With the advent of symptoms of obsessive-compulsive disorder, life will never be the same. Breaking once, the brain seems to be losing adequacy and makes the abnormal deeds. Thoughts and actions as if they lose consistency with reality. Why does it happen?
Often, along with an obsessive-compulsive disorder of personality in humans, hypochondria, alarming, panic and other neurotic disorders are observed. What are the causes of obsessive-compulsive disorder and how to get rid of it alone, read in this article.
An obsessive-compulsive disorder of personality, or neurosis of obsessive states is a neurotic disease, which includes the availability of obsessions and compulsions. If there is no compulsion, they talk about the obsessive phobic disorder.
Permanent uncontrollable thoughts and rituals take away a normal life. A person does not fall out, he does not have enough time for everyday affairs. Can not learn, work. He is engaged in endless cleaning, washing the hands, the ordering of items, checking its safety, the case. Next to him it becomes difficult to be. The patient himself understands this and suffers from forced social isolation.
Obsessions: repetitive unwanted thoughts, ideas or images that cause severe alarm, from which it is impossible to get rid of.
Compaulsi: Forced repeating actions designed to reduce the internal voltage, from which it is impossible to get rid of.
For obsessive-compulsive disorder of personality is characterized by the chronization of the process. Symptoms can resume and resume with stress, overwork or lack of sleep. Another obsessive action is joined by another, fears grow and multiply. The question arises: "Why am I?" It is scary - do not control your brain. Why did I have symptoms of obsessive-compulsive disorder? "System-vector psychology" Yuri Burlan will help to understand.
The psyche of a separate person consists of vectors. The vector is part of the psyche with the desires peculiar to it. Opportunities are given to achieve them. The realization of desires gives a person a feeling of happiness, unrealization - suffering. But in the state of unrealization, the vector will strive to "peak his" in any way. Will be an unhealthy way.
In each vector, their desires, its own characteristics and characteristics, not similar to others. Total eight vectors, a modern person can have 3-5 vectors. The symptoms of the obsessive-compulsive disorder occur in a person in different combinations of skin, anal, visual or sound vectors during the superstand, long-term unrealization of properties or in the case of vector psychotrams in childhood. From what the symptomatics is dependent on the reason. Consider the most frequent examples of obsessive-compulsive disorder.
Man with endowed with self-discipline, self-control and self-restriction. His properties: logical thinking, quick score, saving time, resources and space, the creation of reserves "for a black day", ambitiousness and competitiveness, careerism. People with skin vector find themselves in trade, business, organization and management, lawmaking, engineering, design. Wherever the use of the developed qualities of the vector is required. Without reaching property acquisitions, career growth and status, it is experiencing stress. Also strong stress for it is financial collapse, dismissal, robbery, loss of valuable things. Congenital fear - skin infection by microbes. When the properties of the vector are not applied in the social sphere, they can begin to manifest themselves the following symptoms of obsessive-compulsive disorder:
Mizophobia - Fear of infection and washing hands.
Arifmayania is an obsessive invoice.
Obsessive compliance with the routine of the day, power and drink mode.
The obsessive fear of failure or loss of things, robbery.
The obsessive security check - the closing of the doors, check the keys, is turned off whether the iron is turned off and so on.
Properties are opposite to skin. If the skin is fast and clever, then the anal is slow and amp. With a combination of both vectors, contradictions may occur. A man with an anal vector is tenacious to detail, doubting, thorough, rigid, brings the matter to the end and is prone to perfectionism. Cleansing, desire for purity - key aspect in an anal vector. His value is family and children, they are excellent husbands and wives, fathers and mother. People with an anal vector become professionals of their business, better artisans, teachers, historians. Congenital fear is disgraced, make a mistake. The superpower is treason of spouse, loss of respect, shame, quick change (change of work, place of residence, etc.). In this case, the following symptoms of obsessive-compulsive disorder may occur:
Obsessive perfectionism.
Obsessive compliance of order - ordering, sorting objects.
Obsessive cleaning and cleansing.
The obsessive fear is harmful to loved ones or yourself.
The presence and anal and skin vectors gives compulsive symptoms of obsessive-compulsive disorder.
People with very emotional, impressionable, constant, inspired and self-supersay, possess a developed imagination, appreciate beauty, enjoy brightness and color. All people are afraid of death, but in a visual person, the fear of death is a congenital emotion, the first and very strong. Such people may develop phobias of all kinds and texts, alarming states, panic attacks. Anxious background in a visual vector enhances stress in the skin and anal vectors and is a factor of reduced stress resistance in general. For example, there are thoughts on death due to hand contamination, and the ritual of hand washing temporarily lowers anxiety in a visual vector. In the structure of obsessive-compulsive disorder of the individual, phobophobia (fear of fear) may appear.
Man with abstract intelligence - he is thinner, philosopher, ideologist. A closed introvert looking inside. Sound vector dominant. Due to the peculiarities of the perception of the sound vector, the symptoms of obsessive-compulsive disorder often acquire the nature of paralogical judgments and conclusions, utasive and delusional ideas.
Other symptoms of unrealized sound vector can be accompanied: depression, sense of meaningless life, insomnia or excessive drowsiness ,. Sounds are particularly concerned with the symptoms of obsessive-compulsive disorder due to congenital fear to go crazy.
Drug treatment of obsessive-compulsive disorder and psychotherapy do not return a normal life to a person, but only help reduce the symptoms. During the disease, there may be periods of improvement. They are connected with the advent of the sale of vectors and a decrease in stress levels. Returns the disorder is already on the laughed path, faster than new symptoms like a snowball. After all, the structure of the personality, the type of response was not changed.
Any obsessive-compulsive disorder understands that it is abnormal, but nothing can do anything. Its like programmed pulls to make these actions, think these thoughts and fear. The unconscious power of the will is impossible to manage, on the contrary - it controls the person. A man with disorder feels it stronger than others. The struggle takes years of life, and the full cure does not occur. And a person talks about the disease calmly, having resigned that it is absolutely impossible to influence him.
The diagnosis of obsessive-compulsive disorder combines different symptoms. System-vector psychology explains how such heterogeneous symptoms is placed in one diagnosis. With the help of the knowledge of the vectors, it turns out to decompose everything on the shelves, clearly knowing where the symptom took. Only so the opportunity to reason about the problem is not speculative, but understanding its causes.
Why does training eliminate obsessive compulsive disorder? It's not just that a person understands his vector set. Each vector - the very essence of the psyche, hidden in the unconscious. The disclosure of this part of the mental gives a profound understanding of the causes of the disease in a particular case. The conscious is already amenable to control, and for this not have to make volitional efforts. After all, looking into the darkness, we do not know what is there, right? Freshing this place with a flashlight, already see what. You can arm a flashlight with the help of training, and then you will never have to wander in the semit.
