28 lip 2014, 11:50
Ach wścieklizna to jeden z klasyków w OCD.
Przede wszystkim na Twój strach nie pomogą ci Twoje pytania czy na pewno się nie zaraziłaś i zapewnienia takie jak daje ci lonsdale że wszystko jest ok. To może cię uspokoić na moment, ale najprawdopodobniej przy kontakcie z innym zwierzakiem znów powróci i będzie gnębić jeszcze bardziej. Szukanie zapewnienia że wszystko będzie ok. prowadzi w ocd do wpadania w błędne koło - należy nauczyć się tego unikać żeby nie pomnażać tych myśli.
Przypomniał mi się fragment z mojej ulubionej książki autoterapeutycznej o dziewczynie z OCD która bała się wścieklizny właśnie. Z tą wścieklizną to naprawdę dość częsty przypadek i powiedziałabym bardzo standardowy: związany z zarazkami/brudem/strachem przed zachorowaniem. W takich przypadkach bardzo skuteczny jest rodzaj terapii który zwie się ERP (exposure and response prevention).
Zamieszczam historię i jedno z ćwiczeń które było pomocne w tym przypadku. Cała książka zawiera dokładny opis tego jak samemu przeprowadzić sobie taką terapię. Jest trudna przyznaję - ale bardzo bardzo skuteczna.
Zamieszczam fragmenty (niestety w języku angielskim):
OPIS PRZYPADKU I JEGO MECHANIZMÓW:
(Oczywiście to skrajny przypadek ale mimo to świetny jeśli chodzi o pokazanie jak wygląda myślenie u osoby z OCD która boi się zarazków/brudu/chemikaliów i tego typu rzeczy - nie tylko w przypadku wścieklizny. Z pewnością wiele osób znajdzie tu wiele z tego jak sami myślą kiedy się nakręcają).
"For fifteen years, Libby’s entire life had been controlled by her fears. It all started one morning, as she prepared to feed her four pet hamsters, she discovered one had died during the night. Naturally she wondered why it had died. “Maybe he died of rabies,” she thought. “If he died of rabies, that means everyone who played with him may have rabies.” Pretty soon Libby began to believe that the sewing room where the hamsters lived was contaminated with rabies germs. Because of her fear she decided that nothing in that room could be touched. To protect herself and others, she locked the door to the room and would allow no one to enter.
By locking the door, Libby believed she prevented rabies contamination from spreading to other areas of her home, and for several months she forgot about the problem. Then one day in early winter, as she was preparing a fire in her living room fireplace, she noticed that the chimney was blocked. She later discovered a dead squirrel there. Libby quickly concluded that the squirrel died of rabies. From then on, in her mind, the living room was contaminated by rabies. Even though the maid cleaned and scrubbed the entire room and its furniture, Libby would not sit by the fireplace, nor allow her husband to be near it. Soon her fear of rabies spread to every outdoor animal. Libby first refused to walk in any wooded areas because a raccoon sitting above her in a tree might drop saliva directly into her mouth. The saliva would then enter her bloodstream and give her rabies. Then her fears spread to parks, gardens, and even to her own cat. She was afraid that when the cat played outside, a squirrel might scratch him, he would contract rabies, and then pass it on to her and her family. So eventually, heartbroken, she had to give her cat away. Libby’s fear became so pervasive that even on hot summer days she wore pantyhose and shoes while she was out walking. In this way, she felt she was protecting herself from rabies germs entering her body through scratches on her legs. This fear was her primary concern for ten years. Then, in 1983, Libby’s mother was diagnosed with cancer, and she became obsessed with a fear of developing cancer through contact with her mother.
Despite her worries, Libby continued to take care of her mother during the several months prior to her death. After her mother died, Libby felt that all the clothes that she wore while tending to her mother were contaminated with cancer, and she threw them away. She also felt that all the objects inherited from her mother were contaminated. Items that were too valuable to be thrown away, such as sterling silverware, were relegated to a corner of the basement. Two years prior to entering treatment Libby developed yet another obsession: She became consumed with fear of AIDS. She could no longer go to her usual flower shop because she thought the man running the store had AIDS. Even her trusted hairdresser was no longer safe, because she suspected he too had AIDS. She immediately began to investigate the other hairdressers in town with the hope of discovering an uncontaminated beauty salon. Eventually she decided that hairdressers who were married and had children didn’t have AIDS. But just in case she had guessed wrong, Libby never used a toilet at the hairdresser’s. Any time Libby entered her house after being outside, she would wash herself extensively. Her showers, which lasted from an hour to an hour and a half, involved scrubbing every inch of her body, starting with her legs and ending with her scalp. And when her husband returned from fishing trips, she required that he decontaminate himself by washing and scrubbing according to her directions.
