To start solving a problem, you need to understand how it works. OCD consists of obsessive thoughts, which in turn lead to obsessive actions. For example, thoughts about infection lead to hand washing 8 times. Rituals can be very diverse and it is not always possible to understand their logical connection. For example, how can stepping over cracks protect against bad events? There is a direct connection in the minds of people with OCD. There are 3 main approaches to treating OCD and let's look at each. 1. Pharmacotherapy OCD varies in severity. In severe cases, unfortunately, no results can be achieved without medications. There are many treatment regimens, so you should not self-medicate. It is not always possible to select the right drug the first time, and in some cases complete pharmacoresistance is observed. When a person does not respond to drugs. Fortunately, such cases are rare. In this case, there is also treatment - deep brain stimulation. This is a proven method for working with OCD. It is used as a last resort when there is no reaction to the drugs. As far as I know, the method is much more expensive than pharmacotherapy. However, if you have money, you can start there. Pharmacotherapy can only be prescribed by a psychiatrist. Neurologists do not have the right to treat OCD (psychoneurologists, including). In order to prescribe treatment, knowledge in the field of psychiatry is required. Possible difficulties: 1. Selection of drugs - it is not always possible to choose the right one the first time. Also, you should not exclude possible side effects; it may become much worse than before treatment. In this case, you need to consult a doctor to adjust the treatment regimen. If there are any side effects, they should not bring significant discomfort in life. If there is no effect, you should also consult a specialist. 2. Unfortunate doctors - it happens that a doctor may not take the disorder seriously. Make fun of, devalue, say that you made it all up and refuse treatment. Do not despair if you come across such a doctor. You don’t give up the idea of ​​a beautiful hairstyle when your hairdresser gives you a bad haircut, do you? You are looking for another master. It's the same here. If you don't like the psychiatrist, find another one. 3. Symptoms return after treatment ends - such cases are not uncommon. They are due to the fact that during the period when the drugs normalized brain function and removed unnecessary anxiety, the person did not change anything in his life. Neither your personality nor your environment. The lifestyle he lived led him to a state of OCD. Naturally, if you remove the cover, the truth will be revealed. In this case, it is more effective to start psychotherapy. Change your personality and change your life.2. Behavioral psychotherapy In this type of psychotherapy, we work with the symptom. It is necessary to reduce anxiety levels through behavioral exercises. No anxiety - no need for rituals. Today, it is the most proven type of psychotherapy for working with OCD. Methods:1. Refusal of rituals 2. Exposure3. Behavioral experiment4. Paradoxical intention5. And other methods. The essence of these methods is to refuse to fight your fear. A person with OCD uses rituals to relieve anxiety. Through methods he stops the struggle and plunges himself into fear. Over time, he adapts to it, sees that everything is safe and the anxiety goes away. Possible difficulties: 1. This is unpleasant - although the exercises are simple, they are quite uncomfortable. Considering that OCD can last for years and the habit of avoidance is formed quite strongly, it is very difficult to start giving it up. From experience, I can say that people are often reluctant to do exercises. And this is not a reproach to the people themselves. True, these exercises are unpleasant and can be difficult to decide on. In this case, it is necessary to develop tolerance to discomfort. Develop your resilience and willpower. This skill is useful not only when working with OCD, but it will also make it much easier to achieve your goals in life. 2. Incorrect technique - A fairly common problem inmy practice. I try to explain in great detail how the technique works, what needs to be done when performing it, and what not to do. I’m going through everything step by step, what needs to be done and how. But still, the brain is a cunning thing and tries to find a trick to avoid fear. Somewhere a person does not complete the exercise, somewhere he uses crutches. Unfortunately, you won’t be able to achieve any effect with crutches. 3. Individual selection - It’s the same as with pharmacotherapy. It is necessary to select exercises individually for each person, depending on his condition, characteristics and needs. Here you can discuss everything with your psychologist. 4. Choosing a competent specialist - what is not currently being treated. Constellations, chakras, esotericism, mother’s forgiveness and other pseudo-proven methods. The last client told how her previous psychologist advised standing on bottles when she became anxious. There is such a thing as evidence-based medicine. It’s a miracle, but there is a protocol for working with OCD. And it is not at all necessary to clean the birth canal to cope with the rituals. When choosing a specialist, pay attention to what methods he uses and if you see something pseudoscientific, run. 5. Severe condition - in a serious condition it is extremely difficult to complete tasks. I would say it's even impossible. The person simply will not react to them. I am silent about the fact that he does not have the strength to fulfill them. In this case, consultation with a psychiatrist and initiation of pharmacotherapy is necessary. When the condition returns to normal, the person will be receptive to psychotherapy. 6. Migration of symptoms - resolved issues with rituals, hypochondria appeared, coped with hypochondria, panic attacks appeared. A common problem with behavior therapy is that it solves the symptom but does not solve the person's internal problem. In this case, I would recommend a therapist who works in both a dynamic approach and a behavioral one. Behavioral therapy helps to cope with rituals, and dynamic therapy helps to resolve internal conflict and cope with the source of tension.3. Psychodynamic psychotherapyThe essence of psychodynamic approaches is the search for intrapersonal conflict. Conflict creates tension within a person, as a result of which this tension needs to be put somewhere. Discharge of tension occurs through obsessive thoughts and actions. Once you resolve the conflict, the tension will pass and obsessions will disappear as unnecessary. The most common OCD conflict is psychasthenic. Between norms, morality, what is right, what is wrong and what a person really is, his needs, desires, interests. A common story is repressed sexuality - what if people call you a prostitute. But OCD does not always equal psychasthenic conflict. There can be just as much hysterical and neurasthenic. Here we work on the personality, on the desire to please everyone, to be good, correct, successful, etc. Here you can either change your attitude and make your view of the world more realistic, or begin to influence the world and bring it into conditions in which the conflict would be resolved. I don’t think it’s entirely correct to talk about any specific techniques; I can give examples of types of therapy: 1. LORPT2. Therapy regimen 3. Acceptance and responsibility therapy4. And other types of therapies It is also worth adding cognitive techniques from CBT here. Even though CBT is not exactly a dynamic approach, CBT methods are good at helping resolve internal contradictions. Possible difficulties: 1. It takes a long time - the in-depth approach is quite drawn out, you should not expect quick results. This is actually why I recommend starting it when the main problems with symptoms have been resolved. In metaphorical language if we speak. Imagine a man in a hole. He feels bad, he suffers, and instead of giving him a ladder to get him out of this hole, you start talking to him and digging into why he feels bad. The condition is dragging on. I recommend first solving the main problems with the help of pharmacotherapy and behavioral therapy, and then proceeding with in-depth study. 2. The condition may worsen. Essentially, OCD is a reflex. Eat.