Symptoms of obsessive-compulsive disorder arise as a result of stress, the unrealization of properties and psychotrames of vectors. What program gave failure - it is necessary to figure it out. Who am I, in what condition is my psyche, that in my versions happens, what do I behave like this? Disclosure of the essence of vectors at the training "System-vector psychology of Yuri Burlan" allows you to deeply realize the cause of obsessive-compulsive disorder in each case. Becoming conscious, part of the unconscious becomes part of the consciousness and loses its power over a person - this is how psychoanalysis works. A person begins to behave normally naturally, in itself. Stress resistance increases, the alarming background and fears are out. It is a chance to get rid of obsessive-compulsive disorder independently, without pills and doctors.
For free lectures "System and Vector Psychology Yuri Burlan." You will learn more about the features of the skin and the anal vectors.
Last update of article 02.02.2018
An obsessive-compulsive disorder (OCD) is a mental illness manifested by obsessive thoughts, doubts and accompanied by a constant rechecification of perfect actions.
An obsessive-compulsive disorder is not such a serious pathology as schizophrenia or depression, but this mental disorder is able to significantly violate the quality of human life, to help reduce self-esteem and even deterioration of the social position of the patient.
The obsessive-complisher disorder can develop due to the interaction of a number of factors. First of all, it is hereditary predisposition. A person inherited certain personal features, a model of behavior in psychotrambulating conditions can be transmitted.
The development of this mental disorder can have sudden mental injuries (a life-threatening situation, the death of a loved one, a natural disaster) or a long stay in stressful conditions, when a person's mental psyche "is depleted." Examples of such a situation - an uninteresting, hated work for a person, with which he cannot quit (lives in a small village, where other work cannot be found).
The first manifestations of obsessive-compulsive disorder appear in adolescent or early mature age. At this time, obsessions arise, which are regarded by patients as something absurd, illogical.
The main obsessions characteristic of the OCC are obsessive thoughts and compulsive actions.
And now let's stop in detail on each individual symptom.
Obsessive thoughts - Practice thoughts, images and attractions, which arise in addition to the will of a person, again and again come to his mind, and which he is trying to resist. Such thoughts "pianic" in the head do not give a man of peace, he would also be happy to switch to something else, but again and again obsessive thoughts arise in his mind.
We are all different, therefore, the obsessive thoughts for each of us their own. However, all obsessive thoughts can be divided into obsessive doubts, obsessive pollution fears or contamination and contrasting obsessions. So, let's talk about each of these groups separately.
The obsessive doubts arose probably from each of us. Did I do everything? Is the decision right to accept? Did I closed the door? Was the gas turned off? Did you write everything in response to the ticket during the commissioning of the entrance exam? Familiar thoughts, right?
Obsessive doubts may be related to the issues of life (whether the door is closed, whether gas is turned off), with official activity (the bank's employee will doubt whether he correctly pointed the bill for which the money transferred, the teacher was correctly appreciated by the apprentice). To make sure that everything is done, the person will again and again check the gas, light, water, the number of the current account. And even if everything carefully do, after some time, doubts may return again (and suddenly the crane was not closed until the end, and I did not see it; what if I still confused the numbers in the account number?)
If such thoughts sometimes arise - nothing terrible, it happens almost everyone. But if you have forced many times to check whether the gas is turned off, the light is still not sure that everything is disabled, in this case it is better to visit the psychiatrist. You may have an obsessive-compulsive personality disorder. Here, by the way, a small anecdote on this topic.
The emergence of various obsessions, especially obsessive doubts, is characteristic of such a personality disorder.
Contrast obsessions can also occur with an obsessive-compulsive disorder. These are bright ideas arising in the imagination of a person, unpleasant in meaning, blasphemous thoughts.
Contrast obsessions include absolutely ground fear to cause harm to themselves or others. It may also be desire to continue someone's replica ironic, an offensive statement. This group of obsessions can be classified as an obsessive presentation of sexual content - obsessivity by the type of forbidden representations of sexual acts with animals, representatives of their own sex.
The obsessive ideas of pollution are otherwise called mizophobia. They can manifest themselves to be blocked to ground, feces, urine, fear of penetration into the organism of microorganisms, harmful substances.
Sometimes the fear of pollution is not strong. At the same time, a person for many years only is too hard with his hands or several times a day without visible causes the floor. This kind of phobia does not significantly affect the quality of life of a person, and others are regarded only as an increased chiper.
Much worse if the obsessiveness of pollution ideas are complicated. At the same time, various actions appear, rituals aimed at preventing contamination. Such a person will avoid touching subjects that could be contaminated. On the street, he will be published only in special clothes, allegedly protecting against pollution. Hands will also wash in a certain sequence and in no case will it violate it (otherwise it will assume that the hands remained dirty). In the later stages of the disease, some people even refuse to go out to do not blocked there, do not pick up some infection.
Another manifestations of Mizophobia - the fear of becoming some disease. Most often, patients fear that the pathogenic microorganisms will fall into their body from outside with some unusual way (for example, due to contact with old things belonging to a sick person).
Compulsive actions - Stereotypically repeated, obsessive actions. In some cases, obsessive actions acquire the form of protective rituals: performing certain actions under certain conditions, a person tries to protect himself from something. It is like this compulsion that can most often meet with OCC.
Among obsessive actions, especially in children's and adolescence, ticks prevail. From ticks in organic diseases of the brain, they differ in that they are much more complex movements that have lost their initial meaning. For example, to obsessive actions, you can count your hand movements, as if casting back long hair (although a person has long been walking with a short haircut) or attempts to blink hard with eyes, as if Sorinka got into the eyes. The performance of these movements is accompanied by a painful sense of non-convulsion, a person understands the meaninglessness of these movements, but they still perform them.
Many of us have bad habits - someone bites the lips, someone turns the ring, someone else comes smoothes. However, these actions are not accompanied by a feeling of obsession.
If you are hard to monitor yourself, you can get rid of such habits. Or if someone from the side pays attention to that the man at that moment is serving his lips, then this person will stop doing this, and his mental state will not break.
If there are obsessive thoughts and actions that are becoming increasingly absurd, it is necessary to take into account that similar symptoms may be observed at. It is also characterized by the progression of emotional depletion, the loss of familiar interests.
Antidepressants (Anafranil, imipramine, amitriptyline, fluvoxamine) can be applied for the treatment of obsessive-compulsive disorder. With contrast obsessions, the best effect is the antidepressant sertalin (gold).
Tranquilizers (hydroxyzine, alprazolam, diazepams, clonazepams) may also be prescribed for the treatment of OCR.
