缓解强迫症

Therapy as treatment for obsessive-compulsive disorder (OCD)

The most effective treatment for obsessive-compulsive disorder is often cognitive-behavioral therapy. Antidepressants are sometimes used in conjunction with therapy, although medication alone is rarely effective in relieving the symptoms of OCD.江西省精神病医院精神科朱健民

Cognitive-behavioral therapy for obsessive-compulsive disorder (OCD)

Cognitive-behavioral therapy for obsessive-compulsive disorder (OCD) involves two components:

1. Exposure and response prevention involves repeated exposure to the source of your obsession. Then you are asked to refrain from the compulsive behavior you’d usually perform to reduce your anxiety. For example, if you are a compulsive hand washer, you might be asked to touch the door handle in a public restroom and then be prevented from washing. As you sit with the anxiety, the urge to wash your hands will gradually begin to go away on its own. In this way, you learn that you don’t need the ritual to get rid of your anxiety?that you have some control over your obsessive thoughts and compulsive behaviors.
2. Cognitive therapy focuses on the catastrophic thoughts and exaggerated sense of responsibility you feel. A big part of cognitive therapy for OCD is teaching you healthy and effective ways of responding to obsessive thoughts, without resorting to compulsive behavior.

Four Steps for Conquering Symptoms of Obsessive-Compulsive Disorder (OCD)

Psychiatrist Jeffrey Schwartz, author of Brain Lock: Free Yourself from Obsessive-Compulsive Behavior, offers the following four steps for dealing with OCD:

• RELABEL ? Recognize that the intrusive obsessive thoughts and urges are the result of OCD. For example, train yourself to say, "I don"t think or feel that my hands are dirty. I"m having an obsession that my hands are dirty." Or, "I don"t feel that I have the need to wash my hands. I"m having a compulsive urge to perform the compulsion of washing my hands."
• REATTRIBUTE ? Realize that the intensity and intrusiveness of the thought or urge is caused by OCD; it is probably related to a biochemical imbalance in the brain. Tell yourself, "It"s not me?it’s my OCD," to remind you that OCD thoughts and urges are not meaningful, but are false messages from the brain.
• REFOCUS ? Work around the OCD thoughts by focusing your attention on something else, at least for a few minutes. Do another behavior. Say to yourself, "I"m experiencing a symptom of OCD. I need to do another behavior."
• REVALUE ? Do not take the OCD thought at face value. It is not significant in itself. Tell yourself, "That"s just my stupid obsession. It has no meaning. That"s just my brain. There"s no need to pay attention to it." Remember: You can"t make the thought go away, but neither do you need to pay attention to it. You can learn to go on to the next behavior.

Family therapy for OCD treatment

Because OCD often causes problems in family life and social adjustment, family therapy can often be beneficial.

• Family therapy promotes understanding of the disorder and can help reduce family conflicts.
• It can motivate family members and teach them how to help their loved one.

Group therapy for OCD treatment

Through interaction with fellow OCD sufferers, group therapy provides support and encouragement and decreases feelings of isolation.

Self-help for OCD tip 1: Challenge obsessive thoughts and compulsive behaviors

Learn to recognize and reduce stress

If you have obsessive-compulsive disorder (OCD), there are many ways you can help yourself in addition to seeking therapy.

Refocus your attention

When you’re experiencing OCD thoughts and urges, try shifting your attention to something else.

• You could exercise, jog, walk, listen to music, read, surf the web, play a video game, make a phone call, or knit. The important thing is to do something you enjoy for at least 15 minutes, in order to delay your response to the obsessive thought or compulsion.
• At the end of the delaying period, reassess the urge. In many cases, the urge will no longer be quite as intense. Try delaying for a longer period. The longer you can delay the urge, the more it will likely change.

Write down your obsessive thoughts or worries

Keep a pad and pencil on you, or type on a laptop, smartphone, or tablet. When you begin to obsess, write down all your thoughts or compulsions.

• Keep writing as the OCD urges continue, aiming to record exactly what you"re thinking, even if you’re repeating the same phrases or the same urges over and over.
• Writing it all down will help you see just how repetitive your obsessions are.
• Writing down the same phrase or urge hundreds of times will help it lose its power.
• Writing thoughts down is much harder work than simply thinking them, so your obsessive thoughts are likely to disappear sooner.

Anticipate OCD urges

By anticipating your compulsive urges before they arise, you can help to ease them. For example, if your compulsive behavior involves checking that doors are locked, windows closed, or appliances turned off, try to lock the door or turn off the appliance with extra attention the first time.

• Create a solid mental picture and then make a mental note. Tell yourself, “The window is now closed,” or “I can see that the oven is turned off.”
• When the urge to check arises later, you will find it easier to relabel it as “just an obsessive thought.”

Create an OCD worry period

Rather than trying to suppress obsessions or compulsions, develop the habit of rescheduling them.

