Monday, July 28, 2008

Obsessive Compulsive Disorder

Steps in Psychotherapy

1. Re-label

Impartial Spectator- separating oneself from the streams of thoughts and feelings so that one can observe them and respond consciously instead of mindlessly- essentially the same mental action as the ancient Buddhist concept of 'mindful awareness'.

At the approach of an unwanted impulse, one should consciously take a note of of it and assertavely re-label it - "that is not something I really wish to do- it is just the prompting of a compulsion I want to be rid of".

2. Re-atribute

Affirm the true source of that urge. "It is not me, it is my OCD". Impress on the mind- the brain is generating this signal out of habit. It is a message that need not be acted upon.

3. Re-focus

To overcome compulsions, one then needs to refocus- to turn the attention away from the unwanted message by engaging in another activity.

Dr Shwartz suggests a '15-minute rule'. Find something wholesome that you enjoy doing and switch to it for at least 15 minutes. Hobbies are excellent choice for refocussing as are physical sports or exercising, reading, music or mentally absorbing game. After 15 minutes of new activity, introspect again. Has the urge diminished? "...because you are working to change the chemistry of brain".

4. Re-value

Revalue the meaning of one's unwanted impulses- "what a terrible person I must be for having such bad thoughts as nothing more than false messages coming from the brain ?".

The key is to realize that the 'thought is happening inspite of your will, not because of it'!

* Adapted from 'Brainlock'- Lawrence Martein, UCLA Medical School
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