Obsessive-Compulsive Disorder For Dummies - Softcover

Elliott, Charles H.

Softcover

ISBN 10: 0470293314 ISBN 13: 9780470293317

Publisher: For Dummies, 2008

Synopsis

Arguably one of the most complex emotional disorders, Obsessive Compulsive Disorder is surprisingly common. Furthermore, most people at some time in their lives exhibit a smattering of OCD-like symptoms.

Obsessive Compulsive Disorder For Dummies sorts out the otherwise curious and confusing world of obsessive compulsive disorder. Engaging and comprehensive, it explains the causes of OCD and describes the rainbow of OCD symptoms. The book shows readers whether OCD symptoms represent normal and trivial concerns (for example, a neat freak) or something that should be checked out by a mental health professional (for example, needing to wash hands so often that they become raw and red). In easy to understand steps, the authors lay out the latest treatments that have been proven to work for this disorder, and provide practical and real tools for living well long-term. Whether you or someone you care about has this disorder, Obsessive Compulsive Disorder For Dummies gives you an empathic understanding of this fascinating yet treatable mental disorder.

About this title

About the Author

Charles H. Elliott, Ph.D.  (Corrales, New Mexico) is a clinical psychologist and a Founding Fellow in the Academy of Cognitive Therapy. He is also a member of the faculty at Fielding Graduate University. He specializes in the treatment of adolescents and adults with obsessive compulsive disorder, anxiety, anger, depression, and personality disorders. He presents nationally and internationally on new developments in the assessment and therapy of emotional disorders.

Laura L. Smith, Ph.D. (Corrales, New Mexico) is a clinical psychologist who specializes in the assessment and treatment of adults and children with obsessive compulsive disorder, as well as personality disorders, depression, anxiety, ADHD, and learning disorders. She is often asked to provide consultations to attorneys, school districts, and governmental agencies. She presents workshops on cognitive therapy and mental health issues to national and international audiences.

From the Back Cover

Understand OCD, get the help you need, and start feeling better

Are you — or is someone you love — struggling with OCD? This reassuring, comprehensive guide explains this disorder in clear language, providing the latest information on treatment to help you in the journey from diagnosis to recovery. You'll find the motivation you need to change, tips for handling day-to-day life, and the best ways to offer support to loved ones.

• Learn the ins and outs of OCD — its causes, various forms, symptoms, and the major approaches to treatment

• Improve your way of thinking — connect the dots between triggers, thoughts, and feelings, and dismantle OCD beliefs

• Undo OCD behavior — identify your fears, open yourself to change, delay or alter rituals, and handle setbacks

• Evaluate medications — discover the pros and cons, explore the options, and know when to combine, decrease, or stop medications

• Manage the OCD mind — accept negative thoughts and feelings and connect with the here and now

• Target specific symptoms — from doubting and checking to symmetry and counting to shame and superstitious thinking, apply techniques for overcoming various types of OCD

• Assist others with OCD — recognize symptoms in children and find professional help, support family and friends, and reinforce the right things

Open the book and find:

• Plain-English explanations of the disorder and its symptoms

• The difference between obsessions and compulsions

• Ways to change OCD thinking and behavior

• How to choose the right mental-health professional

• The latest scientifically based research on treatment

• Tools to help track progress

• The warning signs of relapse and how to handle it

• Tips on treating OCD-related disorders

From the Inside Flap

Understand OCD, get the help you need, and start feeling better

Are you — or is someone you love — struggling with OCD? This reassuring, comprehensive guide explains this disorder in clear language, providing the latest information on treatment to help you in the journey from diagnosis to recovery. You'll find the motivation you need to change, tips for handling day-to-day life, and the best ways to offer support to loved ones.

• Learn the ins and outs of OCD — its causes, various forms, symptoms, and the major approaches to treatment

• Improve your way of thinking — connect the dots between triggers, thoughts, and feelings, and dismantle OCD beliefs

• Undo OCD behavior — identify your fears, open yourself to change, delay or alter rituals, and handle setbacks

• Evaluate medications — discover the pros and cons, explore the options, and know when to combine, decrease, or stop medications

• Manage the OCD mind — accept negative thoughts and feelings and connect with the here and now

• Target specific symptoms — from doubting and checking to symmetry and counting to shame and superstitious thinking, apply techniques for overcoming various types of OCD

• Assist others with OCD — recognize symptoms in children and find professional help, support family and friends, and reinforce the right things

Open the book and find:

• Plain-English explanations of the disorder and its symptoms

• The difference between obsessions and compulsions

• Ways to change OCD thinking and behavior

• How to choose the right mental-health professional

• The latest scientifically based research on treatment

• Tools to help track progress

• The warning signs of relapse and how to handle it

• Tips on treating OCD-related disorders

Excerpt. © Reprinted by permission. All rights reserved.

