Exposure Response
Exposer and response are for behavior such as excessive washing of hands, turning locks an amount of times, and other types of rituals you may have before or after doing something.
You expose yourself to the things that trigger your compulsions. The trick is to wean yourself from that compulsion.
If you wash your hands for ten minutes, the next time do it for only nine then eight and so on.
If you need to turn a lock ten times, the next time do it only nine.
If you have to have things in a specific way such as lining things up by height or facing a specific way, force your self to leave one item out of place, then perhaps two. Reducing the actions you do relieve the anxiety little by little.
Then you are asked to refrain from the compulsive behavior you’d usually perform to reduce your anxiety. For example, if you are a compulsive hand washer, you might be asked to touch the door handle in a public restroom and then be prevented from washing. As you sit with the anxiety, the urge to wash your hands will gradually begin to go away on its own. In this way, you learn that you don’t need the ritual to get rid of your anxiety - that you have some control over your obsessive thoughts and compulsive behaviors.
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2. Cognitive therapy focuses on the catastrophic thoughts and exaggerated sense of responsibility you feel. A big part of cognitive therapy for OCD is teaching you healthy and effective ways of responding to obsessive thoughts without resorting to compulsive behavior.
24 Therefore whosoever heareth these sayings of mine,
and doeth them, I will liken him unto a wise man, which built his house upon a rock
25 And the rain ascended, and the floods came, and the winds blew,
and beat upon that house; and it fell not:
for it was founded upon a rock.
26 And everyone that heareth these sayings of mine,
and doeth them not, shall be likened unto a foolish man,
which built his house upon the sand:
27 And the rain descended, and the floods came, and the winds blew,
and beat upon that house; and it fell: and great was the fall of it. Matt 7:25-27
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Pray to God in times of stress (Psalm 69:1–36)
God is a refuge in times of stress (Psalm 62:1–8)
Wait upon the Lord (Isaiah 40:30–31)
God is always with us (Romans 8:31–39)
God cares about our stress (2 Corinthians 4:8–12)
Don’t let stress cause you to worry (Philippians 4:4–9)
Delegating work can alleviate stress (Exodus 18:13–26)
OCD - Obsessive Compulsive Disorder
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OCD is an anxiety disorder characterized by uncontrollable unwanted thoughts and repetitive, ritualized behaviors you feel compelled to perform. If you have OCD, you probably recognize that your obsessive thoughts and compulsive behaviors are irrational - but even so, you feel unable to resist them and break free. Like a needle getting stuck on an old record, obsessive-compulsive disorder (OCD) causes the brain to get stuck on a particular thought or urge. For example, you may check the stove 20 times to make sure it’s really turned off, or wash your hands until they’re scrubbed raw. Just because you have obsessive thoughts or perform compulsive behaviors does NOT mean that you have obsessive-compulsive disorder. With OCD, these thoughts and behaviors cause tremendous distress, take up a lot of time, and interfere with your daily life and relationships
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Common obsessive thoughts:
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Fear of being contaminated by germs or dirt or contaminating others
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Fear of causing harm to yourself or others
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Intrusive sexually explicit or violent thoughts and images
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Excessive focus on religious or moral ideas
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Fear of losing or not having things you might need
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Order and symmetry: the idea that everything must line up “just right”
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Superstitions; excessive attention to something considered lucky or unlucky
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Common compulsive behaviors:
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Excessive double-checking of things,
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Counting, tapping, repeating certain words, or doing other senseless things to reduce anxiety
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Spending a lot of time washing or cleaning
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Ordering or arranging things “just so”
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Acute praying excessively or engaging in rituals triggered by religious fear
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Accumulating “junk” - hoarding and other disorders
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However, people with hoarding symptoms are more likely to also be suffering from other disorders, such as depression, PTSD, a specific phobia, skin picking, kleptomania, ADHD, tic disorders, or compulsive buying.
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If you or a loved one has OCD, tell your doctor about any symptoms of hoarding, difficulty discarding junk, or obsessing about losing things.
OCD symptoms in children
While the onset of obsessive-compulsive disorder usually occurs during adolescence or young adulthood, younger children sometimes have symptoms that look like OCD. However, the symptoms of other disorders, such as ADD, autism, and Tourette’s syndrome, can also look like obsessive-compulsive disorder, so a thorough medical and psychological exam is essential before any diagnosis is made. (Source: Journal of Psychiatric Research)
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Therapy as treatment for obsessive-compulsive disorder (OCD):
There are two ways of dealing with OCD: one is by medication, the other is cognitive-behavioral therapy.
