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Stop Obsessing!
This kind of book, a whole practical course of health care, even if short, is a very interesting experience. It is esy to see that there is a huge experience behind the text. Scarcely anything, I think nothing, is agaist the bare common sense, although such hair rising cases of extreme developments of obsessions are presented. And declared as overcome by the methods presented here. It only encourages the reader: my case is nothing compared with these. Maybe also my problems can be solved. But by this simple approach, by just self-treatment, is it possible?
The core of te solution of the most versatile appearances of obsession is its acceptance, diminution to futile commonplace sensation, a part of myself, feeling that comes and goes, nothing special. Trying to get rid of something that obsesses and haunts me to the limits of tolerance is according to this book a completely wrong treatment, as contrary as it seems to be at first sight. But there is also the common sense in it. What is common place and everyday, is acceptable and possible to live with.
Pagetop
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Sisällysluettelo Contents Содержание (Code: (1,2,3,4,5))
| 134 | 00000001 | Self-help Practice 4: add a Consequence to Your RITUAL5 One simple change that can greatly increase your |
| 137 | 00000002 | Self-help Practice 5: Choose Not to Ritualize |
| 143 | 01 | Part III The Intensive Three-Week Program |
| 143 | 0101 | Treatment for Ritualizers |
| 146 | 010101 | How Three Negative Beliefs Change 2268,3,The Program Design |
| 151 | 010102 | The Treatment of Washers |
| 161 | 010103 | The Treatment of Checkers and Repeaters 2536,3,The Treatment of Hoarders and Orderers |
| 170 | 010104 | The Treatment of Thinking Ritualizers |
| 172 | 0102 | 8 Your Three-Week Self-Help Program |
| 173 | 010201 | Preparing for Your Self-Help Program |
| 173 | 01020101 | 1. Rearrange your daily commitments. |
| 173 | 01020102 | 2. Prepare your family and friends. |
| 175 | 01020103 | 3. Choose supportive people to help you practice. |
| 176 | 010202 | The Three Techniques of Your Self-Help Program |
| 180 | 010203 | Example of an Imagery Script for a Washer |
| 182 | 010204 | Self-Help Program for Washing and Cleaning Rituals |
| 190 | 010205 | Self-Help Program for Checking and Repeating Rituals |
| 200 | 010206 | Self-Help Program for Ordering Rituals |
| 205 | 010207 | What lf I Have More Than One Ritual? 3096,3,Dealing with Setbacks |
| 207 | 010208 | Follow-Up Program 3124,s,For Washing Rituals 1. Take advantage of any opportunity in your everyday life to practice exposure. The more you continue your contact with previous contaminants, the faster you will get rid of residual distress. 2. Do not wash your hands more than five times a day, thirty seconds each time. 3. Do not use soap while washing your hands unless your hands are visibly dirty. 4. Hand washing should take place only after using the toilet, before handling food, or when hands are visibly dirty. 5. Take at most one ten-minute shower per day. Do not ritualize during the shower. |
| 208 | 010209 | What If I’m Not Making Any Progress? |
| 209 | 0103 | Medications That Help OCD |
| 210 | 010301 | Should Medication Be Used Instead of a Self-Help Program? |
| 211 | 010302 | Which Medications Should I Take |
| 211 | 010303 | What Benefits Can You Expect from These Medications? |
| 212 | 010304 | Guidelines for Medication Use |
| 213 | 010305 | Medication Descriptions |
| 214 | 010306 | Tricyclic ANTiDEPRESSANT |
| 215 | 010307 | Selective Serotonin Reuptake Inhibitors (SSRIs) |
| 219 | 010308 | 10 Graduating from the Program: Encouraging Stories from Recovered Obsessive-Compulsives |
| 219 | 01030801 | Shirley |
| 228 | 01030802 | Joel |
| 235 | 01030803 | Annette |
| 243 | 01030804 | Kate |
| 249 | 01030805 | Gustina |
| 260 | 010309 | A Last Word of Encouragement |
| 262 | 010310 | Resources |
| 262 | 010311 | National Service Organizations |
| 263 | 0104 | Appendix A |
| 263 | 010401 | The Obsessive-Compulsive Inventory |
| 263 | 010402 | The Obsessive-Compulsive Inventory (OCI) |
| 270 | 010403 | Appendix B |
| 270 | 010404 | About the Authors |
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1 (75) • Special triggering thoughts or events 1925,3,Changing Your Rituals 1951,s,Action 1: jy Action 2: {> Action 3: 0 Action 4: £ Action 5: /) Action 6: 2 (174) Specifically, you and your family need to adopt the following guidelines: • Family members should stop helping you perform your rituals. For example, spouses should refuse to check doors and electrical appliances repeatedly or keep track of the number of times you rotate your hands while washing. • Family members should stop performing any rituals because of your obsessions. You should instruct your children to refuse your requests to wash excessively or to take their temperature repeatedly. If your children are young, your spouse should be in charge of routines that have been the focus of your compulsions. • Family members must agree that your requests for reassurances will not be granted. When you ask questions such as “Did I touch the toilet seat?” “Do I have a lump on my neck?” or “Should I call the Poison Control Center?” your family should respond by saying, "We have all agreed that we cannot answer this question.” 3 (175) Consider these guidelines for selecting your support people: • They should be warm and encouraging. • They should be ready to suggest and participate in activities-taking a walk, engaging in conversation, shopping, or going to the movies-that will distract you from the urge to ritualize. • They should not use force or ridiculing comments if they find you engaging in your rituals. Instead, they should remind you of your commitment and help you engage in distracting activities. • As with family members, other support people should not reassure your obsessive concerns or help you perform your rituals. 