Obsessive-Compulsive Disorder For Dummies

By Charles H. Elliott Laura L. Smith

John Wiley & Sons

Copyright © 2009 Charles H. Elliott and Laura L. Smith
All right reserved.
ISBN: 978-0-470-29331-7

Chapter One

Reviewing Obsessive-Compulsive Disorder(OCD)

In This Chapter

* Finding out about OCD

* Seeing how media obsessions can influence OCD

* Discovering treatments available for OCD

* Helping others who suffer from OCD

Depending on how you define the terms, everyone has a few obsessive or compulsive traits. In popular vernacular, obsessive is a word often used to describe someone's intense interest in something. For example, a man who stalks a movie star is totally obsessed with her. Or a woman who spends hours putting on her make-up and doing her hair obsesses about her looks. An obsession also can refer to an intense interest in a sport, a hobby, or a career. On the other hand, compulsive often is used to refer to rigid patterns of behavior, as reflected in descriptions such as "He is compulsive about keeping his house clean," or, "She compulsively balances her checkbook every week without fail."

But mental-health professionals define these terms quite differently. In the mental-health field, obsessions are considered to be unwanted thoughts, images, or impulses that occur frequently and are upsetting to the person who has them. Compulsions are various actions or rituals that a person performs in order to reduce the feelings of distress caused by obsessions.

You can find examples of obsessions and compulsions in lots of places. For example, many major-league pitchers have elaborate good-luck rituals that can look pretty strange. Some feel compelled to hear the same song prior to the game; others eat exactly the same food. You probably have watched pitchers straighten their hats, smooth out the dirt on the mound, and spit in the sand before each pitch. Many baseball hitters have elaborate rituals they carry out with their bats. Other athletes have strange beliefs, good-luck charms, or compulsive acts that they must perform, allegedly to help their performance. If you are a major-league sports player making zillions of dollars to play a game, you can indulge in a few weird behaviors. No one will bother you.

REMEMBER

Anyone can have a few obsessions or compulsions, and, in fact, most people do. But it isn't obsessive-compulsive disorder (OCD) unless the obsessions and compulsions consume considerable amounts of time and interfere significantly with the quality of your life.

In this chapter, we introduce you to OCD. We reveal how it debilitates individuals who have it and what it costs society. We also provide an overview of the major treatment options - much can be done for OCD nowadays. Finally, because OCD treatment can be greatly enhanced by the help of friends and family, we provide tips on what you can do to help someone you care about who has OCD.

What Is OCD?

OCD has many faces. Millions of people are held prisoner by the strange thoughts and feelings caused by this disorder. Most people with OCD are bright and intelligent. But doubt, uneasiness, and fear hijack their normally good, logical minds.

Whether or not you have OCD, you can probably recall a time when you felt great dread. Imagine standing at the edge of an airplane about to take your first parachute jump. The wind is blowing; your stomach is churning; you're breathing hard. Suddenly the pilot screams, "Stop! Don't jump! The chute is not attached!"

You waver at the edge, terrified, and fall back into the plane, shaking. That's how many people with OCD feel every day. OCD makes their brains believe that something horrible is going to happen. Some people fear that they left an appliance on and the house will burn down. Others are terrified that they may get infected with some unknown germ. OCD causes good, kind people to believe that they might do something horrible to a child, knock over an elderly person, or run over someone with their car.

Those with OCD almost always struggle with two major issues: shame and the intense desire to avoid all risks. We discuss these issues in the next two sections.

Suffering shame

Because the thoughts and behaviors of those with OCD are so unusual or socially unacceptable, people with OCD feel deeply embarrassed and ashamed. Imagine having the thought that you might be sexually attracted to a statue of a saint in your church. The thought bursts into your mind as you walk by the statue. Or consider how you would feel if you stood at a crosswalk and had an image come into your mind of pushing someone into oncoming traffic.

However, the frightening, disturbing thoughts of OCD are not based on reality. People with OCD have these thoughts because their OCD minds produce them, not because they are evil or malicious. It is extremely rare for someone with OCD to actually carry out a shameful act.

REMEMBER

Throughout this book we often refer to the "OCD mind" rather than you or someone you care about with OCD. The reason we do that is to emphasize that you are not your OCD. You have these thoughts, urges, impulses, and rituals because of a problem with the way your brain works. OCD is not your fault.