One particular class of medication is serotonin reuptake inhibiters (SSRIs), Clinifermean, (inafrenil). Selective SRIs include Fluoxetine (Prozac), phlewoxameen (lewvox), paraxial, sertraline (Zoloft), citalopram (celexa), talapran (Lexapro).
These are effective but with side effects.Antidepressants are sometimes used in conjunction with therapy, although medication alone is rarely effective in relieving the symptoms of OCD.
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The most effective treatment for obsessive-compulsive disorder is often CBT Exposure Response.
Four steps for conquering symptoms of OCD
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Psychiatrist Jeffrey Schwartz, author of Brain Lock: Free Yourself from Obsessive-Compulsive Behavior, offers the following four steps for dealing with OCD:
RE-LABEL – Recognize that the intrusive obsessive thoughts and urges are the result of OCD. For example, train yourself to say, "I don't think or feel that my hands are dirty. I'm having an obsession that my hands are dirty." Or, "I don't feel that I have the need to wash my hands. I'm having a compulsive urge to perform the compulsion of washing my hands."
RE-ATRIBUTE – Realize that the intensity and intrusiveness of the thought or urge is caused by OCD; it is probably related to a biochemical imbalance in the brain. Tell yourself, "It's not me—it’s my OCD," to remind you that OCD thoughts and urges are not meaningful, but are false messages from the brain.
RE-FOCUS – Work around the OCD thoughts by focusing your attention on something else, at least for a few minutes. Do another behavior. Say to yourself, "I'm experiencing a symptom of OCD. I need to do another behavior."
RE-VALUE – Do not take the OCD thought at face value. It is not significant in itself. Tell yourself, "That's just my stupid obsession. It has no meaning. That's just my brain. There's no need to pay attention to it." Remember: You can't make the thought go away, but neither do you need to pay attention to it. You can learn to go on to the next behavior. Source: Westwood Institute for Anxiety Disorders
Family therapy for OCD treatment
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Because OCD often causes problems in family life and social adjustment, family therapy can often be beneficial.
Family therapy promotes understanding of the disorder and can help reduce family conflicts. It can motivate family members and teach them how to help their loved one.
Group therapy for OCD treatment
Through interaction with fellow OCD sufferers, group therapy provides support and encouragement and decreases feelings of isolation.
Self-help for OCD tip: Challenge obsessive thoughts and compulsive behaviors.
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If you have (OCD), there are many ways you can help yourself in this addiction:
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Refocusing your attention
When you’re experiencing OCD thoughts and urges, try shifting your attention to something else. You could exercise, jog, walk, read. The important thing is to do something you enjoy for at least 15 minutes in order to delay your response. At the end of the delaying period, reassess the urge. In many cases, the urge will no longer be quite as intense. Try to delay for a longer period. The longer you can delay the urge, the more it will likely change.
Anticipate urges before they arise
This can help ease them. For example, if your compulsive behavior involves checking that doors are locked, windows closed, or appliances are off, try to lock the door or turn off the appliance with extra attention the first time. Create a solid mental picture and then make a mental note. Tell yourself, “The window is now closed,” or “I can see that the oven is turned off.” When the urge to check arises later, you will find it easier to relabel it as “just an obsessive thought.”
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Create a worry period
Rather than trying to suppress - reschedule them. Plan one or two 10-minute “worry periods” each day that you can devote to obsessing. Choose a set time and place (e.g. in the living room from 8:00 to 8:10 a.m. and 5:00 to 5:10 p.m.) that’s early enough it won’t make you anxious before bedtime. Focus only on negative thoughts or urges. Don’t try to correct them. At the end of the worry period, take a few calming breaths, let the obsessive thoughts or urges go, and return to your normal activities. The rest of the day, however, is to be designated free of obsessions and compulsions.
hen thoughts or urges come into your head during the day, write them down and “postpone” them to your worry period. Save it for later and continue to go about your day. Go over your “worry list” during the worry period. Reflect on the thoughts or urges you wrote down during the day. If the thoughts are still bothering you, allow yourself to obsess about them, but only for the amount of time you’ve allotted for your worry period.
