCD is twice as common in boy children than girls. In adults the number of men and women with OCD is equal. Since mild obsessional symptoms are common in the general population, you don't get a diagnosis of OCD unless your obsessions and compulsions interfere with your life or stop you from doing some of the things you want to do. Population surveys have shown that approximately one in two hundred adult person with OCD each year. Once you have OCD it is rare for it to go away without proper treatment, so if the symptoms described above sound familiar you should seek help from a professional who is familiar with the treatment of OCD.
What treatments have proven benefits?
Two treatments have been proven to help people with OCD. One is Behaviour Therapy and the other is medication with one of the serotonin selective re-uptake inhibitors (SSRIs).
What is behaviour therapy?
Behaviour therapy for OCD consists of graded exposure and response prevention. This means learning to confront your fears without washing, checking, reassuring yourself, or doing any other compulsions that temporarily take away your fear and make you feel better. The first step involves recognising the link between obsessions, compulsions and anxiety. Most people feel anxious, scared or uncomfortable whenever they have an obsessional thought, and reassured or relieved after they perform their compulsion (even if they also feel frustrated because they're tired of performing compulsions). Human beings don't like to feel anxious, scared, or uncomfortable, and so when something is making you anxious it makes sense to try and do something to take that feeling away. In this context it is easy to see why you wash your hands if you doubt they are dirty, or why you keep checking the stove if you doubt it might be on. But when you have OCD these behaviours help to keep your fears alive, because the doubts always come back again, bringing more anxiety, and so you have to keep repeating your compulsions in order to get any relief. A good general rule is that when you have OCD the doubts gets stronger the more you give in to them, and weaker the more you resist them.
The next step is to understand what happens when you resist your compulsions.
Most people have tried to resist their compulsions at some stage, but they
usually try to resist too many compulsions all at once, or a compulsion which is
too strong to start with, and so they feel overwhelmed very quickly and end up
giving in. However, when you continue to resist a compulsion over a period of
hours, you will notice that the strong anxiety you have at the start does not
last, nor does the strong urge you have at first to give in to your compulsion.
If you are truly confronting your fear, then these feelings will gradually
weaken and fade away. After two or three hours you might still feel a little
uncomfortable, but you will be nowhere near as anxious as you were immediately
after you resisted the compulsion.
For instance, if you are afraid of
contamination and you decide to confront your fears by touching money or
doorhandles without washing your hands, you will initially feel anxious and have
a strong urge to wash. But after a while it will get easier and your anxiety
will fade. Then next time you touch the same thing and you resist washing your
hands it will not be so scary, and the time after that it will be easier still.
Repeating exposure tasks in this way is very important because doing something
once will not get you better. You have to do it over and over again until there
is no more anxiety associated with that activity.
Planning Graded Exposure and Response Prevention
For most people, some compulsions will be easier to resist than others. Below is a list of steps for developing a graded exposure plan that allows you to gradually start confronting your fears in a structured and systematic way. However, exposure can be scary and difficult to do on your own, so if you need help don't hesitate to seek advice from a professional Clinical Psychologist or Psychiatrist who is experienced in the use of behaviour therapy for OCD.
- Make a list of situations where your symptoms occur. (e.g. when leaving the house, or after touching an item you think is "dirty").
- Next list all the thoughts, images or impulses which come in to your mind in each situation (obsessions) (e.g. "the stove might be on", "my hands are dirty").
- Write down all the things you do in these situations to avoid danger or to take away the thoughts (compulsions) (e.g. checking the stove, washing your hands).
- Finally, list any activities or situations you avoid because of your obsessions.
- Go through these lists and rate how anxious you think you would be if you tried to resist each of the compulsions in each different situation. Use a rating scale of 0 to 10, where 10 means you would be extremely anxious, 8 means highly anxious, 5 means moderately anxious, and 3 means mildly anxious.
- Choose one thing on the list which you think you could resist with only mild to moderate anxiety. Next time you are in that situation try as hard as you can to resist that compulsion without giving in. Pay attention to how anxious you feel at the start and to the way this anxiety fades over time.
- Repeat this same activity, resisting the compulsion, every time you are in that situation (at least once every day). You should notice that with practice it gets easier and easier to resist because your anxiety is fading.
- Once you are comfortable with this activity, choose another, slightly
harder compulsion and repeat step 7. Continue in this way until you've worked
though all compulsions on your list. Be careful that you don't start giving in
to new compulsions once you've stopped the old ones.
Remember that when you have OCD the doubts gets stronger the more you give in to them, and weaker the more you resist them.
Medication
Although medication using Serotonin Specific Re-uptake Inhibitors (SSRIs) may
be of great benefit to some people, the amount of improvement varies from person
to person. Most people who benefit from medication usually find that the
obsessions and compulsions are still there but they are less frequent and
distressing. In general the SSRIs help people to manage the symptoms of OCD, but
they are not a cure, so the symptoms worsen again after a few weeks of stopping
drug therapy. On average medication is not as effective as combining medication
with behaviour therapy, or doing behaviour therapy on its own.
Examples of
medications that have been proven to help with OCD include Fluoxetine (also
called Prozac or Lovan), Sertraline (Zoloft), and Clomipramine (Anafranil).
These drugs may be marketed under different names outside of Australia.
How successful are the standard treatments?
Treatment studies have consistently shown that about 70% of people with OCD respond very well to Behaviour Therapy and say that their symptoms are greatly improved. The average reduction in severity of symptoms with medication is about 50%.
----- Original Message -----From: Saketh RajanSent: Monday, May 31, 2010 6:06 AMSubject: Re: againHello Rebewelcome to the group... will let you know if I can come acrossany successful strategies..Do stay in touchRegardsSaketh
On Mon, May 31, 2010 at 6:20 PM, rebe <infin...@gmail.com> wrote:
just want to add.... i'm the guy who first reported this problem in
mentalhelp.net ....that was 7 years ago! but i've had this problem for
around 17 years or so ... i'm not sure what triggered the condition
but my story is similar to saketh in a lot of ways .... but i'm
certain there's a solution out there
btw, (similar to saketh)...i'm so ashamed of my condition that i do
not use my real name/email account ... but i'm based in london ... in
my 40s ... i've never discussed this problem with anyone apart from my
doctor/psychologists ...my wife/family etc don't know & i can't
discuss it with them
we need to publicise this forum ...get more people to discuss their
experiences and hopefully solutions