Wrestling with risk

The OCD mind attempts to avoid risks of all kinds almost all the time. That's why those with Contamination OCD spend many hours every single day cleaning, scrubbing, and sanitizing everything around them. People with Superstitious OCD perform rituals to keep them safe over and over again. Interestingly, most OCD sufferers focus on reducing risks around specific themes such as contamination, household safety, the safety of loved ones, or offending God. But those with contamination fears don't necessarily worry about damnation. And those who worry about turning the stove off usually don't obsess about germs.

Risks of all kinds abound in life. We don't know of any human who has avoided the ultimate worry - death. And no one can ever know when death is about to knock on the door. The following famous people were living their lives with normal precautions and died of random, unexpected events:

  Felix Faure: The president of France died in 1899 from a stroke while having sex.

  Isadora Duncan: A dancer, Isadora was strangled to death when her silk scarf was entangled in the wheel of a car in which she was a passenger.

  Sherwood Anderson: This famous author died after he accidentally swallowed a toothpick at a party.

  Tennessee Williams: A playwright, Williams accidentally choked to death on the bottle cap of his nose spray.

  Vic Morrow: An actor, Morrow was decapitated while making a movie when a helicopter went out of control and crashed.

Given scenarios like those in the preceding list, it's hard to imagine how OCD rituals and behaviors could actually anticipate and save anyone from similar circumstances. But the OCD mind tries to create the illusion that almost all risks can be anticipated and avoided.

In truth, OCD doesn't provide significant protection in spite of extraordinary efforts to reduce risks. In chapters to come, we give you ideas about how to accept a certain amount of risk in order to live a full life, no matter how long or short that life is.

Counting the Costs of OCD

People with OCD suffer. They are more likely than others to have other emotional disorders such as depression or anxiety. Due to embarrassment, they often keep their symptoms secret for years, which prevents them from seeking treatment. Worldwide, it is estimated that almost 60 percent of people with OCD never get help.

The pain of OCD is accompanied by loneliness. OCD disrupts relationships. People with OCD are less likely to marry, and, if they do, they are more likely to divorce than others. Those who do hang on to their families often have more conflict.

OCD also costs money. A study done in the '90s reported that the estimated price tag of OCD was over 8 billion dollars in the United States alone. This amount represents the cost of treatment, lost productivity on the job, and lost days at work. Even with improved treatments, these costs have no doubt risen along with increased population and healthcare costs.

Encouraging OCD through the Media

OCD is not a new disorder. However, you can't help but think that the appetite for sensation in the media accelerates OCD concerns. Recently, we saw a television special about people buying used mattresses. Reporters used special lights and took cultures to find all sorts of horrible matter (bed bugs, fecal matter, and body fluids) still clinging to supposedly refurbished bedding.

In another show, zealous reporters burst into hotel rooms armed with petri dishes and black lights to help them find filth and grime on the glasses left in the room, as well as on the carpet and bedding. Media also warns about such dangers as inadvertently inhaling gasoline fumes while pumping gas (of course, who can afford that anymore?) and kindergarten children inadvertently becoming intoxicated from magic markers.

Furthermore, the sales of cleaning products, sanitizers, personal hygiene products, and mouthwash have soared over the years. You can find antibacterial ingredients in products designed to clean your refrigerator, mop your floors, scrub your body, and disinfect your toilets. Antiviral ingredients are also becoming quite the rage.

Yet, try and find solid evidence about deaths from refurbished mattresses, less-than-pristine hotel rooms, incidental exposure to fumes, and homes not cleaned with every antibacterial and antiviral ingredient known to humans, and you'll come up wanting. In fact, a clever study conducted by researchers at Columbia University in Manhattan provided households with free cleaning supplies, laundry detergent, and hand-washing products. All the brand names were removed. Half of the households were given products with antibacterial properties and the other half was provided supplies without antibacterial properties. The researchers carefully tracked the incidence of infectious diseases (runny noses, colds, boils, coughs, fever, sore throats, vomiting, diarrhea, and conjunctivitis) for almost a year. They found no differences between those who used antibacterial cleaning agents and those who did not.

WARNING!

If you spend loads of time cleaning and using antibacterial disinfectants, you may be doing yourself more harm than good! Scientists now believe that excessively clean environments may actually be causing an increase in allergies and asthma. Furthermore, excessive use of antibiotics appears to run some risk of encouraging the development of new, resistant bacteria.

No, we are not suggesting that people stop washing their hands - especially in hospitals! And we're well aware of the long-term dangers posed by prolonged exposure to air pollution, insecticides, and toxic chemicals. Furthermore, we're grossed out by a dirty hotel room as much as anyone else. At the same time, the media and advertisers have shown a disturbing obsession with issues involving excessive cleanliness and minimal exposure to low-level risks.