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Write down your obsessive thoughts or worries
Keep a pad and pencil on you, or type on a laptop, smartphone, or tablet. When thoughts or urges come into your head during the day, write them down and “postpone” them to your worry period. Save it for later and continue to go about your day. Go over your “worry list” during the worry period. Reflect on the thoughts or urges you wrote down during the day. If the thoughts are still bothering you, allow yourself to obsess about them, but only for the amount of time you’ve allotted for your worry period.
When you begin to obsess, write down all your thoughts or compulsions. Keep writing as the urges continue, aiming to record exactly what you're thinking, even if you’re repeating the same phrases or the same urges over and over. Writing it all down will help you see just how repetitive your obsessions are. Writing down the same phrase or urge hundreds of times will help it lose its power.
Writing thoughts down is much harder work than simply thinking them, so your obsessive thoughts are likely to disappear sooner.
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Record obsessions
Focus on one specific worry or obsession and record it to a tape recorder, laptop, or smartphone. Recount the obsessive phrase, sentence, or story exactly as it comes into your mind. Play the tape back to yourself, over and over for a 45-minute period each day, until listening to the obsession no longer causes you to feel highly distressed. By continuously confronting your worry or obsession you will gradually become less anxious. You can then repeat the exercise for a different obsession.
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Take care of yourself
A healthy, balanced lifestyle plays a big role in keeping your behavior, fears, and worry at bay. Practice relaxation techniques; stress can often make obsessive-compulsive behavior worse. Mindful meditation, yoga, deep breathing, and other stress-relief techniques may help reduce the symptoms of anxiety brought on by OCD. Start the day right with breakfast, and continue with frequent small meals throughout the day. Going too long without eating leads to low blood sugar, which can make you feel more anxious. Eat plenty of complex carbohydrates such as whole grains, fruits, and vegetables. Not only do complex carbs stabilize blood sugar, they also boost serotonin, a neurotransmitter with calming effects. Regular exercise is a natural and effective anti-anxiety treatment that helps to control symptoms by refocusing your mind when obsessive thoughts and compulsions arise. Try to get a half hour or more a day. Aerobic exercise relieves tension and stress, boosts physical and mental energy, and enhances well-being through the release of endorphins, the brain’s feel-good chemicals.
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Avoid alcohol and nicotine
Alcohol temporarily reduces anxiety and worry, but it actually causes anxiety symptoms as it wears off. Similarly, while it may seem cigarettes are calming, nicotine is actually a powerful stimulant. Smoking leads to higher, not lower, levels of anxiety and OCD symptoms.
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Get enough sleep
Not only can anxiety and worry cause insomnia, but a lack of sleep can also exacerbate anxious thoughts and feelings. When you’re well rested, it’s much easier to keep your emotional balance, a key factor in coping with anxiety disorders such as OCD.
Reach out join a support group
OCD can get worse when you feel powerless and alone, so it’s important to build a strong support system. The more connected you are to other people, the less vulnerable you feel. Just talking about your worries and urges can make them seem less threatening.
Stay connected to family and friends. Involving others in your treatment can help guard against setbacks and keep you motivated.
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Helping a loved one with OCD
Your most important job is to educate yourself about the disorder. Share what you’ve learned with your loved one and let them know that there is help available. Simply knowing that OCD is treatable can sometimes provide enough motivation for your loved one to seek help. The way you react to a loved one’s OCD symptoms can have a big impact. Negative comments or criticism can make OCD worse, while a calm, supportive environment can help improve the outcome of treatment. Focus on the positive qualities and avoid making personal criticisms. Don’t scold someone with OCD or tell the person to stop performing rituals. They can’t comply, and the pressure to stop will only make the behaviors worse. Remember, the behaviors are symptoms, not character flaws.
Be as kind and patient as possible. Each sufferer needs to overcome problems at their own pace. Praise any successful attempt to resist, focus attention on positive elements. Do not play along with your loved one’s OCD rituals. Helping the sufferer with rituals will only reinforce the behavior. Support the person, not their rituals. Sit down as a family and decide how you will work together to tackle your loved one’s OCD. Try to keep family life as normal as possible and the home a low-stress environment. Communicate positively, directly and clearly. Communication is important so you can find a balance between standing up to the OCD and not further distressing your loved one.
