Breaking free from Pure Obsession

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Slide 1: 

Breaking free from Pure Obsession

To want to forget something is to think of it. : 

To want to forget something is to think of it. بفكر فيك وأنا ناسي

Slide 3: 

There is a form of OCD mainly involves thoughts-introsive, horrific thoughts and images of causing danger or harm to others. The thoughts are experienced as part of one’s own mind and cause great distress, fear, and shame. Some people with pure obsessions have no overt compulsions, many others have mental rituals to counteract and neutralize the discomfort of their unwanted introsive thoughts.

examples : 

examples

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Paula, 25-Ys old, was playing with her beloved cats while smoking a cigarette. Out of the blue, the thought popped into her mind of burning a cat with the cigarette. The thought horified her, prompting intense feeling of guilt. She wondered over and over, “How can I think such thoughts… May be I don’t really love my cats. I must be a horrible person to think of doing that” From then on, caring for her cats was nerve-wracking because she felt that her cats were in some danger being near her. She avoided touching her animals except when it was absolutely necessary. examples

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Anthony, a 23 Ys old busness student, while sitting in a large lecture class, had the intrusive thought that should he open his mouth to ask a question, he would lose control and vomit in front of the entire class Not normally a shy person, Anthony had always participated actively in school classes from a young age. However , the intrusive thoughts so frightened him that he now avoids asking questions in class and dreads being called upon by his professors. examples

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Steve is a 48-Ys-old, devoutly religious teacher, who has had disturbing, intrusive thoughts involving images of jesus & Marry. Often his thoughts involved sexual encounters with them. The images were embarrassing and humiliating. He felt extremely guilty, especially since they tended to increases when he was in church. Feeling unworthy, he avoided church examples

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Robert, a 33-Ys-old physician, had been married a year when his wife gave birth to their first child. One night, while watching his baby girl sleeping peacefully, the intrusive image of touching the child’s genitals popped into his mind. Feeling guilty, embarrassed, and ashamed, he avoided any physical contact with the child. His wife began to wonder why he refused to change the baby’s diaper or even hold her. examples

The nature of pure obsessions : 

The nature of pure obsessions

People with pure-O have an abnormal reaction to normal thought processes : 

People with pure-O have an abnormal reaction to normal thought processes Everyone experiences unwanted, introsive thoughts at some time. People with pure obsessions seem to have an extreme oversensitivity to these normaly occuring “weird” thoughts عجيبة-غريبة. The obsessive compulsive cycle arises from striving to alleviate the guilt and discomfort of having the thoughts. These results in attempts to aviod, supress, or escape the introssive thoughts These attempts amplify and strenghten the toughts, making them worse and worse.

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People with pure-O are not in danger of acting out these horrible thoughts. People who do act on such thoughts may have what is known as antisocial personality disorder; Lacking a conscience tend not to warry about bad thoughts their action are not disturbing them having lack of remorce doing bad things committing crimes People with pure-O are highly unlikely to carryout the horrific acts and urges that pop into their heads

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People with pure obsession; tend to be excessively rule-bound concerned with doing things rights fear and avoid doing things wrong tend to be perfectionists. unforgiving standards to everything they think, do > and say People with pure-O are highly unlikely to carryout the horrific acts and urges that pop into their heads

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Antisocial personality دول مش هاممهم المصايب اللي عملوها People with pure obsession ودول مرعوبين من البلاوي اللي خايفين يعملوها People with pure-O are highly unlikely to carryout the horrific acts and urges that pop into their heads

Rituals make it worse : 

Rituals make it worse To control the anxiety and disfomfort, people with pure obsessions carryout subtle neutalization strateiges. Examples: repeating a silent paryer over and over subvocalizing a statement such as: أنا مش عايز دا يحصل أنا بريء من الكلام ده ليوم القيامة أنا مستحيل اعمل كده والله العظيم أنا مش كده والله ما كان قصدي كده (الطلاق) These are compulsive thoughts meant to magically undo the negative thought.

