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You can trust us with your bizarre or disgusting thoughts. We've heard it all after treating hundreds of people with Pure OCD!
I'll Tell You Why Trying To Shout Out Your Intrusions Will Backfire!
Trying to get rid of your obsessive thoughts, images, or compulsions just DOESN'T WORK.
If you don't learn how to manage your intrusions and continue suppressing your obsessions, you'll perpetuate your distress, making your intrusions more frequent, feeling hyper-alert, never learning to overcome your fears, and feeling anxious all the time.
At Anapsys, we use the latest Cognitive Behavioural Techniques to improve your OCD and pure obsessions as much as 80% in a few months.
We specialise in OCD, and particularly, pure O (or pure obsessions), and we excel in this area because we have treated 100s of cases for the past 20 years from all over the world (success rate around 85% to achieve an 80% improvement in about 8- 12 sessions).
Please stop trying to get rid of your obsessions and give us a chance to really help you correctly manage them! Contact us for an appointment and stop wasting time suppressing those intrusive thoughts that have a mind of their own!
Types of OCD
CONTAMINATION OBSESSIONS LEADING TO EXCESSIVE CLEANING OR WASHING
(e.g., Ritualised washing of hands, whole body or specific body parts, excessive cleaning of house, objects, and clothes.)
The most common type is the one involving contamination obsessions, and 47% of those suffering from OCD experience this kind of obsession. The most common rituals are washing and cleaning. People with this kind of OCD usually complain about feeling dirty (mental pollution) or contaminated if they do not ritualise. They may fear to catch a disease or to contaminate another person.
DOUBTING OBSESSIONS LEADING TO EXCESSIVE CHECKING
People suffering from doubting OCD present with a lack of self-trust, and commonly feel guilty and extremely anxious unless they ritualise. An example of doubting OCD is the individual who checks the gas cylinder, doors, or windows over and over again. This client is afraid of causing HARM to himself, another person, or their property. Therefore, rituals are performed in order to neutralise and compensate for the perception of risk associated with the self-image of not being a careful, responsible, or decent person.
PERFECTIONIST OBSESSIONS OF ORDER, PRECISION, AND SYMMETRY
This type of OCD may also be accompanied by pathological slowness based on the obsessive idea of perfectionism. This can make you obsess about trying to feel "in a perfect state" to avoid annoyance and irritation. Nevertheless, the obsession with symmetry and order usually are associated with "magical thinking" to prevent harm in others. Typical compulsions are to organise clothes, paper, personal affairs, in a particular, stereotypical manner, following a specific order and respecting certain fixed positions.
PURE OBSESSIONS WITHOUT COMPULSIONS
This type is one of the frequently-occurring ones. We have extensive experience in treating complex cases of Pure OCD. Pure obsessions are categorised as sexual, aggressive/ harming, or religious (also termed scrupulosity).
Sexual obsessions include fears that one might be gay, one might sexually abuse a child (e.g., being a pedophile or a pervert), or one might do something sexually inappropriate to another adult.
Aggressive or harming obsessions include fears that one may harm small children, one may hurt someone in the family, or one might self-harm/taking their own life, without having control over the action. Examples of these kinds of obsessions are the fear of stabbing or hitting your wife or children, that you may jump from a high place and or committing suicide without wanting it. Some obsessions do not fall into any of these categories (e.g., fear of not being able to speak or fear of going blind). This does not mean they cannot be treated.
HOARDING
People with this type of OCD are obsessed with the accumulation of useless things like trash, paper, and various objects.
In their minds, they overestimate catastrophically the things that might happen if they stopped accumulating objects, as well as the negative consequences their "carelessness" or "negligence" might have.
Unfortunately, we don't treat this type of OCD because it usually requires a team of professionals who need to help the person discard all the collected martial from the house.
Cognitive Behavioural techniques are not sufficient to treat hoarding effectively.
OCD: WHEN DOES EXPERIENCING BIZARRE THOUGHTS, IMAGES OR URGES BECOME A DISORDER
Many studies have found that 80% to 90% of the population has had intrusive thoughts on occasion. Some have had an impulse to run someone over while peacefully driving down the street, to jump off a bridge or to cry out an obscenity. It has occurred to others to do something inappropriate to someone, and many other thoughts go through people's heads for no reason at all.
A study conducted by Purdon and Clark (1992) showed that almost 95% of people who don't suffer from OCD also experience abnormal or bizarre thoughts. However, if you experience intrusive thoughts, images, or urges similar to these that you find difficult to dismiss, you may be suffering from OCD.