With an obsessive fear of pollution accompanied by a complex system of protective rituals, neuroleptics (Sonapaks, Trucal, Reeazine) can be used.
In most cases, effective treatment of OCC is impossible without the use of psychotherapy. Her goal is to reduce the self-control of a person, to teach him to relax. One of the methods of psychotherapeutic treatment is a targeted and consistent contact of a person with the things he avoids. This is done so that the patient learned to consciously control its emotions in such situations.
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An obsessive-compulsive disorder is dysfunction of mental activity that manifested by involuntary thoughts of an obsessive nature that impede normal vital activity, as well as various fears. These thoughts give rise to anxiety, from which you can get rid of only performing obsessive and tedious actions called compulsions.
An obsessive-compulsive disorder may have a progressive or episodic nature, and also go chronically. The obsessive dooms are ideas or grave, which again and again in the stereotypical form are in the head of man. The essence of these thoughts is almost always painful because they are either perceived as meaningless ideas or carry indecomposable or aggressive content.
The root causes of the disorder under consideration are rarely detected on the surface. The obsessive compulsive disorder of the OCR is characterized by compulsies (ritual actions) and obsessions (obsessive thoughts). The most common involuntary annoying thoughts are:
Fear of infection (for example, viruses, microbes, from liquids, chemicals or excrement);
Signs of obsessive-compulsive disorder in children:
Wet cracked hands (if the child suffers with obsessive hand washing);
Long stay in the bathroom;
Slow fulfillment of homework due to fear make a mistake;
Making a lot of corrections and amendments to school work;
Strange or repeating behavior, for example, a constant check of doors for their closedness or cranes;
Tedious unchanged issues requiring assurances, for example, "Mom, Turn, I have a heat."
How to treat obsessive-compulsive disorder in children? Many parents want to know it. In the first turn, it is necessary to accurately determine whether their child suffers from an obsessive-compulsive disorder or simply practicing some of their rituals. It is possible to distinguish completely normal rituals for children who are often taken for violations. These include:
In children, until three years, there are often certain "traditions" of waste to sleep, it is usually either usually either passed, or becomes weak;
Invented games with certain rules, collecting (starting from the five-year-old age);
Excessive passion by some performer, subculture, which is a way to socialize, building relationships with peers having similar hobbies.
Before getting rid of obsessive compulsive disorder, parents need to differentiate it from normal manifestations inherent in the age period in which their crumb is located. The main difference of the described syndrome from normal rituals is an understanding of adolescents and children of abnormalities of obsessive thoughts and ritual actions. Children realize that their actions are deviating from the norm, so they try to resist them. This understanding pushes them to conceal obsessive thoughts and ritual actions from the environment. Therefore, if the baby is committed before going to bed, not going on, a certain ritual, it does not indicate the presence of an ailment. It is necessary to understand what behavior is only inherent in its age period.
The syndrome previously considered was considered a state sustainable (immune treatment) to treatment, since traditional psychotherapeutic methods based on principles rarely brought the effect. Also not happy and the results of the use of various drugs. However, in the eighties of the last century, the current situation changed dramatically due to the introduction of new methods of behavioral direction of therapy and pharmacopoeia medicine, the effectiveness of which was proved by conducting large-scale research.
Scientists of that time, trying to find the answer to the question "How to treat an obsessive-compulsive disorder" by experimentally proved that the most effective method of behavioral therapy of the considered violation is the method of preventing the reaction and exposure.
The patient receives instructions how to resist the performance of compulsive actions, after which it is placed in a situation provoking discomfort caused by obsessions.
The main thing in the treatment of the considered atmosphere is the timely recognition of obsessive-compulsive disorder and the correct diagnosis.
Currently, selective inhibitors of serotonin feeding (clomipramine), anxiolitics (clonazepam, buxpiron), normotimics (lithium) and antipsychotic drugs are the main drug treatment facilities of the obsessive-compulsive disorder.
How to get rid of obsessive compulsive disorder? Most therapists converge in the fact that the treatment of this disease should be started with the appointment of antidepressants, namely drugs of a group of selective inhibitors of serotonin reverse seizure in an adequate dose. Preparations of this pharmacotherapeutic group are better tolerated by patients and are considered more secure than clomipramine (tricyclic antidepressant, causing the blocking of serotonin reverse seizure), previously used in the treatment of the disorder under consideration.
Also practiced the purpose of anxiolytic in the complex with other drugs. Use them as a drug monotherapy is not recommended. The appointment of normotimics is shown, namely, lithium preparations, since lithium, contributes to the release of serotonin.
A number of researchers have shown the effectiveness of the appointment of atypical antipsychotic drugs (Olanzapin) in a complex with serotonergic antidepressants.
In addition to the use of medicines in the treatment of obsessions and compulsions, a modern approach involves the use of psychotherapeutic methods. An excellent psychotherapeutic effect gives a method of four steps, which provides the ability to simplify or modify ritual procedures. This method is based on the awareness of the patient problem and gradually overcoming symptoms.
Obsessively compulsive disorder treatment at home is not recommended, but there are a number of medical and preventive measures that can reduce the severity of manifestations.
So, obsessive compulsive disorder treatment at home suggests:
Reducing the use of alcohol and beverages containing caffeine;
Getting rid of bad habits;
Regular nutrition, since the feeling of hunger, lack of nutrients, the reduction in the level of sugar can provoke a stressful state that will cause the appearance of symptoms of obsessive-compulsive disorder;
Regular performance of physical exercises, since the systematic release of endorphins improves metabolism, increases stress resistance and improves human overall health;
Establishing the optimal mode of sleep and wakefulness;
The adoption of warm baths, during which a cool compress should be on the head of an affected individual, this procedure should be carried out several times a week for twenty minutes, each procedure should be reduced water temperature;
For removal of anxiety, with the aim of relaxation and calm the patient's individual, the adoption of herbal bravery and infusions with a sedative effect (the grass of valerian medicinal, melissa, mother-in-law);
Systematic use of the Hypericum, which allows, to increase mental concentration, improve clarity of consciousness that affects the force of coercion to perform ritual actions;
The daily conduct of respiratory gymnastics, which allows you to restore a normal emotional background that promotes the "sober" assessment of the current situation.
After the therapy performed, social rehabilitation is required. Only in case of successful adaptation after the treatment of obsessive-compulsive disorder, clinical symptoms will not return. A complex of rehabilitation activities includes training fruitful interaction with the social and nearest environment. For complete cure from the obsessive-compulsive disorder, the support for loved ones is played.
Doctor of the Medical and Psychological Center "Psomed"
1463 2018-06-21
Ossessive-compulsive disorder (OCD) - syndrome, the causes of which rarely lie on the surface. This severe mental state is characterized by the presence of obsessive thoughts (obsessions), which a person meets certain actions (compulsions), similar to the infinite obsessive dialogue of a person with himself.
