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Daniel

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David Clark's Cognitive Approach to OCD

The word “intrusive” has a pathological connotation, but most thoughts are intrusive, that is, they come to the thinker unbidden. Very few thoughts are produced intentionally. Pointing this out to patients and not referring the obsessive thoughts as “intrusive” helps to normalize patients’ appraisals of their thoughts and of themselves.
 

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Some people report that they have difficulty distinguishing between spikes [unwanted thoughts] and "legitimate important thoughts." A fool proof litmus test for telling the difference is to ask yourself did the thought or question come with an associated anxiety or feeling of guilt. Ultimately all such thoughts can be placed in the realm of OCD. When asked "What if it's not OCD," I say "Take the risk and live with the uncertainty."

~ Steven Phillipson, Ph.D
 

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“If you surrender to uncertainty, nothing goes wrong.”

~ Deepak Chopra
 

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"Our energy and the energy of the universe are always in flux, but we have little tolerance for this unpredictability, and we have little ability to see ourselves and the world as an exciting, fluid situation that is always fresh and new. How we relate to this dynamic flow of energy is important. We can learn to relax with it, recognizing it as our basic ground, as a natural part of life; or the feeling of uncertainty, of nothing to hold on to, can cause us to panic, and instantly a chain reaction begins. We panic, we get hooked, and then our habits take over and we think and speak and act in a very predictable way."

~ Pema Chödrön, Taking the Leap
 

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“Gratitude is an emotion that grounds us and is a great way to balance out the negative mindset that uncertainty engenders.”

~ Guy Winch
 

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Actual genuine blog

There should be more about about the less well-known symptoms of Obsessive-compulsive disorder, things such as

  • hyper-morality (extreme black and white moral reasoning)
  • hyper-responsibility (feeling responsible for everything to a self-destructive degree, even feeling responsible for events which have nothing to do with you)
  • intolerance of uncertainty, (feeling very uncomfortable if you do not know everything about a given situation).
  • Excessive and persistant desire for reassurance
  • Extreme bouts of anger
Everyone who has OCD has it in a different form, so they might not show all of these symptoms but for others it can be a defining part of their illness.
 

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Untangling the Web of Comorbid Obsessive-Compulsive Disorder and Medical Illness | Psychiatric Times

A recent Swedish population-based study showed unexpected results: a higher dose of SSRIs and longer treatment duration were correlated with a lower risk of metabolic or cardiovascular problems. This evidence can be explained in many ways, including better disease control, appropriate pharmacological treatment, and unhealthy habits (smoking, unhealthy diet). Full doses of SSRIs could prevent secondary depression; comorbidity can be as high as 80%, but most prevalence rates are around 25% and 50%, considering OCD. Moreover, better symptom control could reduce anxiety, which plays a key role in causing metabolic and cardiovascular alterations.

Both depression and OCD have an impact on glycemic control, which is exacerbated with high anxiety with consequent hyperglycemia via activation of autonomic responses and triggering the HPA axis. Hyperglycemia can also lead to anxiety in different ways. By increasing cortisol secretion, altering heart rate, and modifying skin conductance levels it can lead to stress-like arousal patterns pervasive in psychiatric patients.

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Can diabetes cause anxiety? Blood sugar and other causes

The emotional challenges of living with diabetes can also trigger anxiety.

Researchers report that anxiety affects about 40% of people with diabetes. This prevalence is much higher than that in the general U.S. population, where the condition affects 18.1% of people.

People with diabetes are at risk of developing low blood sugar, or hypoglycemia. Some of the symptoms of hypoglycemia are identical to those of anxiety.
 
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Brain scans reveal why it is so difficult to recover from OCD

Current exposure therapies may only teach patients how to deal with their compulsions rather than truly learning that the situations they are so scared of are not actually dangerous...

An avenue for improving future treatment for OCD would be to explore better learning in patients that not performing compulsive safety behaviours is truly safe. This could be achieved by boosting rewards in therapy for not performing safety behaviour or possibly with the help of certain drugs that can enhance the positive experience of not having to perform the compulsions.
 

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Self-vulnerabilities, attachment and obsessive compulsive disorder (OCD) symptoms: Examining the moderating role of attachment security on fear of self - ScienceDirect
October 2020

Screenshot_2020-12-20 Self-vulnerabilities, attachment and obsessive compulsive disorder (OCD) s.png

Fear of self (FOS), denoting fear of who might one be or who might one become (Aardema et al., 2013), for instance, has been implicated in the development and maintenance of OCD symptoms and has been shown to relate to OCD symptoms in clinical and non-clinical samples (Aardema et al., 2017; Melli, Aardema, & Moulding, 2016)...

Our findings are consistent with theoretical writings implicating attachment insecurities in the development and maintenance of OCD symptoms (e.g., Doron & Kyrios, 2005; Doron, Sar-el et al., 2012; Guidano & Liotti, 1983). Attachment security and contextual activation of the sense of attachment security have been linked with cognitive and emotional flexibility, tolerance for uncertainties and ambiguities, and openness to inner pain (e.g., Cassidy, Shaver, Mikulincer, & Lavy, 2009; Mikulincer, 1997; Mikulincer, Shaver, & Rom, 2011). Our findings suggest that the cascade of mental events linking self-vulnerabilities with OCD is more likely to occur among insecurely attached people than among secure ones, and that dispositional attachment security may protect against the development of OCD-symptoms. The mobilization of mental representations of supportive others or actual sources of support may sustain optimistic beliefs and constructive strategies of distress regulation and maintain a stable sense of self-worth (Mikulincer & Shaver, 2016), thereby preventing the development of OCD.
 
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Feared self-perception interacts with dysfunctional reasoning in the prediction of obsessive-compulsive symptoms

  • CBT based on this model explicitly addresses feared self-perceptions in OCD, and aims to help clients develop a greater level of self-trust by utilising more reality-based criteria in defining their sense of self.
  • Need to demonstrate to clients that their feared possible self arises on the basis of dysfunctional reasoning that renders the feared self invalid.

Feared possible selves in cognitive-behavioral theory: An analysis of its historical and empirical context, and introduction of a working model - ScienceDirect

  • Self-constructs have been largely ignored in cognitive formulations.
  • The feared self is believed to be highly relevant in OCD and related disorders.
 
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OCD and Isolation

While the Internet cannot take the place of face-to-face interaction, I do believe that social media sites have the potential to lessen the feelings of isolation that OCD sufferers feel. Connecting with others on forums, or even just reading about people who are suffering as they are, can help reduce loneliness, and in the best case scenario, prompt those with OCD to seek appropriate help.
 

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obsess - Wiktionary

From Latin obsessus, perfect passive participle of obsideō ("sit on or in, remain, besiege"), from ob ("before") + sedeō ("I sit"); see sit, session, etc.


compulsive - Wiktionary

Borrowed from French compulsif, formed from Latin compulsus, past participle of compellere (“to compel”), from com- (“together”) + pellere (“to drive”).


disorder - Wiktionary

From dis- +‎ order.
 

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