Before we talk about OCD, let’s talk about obsessive-compulsive phenomena: almost all of us have probably experienced obsessive-compulsive phenomena: for example, sometimes there is a song that keeps playing in your head, or when you leave the house you are always worried about whether you forgot to lock the door. Is the gas left on? You may even go home to check. Children and teenagers can also experience obsessive-compulsive phenomena, such as children walking on the road and having to take four steps and jump one step to continue walking.
If the compulsion is mild, short-lived, and does not cause severe anxiety or other emotional disorders, it is a normal expression.
OCD, on the other hand, is a group of neurological disorders with obsessive-compulsive symptoms (mainly including obsessive-compulsive ideas and compulsive behavior) as the main clinical manifestation. Its main symptoms are characterized by the recurrence of certain ideas and certain behaviors.
There was a patient who washed his hands for 3-4 hours, and his hands were broken, but he could not stop; there was another patient who had to check repeatedly before going out, and he could not leave the house for 3 hours, so he did not go out for the whole day. It can be said that OCD patients are very painful, and it is not uncommon to see patients who are unable to work because of OCD. The cause of OCD is still a mystery, but what we do know is that it is always related to personality traits, previous traumas (especially sexual ones), and stressful events.
A survey in the United States showed that the prevalence of OCD was about 1%, and a survey of 12 regions in China in 1982 showed that the prevalence of OCD was 0.3 per 1,000. In fact, this figure is much lower than the actual prevalence rate. Combined with clinical practice, it is estimated that there are 5-10 million people with OCD in China, with a prevalence rate of about 5‰-10‰. 80% of OCD cases develop before the age of 25, with more men than women.
In layman’s terms, OCD can be explained by the simple terms “thinking more and doing less” and “thinking less and doing more”.
Why does a person have OCD? Because he thinks too much and does too little. OCD sufferers can think about it, you yourself are not spending 90% or more of your time all day long thinking about those boring and unanswered questions, while eating, studying, working, playing and so on these things are a little distracted? And why does a person not have OCD? Because he spends at most 50% of his time thinking, and 50% of his time doing things, and of course even 60%, 70%, 80%, 90% of his time doing things, and is fully engaged in what he is doing.
So, it can be said that there are just two opposite directions between people with OCD and healthy people, one is thinking more and doing less, and one is thinking less and doing more.
The two main reasons why OCD is difficult to treat
OCD is a psychological disorder that is difficult to treat, and the pain it causes is difficult for people who do not personally experience it to understand. In reality, many OCD patients are choosing various psychological, physical and pharmacological treatments to treat their OCD, but the effect of the treatment is sometimes poor, of course, it is not that these treatments are useless, but because the patient does not have a correct understanding of OCD. Here is an analysis of the two main reasons why OCD is difficult to treat.
1. People have compulsive tendencies
The greatest wish in the hearts of people with OCD may be to never have a trace of compulsive ideas in their minds again. This idea is wonderful, but it is also dangerous because the idea that there is no trace of compulsion is a perfectionist idea that will lay a hidden danger for you to come out of the whirlwind of OCD in the future.
In real life, each of us will encounter some frustration, discomfort and the need to make choices, and at this time, each of us will be troubled by this, will continue to think repeatedly in the mind how to deal with these things, especially when we face a major choice, it is possible that this repeated thinking will last longer, in fact, from another point of view this repeated thinking is a kind of In fact, from another point of view, this repeated thinking is a kind of compulsion, so in fact, we all have compulsive tendencies, but those who are healthy they are resolved after the matter, the compulsion will also end.
So people with OCD should give up the perfectionist desire not to have a hint of compulsive ideas appear, because you hold on to it, these inevitable compulsions in life will combine with your OCD to aggravate your symptoms, which is why it is difficult to eradicate OCD, you do not put down, the compulsion simply can not be completely eradicated.
2. Generalization of compulsions
One characteristic of OCD is that it is easy to generalize, which means that at first we have only one idea of compulsion, but later on, there are more and more compulsions, one after another, they may be compulsions at the same time, or they may be compulsions one after another.
The reason for the generalization of compulsions starts with the personality. Generally people who suffer from OCD are more introverted and at the same time perfectionist, sensitive and stubborn. When you have OCD, the symptoms make you more sensitive to the original personality components, so you generalize. Of course, from a behavioral point of view, this is due to the formation of a compulsive habit. From a psychoanalytical point of view, generalization is actually a manifestation of persistent unresolved psychological conflicts.
