1, medication to control symptoms The core symptom of OCD is anxiety, which can cause extreme discomfort and even a sense of insanity. Therefore, early in the treatment of OCD, especially the more severe OCD, emphasis is placed on medication to quickly and effectively control uncomfortable symptoms, which is the key to building patient trust and treatment continuation, and if the patient’s painful symptoms cannot be effectively controlled within 8 weeks, talk about what “Morita therapy” and “Freud” are all in vain. Yang Lejin, Department of Psychology, Qilu Hospital, Shandong University Many people do not understand how OCD can be treated by medication. At present, the pathogenesis of OCD is unclear. A large number of clinical studies have found that OCD may be associated with neurotransmitter imbalance in the brain, including: 5-HT hypofunction; DA dysfunction, etc. All anti-OCD drugs currently on the market are antidepressants and anxiolytics, while some antipsychotics can also treat obsessive-compulsive symptoms. These drugs on the one hand act on a variety of neurotransmitters such as 5-HT and NE in the brain to reduce the patient’s anxiety level and relieve the negative emotions brought about by the obsessive-compulsive symptoms themselves; on the other hand, by directly interfering with the levels of these neurotransmitters, thus reducing obsessive-compulsive thinking and compulsive behavior. Anti-compulsive medication should follow the principle of adequate amount and duration of treatment. Adequate dosage: The dosage of anti-compulsive medication is usually higher than that for depression, as indicated in the medication instructions. Therefore, it is important to closely monitor the side effects of medication and regularly test the liver and kidney function during the course of medication. Adequate course of treatment: Generally, it is divided into 3 phases: Acute phase: medication is evaluated once in 6-8 weeks, medication use starts with low doses and gradually increases to therapeutic amounts to rapidly reduce the frequency and severity of symptoms, help patients build treatment confidence and improve the quality of patient survival. Consolidation phase: When the patient’s symptoms are relieved or disappear after 4-8 months of treatment, medication is continued to prevent recurrence, while the psychotherapy phase is started. Maintenance phase: The purpose is still to prevent recurrence of symptoms. After a period of maintenance treatment, the drug dose can be gradually reduced to discontinuation according to the patient’s condition, but the early signs of relapse should be closely monitored and the original treatment dose should be quickly restored once the symptoms are found to recur. 2, the criticality of psychotherapy: the treatment of OCD, medication is only the beginning of treatment, and the key point of treatment is to enter the consolidation period after the start of psychotherapy. Usually clinically used are family interpersonal therapy, cognitive-behavioral therapy, exposure combined with response prevention method, etc., and will not be repeated here. Self-psychological treatment of OCD 1. Re-awareness: The origin of OCD is the “three no’s” in our heart. Therefore, the root of the existence of compulsions is due to one’s own counter-compulsions, i.e., the perception that one’s compulsive thoughts and behaviors are pathological. You may be thinking, “Why don’t people do this, and why do I do it? In fact, you are only demanding and binding yourself in the way most people behave, in other words, maybe this compulsive behavior is pathological for others, but definitely beneficial for you. When you use this kind of thinking or behavior to achieve your purpose, you start to criticize it harshly, isn’t it a bit like “the rabbit dies, the dog is cooked, and the bird is hidden”? Reconceptualizing yourself and your behavior and re-accepting these so-called obsessive-compulsive symptoms instead of the name of the disease is the first step to start treating your compulsions. 2, looking for the root cause: According to the data, nearly 70% of OCD patients are obsessive-compulsive personality, personality, but also become a lot of people continue their compulsive behavior pretext and excuse, but why will appear obsessive-compulsive personality? What are the characteristics of an obsessive-compulsive personality? They are unwilling to continue their self-exploration. For example, what is the purpose of pursuing perfection and doing everything perfectly? “For others to see” is probably the most frequent answer. Why don’t we go further and ask ourselves, what is the purpose of making others look up to us? In fact, you just hope that through the affirmation of others and your achievements to consolidate their own self-confidence at all times, in terms of self, you are always used to denying yourself, so you need to look to the outside world, through the affirmation of others and achievements to establish a balance, I am sorry to tell you that this is very insecure. The perfect character