When she finally entered treatment, Libby suffered from all three of her primary obsessions relating to catching a disease. Each of the three fears-rabies, cancer, and AIDS-required several weeks of therapy, consisting of three treatment sessions per week. By the end of treatment, Libby was completely free of symptoms. She rarely felt the urge to wash, she enjoyed her walks in the woods and parks, and she used her mother’s silverware without hesitation. Libby’s compulsive behavior is one of the most common in obsessive-compulsives, the washing-and-cleaning ritual. People with this obsession believe they will become “contaminated” or “dirty” from contact with certain situations or objects. If such contact is made, they may experience an unpleasant sensation directly on their skin. And they want nothing more than to get rid of this sensation. Common contamination obsessions involve bodily secretions, such as feces, urine, menstrual blood, and sweat. In many cases, these worries involve the idea that bodily secretions are contaminated by germs and therefore should be avoided. For instance, some people fear that contact with public toilets will expose them to some disease that they, in turn, will transmit to others. Some may not have a particular disease in mind—only a vague sense of danger. While the actual chance of contracting disease in this manner is very low, the obsessive-compulsive feels and acts as if a disease is imminent. The desire to avoid contact with germs is understandable. For instance, suppose you feel that dogs spread dangerous germs that can easily be transmitted to humans. It would be natural for you to begin avoiding dogs because you don’t want to catch the illnesses that the dogs spread. Nor do you want to pass those germs on to those around you, such as your small children. But obsessive-compulsives cannot successfully steer away from germs by simply avoiding dogs. One of the most prominent characteristics of this disorder is the belief that contamination can travel endlessly from one object to another even without physical contact. Imagine that you have developed concerns regarding contamination by dogs. Not only will you avoid dogs, but you will also avoid houses where dogs live, streets where dogs walk, parks where dogs roam. The chain of situations can become endless, and the entire physical world around you can become contaminated. It then becomes impossible to avoid dog germs by simply avoiding certain places. Therefore, you will create some active procedure to remove the contamination: You begin to wash."
I JESZCZE OPIS JEDNEGO Z ĆWICZEŃ:
(jedno z wielu właśnie zilustrowane przykladem ze wścieklizną - tak naprawdę warto by przeczytać całą książkę żeby sobie dobrać najlepsze ćwiczenia dla siebie - a tu w całości wkleić byłoby ciężko :)
"Audiotape Practice of an Extended Obsession
Write out a detailed story of the feared event in the following way: Imagine you are in the middle of a spontaneous obsession. Write a moment-by-moment description of the exact words and pictures that come into your mind. Give as many details as possible about the setting, your action, the responses of others, and especially your emotions. Read your story aloud several times to rehearse the tone and pacing that best reflect your emotions within the story. Record your story on an audiotape. Each day listen repeatedly to the tape for forty-five minutes or longer. Attempt to become as distressed as possible by the story. Continue daily practice until you no longer feel undue discomfort. Repeat this process for each additional obsession.
Sometimes you may have trouble trying to identify the exact reasons why you are so anxious or distressed. An example is Jennifer, a woman who sought treatment for her obsession about a terminal illness. Jennifer was continuously preoccupied with this thought. She called doctors repeatedly and plied her medical-student husband with questions designed to alleviate her distress. Seeking reassurance, like any other ritual, provides temporary relief, but the worries and obsessions return sooner or later. Initially, Jennifer presented her problem as fear of dying of rabies, and accordingly her treatment program included an extended tape recording that described how she actually came down with the disease and finally died. Jennifer became somewhat anxious at certain points during the practice but did not get as anxious as one might expect, given her extreme anxiety when thoughts about rabies occurred spontaneously Nor did she become less fearful of dogs. After eight practice days with the tape, Jennifer did not experience any improvement. Puzzled by her lack of progress, the therapist decided to reanalyze the problem. It then became clear that it was the doubt about whether she had rabies rather than the dying itself that caused her distress. The knowledge that she was actually dying was less disturbing than being left in the dark with doubt. With this insight, a new tape was prepared that focused on her uncertainty. Listening to this tape, Jennifer became extremely anxious. After four practices she began to get used to the message, and her anxiety lessened. After eight practices the obsession lost its power and subsided."
Jeśli chcesz wyślij mi maila na pw, podeślę ci całą książkę :)