Doctors include such a disorder to. The name of the disease "obsessive-compulsive disorder" of origin. In translation, it sounds like "obsession of the idea of \u200b\u200bcoercion", which very accurately determines the essence of the disease. According to medical statistics, the obsessive-compulsive disorder is formed in the interval from 10 to 30 years. Regardless of when it was the first of his symptoms, people treat a doctor between 27 and 35 years. This means that from the moment of the development of the disease and before the start of treatment it takes several years. The symptoms of the disorder may vary depending on the age of the patient.
Obsession (lat. obsessio. - "Siege") - a thought or desire, which constantly pops up in the mind. Thought this difficult to control or get rid of it, and it causes strong. The obsessive states are characterized by the appearance of contradictory will and the mind of desires and aspirations that a person clearly realizes, but does not accept and does not want to implement. The obsessive thoughts conflict with the subconscious, causing an increase in emotionality, depression and anxiety, phobias, panic attacks, all this is accompanied by shame and a sense of guilt. People with OCC syndrome do not seek professional help, because they are shy, they are afraid or do not know that their illness can be treated, incl. non-drug. Get rid of independently from obsessive ideas is unlikely to succeed. In this case, the help of a specialist is required. Otherwise, the ailment completely absorbs the psyche of man. Avoidance and impulsive actions initially "work": a person thinks that he has prevented harm, and it ceases to feel alarm. But in the future, they will create even more anxiety and fear, fueling the obsession.
People faced with obsessive-compulsive disorders even during the times of gloomy Middle Ages (at that time such a state was called obsession), and in the IV century it was counted to melancholy. OCPs were periodically recorded in paranoia,, manic psychosis, psychopathy. Modern doctors include pathology to neurotic states.
Almost everyone experienced similar obsessive thoughts. However, a person from the OCC has a level of concern from such thoughts. People suffering from OCD, in some countries are considered disabled. Most of them spend a lot of time meaningless due to compulsions. To avoid too strong anxiety, a person is often forced to resort to some "guarding" actions - compells (LAT. compello. - "Forced").
At the initial stage, the symptoms of illness are manifested in the form of obsessive states and various phobias. During this period, a person can still realize their irrationality. Over time, subject to the absence of drug and psychological assistance, the disorder is sharpened. A person loses the ability to adequately regard his fears. In the launched cases, hospitalization and treatment with the use of serious medicines is possible.
The term compulsion often denotes obsessive movements or rituals performed by man every day. These are actions that a person repeats again and again in response to an obsessive idea to reduce the risk of damage. A compulcing can be physical (like a repeated check, whether the door is locked, repetition of certain gestures) or mental (as the pronunciation of a certain phrase in the mind). For example, it can be the pronouncement of a special phrase to "protect relatives from death" (this is called "neutralization").
Compaulsis in the form of endless checks (for example, gas cranes), mental rituals (special words or prayers, repeated in the prescribed manner), are common in the OCR syndrome. Compaulsia (which distinguishes them from impulsive deposits) never become reality, do not implement. The man himself considers his attachments wrong, unclean or nasty nature - and therefore it worries very hard. In turn, the fact of the emergence of unnatural desires provokes the emergence of an obsessive feeling of fear.
The most common fear of infection with microbes in combination with obsessive washing and cleaning. Because of the fear of becoming infected, people go on a lot: do not touch the door handles, the seats of the toilet, they avoid handshake, do not touch or wear gloves without removing. What is characteristic, in the syndrome of the OKR, a person stops wash his hands not when they are clean, and then, when will finally feel "relief".
For example, against the background of the fatigue of a woman who raises a child, can periodically visit the thoughts on causing harm to their baby. Most, of course, dismissed such obsessions, ignores them. People suffering from the OCR, exaggerate the importance of thoughts and react to them, as in the threat: "What if I really can do this?!"
A woman begins to think that it can become a threat to a child, and it causes her alarming and other negative, such as disgust, a sense of guilt and shame. Thoughts represent the most deep fears of personality.
The fear of its own thoughts can lead to attempts to neutralize negative feelings arising from obsessions, for example, avoiding situations causing relevant thoughts, or participating in the "rituals" of excessive self-cleaning or prayer.
Despite the many research devoted to the OCR, it is still possible to say unequivocally, which is the main reason for the violation, but there are a large number of theories. For this condition, they can respond as physiological factors (impairment of the balance in nerve cells) and psychological.
According to one of the fundamental laws of behavioral psychology, the repetition of a behavioral act makes it easier to reproduce it in the future.
People with OCC syndrome always try to avoid things capable of running fear, "fight" with thoughts or perform "rituals" to reduce anxiety. Such actions temporarily reduce fear, but paradoxically, according to the law vicked up above, increase the likelihood of obsessive behavior in the future. Avoiding the object of fear, instead of pulling it out, can lead to sad consequences.
Researchers suggest that the suffering of OCD give the exaggerated meaning of thoughts due to false beliefs obtained in childhood. For example:
Ossessive compulsive syndrome is amazing and unpredictable. It is quite common (according to statistics they suffer to 3% of people). Representatives of all ages are exposed to him, regardless of the floor and the level of social status. Studying for a long time, the features of this disorder, scientists made curious conclusions:
The symptoms of the OCD are about the same, have a general mechanism.
Obsessive thoughts. Anxious reflections, relentlessly persecuting a person, more often concern fear of diseases, microbes, death, possible injuries, loss of money. From such thoughts, a person comes into panic horror, unable to cope with them.
Constant anxiety. Being in captivity of obsessive thoughts, people with obsessive-compulsive disorder are experiencing an internal struggle with their own state. The subconscious "eternal" alarms give rise to a chronic feeling that something terrible will happen. Such people are difficult to derive anxiety from the state.
Repeating movements. One of the bright manifestations of the syndrome is the constant repetition of certain movements (compulsion). Obsessive actions differ in rich variety. Human can:
Sometimes the syndrome is accompanied by a decrease. OCD is such a disorder, which is particularly subject to a minting personality. They have a habit to control everything, starting with affairs at work and ending with diet of domestic animals. The decrease in self-assessment occurs due to the awareness of the changes occurring and the inability to deal with them.
Often impulsively compulsive disorder requires a person to create its own inspection system, a certain individual ritual of exit from home, laying into bed, food intake. Such a system is sometimes very complex and confusing. If something is broken in it, the person begins to spend it again and again.
A man with OCD can too exaggerate its capabilities and the ability to influence the world. He believes in his power to call or prevent bad events by the power of thought. "Magic" suggests faith in the fact that the fulfillment of certain special actions, rituals will prevent something undesirable (similar to superstition).
