HOW TO MANAGE OBSESSIVE-COMPULSIVE BEHAVIOR

For many people, obsessive-compulsive disorder responds well to a combination of antidepressant medication and cognitive therapy. Most people with OCD appear to be predisposed to the symptoms. Usually you can find other extended family members who share a similar pattern of ritualistic behavior. Therapeutic treatment involves the following process: relabeling, reattribution, relaxation techniques and refocusing strategies. Relabeling and reattribution techniques are designed to assist in objectifying the disorder and realizing that people are more than their obsessions. For example, I teach people to internally respond by saying, "A part of my brain works in ways that make me repeat things continuously. This is merely my disorder speaking; I am more than my disorder." This way of perceiving one’s obsessive features helps people to detach the nature of their problem from their sense of self. Relaxation techniques may involve exercise, music, message, meditation and vacationing in a soothing environment. These strategies slow down the sympathetic nervous system minimizing anxiety and making it easier for people with OCD to manage their thoughts and behavior. One’s level of anxiety is directly related to the impact of compulsive behavior.
Refocusing techniques refers to assisting patients to shift from obsessional thinking and behavior to other more self-rewarding activities. A change in activities lessens the impact of the OCD thinking and behavior. For example, a child may have a ritualistic pattern of continuously changing the television remote control in a certain order. A therapeutic goal might be to get the child to leave his obsession by getting up and leaving the room, possibly departing the house for a brief walk. I have people track the intensity of their anxiety during the time that they are away from their ritualistic behavior. When removed from an obsessional behavior, anxiety initially becomes worse and then dissipates in strength over time. Once the child returns to the obsessional pattern after voluntarily leaving it, it usually has decreased in its impact and intensity. The child may say, "I was able to keep from repeating the pattern continuously. I only did it twice!" Reinforcement and encouragement are important for people attempting to minimize obsessive patterns.

Those who experience OCD are typically anxious about their symptoms and fight to get rid of them. It is essential that those who suffer from OCD learn to accept their symptoms rather than struggle with them. Acceptance of any form of anxiety helps one to minimize the symptoms. For example, one might say, “Here come those “crazy feelings” again. They sure are annoying but they won’t hurt me. If I learn to “let them be” they will eventually dissipate in their effect on me.”

It is important for those who experience OCD to share their problem with a close friend or therapist. Expressing one’s feelings about the pattern may help in dealing with any feelings of shame or embarrassment. For the OCD sufferer, it is significant to remember that most people experience features of the disorder. All behavioral problems lie on a continuum. Struggling with OCD is no exception. When we share our problems with others, we realize that we are not alone in our difficulties. It takes courage to admit that we are less than perfect and to allow ourselves to share our humanity with others. When we learn to quit fighting with our imperfections, the issue eventually seems less troublesome.

James P. Krehbiel, Ed.S., LPC is an author, freelance writer, and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. His book, Stepping Out of the Bubble is available at www.amazon.com. Now you can "ask James" through his interactive forum at www.theparentstation.com.

DEALING WITH POST-TRAUMATIC STRESS DISORDER

Many people have experience Posttraumatic Stress Disorder symptoms. One of my patients was in a highly abusive relationship with a man who physically beat her. This went on for some time as she allowed herself to remain in a pattern to be re-traumatized. Currently, relationships still terrify her. Due to mistrustful feelings, she pushes men away with her anger and rage. Then she becomes upset with herself for behaving in impulsive ways. The key to treatment for her is to isolate the traumatic feelings, explore the pain around them, and to teach her new ways of behaving that are based on rational thinking. She no longer needs to view herself as the victim in relationships. She needs to expand her psychic map to include new feeling, thoughts, and behavior. This exploration process is painful, but it will free her of the need to continue victimizing herself. She needs to flush out the negative energy that has allowed her to be re-traumatized. The cycle can be broken with proper therapeutic intervention.

Clients who suffer from Posttraumatic Stress Disorder experience the effects of psychic numbing. These people also tend to suffer from anxiety, depression, panic, anger and rage and startle response. A friend of mine, who was a Lieutenant during the Vietnam War, experiences features of this disorder. When the snowplows rumble through his hometown during a major snowstorm, it is not unusual for him to be awakened in the early morning by the sounds. Sometimes, he jumps out of the bed in total confusion and panic. It’s as if he back in the rice paddies of Vietnam waiting for the next mortar found to explode. What he is experiencing is the startle response or hypervigilence. Isn’t it amazing how the brain works? After thirty years loud noises still take him back to a place where psychic numbing was necessary for survival. All of the painful psychic energy is stored in our bodies and mind. Many times I recommend message therapy as an adjunct treatment to clients who have stored painful feelings, because it is one more entry point for ferreting out troublesome emotional energy.

It is important that we do not forget those of have been the victims of PTSD. Now that the dust has settled, do we still remember that we have an obligation as a country to treat those who have suffered for this disorder as a result of war and natural disasters? Let us not forget our families who have suffered from the ravages of our current struggle in Iraq, “the war on terror,” and those who endured Hurricane Katrina.


James P. Krehbiel, Ed.S., LPC is an author, freelance writer, and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. His book, Stepping Out of the Bubble is available at www.amazon.com. Now you can “ask James” through his interactive forum at www.theparentstation.com.