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What is Obsessive-Compulsive Disorder and When Do You Need Treatment?

What is Obsessive-Compulsive Disorder and When Do You Need Treatment?

Written by: Fred Chin, Psychologist

 

What is Obsessive-compulsive Disorder?

Think of the following scenario: you have friends over at your place and you serve them drinks. Before they can place their cups on your beautiful coffee table, you exclaim and dart out coasters underneath the ice-cold glasses before the first drop of dew can drip on that expensive rosewood. Your lightning-fast reflexes have intercepted what would have been a disaster. Your friends are startled at first, then they laugh and tease you. They say you have OCD – obsessive-compulsive disorder.

This, or a similar instance, may have happened at some point in our lives before. We tidy up a mess in the presence of others, or when our belongings are organised ever so neatly, and we end up joking about OCD.

But in truth, OCD is far from such behaviours that could be written off so light-heartedly.

A person with OCD will have compulsions – they feel the need to perform certain repeated behaviours to reduce emotional distress or to prevent undesirable consequences. These compulsions are so intense that they cannot carry out other daily routines without acting on them. Some common ones include:

  • Excessive washing or cleaning – They fear contamination and clean or wash themselves or their surroundings many times within a day.
  • Checking – They repeatedly check things associated with danger, such as ensuring the stove is turned off or the door is locked. They are obsessed with preventing a house fire or someone breaking in.
  • Hoarding or saving things – They fear that something bad will happen if they throw anything away, so they compulsively keep or hoard things, usually old newspapers or scraps of papers which they do not actually need or use.
  • Repeating actions – They repetitively engage in the same action many times, such as turning on and off a light switch or shaking their head a numerous number of times, up 20 to 30 times.
  • Counting and arranging – They are obsessed with order and symmetry, and have superstitions about certain numbers, colours, or arrangements, and seek to put things in a particular pattern, insisting to themselves that the layout must be symmetrical.

When Does OCD Become Chronic and What Should You Do If That Happens?

OCD is a chronic disorder, so it is an illness that one will have to deal with for the rest of his or her life. It is difficult to tell when the disorder becomes chronic, as it presents the individual with long-lasting waxing and waning symptoms. Although most with OCD are usually diagnosed by about age 19, it typically has an earlier age of onset in boys than in girls, but onset after age 35 does occur.

A cognitive model of OCD suggests that obsessions happen when we perceive aspects of our normal thoughts as threatening to ourselves or to others, and we feel responsible to prevent this threat from happening. These misperceptions often develop as a result of early childhood experiences. For example, a child may experience living in a dirty and dusty environment, while being subjected to some form of trauma at the same time. He associates a lack of hygiene with suffering from the trauma. At a later stage in life, he may start to feel threatened upon seeing the unhygienic behaviours of someone he lives with, be it his parents, romantic partner, or flatmates. This leads to the reinforcement of the association and to the development of his beliefs that suffering is inevitable when unhygienic conditions are present, giving him compulsions to improve these unsanitary conditions through washing and cleaning. 

If one is affected by OCD to the extent that he or she is unable to hold down a job and to manage household responsibilities, then there is a need for clinical treatment as the symptoms have become severe. Like in the above-mentioned example, recurrent and persistent thoughts of dirt will give the individual compulsions to neutralise these thoughts, resulting in repetitive washing, and checking behaviours. This causes distress and significantly affects one’s functioning.

When OCD has become a chronic illness, through a formulation of intervention strategies, the psychologist should extrapolate the client’s pattern of behaviour and expect a positive prognosis for functional improvement.

 

How Can OCD Be Treated?

A person diagnosed with OCD may seek treatment through a treatment plan that consists of cognitive strategies. These cognitive strategies involve consciously implementing sets of mental processes in order to control thought processes and content. Through these cognitive strategies, we can examine and restrict the thoughts and interpretations responsible for maintaining OCD symptoms. This is conducted in the initial stages of therapy.

Thereafter, Exposure Response Prevention (ERP) methods are carried out once a client is able to understand and utilise these cognitive strategies. ERP requires the client to list out their obsessive thoughts, identify the triggers that bring about their compulsions and obsessions and rate their levels of distress on each of these. Starting with a situation that causes mild or moderate distress, the client is exposed to their obsessive thoughts and simultaneously tries to resist, engaging in any identified behaviours that they have been using to neutralise these thoughts. The amount of anxiety is tracked each time the process is repeated. When anxiety levels for this particular situation eventually subside, over several repeated processes, and when they no longer feel significant distress over this situation, the same method is repeated for the next obsessive thought with the next level of distress.

