Therapy

Obsessive Compulsive Disorder – part 2

Yesterday, I explained a little bit about obsessions. Today, I want to describe the other half of OCD, compulsions.

Compulsions are the acts or rituals that people use in attempts to relieve their obsessive thoughts.  Obsessions can be very tormenting and compulsions are failed attempts to quiet and calm those awful thoughts and feelings.

Common categories of compulsions are:

  1. Incessantly arranging things
  2. Extreme cleaning and grooming behavior
  3. Touching objects in a particular way or order
  4. Checking doors, locks, stove, windows, keys
  5. Undue tidiness or orderliness
  6. Checking to be sure that you haven’t done harm.

OCD may be partly inherited, may be learned, may have developed as a result of early experiences, or exists as an element of personality – no one knows for sure.  Children who distrust relationships and who have been frustrated in their attempts to exert control over their environment may become more controlling of themselves as adults.  In this way, early learning, experiences and temperament can be seen to influence later behaviors. OCD can be treated with therapy and medications.  Over the years, I have seen remarkable improvement in both therapy techniques and varieties of medications.  Get help.

Obsessive Compulsive Disorder – part 1

We are all creatures of habit. After writing about superstition, OCD comes to mind because it is the mental disorder most closely tied to superstition – OCD, Obsessive-Compulsive Disorder.

As creatures of habit,  we tend to repeat certain behaviors, wear lucky clothes, or organize our lives into patterns.  Sometimes this goes beyond habit and become a serious problem – obsessive compulsive disorder.

When you shower 3X a day, brush your teeth so often that you have rubbed the enamel off your teeth, undress in the hall so you don’t bring dirt into the house, check the door 15X before you leave the house, count words in your head, or can’t sleep until you have meticulously lined up everything in your room, you may have slipped out of the range of normal habits and into obsessive compulsive disorder.

Obsessive compulsive disorder (OCD) has 2 components – the obsessions and the compulsions.  OCD causes people to be plagued by repetitive thoughts (obsessions) and/or to repeat certain rituals (compulsions).

Obsessions are unwanted, intrusive thoughts that are often frightening.  People generally cannot ignore them.  The thoughts get better and worse depending on your levels of stress.

Common categories of obsessive thinking:

  1. Fear of people or the environment contaminating you with dirt, germs, body waste or fluids.
  2. Excessive worry that a task was done poorly
  3. Extreme need for order
  4. Fear of thinking evil thoughts
  5. Fear of having committed a crime
  6. Repeated, excessive sexual thoughts
  7. Concerns with certain sounds, words or numbers

Tomorrow, compulsions……..

 

List Lover

I confess, I am a devotee of lists. Lists are my friends. I take great satisfaction in making lists of things, and then I enjoy crossing these items off my list, one by one.  I will not admit or deny that I add things to my list just so I can have the pleasure of crossing them off.  I have my standards. I cannot add a chore to the list I made today if that task was completed last week.  However, I can add very short tasks (inhale, exhale) if I need more guaranteed check marks or a boost to my self esteem. For those of you who also love lists, you do not need to read further, but you are probably the only people who will keep reading.

I don’t expect everyone to be this nutty, but I may be able to convince you that lists can be very useful.  Here’s the trick – think of lists as a compilation of things you WANT to do, not things that you have to do. For example, I have “Watch Project Runway,” on this weekend’s list.  I also have laundry, pay bills, and sweep the garage on the list and they are not quite as appealing as things-to-do, but I do want to get them done and will be pleased when I have finished.

Tips for list making:

  1. Most importantly, have enough things on your list that you WANT to do, like, “Shop for a camel jacket.”  I was able to check that off rather quickly.
  2. Decide if your list is for a day, week, or six months and make the number of chores appropriate.
  3. If you need to carry things over from one list to another, do it – so what.
  4. Be reasonable.  For a daily list, don’t write, “Lose 8 lbs.”  Maybe you want to say, “Eat a salad” or “Go for a walk.”
  5. Lists that are ridiculously impossible only make you feel bad; they don’t work. Keep it somewhat reasonable.
  6. You are the boss. Change your list if you need to. After all, this is not homework for 6th grade and your teacher isn’t watching.
  7. Break things down into small steps (baby steps).  For example, my monthly list has, “Paint the dining room,” but this weekend has, “Take down the cabinet.” The full week’s list has, “Pick paint color, Buy paint, Tape woodwork” – very possible with llots of check marks.

Lists work.  They get the chores out of your head and on paper; you can think about other things; you won’t forget; you are focused; you feel organized; and you will get more done. Tell me about your lists and share your tips.

“We Just Don’t Communicate!”

Very often, when people come in for couples counseling, this is one of the first things that they say.  Sometimes, it isn’t about communication at all, but when the problem is, remember communication isn’t magic.  Everyone can do it! When you see someone do a dangerous trick on TV, they follow it up with, “Don’t try this at home!”  Well, DO try this at home.ATT00010.jpg animal friends

Think about communication as “the process of exchanging information”. It can always be improved.

Here are 5 basic principles:

  1. In all relationships (family, work, love), communication never stops.  It is always there, so don’t bother to fight it.  Instead, pay attention and get good at it. You are always sending and/or receiving information.
  2. Communication can be verbal (messages sent through words).  Communication can be nonverbal (messages sent by actions or inactions).
  3. When you have a negative message to send, it is best to send it consciously and verbally rather than carelessly and nonverbally.  Communicating with words allows further, useful discussion.
  4. Communication can be simple and overt (“I am going to feed the dog”) or it can be more complicated (“I am going to feed the dog” accompanied by frown, groan, slamming the dog food on the counter, or announced when you in the middle of an argument).
  5. Communication is always edited and that is okay.  No one says everything that is on their mind and that’s just fine – it is civilized.
  6. Poor communication is not a personality problem (usually) or character flaw.  If you work at communication, you will get good at it.