Slide 15: 

The introsive thoughts tell us nothing about: a person’s character true desires or intentions All they mean is that the person with the thoughts has a disease called OCD

Anatomy of pure obsession : 

Anatomy of pure obsession Intrusive thoughts Negative appraisal Increased anxiety and Overcontrol Vigilance covert rituals testing Temporary anxiety reduction Cycle starts over again حذر

Intrusive thought : 

Intrusive thought A thought, image, or urge; kind; disturbing humilating مذل أو مخزي embarrassing مربك horrifying مروع content; sexual aggressive causing; guilt shame negative appraisal

examples : 

examples If you are a lover of children, the intrusive thought will be “what if I actually harmed my childern” If you are a religious or moral person, the intrusive thoughts may involve “blasphemous religious سب themes with strong sexual or aggressive content If you tend to be non-violent, OCD themes will be aggressive and hostile If you pride yourself on being responsible person, introsive thoughts and urges are commeting irresponsible acts, such as setting a house on fire or pushing an innocent into oncoming traffic If you are secure in your heterosexual gender identity, OCD may fill your mind with images of homosexual activity

Negative appraisal (thought action fusion) : 

Negative appraisal (thought action fusion) Many people with OCD suffer from the cognitive error called “thought-action fusion” in which thoughts are experienced & felt as if they were the same as action Increased anxiety & worry

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I’m having a bad thought-that must mean I’m bad. I wouldn’t be having these thoughts if I wasn’t truly bad! The more bad thoughts I have, the more proof I have that I’m likely to do something bad If I don’t try hard to prevent harm from happening, it is as bad as doing something bad on purpose Since it is likely that I’m going to do something bad, I’d better watch out for it. I may even have to make sure that others are protected from my bad actions Negative appraisal (thought action fusion) Increased anxiety & worry

Overcontrol : 

Overcontrol People with pure obsessions attempt to avoid, suppress, or neutralize their anxiety about their thoughts by using the following strategies: vigilance covert rituals testing Increased anxiety & worry

Overcontrol : 

Overcontrol The mind becomes nervously preoccupied with “catching the bad thought” The thoughts become overly important. The mind ruminates about the next occurrence of the thoughts More and more energy is tied up in preventing and controlling them Attempts to suppress or stop the thoughts become more and more and more elaborate. Increased anxiety & worry vigilance

Overcontrol : 

Overcontrol to “undo” or neurtralize the thought, such as: Silent praying-”forgive me God for having that thought” Undoing rhymes or phrases-”I really don’t want to do that” Balancing the the thought with a “correct” thought or image Silent counting, using “good” numbers Increased anxiety & worry Covert Rituals

Overcontrol : 

Overcontrol Many pateint develop “testing” strategies to reassure themselves about their intrusive thoughts. These are persistent, repetitive , and sometimes odd behaviors. Paula, hold a knife Testing is considered a neutralization strategy that brings only temporary relief from the anxiety of the thought. Increased anxiety & worry testing

4 steps to break free from pure obsession : 

4 steps to break free from pure obsession When I let the thought be, they let me be سيب وانا اسيب معاكسة البنات

Slide 26: 

Intrusive thoughts worksheet 4 steps to break free from pure obsession Step 1. write it down

Slide 27: 

The OCD thought is senseless and means nothing Rate your beliefs using this 8-point scale: 0 = no chance at all 4 =pretty strong chance 8 =I’m extremely likely to act upon my intrusive thoughts 4 steps to break free from pure obsession Step 2. remind yourself: “ I’m not my OCD thoughts”

Slide 28: 

Intrusive thought rating worksheet most people with pure obsession initially will rate their beliefs between 4 & 8. this indicate the presence of thought-action fusion and the tendency toward doubt, which are hallmarks of OCD Remember, thought-action fusion is the belief that just thinking a bad thought, will cause bad things to happen. 4 steps to break free from pure obsession

Step 3. accept the presence of thought & resist the urge to perform avoidance-neutralization strategies : 

Step 3. accept the presence of thought & resist the urge to perform avoidance-neutralization strategies You allow the thought to be there without judgment Ceasing all judging of your intrusive thoughts takes effort, but it will enhance your ability to be an objective observer of your thoughts without getting too caught up in them 4 steps to break free from pure obsession

Step 4. confront your thought: Do exposure exercises to habituate to the thought’s presence : 

Step 4. confront your thought: Do exposure exercises to habituate to the thought’s presence Intrusive thoughts are frequency with emotions of fear & dread Classic physiological responses to fear may be present: racing heart, sweaty palms &dry mouth The process of “desensitizing” your brain to the thoughts involves exposing yourself to the bad thoughts until the brain habituates, i.e. to have the thought without the accompanying discomfort 4 steps to break free from pure obsession

Step 4. confront your thought: Do exposure exercises to habituate to the thought’s presence : 