leads you to pursue something better, you are always reflecting, self-criticism, in the conscientious rush forward, and ignore the good things behind you, so when you always focus on what you lack, you will absurdly find that you still have nothing, you are full of eyes and heart is your own defects and fate of the many, which will aggravate your insecurity and uncertainty, so then, your dissatisfaction is further intensified. In fact, your attention deceives you. Human attention has a width, just like the focus function of a camera, when you focus on something, other things naturally become the background and are ignored by everyone. But ignoring doesn’t mean not existing, just like yourself, you are still the one who is capable, not resigned to others, not resigned to the status quo, just in your self-denial process, they are ignored. Therefore, the root of OCD lies in the acceptance and affirmation of the self, people give it a name: self-confidence! 3, the specific implementation: the reason is good, things are difficult to do. For example, self-confidence, we all know it is a good thing, but how to build a sense of achievement, how to affirm the self? Before doing something, you have not looked ahead, fearful? You are always humble and cautious, or you always will not refuse. These are all forms of lack of self-confidence. The first step: you can try to correct yourself from the mind first, in a month’s time, without denying yourself, and do not hesitate to reject what hurts your interests. Do not worry that this bold attempt will make you embarrassed and embarrassed, and do not worry that you will be frivolous and out of control. The compulsive personality itself is very powerful in its self-discipline, and this imprisoning force is gradually built up over a long period of growth; your temporary overkill will not free you from harnessing this force. This exercise simply allows you to experience what it is like to respect your self. Step 2: Record your growth notes, either in one sentence or in a book of 10,000 words. Try to record your progress every day, note that you are only recording your progress truthfully, and go through your notes at regular intervals every weekend. It will allow you to retrieve what you have forgotten by your “sense of choice” and allow you to reevaluate and reposition yourself. Generally a habit takes about three weeks to develop, so when you just start the project there are always many reasons to pause or terminate it, I hope you can stick with it for three weeks, no reason, just do it well, maybe you will find yourself a completely different side. Step 3: Shift your focus. We can’t guarantee that every day is on track and that we can’t avoid the potential hazards and risks of life. In fact, we make a logical mistake when we carefully protect ourselves from those frustrations and pains. It’s not the events themselves that make people frustrated and miserable at all, but the perspective from which we approach them. So unfortunately, when you can’t avoid these bad experiences, try shifting your perspective a bit. Any fun, enriching action will do, preferably your own hobby, such as walking, jogging, hiking, playing basketball and other aerobic activities. On the one hand, they allow you to take a break from the clutter of chores and rethink things themselves; on the other hand, they allow you to temporarily get rid of negative emotions that interfere with your judgment. This “escape” allows you to get away from the source of stress, thus reducing your stress response, but “escape” does not mean cowering, but only a roundabout tactic in the way. In the use of this strategy, many people will produce habitual diversion, which can only be a self-indulgent. Step 4: Behavior shaping, willpower training is the core part of OCD treatment. In layman’s terms, OCD is a result of not having strong willpower to harness your own nature, but instead, being coerced by your own character that demands perfection. So, there is nothing wrong with your imagination and decision making at all, you may get more and more imaginative as your condition gets worse and your goals pile up more and more bloated, but unfortunately, you still can’t take even the first step when you find out after numerous votes. Go repeat the same thing every day, like waking up at a regular time, taking a regular walk, etc. They allow you to improve your ability to execute. At the same time, give yourself a reward in a timely manner after you have completed your task very well, and never be stingy, and have spiritual and material rewards go hand in hand. This will keep your behaviors reinforced, and they appear and repeat with increasing frequency. Finally, OCD is by its very definition a symptomological descriptor, and when you think of it as an illness, you may have a hard time getting rid of the nasty experience, and when you think of it as just a symptom, you may quickly forget about it. So the treatment of OCD should not be overly obsessed with medications and doctors, but it is you who plays the key role.