So a person feels the illusion of comfort, as if he has more influence on events and control over what is happening. As a rule, wanted to feel calmer, the person produces rituals more and more often, which leads to the progression of neurosis.
The attacks of the disease occur more often when a person finds himself in the middle of a big crowd. He instantly wakes up squeaming, fear of illness and nervousness from the feeling of danger. Therefore, such people deliberately avoid society, communication and walks in crowded places.
To confirm or refute the Mental Disorder of OCC, a person should be consulted by a psychiatrist. After a psychodiagnostic conversation conducted, the doctor differentizes the presence of pathology from similar mental warehouse disorders. To accurately detect the syndrome, the doctors use a special scale of Yel-Brown. Any attempts to take control of your own consciousness and defeat the OCD most often lead to a deterioration in the state. And the pathology "rushes" in the crust of the subconscious, destroying the human psyche even more. Symptoms of the disease to have medical importance should be repeated at least 50% of days within two weeks.
The main goal of treatment develops from the establishment of the confidence relations of the patient of a person and his close environment (relatives, friends). Reward yourself. Psychologists advise constantly celebrating steps towards success, even the most minor. You need to praise yourself for the acquired changes and the surveyed skills.
Treatment of the OCR, which includes combinations of methods of psychological correction, may vary depending on the effectiveness of the sessions.
To date, experts have significantly expanded the ideas about the etiology of the disease. The most important factor in the direction of therapy of obsessive compulsive disorders to neurotransmission is important. This discovery is a revolution in the treatment of the disease under consideration, it makes it possible to cure millions of pain around the world. What way is possible to replenish the deficit of serotonin in the body? Help in this question can
Cognitive behavioral psychotherapy (CCT), EMDR-therapy, short-term strategic psychotherapy, respiratory practices, and hypnosis are used to treat the obsessive-compulsive disorder.
Complete disposal of symptoms of obsessive compulsive disorder in medical practice is observed extremely rare. The stabilization of symptoms and facilitating the state of a person by improving the quality of his life will be more realized.
Syndromes (symptoms complexes) are a prominent role among mental illness (symptoms), combined into a group of obsessive-compulsive disorder (OCD), which received its name from Latin terms Obsessio and Compulsio.
Obsessia (lat. Obsessio - underline, siege, blockade).
Compells (lat. Compello - forcing). 1. The obsessive attractions, the type of obsessive phenomena (obsessions). Characterized insurmountable attractions, arising in spite of mind, will, feelings. Often they turn out to be unacceptable for the patient, contradict its moral and ethical properties. Unlike impulsive deposits, a compulcility is not implemented. These attractions are aware of the patients as wrong and they are experiencing them, especially since the occurrence of them due to its incomprehensibility often generates a sick feeling of fear 2. The term compulsion is also used in a broader sense to designate any intrusiveness in the motor sphere, including obsessive rituals.
Currently, almost all obsessive states are combined in an international classification of diseases under the concept of "obsessive-compulsive disorder".
The concept of the OCR has undergone a fundamental revaluation over the past 15 years. During this time, the clinical and epidemiological value of the OCC is completely revised. If it was previously believed that this was a rarely jerky state observed in a small number of people, now it is known: OCD meets often and gives a large percentage of morbidity, which requires urgent attracting mental attention throughout the world. In parallel, our ideas about the etiology of the OCD were expanded: a fuzzy formulated psychoanalytic definition of two past decades was replaced by a neurochemical paradigm exploring neurotransmitter disorders underlying the OCD. And that the most significant, pharmacological intervention, directed specifically for serotonergic neurotransmission, made a revolution in the prospects for the recovery of millions of patients suffering from OCR, in all over the world.
The discovery that intensive inhibition of serotonin inverse seizure (IOPS) is the key to effective treatment of OCC, was the first stage of the revolution and stimulated clinical studies that showed the effectiveness of such electoral inhibitors.
According to the description given in ICD-10, the main features of the OCC are repeated obsessive (obsessive) thoughts and compulsive actions (rituals).
In a broad sense, the OKR kernel is an obsessiveness syndrome, which is a state with a predominance in a clinical picture of feelings, thoughts, fears, memories arising beyond the desire of patients, but when aware of their pain and critical attitude towards them. Despite the understanding of the unnaturalness, the alogicity of obsessive ideas and states, patients are powerless in their attempts to overcome them. The obsessive motivations or ideas are recognized by alien personality, but as if walking from the inside. Obsessive actions can be the execution of rituals intended to facilitate anxiety, such as washing hands to combat "pollution" and in order to prevent "infection". Attempts to drive non-crude thoughts or motivations can lead to a severe inner struggle, accompanied by a tense anxiety.
The obsessions in the ICD-10 are included in the group of neurotic disorders.
The prevalence of OCP in the population is quite high. According to some data, it is determined by the index of 1.5% (meaning "fresh" cases of diseases) or 2-3%, if the episodes of exacerbations observed throughout life are taken into account. Surveying obsessive-compulsive disorders are 1% of all patients receiving treatment in psychiatric institutions. It is believed that men and women are amazed to approximately equally.
Clinical picture
The problem of obsessive states attracted the attention of clinicians at the beginning of the XVII century. For the first time they were described by Platter in 1617. In 1621, E. Barton described the obsessive fear of death. Mention of obsessions are found in the works of F. Pinel (1829). I. Balinsky proposed the term "obsessive ideas", rooted in Russian psychiatric literature. In 1871, Westphal introduced the term "agoraphobia", which denoted the fear of staying in public places. M. Lehran de Sol, analyzing the features of the dynamics of OCP in the form of "insoluction of doubts with nonsense of touch, indicates a gradually more complex clinical picture - obsessive doubts are replaced by ridiculous fears of" touch "to the surrounding subjects, motor rituals are joined, the fulfillment of the whole life of patients is connected. However, only at the turn of the XIX-XX centuries. Researchers managed to more or less clearly describe the clinical picture and give the syndromatic characteristic of obsessive-compulsive disorders. The beginning of the disease, as a rule, falls on teenage and youthful age. The maximum of clinically outlined manifestations of obsessive-compulsive disorder is celebrated in the age range of 10-25 years.
The main clinical manifestations of the OCC:
The obsessive thoughts are painful, arising in addition to the will, but recognized by patients as their own, ideas, convictions, images that in stereotypical form are invited to the Consciousness of the patient and which he is trying to somehow resist. It is this combination of an internal feeling of compulsive motivation and efforts to resist him characterizes obsessive symptoms, but from these two components more changeable the degree of accompanying efforts. The obsessive thoughts can take the form of individual words, phrases or poetic lines; Usually they are unpleasant for the patient and can be obscene, blasphemous or even shocking.