We specialise in treating Obsessive Compulsive Disorder, particularly in Pure Obsessions such as harming, gay obsessions, fear of being a pervert or pedophile, relationship OCD, and some others involving the body (e.g., blinking, moving, etc.) In CBT therapy, you will be able to understand better why you developed OCD and effective ways to reduce the frequency and distress of your obsessions.
What are obsessions?
For a diagnosis of OCD to be made, the client must exhibit either obsessions or compulsions, in accordance with the diagnostic criteria of DSM-IV-TR. There doesn't need to be both obsessions and compulsions, although they occur together as a rule.
Obsessions must fulfill the following criteria in order to be diagnosed as OCD:
Thoughts, impulses, or recurring and persistent images considered intrusive or inappropriate, which cause significant anxiety and discomfort. These intrusive thoughts, impulses, or images are not restricted to a mere excessive preoccupation about real-life problems. If they were just usual worries, the diagnosis would likely be of Generalised Anxiety Disorder, commonly known as GAD.
Notwithstanding, there are specific obsessions that can be mistaken for simple worries. In these cases, a detailed assessment is in order. Here are some examples of bizarre obsessions Sylvia treated in the past: A man who was obsessed that his eyes would remain turned inside out, a woman who thought she was walking strangely, with one foot higher than the other and another client who could not understand how the brain could form words and how she could manage to speak or utter words.
The second feature is that obsessions are ego-dystonic and not simple worries. Ego-dystonic is a term used in CBT. The word means that the content of the thoughts, images, or urges experienced are inconsistent with the person's belief system. Therefore, those obsessions perceived as utterly out of character or alien to them. Worries, on the other hand, are ego-syntonic. That means that an individual does not find the thoughts totally inconsistent with his or her belief system. Another critical difference between worries and obsessions is that obsessions usually are resisted, and worries are not.
The degree of intrusion will be determined by the importance attached to the experience, its consequences, and its implications. When there are great consequences and implications, a series of automatic negative thoughts will be activated. An example of this is, "If I think about killing my girlfriend, maybe I will lose control and end up killing her for real."
People try to either ignore or suppress these thoughts, impulses, and images. They may also try to neutralise them with other thoughts or actions. There must be some resistance present for obsessions to be considered as such. It is logical for people to try to neutralise something that is bothering them and causing discomfort. There are several ways of neutralising obsessions. One is by developing rituals and compulsions designed to eliminate the emotional response produced by the thought, image, or impulse.
The final consideration is that obsessions need to be viewed as the product of a person´s mind. The client must not think that they were imposed as in the case of thought insertion. A small percentage of people with OCD do not consider their obsessions to be extravagant or irrational, although they clearly are. In these cases, such ideas, which are overestimated in an almost illusory manner, must be sufficiently refuted. This is called OCD with poor insight.
Examples of obsessive thoughts associated with pure obsessions
These are some of the obsessive thoughts, images, or urges that we've treated in the past:
- What if I am attracted to children, and that's why I notice a groinal response?
- What if I secretly desire to abuse children sexually, and that makes a pedophile?
- What would happen if I lost control and said something insulting/abusive/ridiculous? (this could also be a common worry in those with social anxiety)
- What would happen if I suddenly did something dangerous like cutting my veins without wanting, throwing myself in front of a speeding car, stabbing myself to death, etc.?
- Did I turn off the oven?
- Maybe I got pregnant from using my father's towel.
- What if I can't stop focusing on the way I speak or blink?
- Did I just drop my keys while posting the letter in the letterbox?
- I feel the urge to spit on people when I am being introduced to them.
- I feel the urge to strangle my wife while she sleeps.
- What if I am gay?
- Did I kill a person while driving?
- Did I rape my girlfriend while sleeping?
- Did I sin against God?
What are compulsions?
Compulsions are acts that may be performed either in public or in secret, which are, in most cases, associated with the presence of obsessions. They are usually performed in a ritualistic, stereotypical way and are known as compulsive rituals.
DSM-IV-TR offers the following definition for compulsions:
1. Behaviours or mental acts of a repetitive nature that an individual feels compelled to perform as a response to an obsession, or according to a particular set of established rules.
It is important to bear in mind that compulsions can be not only behavioural but also be performed in one´s mind. Some known mental rituals are repeating certain words or phrases, praying, making calculations, and singing.
2. Compulsions are aimed at preventing or reducing discomfort or preventing adverse events or situations. When it seems necessary to try to neutralise obsessions, the acts aimed at neutralising them are described as compulsions or rituals. These rituals can be either behavioural or mental.
Although an individual´s active resistance level is considered essential for diagnosis, sometimes resistance to obsessions is barely present in chronic cases. This may be the result of years spent attempting to control the behaviour without success.