Exploring Treatment Options for OCD

If you had OCD during the Middle Ages, you very well may have been referred to a priest for an exorcism. The strange, violent, sexual, or blasphemous thoughts and behaviors characteristic of OCD were thought to derive from the devil. If you had OCD during the dawn of the 20th century, you may have been sent for treatment based on Freudian psychoanalysis, which purportedly resolved unconscious conflicts from early development. For example, if your OCD involved sexual obsessions or compulsions, you were assumed to have unconscious desires for your mother or father. In fact, the common use of the word "anal" to describe people who are overly rigid, controlled, and uptight came from the Freudian idea that strict, early toilet training caused children to grow up with excessive concerns about neatness and rules.

However, neither exorcism nor psychoanalysis ultimately proved to have much impact on OCD. Only in the last 40 years or so have effective treatments evolved for OCD. And some of these treatments have only become widely available quite recently.

In the next few sections we provide an overview of the major treatment options for OCD that have shown significant promise based on scientific studies. For clarity, we have divided these therapies into the categories of CBT, mindfulness, ERP, and medications. In reality, rarely are any of these therapies used as a single, exclusive treatment for OCD.

TECHNICAL STUFF

Changing the way you think with CBT

Cognitive therapy was developed by Dr. Aaron Beck in the early 1960s and is a major component of the broader term, Cognitive-Behavioral Therapy.

Originally, this approach was used to treat depression. Cognitive therapy is based on the idea that the way you feel is largely determined by the way you think or the way you interpret events. Therefore, treatment involves learning to identify when your thoughts contain distortions or errors that contribute to your misery. After you've identified those distortions, you can learn to think in more adaptive ways. Soon after it was adopted for treating depression, cognitive therapy was applied quite successfully to anxiety disorders and, ultimately, to a dizzying array of emotional problems, including eating disorders, oppositional defiant disorder, and even schizophrenia.

In the early years, cognitive therapy was not applied to OCD, perhaps because of the success of ERP (described in the section "Modifying behavior through ERP"). However, in recent years, the cognitive therapy component of CBT has been found to be quite effective in treating OCD. Usually, CBT includes at least some elements of ERP. Some practitioners believe that applying cognitive strategies first may make the application of ERP somewhat more comfortable and acceptable to the person contemplating that approach. See Chapters 8, 9, and 10 for more information about the various subtypes of CBT.

Approaching OCD mindfully

The OCD mind focuses on possible future calamities. The predictions almost never come true. Yet, the obsessive thoughts keep coming and demanding attention.

  I worry about shouting obscenities, so maybe someday I'll lose control and do it in church.

  Maybe my thoughts of death will cause harm to someone I love.

  Perhaps touching that doorknob will make me sick.

When it isn't thinking about the future, the OCD mind dwells on possibilities from the past. The mind fills with thoughts about what might have occurred.

  Maybe I left the stove on.

  Maybe I ran that person over with my car.

  Perhaps I was poisoned by that tuna fish sandwich.

Furthermore, the OCD mind judges people, the world, and even OCD itself harshly.

  A bad thought is just the same as doing something bad.

  Having OCD thoughts means that I'm crazy.

  I am a weak person for having these thoughts.

Mindfulness is the practice of existing in the present moment without judgment or harsh evaluations. Thus, as you acquire a mindful approach to OCD, you understand that thoughts are truly just that - thoughts. Thoughts do not make someone good or bad. See Chapter 9 for more information about how to apply mindfulness to your life and your OCD. As you do, you will become more self-accepting and better able to quiet your OCD mind.

Modifying behavior through ERP

A true breakthrough in the treatment of OCD occurred in the mid 1960s when Victor Meyer tested a treatment called exposure and response prevention (ERP) with two patients suffering from severe cases of OCD. These patients had not improved with shock therapy, supportive therapy, or medication. The drastic measure of brain surgery was even being considered. One of the patients was obsessed with cleaning. Dr. Meyer and a nurse exposed this patient to dirt and did not allow her to clean (ergo, the term "exposure and response prevention"). This radical treatment was the first to help decrease the patient's symptoms. The other patient was obsessed with blasphemous thoughts. She was told to purposefully rehearse those thoughts without doing the rituals that she had used to decrease her obsessions. Like the first patient, this woman was helped by ERP after years of other unsuccessful therapies.

(Continues...)

Excerpted from Obsessive-Compulsive Disorder For Dummiesby Charles H. Elliott Laura L. Smith Copyright © 2009 by Charles H. Elliott and Laura L. Smith. Excerpted by permission.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

Edition details

• Publisher: For Dummies
• Publication date: 2008
• Language: English
• ISBN 10: 0470293314
• ISBN 13: 9780470293317
• Binding: Paperback
• Edition number: 1
• Number of pages: 380