Observatory images are vividly represented scenes, often having the nature of violence or disgust, including, for example, sexual perversions.
The obsessive impulses are motivated to perform actions, usually destructive, dangerous or able to disgrace; For example, jump out on the road in front of a moving car, painful the child or shout, being in society, obscene words.
The obsessive rituals include both mental activities (for example, a recurring account in some special way, or repeating certain words), and repeated, but meaningless actions (for example, washing hands twenty or more times a day). Some of them have an understandable connection with the obsessive thoughts preceding them, for example, re-washing hands - with thoughts about infection. Other rituals (for example, regular folding of clothing for some complex system before you wear it) such a connection do not have. Some patients feel an overwhelming motivation to repeat such actions a certain number of times; If it does not work, they are forced to start all over again. Sicks are invariably realized that their rituals are illogical, and they usually try to hide them. Some are afraid that such symptoms are a sign of a starting madness. Both obsessive thoughts and rituals inevitably lead to problems in everyday activity.
Obsessive reflections ("mental chewing") is an internal debate under which the arguments for and against even the simplest daily activities are infinitely revised. Some obsessive doubts relate to actions that could be incorrectly fulfilled or not completed, such as turning off the crane of the gas stove or locking the door; Others relate to actions that could harm other people (for example, the opportunity driving by a car past a cyclist, knock him down). Sometimes doubts are associated with a possible violation of religious regulations and rituals - "remorse of conscience".
Combulsive actions are repeated stereotypical actions, sometimes acquiring the nature of protective rituals. The latter are intended to prevent any objectively unlikely events dangerous for the patient or its loved ones.
In addition to the above, in a number of obsessive-compulsive disorders, a number of outlined symptom complexes are distinguished and among them obsessive doubts, contrasting obsessions, obsessive fears - phobias (from Greek. Phobos).
Obsessive thoughts and compulsive rituals may in certain situations increase; For example, obsessive thoughts on damage to other people often become persistent in the kitchen or some other place where knives are stored. Since patients often avoid such situations, the surface similarity with the characteristic model of avoidance detected during an alarming-phobic disorder can be observed. Anxiety is an important component of obsessive-compulsive disorders. Some rituals weaken the alarm, whereas after the other it increases. The obsessions are often developing within the framework of depression. In some patients, it looks like a psychologically understandable reaction to obsessive-compulsive symptoms, but other patients have repetitive episodes of depressive moods that occur independently.
The obsessions (obsessions) are divided into figurative, or sensual, accompanied by the development of affect (often painful) and the obsessivity of affective neutral content.
Sensual obsessions include obsessive doubts, memories, ideas, attractions, actions, fears, an obsessive feeling of antipathy, obsessive concern about the usual actions.
Obsessive doubts - annoying contrary to logic and reason the uncertainty in the correctness of the accuracy and perfect actions. The doubt content is different: obsessive household fears (whether the door is locked, windows or water taps are sufficiently closed, whether gas, electricity is turned off), doubts associated with official activities (a particular document is written correctly, the addresses on business papers are not confused whether inaccurate numbers are not specified, or orders are true), etc. Despite repeated verification of the perfect action, doubt, as a rule, do not disappear, causing psychological discomfort in the obsession suffering from this kind.
The obsessive memories include persistent, irresistible painful memories of any sad, unpleasant or shame for sick events, accompanied by a feeling of shame, repentance. They dominate the patient's mind, despite their efforts and efforts do not think about them.
Obsessive belongings - motivating to committing one or another hard or extremely dangerous action, accompanied by a sense of horror, fear, confusion with the inability to free him from him. The patient covers, for example, the desire to rush under the passing train or push under him a close person, to kill an extremely cruelly wife or child. In this case, patients are painfully afraid that this or that action will be implemented.
The manifestations of obsessive performances may be different. In some cases, this is a bright "vision" of the results of obsessive impositions, when patients represent the result of a perfect cruel deed. In other cases, obsessive performances, referred to as mastered, act as implausible, sometimes absurd situations that patients are taken for valid. An example of obsessive performances can be the conviction of the patient that the buried relative was alive, and the patient is painfully presents and is experiencing the suffering of the deceased in the grave. At the height of obsessive representations, the consciousness of their absurdity, inappropriateness disappears and, on the contrary, confidence appears in their reality. As a result of obsessions, the nature of ultra-subject formations (dominant ideas that do not correspond to their true meaning) are acquired, and sometimes Breda.
The obsessive sense of antipathy (as well as obsessive loose and blasphemous thoughts) - nothing justified, distilled off by patients from herself of antipathy to a certain, often a close person, cynical, unworthy thoughts and ideas for respected people, religious persons - with respect to the saints or ministers of the Church .
Obsessive actions - actions committed against the desire of patients, despite the efforts attached to their deterrence. Some of the obsessive actions are patients until they are implemented, others are not noticed by the patients themselves. Obsessive actions are painful for patients especially in cases where they become the object of attention around.
The obsessive fears, or phobiam include the intrusive and meaningless fear of height, large streets, open or limited spaces, large clusters of the people, the fear of the onset of sudden death, fear of becoming sick with one or another incurable disease. In some patients, a wide variety of phobias may occur, sometimes acquiring the nature of the fear of all (panfobia). Finally, there is an obsessive fear of the occurrence of fears (phobophobia).
Hypochondriatic phobias (nosophobia) are obsessive fear of any serious illness. Most often, cardio-, stroke, syphilo- and speedophobia are observed, as well as the bomney of the development of malignant tumors. At the peak of the alarm, patients sometimes lose a critical attitude towards their state - turn to the doctors of the corresponding profile, require surveys and treatment. The implementation of hypochondriad phobias occurs in connection with psycho- and somatogenic (common incomprehensive diseases) by provocations and spontaneously. As a result, the resulting hypochondriatic neurosis is developing, accompanied by frequent visits to doctors and unreasonable drug intake.
Specific (isolated) phobias - obsessive fears limited by a strictly defined situation - fear of height, nausea, thunderstorms, pets, treatment with dental physician, etc. Since contact with situations that cause fear is accompanied by intensive alarm, characterized by the desire of patients to their avoidance.
The obsessive fears are often accompanied by the development of rituals - actions that have the meaning of "magical" spells, which are produced, despite the critical attitude of the patient to the obsession, in order to protect against one or another impaired misfortune: before the start of any important case, the patient should commit some kind A certain action to eliminate the possibility of failure. Rituals can, for example, to be expressed in clicked fingers, reproducing with some melody or in the repetition of certain phrases, etc. In these cases, even relatives do not recognize the existence of such disorders. Rituals in combination with obsessions are a rather stable system that exists usually for many years and even decades.