Step 4. confront your thought: Do exposure exercises to habituate to the thought’s presence Observe how your reaction to the thought after 15 repetition Pay attention to your internal “feeling” reaction to the thought now Because of constant repetition, your nervous system has become “bored” This is how it works; by repeating a feared thought, it loses its power & imact over you. 4 steps to break free from pure obsession

Thought Habituation Exercise : 

Thought Habituation Exercise to help you hold an uncomfortable thought in your mind without feeling undue discomfort. Exercise 1. written exposure Exercise 2. taped exposure Exercise 3. self-talk strategies Exercise 4. intensive taped exposure for thought action fusion Thought Habituation Exercises

Thought Habituation Exercises : 

Thought Habituation Exercises A pad of lined paper & divide the paper in half so that are two columns. On the left side, write the thought down. Note your SUDS level (0-100) and write it in the right column Resist avoiding, distracting, or ritualizing away the anxitey of the thought Go back to the left colmn, go down to the next line and write the identical thought again. Rate your SUDS level in the right column again. Repeat step 1-3 until your SUDS leve dimishes down to 20-30. you may have to write the thought down fifty or more times before your SUDS level starts to reduce. When this happens, go to another thought, an repeat step 1-3 Exercise 1. written exposure

Thought Habituation Exercises : 

Thought Habituation Exercises Using a cassette tape recorder (MP3 player), record the thought(s) by saying it over and over about 30 times Rewind the tape and listen to the thought repeated over and over. Be aware of your tendency to avoid listening or to distract yourself from listening Note your SUDS level after each listening. Write it down. Rewind and listen again. Repeat step 1-3 until your SUDS goes down to a level of 20-30 Exercise 2. taped exposure

Thought Habituation Exercises : 

Thought Habituation Exercises No one ever died or lost control merely from the presence of a thought ! It is the interpretation of the meaning of the thought that determines how people behave and what they actually do. Although it is unrealistic to expect your intrusive thoughts to go away magically, you will experience significant relief once you have understood that a thought is just a thought! Nothing more. Remember “whatever you resist, persists” When you give up trying so hard to control the activity in your head, the ocd will lessen. Exercise 2. taped exposure

Thought Habituation Exercises : 

Thought Habituation Exercises Jeffery Schwartz, in Brain Lock, the concept of the “impartial observer المشاهد النزيه” capacity all human beings have to observe their own thoughts, feelings, and behavior. You can be an impartial observer of your own thoughts too. Allow the intrusive thoughts to be there, don’t give them control For example:… Exercise 3. self-talk strategies

Thought Habituation Exercises : 

Thought Habituation Exercises For examle:… Exercise 3. self-talk strategies

Thought Habituation Exercises : 

Thought Habituation Exercises For people who overestimate the likelihood of their doing harm to others This exposure is highly stressful,it is advised to be done in the presence of a mental health professional A portable cassette; walkman or MP3 is most useful Prepare the taped expusre exercise Listen to the tape in presence of the person who is the target or object of feared harm or danger Listen to the tape. Allow your anxiety to rise. Resist avoiding, suppressing, or ritualizing. For at least 45-min. reduce your SUDS level to below 20 through habituation. use daily exposure practice. Monitor your daily progress Exercise 4. intensive taped exposure for thought action fusion

Dealing with Covert Rituals : 

Dealing with Covert Rituals These are mental compulsions include repetitious prayer, phrases, words, counting numbers, recalling the past, & thought balancing(good thought against bad thought) They are: compulsive repetitive thought patterns done as a direct response to an obsessive thought. Their purpose is to neutralize the discomfort of obsessive thoughts

Dealing with Covert Rituals : 

Dealing with Covert Rituals Ritual delay: put off the performance of the covert ritual. Put it for a few minutes, or hours, or day. Thought stopping: Some helpful techniques

Dealing with Covert Rituals : 

Dealing with Covert Rituals Does this thought cause anxiety? If your answer is “yes” it is an obsessive thought. The overall self-help strategy is to confront, invite, encourage, and face the discomfort Does this thought relieve anxiety? if your answer is “yes” it is a mental compulsion. the overall self-help strategy is to block, reduce, or change. Difference between obsessive thoughts and mental compulsions

Slide 42: 

Pure-O are not more difficult to help than obsession with covert compulsions By using the techniques described above with the right medications, you can break free from pure obsessions The reward will be;- relief from frustration - stop the constant noise in your mind Will your pure obsession go away completely, and forever? probably not You can learn to live more comfortably with your annoying thoughts Thoughts can become mere occasional background noise, Learn to enjoy life once again

gawab@tabibnafsany.com : 

gawab@tabibnafsany.com

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