Give up therapy
It is said that Morita therapy is renunciation therapy, which means that if you give up treatment completely, then your neurosis will be cured. This is a very true statement, and it can be said to be the quintessential word. So many of our patients have taken this statement and given up on the treatment, let the compulsion be compulsive, let themselves indulge in the symptoms of compulsion, and in the end, giving up on the treatment not only does not cure their problems, but also the more they give up the more compulsive.
The reason for this is due to the patient’s generalization and half-hearted thinking. They only understand giving up literally, but they have not deeply considered what kind of giving up is the real giving up.
In fact, a prerequisite for true renunciation is to accept your symptoms, acknowledge them as part of your body, and accept that your current state is the normal state. Because only when you fully accept your symptoms as part of your body can you become desensitized to them and make it easier for you to focus on what you should be doing in objective reality.
For example, who would you say is confused about having two hands on their body? Because everyone has two hands, it’s normal, that’s why you don’t care about it. Therefore, you can only accept the symptoms as normal, then you can really give up the treatment of the symptoms and achieve the real treatment. In fact, from another perspective, giving up treatment is actually forgetting about OCD and desensitizing to the symptoms. The symptoms are forgotten, and then your attention is focused on what you should be doing. And in this way you reach the point of going with the flow and doing what you need to do.
If you don’t accept your symptoms first, then the symptoms are a foreign body to you, and our instinctive reaction to a foreign body is to reject it. So on the premise of rejection, would you say that your renunciation is real renunciation? Giving up under this premise is actually a kind of repression, a focus on another angle of the symptoms.
So if you want to give up treatment, you must first accept the symptoms.
Acceptance of symptoms
The first thing you need to do, whether you have OCD or other mental illnesses, is to accept the symptoms. Of course, we can deeply appreciate the pain that the symptoms bring to our patients, and we also deeply know that our patients are eager to get better as soon as possible, so their lack of acceptance, self-blame, and even hatred of the symptoms is understandable. But the important thing is that, although these are understandable, if you really do this, it is contrary to your original desire to get better as soon as possible.
Let’s use an analogy to illustrate why accepting symptoms is the only way to really get better as soon as possible. For example, if we have a scrape on our hand or foot that leaves a blood clotted scar, what do you think we should do to make the scar disappear from our body? The right thing to do is simply to accept it and not bother with it at all, because when the skin under the scar is completely healed, it will naturally fall off and disappear.
If we compare this scar to OCD, how do our OCD sufferers treat this scar in real life? They are constantly picking at the scar, wanting to remove it instantly and forever, but what is the result of this? The result is that the more they pick, the more they bleed, and the more they pick, the bigger the scar becomes. In the end, the OCD is tightly gouged by the patient.
Therefore, the only thing we can do to face the symptoms that have appeared, and the only thing that can make us get better is to accept it and not treat it as something that will happen, then the symptoms will be reduced a lot in this accommodating mindset of ours, and will gradually disappear in a natural way.
To achieve healing, reasoning is futile. Just as it is not possible to reason that there are no ghosts but still feel fear when walking through a cemetery at night, it is not possible to understand intellectually alone, but only to experience emotionally in order to change. The more concentrated the attention, the stronger the emotion; ignore the nature, but gradually fade; in the same feeling of habit, the emotion becomes dull; to the patient’s distress, worry emotion without comfort, let it develop to the peak, also no longer feel distress and worry. Therefore, patients are required to first acknowledge the reality of their symptoms, not to force changes, to let nature take its course, to recognize the laws of emotional activity, to accept emotions, not to repress and reject them, to let them grow and die on their own, and to cultivate positive and healthy emotional experiences through their own continuous efforts.
And when you have a correct understanding of OCD and understand the essence of renunciation therapy, and still cannot do this on your own, you can seek help from professional psychological institutions, using outpatient therapy, once a week in an outpatient clinic, under the guidance of a doctor with the principles of Morita therapy for interviews and guidance diary, some people get rid of OCD through Morita therapy on this, and some people also need to combine professional psychotherapy methods Some people get rid of OCD through Morita therapy, and some people need to combine it with professional psychotherapy, such as psychoanalysis and cognitive behavioral therapy.
In order to really help the visitors, our clinical psychology department promotes integrated treatment, which means that psychoanalysts also use the techniques of Morita and cognitive-behavioral therapy in the treatment process, and I believe the best answer is the patients we have cured.