The obsessions of the affective-neutral content is obsessive womb, an obsessive account, recall of neutral events, terms, formulations, etc. Despite their neutral content, they are patient, they interfere with its intellectual activity.
Contrast obsessions ("aggressive obsessions") - unable, blasphemous thoughts, fear of causing harm to themselves and others. The psychopathological formations of this group are predominantly in shaped obsessions with pronounced affective saturation and mastering the consciousness of patients with submissions. They are distinguished by the feeling of alienity, the absolute non-motivation of the content, as well as a close combination with obsessive deductions and actions. Patients with contrasting obsessions and complain about an irresistible desire to add to the just heard ending replicas that appeal to the unpleasant or threatening sense, repeat over the surrounding, but already with a touch of irony or malice, phrase of religious content, shouting cynical, contradicts their own installations and generally accepted morals They may experience the fear of losing control over themselves and the possible committing dangerous or ridiculous actions, applying injury to themselves or their loved ones. In the last cases, obsessions are often combined with object phobias (the fear of acute items - knives, forks, axes, etc.). The group of contrasting partially includes the obsessions of sexual content (obsessions by the type of forbidden ideas about perverted sexual acts, the object of which children becomes, representatives of the same gender, animals).
The obsessive ideas of pollution (misophobia). This group of obsessions include both fear of pollution (land, dust, urine, felling and other uncleans) and fear of penetration into the body of harmful and poisonous substances (cement, fertilizers, toxic waste), small items (glass fragments, needles, specific species dust), microorganisms. In some cases, the fear of pollution can be limited, staying for many years at the preclinical level, manifested only in some features of personal hygiene (frequent shift of linen, repeated hand washing) or in the order of household (careful processing of food, daily floating floors , "Taboo" on domestic animals). This kind of monophobia does not significantly affect the quality of life and are estimated to be surrounding as habits (extended pureliness, excessive squeaming). Clinically manifested Mizophobia options relate to a group of heavy obsessions. In these cases, there are gradually complicated protective rituals: avoiding the sources of pollution and touches to "unclean" subjects, the processing of things that the dirt could have, a certain sequence in the use of detergents and towels, allowing to maintain "sterility" in the bathroom. Stay outside the apartment is also furnished by a series of protective events: an exit to the street in a special, most closing clothes, special treatment of carrious things on returning home. In the late stages of the disease, patients avoiding pollution, not only do not go out, but do not even leave the limits of their own room. In order to avoid dangerous in terms of contamination of contacts and contact, patients do not even let themselves even the closest relatives. Misophobia also adjoins the fear of infection of any disease, which does not refer to the categories of hypochondriac phobias, since it is not determined by the concerns of the presence of a suffering of a disease of a disease. In the foreground - fear of the threat from outside: fear of penetration into the body of pathogenic bacteria. Hence the development of relevant protective actions.
A special place in a number of obsessions occupy obsessive actions in the form of isolated, monosimptomic motor disorders. Among them, especially in childhood, ticks prevail, which, unlike organically determined involuntary movements, are much more complex motor acts that have lost their original meaning. Tiki sometimes make the impression of exaggerated physiological movements. This is a kind of caricature on certain motor acts, natural gestures. Patients suffering from teaks can shake their heads (as if checking whether the hat sits well), produce movements with hand (as if throwing out interfering hair), blink with eyes (as if getting rid of sortie). Along with obsessive ticks, it is often observed by pathological habitual actions (breaking lips, grinding tooths, touching, etc.), differing from actually obsessive actions, the absence of a subjective feeling of non-conceptions and experiences as alien, painful. The neurotic states characterized only by obsessive ticks usually have a favorable forecast. Appearing most often in preschool and younger school age, ticks usually fade by the end of the period of puberty. However, such disorders may be more resistant, maintained over the years and only partially modified by manifestations.
The course of obsessive compulsive disorder.
Unfortunately, as the most characteristic trend in the Dynamics of the OCC, you must specify the chime. Cases of episodic manifestations of illness and complete recovery are relatively rare. However, in many patients, especially in the development and preservation of one such type of manifestation (agoraphobia, an obsessive account, ritual washing of hands, etc.), a long stabilization of the state is possible. In these cases, the gradual (usually in the second half of life) mitigate psychopathological symptoms and social redependaptation. For example, patients who experienced the fear of trips on certain types of transport, or public speeches, cease to feel flawed and work along with healthy. With light shapes of the OCC, the disease, as a rule, is favorably (on an outpatient level). The inverse development of symptoms occurs after 1 year - 5 years from the moment of manifestation.
Heavier and complex OCRs, such as phobias of infection, pollution, acute items, contrasting views, numerous rituals, on the contrary, can become persistent, resistant to treatment, or detect a tendency to recurrence with persistent, despite active therapy, disorders. The further negative dynamics of these states indicates a gradual complication of the clinical picture of the disease in general.
Differential diagnosis
It is necessary to distinguish the OCR from other diseases in which obsessions and rituals occur. In some cases, obsessive-compulsive disorder should be differentiated with schizophrenia, especially when obsessive thoughts are unusual in content (for example, mixed sexual and blasphemes) or rituals exclusively eccentric. The development of a sluggish schizophrenic process cannot be excluded at the increase in ritual formations, their persistence, the occurrence of antagonistic trends in mental activities (inconsistency of thinking and actions), emotional manifestations. The protracted obsessive states of the complex structure must be accommodated from the manifestations of the bred schizophrenia. In contrast to neurotic obsessive states, they are usually accompanied by a sharply growing anxiety, significant expansion and systematization of the circle of obsessive associations acquiring the nature of "special meaning": previously indifferent items, events, random observations of others resemble patients about the content of phobias, offensive thoughts and acquire the most In their presentation, a special, threatening value. In such cases, it is necessary to refer to the psychiatrist to exclude schizophrenia. Certain difficulties may also represent the differentiation of the OCR and states with the predominance of generalized disorders known as the La Turkett's housing syndrome. Teaks in such cases are localized in the area of \u200b\u200bthe face, neck, upper and lower extremities and are accompanied by grimaces, opening the mouth, leading the tongue, intense gesticulation. To eliminate in these cases, this syndrome helps the coarseness of motor disorders characteristic of it and more difficult mental disorders.
Genetic factors
Speaking of hereditary predisposition to the OCD, it should be noted that obsessive-compulsive disorders were detected by about 5-7% of parents of patients with such disorders. Although this indicator is low, it is higher than in the overall population population. If the evidence of the hereditary predisposition to the OCD is still undefined, then the features of a psychospace personality can be significantly explained by genetic factors.