4 (177) Below you will find ten guidelines to help you with your exposure and imagery practice: 1. Start by turning back to Tables 1 and 2 in Chapter 3 and review the situations and thoughts that provoke your distress. 2. Begin your program with situations that evoke a discomfort rating of about 50. As the program progresses you will gradually proceed upward to the items that provoke your highest discomfort level. 3. Each time you practice, confront a given situation or image until your discomfort level decreases by at least half. 4. Practice again and again with each given situation or image until your discomfort decreases significantly. At that time you can proceed to the next highest item on your list. 5. Practice daily with sessions lasting at least one or two hours. Studies have repeatedly found that long exposures are much more effective than short ones. Therefore, it is best that your exposure be continuous and not interrupted. If you confront a distressing situation in time segments of five minutes each, your distress will not decrease much, even if your total exposure time is one or two hours. So make sure your exposure practice is continuous. The rule of thumb: Do not end an exposure practice until your discomfort is reduced at least by half. 6. Use Tables 9 and 10 to monitor each exposure practice. Write down the situation, object, or image you practiced that day and monitor your distress level periodically. 7. If your discomfort with a situation or image does not decrease during any given day, then practice this situation an extra day and, if possible, add another hour to your exposure practice. 8. Once your distress level stays consistently low over several days with a particular situation or thought, you need not continue practicing it regularly. 9. Continue the program until you have successfully confronted the most distressful situations or images on your list. If you do not confront the situations that evoke the highest distress, it is more likely you will lose the gains you made during the program. 10. Enlist the help of supportive friends or relatives whenever you feel that such help is going to encourage you to work harder. 5 (270) Edna B. Foa, Ph.D., is a professor of clinical psychology in psychiatry at the University of Pennsylvania, and director of the Center for the Treatment and Study of Anxiety Dr. Foa has devoted her academic career to the study of the psychopathology and treatment of anxiety disorders, primarily obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), and social phobia, and is currently one of the world’s leading experts in these areas. Dr. Foa was the chair of the DSM-IVSubcommittee for OCD and cochaired the DSM-IV Subcommittee for PTSD. Dr. Foa has published several books and more than 250 articles and book chapters and has lectured extensively around the world. Her work has been recognized with numerous awards and honors. Among them are the Distinguished Professor Award under the Fulbright Program for International Exchange of Scholars; the Distinguished Scientist Award from the American Psychological Association, Society for a Science of Clinical Psychology; the first annual Outstanding Research Contribution Award presented by the Association for the Advancement of Behavior Therapy; the Distinguished Scientific Contributions to Clinical Psychology Award from the American Psychological Association; and a Lifetime Achievement Award presented by the International Society for Traumatic Stress Studies. R. Reid Wilson, Ph.D., is associate clinical professor of psychiatry at the University of North Carolina School of Medicine and a psychologist in private practice in Chapel Hill, NC. He is author of Don't Panic: Taking Control of Anxiety Attacks and directs the free self-help site anxieties.com. He designed and served as lead psychologist for American Airlines’ first national program for the fearful flier. Dr. Wilson served on the board of directors of the Anxiety Disorders Association of America for twelve years and as program chair of the National Conferences on Anxiety Disorders for three years. 6 (271) This book is not intended to replace personal medical care and supervision: there is no substitute for the experience and information that a professional familiar with Obsessive- Compulsive Disorder can provide. Rather, it is our hope that this book will supplement the help which a professional can provide and prove of assistance to those without access to a professional experienced in this disorder. To protect the privacy of the individuals involved, the names and identifying characteristics have been changed in the case histories we recount. STOP OBSESSING! Revised Edition A Bantam Book PUBLISHING HISTORY Bantam trade paperback edition / September 1991 Bantam revised trade paperback edition / August 2001 All rights reserved. Copyright © 1991 and 2001 by Edna B. Foa, Ph.D., and Reid Wilson, Ph.D. Foreword copyright © 2001 by David H. Barlow, Ph.D. Library of Congress Catalog Card Number: 90-27748 No part of this book may be reproduced or transmitted in any form or by any means, or by any information storage and retrieval system, without permission in writing from the publisher. For information address: Bantam Books. elSBN: 978-0-307-57402-2 Bantam Books are published by Bantam Books, a division of Random House, Inc. Its trademark, consisting of the words “Bantam Books” and the portrayal of a rooster, is Registered in U.S. Patent and Trademark Office and in other countries. Marca Registrada. Bantam Books, 1540 Broadway, New York, New York 10036. |
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