• Choose one or two 10 minute “worry periods” each day, time you can devote to obsessing. Choose a set time and place (e.g. in the living room from 8:00 to 8:10 a.m. and 5:00 to 5:10 p.m.) that’s early enough it won’t make you anxious before bedtime.
• During your worry period, focus only on negative thoughts or urges. Don’t try to correct them. At the end of the worry period, take a few calming breaths, let the obsessive thoughts or urges go, and return to your normal activities. The rest of the day, however, is to be designated free of obsessions and compulsions.
• When thoughts or urges come into your head during the day, write them down and “postpone” them to your worry period. Save it for later and continue to go about your day.
• Go over your “worry list” during the worry period. Reflect on the thoughts or urges you wrote down during the day. If the thoughts are still bothering you, allow yourself to obsess about them, but only for the amount of time you’ve allotted for your worry period.

Create a tape of your OCD obsessions

Focus on one specific worry or obsession and record it to a tape recorder, laptop, or smartphone.

• Recount the obsessive phrase, sentence, or story exactly as it comes into your mind.
• Play the tape back to yourself, over and over for a 45-minute period each day, until listening to the obsession no longer causes you to feel highly distressed.
• By continuously confronting your worry or obsession you will gradually become less anxious. You can then repeat the exercise for a different obsession.

Self-help for OCD tip 2: Take care of yourself

A healthy, balanced lifestyle plays a big role in keeping OCD behavior, fears, and worry at bay.

Practice relaxation techniques

While stress doesn’t cause OCD, a stressful event can trigger the onset of obsessive and compulsive behavior, and stress can often make obsessive-compulsive behavior worse.

• Mindful meditation, yoga, deep breathing, and other stress-relief techniques may help reduce the symptoms of anxiety brought on by OCD.
• Try to practice a relaxation technique for at least 30 minutes a day.

Adopt healthy eating habits

Start the day right with breakfast, and continue with frequent small meals throughout the day. Going too long without eating leads to low blood sugar, which can make you feel more anxious.

• Eat plenty of complex carbohydrates such as whole grains, fruits, and vegetables. Not only do complex carbs stabilize blood sugar, they also boost serotonin, a neurotransmitter with calming effects.

Exercise regularly

Exercise is a natural and effective anti-anxiety treatment that helps to control OCD symptoms by refocusing your mind when obsessive thoughts and compulsions arise.

• For maximum benefit, try to get 30 minutes or more of aerobic activity on most days. Aerobic exercise relieves tension and stress, boosts physical and mental energy, and enhances well-being through the release of endorphins, the brain’s feel-good chemicals.

Avoid alcohol and nicotine

Alcohol temporarily reduces anxiety and worry, but it actually causes anxiety symptoms as it wears off. Similarly, while it may seem that cigarettes are calming, nicotine is actually a powerful stimulant. Smoking leads to higher, not lower, levels of anxiety and OCD symptoms.

Get enough sleep

Not only can anxiety and worry cause insomnia, but a lack of sleep can also exacerbate anxious thoughts and feelings. When you’re well rested, it’s much easier to keep your emotional balance, a key factor in coping with anxiety disorders such as OCD.

Self-help for OCD tip 3: Reach out for support

Obsessive-compulsive behavior (OCD) can get worse when you feel powerless and alone, so it’s important to build a strong support system. The more connected you are to other people, the less vulnerable you’ll feel. Just talking about your worries and urges can make them seem less threatening.

Stay connected to family and friends

Obsessions and compulsions can consume your life to the point of social isolation. In turn, social isolation can aggravate your OCD symptoms. It’s important to have a network of family and friends you can turn to for help and support. Involving others in your treatment can help guard against setbacks and keep you motivated.

Join an OCD support group

You’re not alone in your struggle with OCD, and participating in a support group can be an effective reminder of that. OCD support groups enable you to both share your own experiences and learn from others who are facing the same problems. For a searchable database of OCD support groups, see the Resources and References section below.

Helping a loved one with obsessive-compulsive disorder (OCD)

If a friend or family member has OCD, your most important job is to educate yourself about the disorder. Share what you’ve learned with your loved one and let them know that there is help available. Simply knowing that OCD is treatable can sometimes provide enough motivation for your loved one to seek help.

Tips for helping a friend or family member with OCD

The way you react to a loved one’s OCD symptoms can have a big impact.

• Negative comments or criticism can make OCD worse, while a calm, supportive environment can help improve the outcome of treatment. Focus on the sufferer’s positive qualities and avoid making personal criticisms.
• Don’t scold someone with OCD or tell the person to stop performing rituals. They can’t comply, and the pressure to stop will only make the behaviors worse. Remember, your loved one’s OCD behaviors are symptoms, not character flaws.
• Be as kind and patient as possible. Each sufferer needs to overcome problems at their own pace. Praise any successful attempt to resist OCD, and focus attention on positive elements in the person’s life.
• Do not play along with your loved one’s OCD rituals. Helping the sufferer with rituals will only reinforce the behavior. Support the person, not their rituals.
• Create a pact to not allow OCD to take over family life. Sit down as a family and decide how you will work together to tackle your loved one’s OCD symptoms. Try to keep family life as normal as possible and the home a low-stress environment.
• Communicate positively, directly and clearly. Communication is important so you can find a balance between standing up to the OCD and not further distressing your loved one.
• Find the humor. Seeing the humor and absurdity in some OCD symptoms can help the sufferer become more detached from the disorder. Of course, a situation is only humorous if the sufferer finds it funny, too.