Approximately two-thirds of cases, the improvement in the OCP occurs during the year, more often by the end of this period. If the disease continues for more than a year, fluctuations are observed in its course - periods of exacerbations are interspersed with periods of improved health status in several months to several years. The forecast is worse if we are talking about a psychological personality with severe symptoms of the disease, or if there are continuous stressful events in the life of the patient. Heavy cases can be extremely persistent; For example, as a result of the study of hospitalized patients with OCC, it was found that three quarters of them are symptoms remained unchanged and after 13-20 years.
Treatment: Basic Methods and Approaches
Despite the fact that OCD is a complex group of symptom complexes, the principles of treatment for them are one. Drug therapy is considered the most reliable and effective method of treatment of OCC, when conducting a strictly individual approach to each patient, taking into account the characteristics of the manifestation of the OCR, age, gender, the presence of burdensomeness by other diseases. In this regard, we must warn patients and their relatives from self-medication. With the emergence of any disorders similar to mental, it is necessary, first of all, to contact the specialists of the psycho-neurological dispensary at the place of residence or other medical institutions of a psychiatric profile to establish the correct diagnosis and purpose of competent adequate treatment. It should be remembered that at present a visit to the psychiatrist does not threaten any negative consequences - the sadly famous "accounting" has been canceled more than 10 years ago and replaced by the concepts of consultative and medical care and dispensary observation.
In treatment, it is necessary to bear in mind that obsessive-compulsive disorders often have a fluctuating nature of the flow with long periods of remissions (improvement of the condition). The obvious suffering of the patient often as if they require energetic treatment, but should be remembered about the natural course of this state to avoid a typical error that consists in excessively intensive therapy. It is also important to also take into account that OCC is often accompanied by depression, the effective treatment of which often leads to mitigating obsessive symptoms.
The treatment of OCPs begin with clarification of the sick symptoms and, if necessary, with deceptions in the fact that they are the initial manifestation of madness (the usual reason for the concern of patients with obsessions). Suffering from those or other obsessions often involve other family members into their rituals, so relatives need to relate to the patient firmly, but sympathy, mitigating the symptoms as possible, and not exacerbating it with excessive reinforcement of painful fantasies of patients.
Drug therapy
In relation to the currently identified type of OCPs, the following therapeutic approaches exist. From pharmacological preparations, with OCPs, serotonergic antidepressants, anxiolytics (mainly benzodiazepine series), beta blockers (to relieve vegetative manifestations), MAO inhibitors (reversible) and triazole benzodiazepines (alprazoleum) are used. Anxolytic drugs give some short-term relief of symptoms, but they cannot be appointed more than a few weeks in a row. If the treatment with anxiolithics is required for a period of more than one or two months, sometimes minor doses of tricyclic antidepressants or small neuroleptics are helping. The main link in the treatment regimen, overlapping with negative symptoms or with ritualized obsessions, are atypical neuroleptics - risperidone, olanzapine, quetiapine, in combination or with CSS class antidepressants, or with antidepressants of other rows - moklobmeid, thianeptine, or with high-precantial benzodiazepine derivatives ( Alprazolam, clonazepam, bromases).
Any accompanying depressive disorder is treated with antidepressants in an adequate dose. It has evidence that one of the tricyclic antidepressants, clomipramine, has a specific effect on obsessive symptoms, but the results of a controlled clinical test showed that the effect of the use of this drug is insignificant and manifests itself only in patients with distinct depressive symptoms.
In cases where obsessive-phobic symptoms are observed within the framework of schizophrenia, the greatest effect has intensive psychopharmacotherapy with proportional use of high doses of serotonergic antidepressants (fluoxetine, fluouxamine, sertraline, paroxetine, cytalopram). In some cases, it is advisable to connect traditional neuroleptics (small doses of haloperidol, trifluorcezine, fluanxola) and parenteral administration of benzodiazepine derivatives.
Psychotherapy
Behantic psychotherapy
One of the main tasks of a specialist in the treatment of OCC is the establishment of fruitful cooperation with patients. It is necessary to inspire a patient to faith in the possibility of recovery, overcome its prejudice against "harm", informed by psychotropic drugs, convey its conviction in the effectiveness of treatment under the condition of systematic compliance with the prescribed appointments. The patient's faith in the possibility of healing is necessary to fully support both the relatives of the suffering from the OKR. If there are rituals in patient, it is necessary to remember that the improvement usually occurs when using the combination of the method of preventing the reaction with the premises of the patient to the conditions aggravating these rituals. Significant, but not complete improvement can be expected approximately two thirds of patients with moderately heavy rituals. If due to such treatment, the severity of rituals is reduced, then the accompanying obsessive thoughts are receded. Prabobios use predominantly behavioral techniques aimed at reducing sensitivity to phobic incentives supplemented by elements of emotional-supporting psychotherapy. In cases of predominance of ritualized phobias, along with desessibizations, behavioral training is actively used to overcome avoiding behavior. Behavioral therapy is significantly less effective in relation to obsessive thoughts that are not accompanied by rituals. For many years, for many years, for many years, the method of "stopping thoughts" is used, but its specific effect is not convincingly proven.
Social rehabilitation
We have already noted that the obsessive-compulsive disorder has a fluctuating (oscillating) current and over time the patient's condition can be improved regardless of which treatment methods were used. Before recovery, patients can benefit supporting conversations that ensure constant hope for recovery. Psychotherapy in the complex of medical and rehabilitation measures in patients with OCC is aimed at both the correction of avoiding behavior and to reduce the sensitivity to phobic situations (behavioral therapy), as well as family psychotherapy in order to correct the violations of behavior and improving intrasday relations. If married problems exacerbate symptoms, joint interviews with a spouse (wife) are shown. Patients with Panfobius (at the stage of active flow of the disease) due to the intensity and pathological persistence of symptoms need both in medical and socio-labor rehabilitation. In this regard, it is important to determine the definition of adequate treatment for treatment - long-term (at least 2 months) therapy in the hospital followed by the continuation of the course on outpatient conditions, as well as conducting measures to restore social relations, professional skills, intra-family relationships. Social rehabilitation is a set of training programs for patients with OCC methods of rational behavior both in everyday life and in hospital conditions. Rehabilitation is aimed at learning social skills to interact with other people, vocational training, as well as skills necessary in everyday life. Psychotherapy helps the patient, especially those who have a sense of own inferiority, better and correctly apply to themselves, mastering ways to solve everyday problems, gain faith in their forces.
All these methods for reasonable use can increase the efficiency of drug therapy, but are not able to completely replace drugs. It should be noted that the methodology of clarifying psychotherapy does not always help, and in some patients with OCD there is even a deterioration, since such procedures encourage them to painful and unproductive reflections on subjects discussed during the treatment process. Unfortunately, so far science is not known how many times and forever heal spiritual ailments. Often the OCPs have a tendency to recurrence, which requires a long prophylactic drug intake.