A client who is able to demonstrate strength in coping with the symptoms has a better likelihood for sufficient recovery.

 

OCD is Becoming More Prevalent in Singapore: How has it Been Accepted in Society?

In recent years, OCD has topped the list of mental disorders in Singapore, with the greatest number of people experiencing it in 2018, compared with other mental illnesses.

The disorder has been found to be more prevalent among young adults than those aged 50 and above. In terms of socio-economic status, OCD is more likely to occur amongst those with a monthly household income of less than S$2,000 than those who earn above that amount.

It has also been found that the prevalence of people experiencing OCD at least once in their lifetime is higher in Singapore than in South Korea, Australia and New Zealand.

In addition to becoming more prevalent, people who experience OCD are also becoming increasingly reluctant to seek psychiatric help or counselling, making matters worse. There is some acceptance of the condition as normal and trivial by society, because people who do not understand the disorder well enough misconceive OCD as a quality of being clean and tidy, as being clean and tidy is usually seen as a good thing. This misconstrual by society is dangerous for the undiagnosed, and their condition will further deteriorate if they continue to put off addressing their disorder.

The disorder will get worse if treatment is ignored, and there is a need to realise it in its early stages through observing how one’s life is being disrupted. Awareness about its onset of symptoms is important.

Do seek out a psychiatrist,  psychologist, psychotherapist (therapist) or counsellor to get professional help for a better recovery journey. Early intervention is crucial to prevent escalation of the condition.

 


reference(s)

https://www.todayonline.com/singapore/mental-illness-more-prevalent-among-young-adults-ocd-one-of-top-disorders-spore

Photo by Anton on Unsplash

COVID-19 AND ADDICTION – RECOVERY USING ONLINE THERAPY

COVID-19 AND ADDICTION – RECOVERY USING ONLINE THERAPY

Author : Andrew da Roza

COVID-19 has posed a challenge to everyone, and those more physically vulnerable in our community clearly need our care and attention. 

There are also people whose mental vulnerability deserves equal care.

Mental illnesses such as depression, anxiety, and addictions are exacerbated by a pandemic crisis in multiple ways. 

Collective family and community fears are (in themselves) contagious; and the constant bombardment of medical and financial bad news, can leave those with mental illnesses lost in a cascade of negative rumination and catastrophising. 

The mentally ill and people with addictions commonly have compromised immune systems, and suffer stress or substance, tobacco and alcohol abuse related diseases – leaving them wide open to severe pneumonia with acute respiratory distress symptoms – and other complications from COVID-19. 

Isolation, separation and loneliness – caused by working at home and social distancing – are perhaps the worst contributors to: low mood; agitation; irrational fears; moments of panic; self-disgust; resentment; anger; and even rage.

People whose ability to pause, use reason and find practical solutions can be severely compromised. They may find themselves bereft of the motivation, and ability to engage in even the simplest tasks of self-care. 

Added to this, listlessness, boredom and frustration can lead to despair. Then self-harm and suicidal thoughts may arise, take hold, and even overwhelm them.

Those in recovery or active addiction may also turn to their compulsive and impulsive behaviours of choice, to sooth and find momentary respite from the moods and thoughts that have hijacked their mind. Triggers, urges and cravings may become relentless and unbearable. 

The solution may begin with finding a way out of isolation. 

Starting the journey out of this darkness can start with talking to people who can demonstrate unconditional positive regard, show kindness and compassion, and help reframe the situation. Such people can assist those suffering to put a name to and validate their emotions. 

In short – therapy can help!

In times of COVID-19, working with a therapist via teleconsultation can be effective using ZOOM, Skype, WhatsApp video and FaceTime. 

Although the calming and soothing sensation of the physical presence of a therapist is absent, for those in isolation – distraught with shame and despair – Internet enabled therapy can prove a lifeline.   

Isolation can be further broken, using similar Internet methods, by attendance in recovery groups such as Alcoholics Anonymous, Narcotics Anonymous and Sex and Love Addicts Anonymous – all of whom now hold Zoom meetings in Singapore. 

These Zoom opportunities in Singapore are supplemented by Zoom, Skype and telephone conference meetings in Hong Kong and Australia (in Singapore’s time zone) and in the U.K. and the US (during our mornings and evenings).             

Having broken the isolation, the second step therapists can provide is guidance and motivation towards self-care. This would include tapering or abstinence from the addictive substances or behaviour. A well thought through relapse intervention and prevention plan, specifically tailored to a person’s triggers, will also assist.

