Case study
Diane had obsessive compulsive disorder (OCD) for 26 years, which she has now finally overcome.
“My earliest memory of the illness was when I was about eight years old. The symptoms were a fear of stepping on the pavement cracks. I don’t know why, but it made me feel physically uncomfortable if I did it.
“That was one ritual. Another ritual, which was a compulsion, was the fear that if I didn’t say my evening prayers correctly and sincerely, my mother might be killed in a car accident. I took on this huge responsibility as a child for another person’s life.
“A lot of people know about the hand washing and the checking of things, but many people are unaware that OCD can also take a sinister angle, where you have a fear that you may harm your own children very violently.
“When I had my fourth child I had intrusive thoughts (obsessions) that at bedtime that I would go to the children’s bedrooms in my sleep, take out their dressing gown cords and strangle each one. This was horrendous to go through, because I didn’t know whether I was going to do it or not- fortunately I did not ever harm my children
“That was the obsession: the compulsion was to try to relieve some of the pain and terror that came from those thoughts. I would get out of bed, find their dressing gowns, take the cords out of the dressing gowns and tie them into as many knots as possible, so that I wouldn’t be able to put the cords around their necks.
“Then I’d go back to bed, but I still couldn’t sleep. I would get out of bed again, get the cords, put them in a bag, seal the bag, and put the bag in a high cupboard. This would give a little relief, but it was still terrifying, I was exhausted.
“After I saw my GP, I saw a consultant psychiatrist. I was put on antidepressants, which helped me enormously. Medication gave me the strength to sleep and eat well, so I could then have cognitive behavioural therapy (CBT), which is a psychological treatment that deals with the present. I was able to put my heart and soul into my own recovery.
“I often used to ask myself what was wrong with my memory and why I couldn’t remember whether the gas has been turned off, even though I’d checked it 13 times and I only checked 10 seconds ago. In fact, people with OCD have a perfectly accurate memory, but what we don’t have is a confident memory. CBT can help to restore that.”
I am worried that my eldest child has OCD they are showing a lot of the behaviours I displayed , I wonder if they have inherited the condition or learnt it from me?
Optimal treatment for most people with obsessive compulsive disorder requires a good combination of treatments that includes psychological counselling sessions, behavioural therapy, medication, social and cognitive development therapies and much more.
In case of Mrs.Diane, both medication and psycho-therapy were given to overcome with the situation which persisted for 26yrs.if we review the complete treatment regime and its outcomes, it shows that exposure with anti-depressants and CBT were highly effective in tumbling the symptoms of the disease. In the following report we can evaluate the contribution of various psychological aspects in the treatment of indistinct behaviours, states of perception and emotional state of mind that were associated with the condition of Mrs.Diane. (Abramowitz, 1997)
Analysing the psychological effects of treatment given to Mrs.Diane, we can evaluate the progress of psycho-therapy that had commenced a synchronised effort in treating a chronic illness. Here we discuss about the effects of psycho-therapy in various dimensions like treating specific behaviours of the patient, its state of perception that includes emotions and conflicts.
CBT and medicines like anti-depressants are safest and most effective initial treatment considered by the psychotherapists for such type of patients, they first need to be motivated so as to comply with psycho-therapy. Many patients have the risk of suicide and self-injurious behaviour or the risk to harm their family members like in case of mrs.diane. In such cases it becomes important to enhance safety of the patient and others too. Psychotherapy contributes to a great extent in these conditions.it helps to change the patient’s state of mind and alters emotions to reduce the crucial symptoms. (Anon, 2016).
Many a times OCD is characterized with incorrect or wrong cognitions. Its sufferers carry a high posibility of danger to conditions which are actually harmless but they have a threat in mind that they are performing something wrong. They also misinterpret how bad the things can happen and upto what severity. For such kind of elevated OCD related stress, several behavioural interventions were developed which later proved to be quiet successful. Psychotherapy plays a very major role in treating these types of mental, social, and physical well-beings. (Anon, 2016).
Once the patient is capable of quickly identifying the obsessions and compulsions, the psychotherapist will initiate a few behavioral experiments to lessen the effect of inaccuracies in thinking about the etiology and effects. The medical practitioner may then practice the outcomes of the experiment done on the patient as substantial for discussion about other types of creative thinking. With the passage of treatment and time, patient learn to recognize and re-estimate truths about the potential results of engaging in or coming out from those behaviors and consequently begin to diminish the level of compulsions to a great extent. (Van Oppen, 1995)
The perceptive therapy designed to help the patients suffering from obsessive compulsive disorder chiefly helps in identifying these automatically generated unrealistic thoughts and confusions, thus changing their interpretations regarding those thoughts and their meanings that results in decreased fretfulness and lessened compulsions.
In the initial stage of intellectual therapy, patients are trained to develop a wakefulness of their uncertainties and threats as obsessions and compulsions. The sufferer is usually asked to track a record of those unrealistic thoughts and situations in a diary which is known as an alleged record. In this, the patient pens down fascinations and the interpretations related with the obsession. Some Significant information to record may contain what activity the patient was performing when the obsession started, what all occurred during that period, the meaning ascribed to the obsession, and what the patient did in response to overcome that situation.
The therapist will do the assessment of that particular record with the patient and will check how that situation was handled. Using moderate thinking and questioning, the therapist will verbally examine an impractical belief. This helps the patient to identify the neurological changes, typically a mis-interpreted assessment of danger, a decreased sense of responsibility, or fears that thinking something critical will make it really happen (thought-action combination).
The patient is trained to maintain the social and emotional balance of thoughts in public and in personal so as to cope-up with emotional states of mind. Another measure towards improvement includes the involvement of good company, positive thoughts and engagement with people on different issues so as to keep one involved. This can help to avoid unnecessary development of unrealistic or inconsequential thoughts.
The most fruitful treatment of OCD is supposed to be EX/RP (exposure and ritual prevention) which has many times proved its effectiveness in reducing symptoms of OCD patients. Treated patients achieved significantly good and meaningful reductions in their OCD and depressive symptoms following this therapy. (Franklin, 2000)
The psychological view points in the treatment of neurological disorders involve an excessive involvement of psychotherapy. Numerous psychological studies that investigate the accuracy of psychological treatments for this particular disease have employed different methods of evaluating the clinical significance of treatment effects. (Fisher, 2005)
The patient who undergo a progression of CBT, notice a marked improvement in most of the cases. Although the Symptoms does not go completely but usually the most visible symptoms becomes remarkably low as compared to previous situations. Many patients have found CBT very stressful and therefore do no go with it. Therefore it is generally stated to accompany medication along with the therapy to gain progressive results in the patient. These bring the symptoms under control in most of the patients adding to their psychological needs too. (Huppert, 2005)
Conclusion:
From all of the above mentioned text it is clearly understood that psychotherapy or psychological perspectives largely affect the mental and social well-being of the patient and also help in the assessment of specific behaviors and different states of mind of the patient during the treatment.
References:
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