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My ideas are constantly changing as I learn. Sometimes they even change midway through writing a post.

Tuesday, July 19

OCD

Here's my response to a reply to another post of mine.

"Most types of anti-anxiety medicine do not work for them, but some do to some extent. Behavioral treatment works on a specific compulsion, but individuals often then move to another one. Few long term studies have been done documenting efficacy of any intervention, and unlike most psychiatric illnesses, serious OCD is remarkably refractory to all forms of treatment." -Michael Golding

I posted the comment as a suggestion to Elliot as to how medicine "might" work by helping thoughts to change indirectly. It seems OCD is a bad example.

I am familiar with people who have OCD-like symptoms (and at least one diagnosed), but not much with their treatment. At least some of them managed to quit things like hand-washing and not pick up any other habits that were a problem (at least they haven't been noticed by them or anyone else yet). By quit, I mean stop doing the action for a while and then eventually stop feeling obsessed about or thinking much about doing the action. It doesn't seem "easy" to do - just possible.

"They fully well know (once explained to them) that washing their hands so frequently actually makes it more likely for them to get an infection, but they still can't stop. So they understand the scientific arguments very well." -Michael Golding

In my experience, having a good understanding of why to stop doesn't always make a habit go away for people who don't seem to have OCD symptoms. It usually takes focusing on some new preferred habit, but I think knowing that the behavior isn't rational is probably a necessary prerequisite (then again, maybe not).

"Interestingly, the same medications which will cause someone to obsess less, will also cause him to think about sex less frequently." -Michael Golding

What sort of medications?

3 comments:

Becky said...

(This comment has been copied over from the Haloscan system to the blogger system)

What I immediately notice about the descriptions you give is not the specific focus (the hand-washing, etc.), but the underlying generalized sense of fear, the idea that the universe is a scary place. Modern psychology and psychiatry seems to have mostly dismissed psychoanalysis in the face of neurology and cognitive / behavioural therapy, but I think this is a mistake.

Sure, the 'talking cure' on its own is not often effective, but mental health professionals need analytic ability to be able to look beyond the surface problems, I think.
acheron_hades | Homepage | 08.03.05 - 3:38 am | #

Becky said...

Are you meaning that the OCD patient might actually have a generalized "fear of the universe" which might be helped with a different kind of therapy? What do you mean by psychoanalysis? Events that created a habit of fear? (I'm just guessing here since I don't know what is specifically meant by psychoanalysis).
Becky

Steve D said...

Are you meaning that the OCD patient might actually have a generalized "fear of the universe" which might be helped with a different kind of therapy?

Yes, I think so, though conventional psychoanalysis probably doesn't go far enough. To intellectually get out of the "scary universe" paradigm one needs some degree of spiritual belief (which is why I think things like The Third Age are important - presenting spirituality in technical terms for 'rational' people who are skeptical of anything too fluffy.)

What do you mean by psychoanalysis? Events that created a habit of fear? (I'm just guessing here since I don't know what is specifically meant by psychoanalysis).

Yeah, tracing back the origins of the fear, normally to parental or social influences. The analysis on its own actually isn't enough, somehow the therapist needs to get their own sense of security (hopefully they have one!) to "rub off" on the patient, but coming to an understanding of causes is often a useful part of the process.

Did you see my post on conscious and unconscious maps? Curing mental illness permanently — and much of what we call 'normal' behaviour is actually a form of OCD (but one can't see that until one has escaped it) — involves correcting and aligning the two sorts of map. Early childhood experiences form the unconscious map, and the conscious map then serves as camoflage / armor for it, so you need to break down the latter to get to the former.