Pay attention to these 5 ideas and see if it helps.  Let me know what you learn.

Many of these ideas came from a 1987 pamphlet prepared by Richard B. Stuart and Barbara Jacobson. It just proves that helpful, basic ideas are still worth remembering.

The Disaster Of Politeness

Most of us have been taught to be polite.  We are drilled with the belief that hurting anyone’s feelings is bad thing to do.  We are cautioned to “play nice”, “be nice”, “don’t be mean”.  I will admit publicly, for the very first time, that in 8th grade at Horace Mann School inn New Jersey, I was voted “most polite”.  Well, with credentials like that, I certainly have the right to post an article about the other side of politeness. I am not going to advocate meanness or bad manners.  I do however, want to point out that there is a dark side to every good quality, and here is the dark side of politeness.

Women’s ability to protect themselves from sexual assault decreases under certain conditions:

  1. When she is conflicted about what to do in the situation, her assertive resistance decreases.  She is more likely to resist politely or go along with his sexual advances.
  2. When she is uncertain about her own wishes, she offers only polite resistance.
  3. When she is in shock, she becomes increasingly passive.

Women especially, suffer from politeness.  Because they have been trained not to hurt anyone’s feelings, they become too passive when they are confused or uncertain.  They want men to like them.  For some women, particularly those with a history of childhood sexual victimization, their appraisal of a situation may be faulty.  They may misread a man’s sexual intentions.

I have listened to many, many stories of unwanted sexual behavior, coercion and assault.  These accounts come from smart, savvy women who, too often, say that they ignored their own wishes because, “I didn’t want to hurt his feelings,”  “I wasn’t sure,” or  “I didn’t want to be rude.” And then, some guy reads her passivity as consent and the hunt is on.  This is what I mean when I say that  the lovely qualities of politeness and kindness towards other people have a dark side – they prevent people from acting on their own behalf.

The above examples are extreme, I know, but tone them down and you still have a problem of ignoring your own well being because you are reluctant to make some other person uncomfortable, angry, frustrated or embarrassed.

Failure to Launch

Holiday Host/Hostess Disorder

Since we are into the holidays, I have a great disorder (it is imaginary) for you to think about – Holiday Host or Hostess Disorder, now referred to as HHD. Here are the symptoms of a person afflicted with HHD: dreamstimefree_1078352 dreidels

*Cleans maniacally before the holiday

*Buys excessive amounts of food, decorations and other holiday paraphernalia

*Feels intense anxiety before holidays

*Gets grumpy at others who do not display the same slavish devotion to holiday madness

*Loves/Hates having people over because the Host or Hostess will be highly stressed

*Feels criticized if anything is less than perfect (and nothing is perfect)

*Feels totally inadequate if one olive is missing a pimento (or something equally goofy)

Sure, I made up this disorder. You will not find it anywhere else. I just wanted to point out that the holidays are a time to be together and NOT let your perfectionism get in the way. People want to be with you, not with your perfect cheese ball or your Santa plates. I like pretty table decorations and a great meal just like everyone else and I do feel bad when I drop the dessert mold on the floor. Nevertheless, it is a mistake to confuse the wrapping with the real gifts of the season.

Does Shopping Therapy Work?

In honor of Black Friday, let’s talk about retail therapy.  You feel blue, maybe a bit depressed, and head for a retail store (or go home, put on your bunny slippers, and get online) to do some shopping to cheer yourself up.  Does it work? In a word, “yes.”  In a smaller word, “no.”

Retail therapy doesn’t work when the problem is serious or your need is great.  It can’t feel an empty space inside you.  You have to do some interior work before a new CD or pair of shoes makes life feel better longer than the time it takes to get shoes out of the box.

However, don’t dismiss shopping therapy. We all need rewards when we have worked hard and those shoes can really hit the spot.  Each time you wear them, you will be reminded that you are capable of success.  We also need treats when life deals us a lousy turn.  The treats are soothing; they don’t make up for a bad review at work or a break up but, a hot fudge sundae, an afternoon movie with a bucket of popcorn, or a new sweater can raise our spirits sufficiently to go back and face the world again tomorrow.

What Do I Say? Cosa Dovrei Dire?

My book with Charlie Waehler, What Do I Say? The Therapist’s Guide to Answering Questions has been translated into Italian. Here it is…………. Tell all your Italian friends.securedownload

False Memories Last A Long Time

We rely so heavily on our memories but how accurate are they? Do false Dreamstimememories last? And do they last as long as true ones? I recently read a study completed by several of the keynote speakers at the European Congress of Psychology who wondered whether experimentally created false memories would persist for an extended period (one and a half years).

The study: 342 subjects participated in a three-stage misinformation procedure (saw the event slides, read the narrations with misinformation, and then took the memory tests). The initial tests showed that misinformation led to a significant amount of false memory. One and a half years later, the participants were tested again. About half of the misinformation false memory persisted, which was the same rate as for true memory. These results strongly suggest that brief exposure to misinformation can lead to long-term false memory and that the strength of memory trace was similar for true and false memories.

It’s scary. This means that lies or misinformation resulting in creation of false memories remains just as long as the real thing. The implications for what children are told or what they come to mistakenly believe is disturbing.

Source:Bi Zhu, Chuansheng Chen, Elizabeth F. Loftus, Qinghua He, Chunhui Chen, Xuemei Lei, Chongde Lin and Qi Dong. 2011 John Wiley & Sons, Ltd.