Obsessive-compulsive disorder: fighting yourself

  Obsessive-compulsive neurosis is a type of neurosis with a prevalence of about 0.3 per 1,000, slightly more in women than in men, and with an onset around 15-30 years of age. It is known to be associated with neurobiochemical changes and genetics. The main symptoms of OCD are obsessive-compulsive thoughts and behaviors. Patients doubt the correctness of their own words and actions, and need to repeatedly check to make sure they are correct. “Down with it”. Compulsive intention is a kind of desire against one’s own will, such as standing on a subway platform and wanting to jump down; to “break the sand pot to the end” of a matter, and to ask others to give explanations or assurances is compulsive inquiry; there are also compulsive examination, compulsive counting, compulsive retardation and so on. Patients can have a variety of symptoms, but they all have a strong sense of being entangled, knowing that it is unnecessary and unreasonable, but they cannot get rid of it, so they are particularly distressed and even have depression and anxiety as a secondary effect. However, there are also chronic cases that lack a strong desire to get rid of them, and instead have become accustomed to pathological behavior patterns in order to avoid the anxiety and distress that arise when confronting them. The course of OCD is usually long and can be mild or severe, and when severe, it can seriously affect social functioning.  In 70% of OCD patients, there are some defects in personality before the disease, mainly manifested as too much self-restraint, too serious, to do things well planned, step by step, formal and stereotypical; the pursuit of perfection and good doubt, indecisive, thought can not be relaxed; a strong sense of morality, very concerned about the evaluation of others, more sensitive, etc..  There are many ways to treat OCD, but the combination of medication and psychotherapy is the most effective. Medications need to be taken under the guidance of a psychiatrist. There are also many psychological treatments, such as supportive therapy, cognitive therapy, psychoanalytic therapy, patient-centered therapy, and so on. Morita therapy, in particular, is most effective for OCD patients with neurotic features (i.e., strong self-concern, strong self-reflection, and strong desire for personality improvement).  OCD has a tendency to relapse because of its own character defects. Therefore, it is easy to control the symptoms but difficult to change the personality. In order to be cured without relapse, the patient must make great efforts to overcome the excessive stereotypes, formalities, sensitivities and desire for perfection, and needs to reinvent a new self. This, in turn, is beyond the reach of drugs and requires long-term efforts and the understanding and support of family and friends.