A client may perceive rituals as a way to prevent contamination, ensure perfection, or free him or herself from catastrophic consequences. Paradoxically, while the client engages in rituals to escape discomfort, Walter and Beech (1969) demonstrated that anxiety and discomfort occasionally increase shortly after the rituals and, in the long run, maintain OCD symptoms.
What is the best evidence-based treatment for OCD and Pure Obsessions?
The most effective treatment for Obsessive Compulsive Disorder, with or without rituals, is Cognitive Behavioural therapy. Improvement rates can reach up to 80%. As with any therapy, results vary depending on the client. However, you must be very committed to completing all the homework tasks assigned in session in order to benefit from your CBT treatment fully.
We are up-to-date with the latest and most effective treatments for OCD. We will not use relaxation techniques or thought suppression to manage your symptoms. While these techniques are still used to treat OCD, they do not help if you are suffering from this type of problem. We'll only use scientifically validated interventions that have been proven effective in the treatment of OCD. The treatment is conducted in a manner that takes into account your own resources to cope with the interventions so as to make it as comfortable as possible.
CBT is the treatment of choice for OCD, with two behavioural interventions, exposure and response prevention, receiving the highest scientific endorsement. Once a thorough assessment and formulation of your particular case have been carried out, a course of Cognitive Behavioural Therapy for OCD will comprise of the components outlined below.
Psychoeducation
In treatment, you'll learn why you may be suffering from OCD, what maintains the problem, what the treatment entails, success rates, how to avoid roadblocks, and the need to commit to doing homework assignments. You will be informed and motivated throughout the course of therapy. The goal is not to eliminate the obsessions but to learn how to avoid engaging with them.
With Psychoeducation, you'll understand how the CBT techniques work and which ones are the most effective to treat OCD.
For example, you'll learn that when in vivo exposure is not possible, imaginal exposure is used. This is particularly relevant for those who have pure obsessions without rituals and fear becoming perpetrators of sexual abuse, of hitting or hurting someone or who fear to sin against God.
Exposure Therapy and Behavioural Experiments
Exposure therapy may be in vivo or in imagination (imaginal exposure), and the goal is habituation. Clients face the feared situations, allowing information to be processed. In vivo exposure is when you are asked to do something you tend to avoid, for example, touching the doorknob, but you are required to do it for an extended period of time, over and over again, until no distress is experienced. Behavioural experiments are also used to gather evidence about the accuracy of your beliefs or predictions e.g., "if I don't ritualise, I will not be able to relax for the next 12 hours".
This type of exposure is carried out with a narrative you write detailing your worst fears, recorded on a tape, which you will be asked to listen to repeatedly each day until your level of distress decreases. For the treatment to be effective, the person must not use any mental rituals, avoidance, distraction, rationalisation, neutralisation, or reassurance-seeking while the exposure is taking place.
Cognitive Restructuring
Cognitive restructuring, as another technique in CBT, allows you to modify your unhealthy beliefs about your OCD or their consequences. However, at Anapsys, we tend to offer behavioural therapy first in order to observe quick improvements at the beginning, but this will depend on the case. Cognitive restructuring is applied in order to address the interpretations which have not changed with exposure, e.g., your core beliefs, beliefs about the need to neutralise your obsessions, or the beliefs that are likely to lead to future relapse. If you are experiencing only pure obsessions (Pure O or Pure OCD), without rituals, cognitive therapy plays an important role on top of the use of behavioural interventions. In therapy, we'll help you identify and modify certain personal beliefs that maintain your obsessions and rituals or that block the course of treatment such as, "If I say this out loud, it proves that I'm a pervert," "If I don't obsess, that means I don't care about what I might do to my children," "If I feel the urge to hit my child, that means I will do it, and I will become a monster for doing it."
Response Prevention
Response prevention appeared in 1966 with Victor Meyer in the United Kingdom. Before that moment, the OCD prognosis was rather bleak. It was then observed that, for an OCD treatment to be effective, a combination of exposure and response prevention therapy was needed. Exposure alone is not enough to treat obsessions with compulsions. It must be implemented alongside response prevention, which means not only encouraging clients to refrain from performing rituals but also shunning any neutralisation, excessive reassurance-seeking behaviours, confession, rationalisation and analysis, excessive monitoring of groinal response, neutralising thoughts or images, etc.
Medication
Some drug therapies are effective in reducing obsessions. New antidepressants, such as the SRIs family (e.g., fluoxetine, paroxetine, sertraline, and fluoxetine) are all recommended for OCD. They have fewer side effects than the tricyclic antidepressants, which were once prescribed (e.g., imipramine or clomipramine). Approximately 50% of those seeking CBT therapy for OCD is taking some type of medication, which improves the efficacy of CBT, particularly when OCD is accompanied by severe depression.
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