Obsessive Compulsive Disorder. Understanding OCD & Managing Reassurance

Transcription

1 Obsessive Compulsive Disorder Understanding OCD & Managing Reassurance

2 OCD What is it?? Small group brainstorm: What do you know about OCD?

3 OCD in the Media A simplistic view

4 How OCD are YOU?

5 OCD obsessions vs normal thoughts Impulse to accelerate on the freeway without steering, and seeing how fast I can go before I crash Image of taking a meat cleaver and threatening someone in the family Sudden urge to kick a baby Thought of putting the cat in the microwave Thought that someone leaving the house might die if I never said goodbye Image of a friend killed in an accident Thought of my child being abducted Thought of someone following me at night Thought of car bursting into flames while I am driving Thought I might have caught a disease from touching a toilet seat

6 All obsessive thoughts are normal Responding to intrusive thoughts with compulsions increases their importance and frequency

7 OCD Often begins in late childhood / early adolescence Obsessions: Recurrent and persistent thoughts, images or impulses that are unwanted Intrusive, distressing and anxiety provoking

8 Common Obsessions Fear of contamination Germs, dirt, bodily waste, toxins Fear of harm to self/others Fear of causing accident, death Intrusive sexual thoughts Unwanted thoughts about children/relatives Religious/moral concerns Worry of right/wrong actions, sin, blasphemy Symmetry Things need to be aligned/just right

9 Compulsions Performance of repetitive and ritualistic behaviours that are excessive, time consuming and distressing Behavioural or cognitive Reduce anxiety in short term

10 Common Compulsions Excessive/ritualistic washing/cleaning Handwashing, bathing, toileting, avoiding handling certain items Excessive checking Locks, appliances, reassurance seeking Mental repetition of words, numbers, images Repeated touching/tapping/ordering Excessive superstitious behaviours Avoiding unlucky numbers

11 OCD Obsessions and compulsions can take up many hours in a day, cause significant interference in family/social relationships & daily routines. Very distressing and debilitating. OCD has previously been recognised by the World Health Organisation in the top 10 of most debilitating illnesses

12 Unstuck An OCD Kids Movie

13 OCD impacts on education Small group brainstorm: What are some of the impacts on education for young people living with OCD?

14 OCD thinking distortions Intolerance of uncertainty Need 100% certainty about everything or can t relax Thought-action fusion / Magical Thinking because I thought something bad, it s very likely to happen Inflated sense of responsibility / hyper-morality I ll go to hell/be punished for the slightest mistake/error Black and white thinking If I don t do it perfectly, then I ve done it terribly What If Thinking What if I do something wrong/make a mistake Perfectionism Whatever I do, it has to be perfect otherwise I won t be able to tolerate it

15 OCD Seeking Reassurance People living with OCD have difficulty with uncertainty Therefore they will do something to alleviate the anxiety / distress linked to the uncertainty Compulsions And / or reassurance seeking from others This may alleviate anxiety / distress in the short-term, but then the uncertainty begins again Therefore, reassurance seeking is NOT useful, it just continues the OCD cycle

16 OCD Seeking Reassurance Rather than providing reassurance, it can be more useful to talk about the process unfolding It sounds like you re wanting me to provide you with reassurance Have you sought reassurance before? Has this helped you in the long term? (People with OCD often have good insight and are able to acknowledge that it is not helpful in the long term, but perhaps just in the short term)

17 OCD Seeking Reassurance Is it okay then if I don't provide you with this reassurance seeing as you have acknowledged it s not really that useful? If the person is desperate for reassurance, provide it once It they ask for it again, then this provides you with a clear example of it not being effective Since you have asked me for reassurance again, it s showing us that it wasn t helpful for me to provide you with this earlier in the conversation, as your distress / anxiety about this has come up again. This is showing us that it s not an effective strategy so I don t want to continue doing something that is not helpful to you

18 OCD Treatment CBT is the gold standard for OCD treatment OCD treatment begins with learning to delay the performance of rituals, working towards resisting compulsions altogether The less attention (eg. compulsions / reassurance) we give to obsessions, the less intense they become This can be a confronting process

19 Strategies for Emotional Regulation Stress and anxiety can exacerbate OCD symptoms. Learning emotional regulation strategies can be helpful Deep breathing Progressive muscle relaxation Mindfulness

20 OCD Where to go for help Anxiety Recovery Centre Victoria OCD & Anxiety Helpline support, info & referrals (03) (M-F, 10-4)