Triggers may be particular places, situations, people, objects or moods. 

The acronym “HALT” is often used by those in recovery; which stands for the triggers of being: Hungry; Angry; Lonely; or Tired.

When these triggers arise, people are encouraged to 

  • HALT their behaviour; 
  • breathe deeply, with long outward breaths;
  • think through consequences;
  • think about alternatives;
  • consult with others; and
  • use healthy tools to self-soothe.      

Daily mindfulness, meditation, exercise, sleep hygiene, healthy eating and following a medication regime are important aspects of self-care – and for some suffering mental illness – these actions – and time – may be all they need to find their footing again.

Luckily, the Internet gives a vast array of possible self-care options, including things to distract us, soothe us and improve us. 

Everything is available from: calming sounds and music; guided meditations; games; home exercise, yoga and tai chi; self-exploration and improvement videos; video chats with loved ones; to healthy food delivery options. They can all be had with a few keystrokes. 

Today we live at a time when suffering from mental illness and addictions is commonplace. But we also live at a time when the solutions are literally at our fingertips – if we only reach out for them. 

For information on teleconsultation for addiction therapy and addiction recovery meetings, contact:  Andrew da Roza at Promises Healthcare by email to andrew@promises.com.sg or by calling the Promises Healthcare clinic at: (+65) 6397 7309 

 

   

 

Intrinsic motivation as a source of vitality?

Intrinsic motivation as a source of vitality?

“Vitality management is provided for organizations that have a vision”. A quote from Pauline van Dorssen, writer of “Vital People in a Vital Organisation”. This is a new successful training (NIP). Positive psychology and the use of vitality are central. The response from Occupational and Organisational Psychologists and Occupational Health Psychologists was exuberant, with all available places booked. In addition, the same question arises from organizations, who often need advice and coaching in the field of vitality.

To know more, here is the original article in Dutch language: Artikel_De Psycholoog_lisa van der Heijden

Written by Lisa van der Heijden, Clinical Psychologist.

If you are interested to know and learn more therapy for children/adolescents, contact Promises Healthcare for more information.

Care Community Fun Fair : 5 August 2017

Care Community Fun Fair : 5 August 2017

HMI Institute of Health Sciences in support of the FestivalForGood (organised by raiSE) invites you to join us for hands-on experiences on caregiving through training simulations and fun activities. Some takeaway knowledge include:

  • Knowing how to create a safe home environment for your aged parents/grandparents
  • Safe feeding skills for Caregivers
  • Understanding Caregivers’ stress & preventing/relieving these stresses
  • Understanding how your aged parents/grandparents feel
  • Recognising illnesses & emergencies
  • Simple skills on CPR

-and many more!

Our Career Coaches will also be around to assist you with information on our training programmes and career services.

Event Details

  • Date & Day: 05 August 2017 (Saturday)
  • 3 Sessions: 9:00am · 11:00am · 1:00pm
  • Venue:
    HMI Institute of Health Sciences @
    Devan Nair Institute for Employment and Employability, 
    80 Jurong East Street 21, #06-03, Singapore 609607

To know more information about this event, you can click here: link:http://hmi-ihs.com/index.php/care-community-fun-fair-05-aug-2017

The Relationship Between Media Multitasking and Executive Function in Early Adolescents

The Relationship Between Media Multitasking and Executive Function in Early Adolescents

The increasing prevalence of media multitasking among adolescents is concerning because it may be negatively related to goal-directed behavior. This study investigated the relationship between media multitasking and executive function in 523 early adolescents (aged 11-15; 48% girls).

The three central components of executive functions (i.e., working memory, shifting, and inhibition) were measured using self-reports and standardized performance-based tasks (Digit Span, Eriksen Flankers task, Dots–Triangles task). Findings show that adolescents who media multitask more frequently reported having more problems in the three domains of executive function in their everyday lives.

Media multitasking was not related to the performance on the Digit Span and Dots–Triangles task. Adolescents who media multitasked more frequently tended to be better in ignoring irrelevant distractions in the Eriksen Flankers task. Overall, results suggest that media multitasking is negatively related to executive function in everyday life.

To read the full article: http://jea.sagepub.com/content/early/2014/02/17/0272431614523133.abstract

Written byLisa van der Heijden, Clinical Psychologist, Susanne E. Baumgartner and Wouter D. Weeda.

Contact Promises Healthcare if you are interested to know and learn more therapy for children/adolescents.