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Obsessive/Compulsive
Disorder I have worked with people suffering from this disorder for many
years and am very pleased to be able to offer a special service
for people suffering from this problem. In the beginning I had very
little help with this work since almost all the literature on this
subject is written by Psychiatrists working with drugs. Psychiatry appears to believe this problem is biological and is rooted in the physiology of the brain. One leading Psychiatrist has even gone so far as to describe it as a kind of throw-back to animal ‘appeasement’ behaviour. It has also been described as a kind of ‘stutter’ in the brain. It is almost always treated with drugs, with the usual hit-or-miss outcome. It may also be treated by a Psychologist using a Cognitive/Behavioural approach, which may be useful when dealing with the kind of OCD that involves an activity, but even then if the root of the problem is not treated it will simply recur in a different form. I have found in my work with OCD clients that there are two clearly separate streams of thought involved. One is purely rational and doesn’t want to undertake the obsessive activity or think the obsessive thought. The other, however, the actual compulsion to carry out the obsession, is almost invariably unconscious to the thinker. So much so that the ‘intrusive’ thought might even appear to be not a part of the thinking process of the client at all, appearing more like an external invader. It is therefore imperative in this work to bring the unconscious thought out into the open, no matter how irrational it might appear to be. For within this irrational thought process lies all the clues as to the origin of the problem. The irrational thought is always intimately connected with the symptoms and with the root of the problem. What we have to do is respect the irrationality and really learn to listen to it. Sigmund Freud, when working with a patient suffering from OCD, noted that way back in the patient’s formative years there had been a time of great trauma when two thoughts became conjoined. The connection between the two thoughts was then lost in the unconscious but the emotional charge remained, although it was then attached to the wrong thought. I have found that it is of utmost importance if this problem is to be rooted out, to find that lost connection and separate out the two thoughts, thereby defusing the emotional charge. This is fairly long-term work, of course, involving working gradually and carefully through the layers of defences around the traumatised area. For many sufferers, the OCD thinking itself represents a defence. It may be the only way the client was able to find that would give them an experience of control in the traumatic situation. This sense of control is, of course, an illusion but it is a powerful illusion and must be treated with care and respect. To wade in and attempt to simply destroy a form of defence, no matter how erroneous or illusory, would only increase the client’s already extremely high anxiety to a level which would be intolerable. It is not therapeutic to increase a client’s anxiety in this way, and this is unfortunately not unusual with Cognitive/Behavioural therapy. However, with this particular disorder, it is also important to work with clients to help them face their fears and to help them to limit the number of times they will perform an activity or think a particular thought, and then to ride out the anxiety until it goes. This is where the ‘Will’ work of Psychosynthesis is absolutely essential. Through negotiation with the therapist, the client chooses the limit they wish to abide by and will put in the hard work of limiting their ritualising according to their chosen limit. If they do not achieve their goal, this is not failure, it simply means perhaps the chosen limit was too high and a lower limit may be negotiated. By limiting the rituals, whether activity based or thought rituals, clients begin to de-sensitise the emotional charge that causes their anxiety to rise. Many clients have permanently resolved their OCD using this combination: limiting rituals and resolving the trauma at the origin of the problem. For those for whom permanent resolution is not possible, significant improvement has been achieved. By its very nature, this work takes a great deal of time and patience, but it is kind and gentle, remembering that the physician should do no harm. It does not re-traumatise the client and when the root of the problem is dealt with, the improvement should be permanent. This disorder is often known as the ‘hidden problem’. Because the symptoms can appear bizarre, people tend not to talk about their problem with friends or relatives. The nature of the rituals may be such that people can no longer work or even leave their homes, and with isolation depression and anxiety are exacerbated, resulting in a severe debilitating illness. We offer two services for OCD sufferers. The first is long-term one to one therapy which takes ‘as long as it takes’ for there are very few short cuts and each person is different in their capacity for change. OCD is a complex problem to resolve. The second service we offer is Group Work which will take the form of small groups of people with OCD meeting for two hours weekly for six weeks. We will work through a programme, beginning with just finding a voice and making oneself known to others in the safety of the Group. We will then expand the range of what we cover each week, to enable each participant to gain knowledge of their own OCD process and to learn some ways of beginning to deal with their problem. Each group will be closed so that participants can build up a sense of safety and trust. New groups will start every three months and will take place in West Sussex.
Barbara Cole, BA, MAHPP For details and bookings please contact: Training for therapists wishing to work with OCD is sometimes available. Please call for details.
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