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Post  counselor on Mon Oct 15, 2012 11:20 am


Obsessions are thoughts, images or impulses that occur over and over again and are outside the control of the person who experiences it. These ideas are perceived as disturbing and intrusive, and, at least when people are not attacked by anxiety, are judged as unfounded and nonsensical. People with OCD may worry excessively dirt and germs and be obsessed by the idea of ​​being able to pollute or contaminate others. Can be terrorized by the fear that we have inadvertently hurt someone (maybe you saw maneuvered the car out of a parking lot), you can lose control of himself and become aggressive in certain situations, they have contracted diseases or being homosexual, although usually recognize that this is not realistic. Obsessions are accompanied by unpleasant emotions, such as fear, disgust, discomfort, doubt, or the feeling of not doing things the "right way", and countless efforts to counter them are not successful, if not momentary.
Obsessions are related to negative events related to issues of daily life, you may fear that to happen. For example, you may be worried about failing an exam, your economic status, health, or your relationships. In contrast to the obsessions, the worries do not seem excessive and lacking a rational basis, but are based on real risks, that everyone recognizes as such.

Compulsions are also called rituals or ceremonies and are repetitive behaviors (hand washing, ordering, checking) or mental acts (counting, praying, repeating formulas mentally) put in place to reduce the sense of unease and anxiety caused by the thoughts and impulses typical of obsessions, are, that is, an attempt to circumvent the discomfort, a way of trying to achieve control over their anxiety. People with an obsession about contamination may wash your hands constantly to provoke the bruises. A person may repeatedly check that you have closed the gas to the obsessive fear to blow up the house, one can count objects over and over again by obsessing over them lost. In general, all the compulsions that include cleaning, washing, checking, ordering, counting, repetition and collect become strict rules of behavior and are often bizarre and frankly excessive. Compulsions often take on a character so habitual and repetitive that are implemented as a preventive measure, even in the absence of obsessions. Become established and actions designed, carried out with meticulous care, which can not in any way be interrupted or modified in their sequence.

Unlike other psychological disorders, substantially homogeneous, in clinical practice can be distinguished by its clarity seven types of obsessive-compulsive disorder, sometimes present at the same time. Despite attempts to create sub-categories, however, the obsessions and compulsions may be the most varied and is therefore likely not be able to recognize fully in any of the categories listed, while suffering from OCD.
In clinical practice, however, we distinguish:
- Noise from contamination - This is related to obsessions and compulsions unlikely (or unrealistic) infection or contamination. People who suffer from it are tormented by the insistent determination that they themselves, or any of their family members, can get sick coming into contact with some invisible germ or toxic substance. Substances "contaminants" often become not only dirt objective, but also urine, feces, blood and syringes, raw meat, sick, genitals, sweat, and even soaps, solvents and detergents containing chemicals potentially "harmful". The feared contamination can also be related to "dirt" of a social nature (the addict, the homeless, the elderly, etc..) Or metaphysical (evil, the devil, etc..). In some cases there is the fear of disease, but only a strong sense of disgust in making contact with certain substances. In any case, public toilets, garbage cans, gardens, bus or telephone booths are carefully avoided, as well as any place that can be "infected". If the person comes in contact with one of the agents "contaminants", puts in place a series of ritual washing, cleaning, sterilization or disinfection designed to neutralize the action of germs and calm compared to the possibility of infection or shake the feeling of disgust . Such rituals, among which the most common are certainly detailed and repeated washing of the hands and body, clothes, food and other personal items, often involving family members, who are "forced" by the patient to avoid places "contaminated" and wash more than necessary.
- Disorders of control - This controls obsessions and compulsions involving protracted and repeated unnecessarily, designed to repair or prevent disasters or serious accidents. People who suffer from it tend to check and recheck both to calm down about the obsessional doubt that he had done something wrong and do not remember it, both as a preventive measure, to make sure you have done your best to prevent any possible disaster. Control so that it has closed the doors and windows of the house, the doors of the car, the gas valve and water, the garage door or the medicine cabinet, to turn off electric stove or other appliances, lights in every room of the house or the car's headlights, you count good money, have successfully built a module or a ledger, you have not lost personal items, dropping them, you have not accidentally hit someone with your car, you do not have traces of blood on him. The compulsive control is therefore to calm down about the constant doubt he had done everything necessary to prevent disasters or doubt of damaging something or someone inadvertently not have noticed. This type of ritual often involves family members who are the subject of constant demands for reassurance and to which is sometimes asked to carry out checks instead of the person.
- Obsessions well - These are thoughts or, more often, images of scenes that the person implementing unwanted behaviors and unacceptable, meaningless, dangerous or socially inconvenient (attack someone, have sex with men or pedofilici, betraying partner, cursing , take actions blasphemous, offensive loved ones, etc.).. These people have no rituals or mental compulsions, but only obsessive thoughts. What brings anxiety is not so much the nature of thought itself, but the fact that its presence is taken as a sign from the subject to be really a homosexual, a pedophile, a pervert, a blasphemer or aggressive. It 's the case of the person who has a sexual fantasy suddenly at the sight of a person of the same sex, perhaps accompanied by a genuine excitement, and interprets the fact that the image in his mind as a possible latent homosexuality. Obsessive pure is therefore characterized by constant concern regarding to the fulfillment of certain events rather unlikely, but intolerable for the subject, often followed by an internal dialogue aimed at reassurance. In practice, the person with fear of being homosexual, the sight of a person of the same sex, develops positive intrusive thoughts or sexual fantasies that fuel his fear. He started to talk to itself to prove that this can not be true, and a search for underlying evidence in the past and in the present, twisting endlessly in search of the guarantee that this suspicion is unfounded.
- Superstition excessive - It is a thought superstitious over the top. Sufferers believe that the fact to do or not do certain things, to speak or not to speak a few words, to see or not to see certain things (eg, hearses, cemeteries, mortuary posters), certain numbers or certain colors, counting or not to count a specific number of times the objects, repeat or not to repeat certain actions the "right" number of times, is decisive for the outcome of events. It 's the case of the person who believes that certain numbers are unlucky and that, after seeing them, remain anxious until it neutralizes the effect of "bad luck" seeing other numbers "lucky". Or the person who is afraid to think of certain adverse events (death, accident, etc..) While performing certain operations (eg, speaking, writing, reading, eating, walking, etc..), Because negative thinking might somehow "imprint "and turn into reality. This effect can be averted only by repeating the act (eg, erasing and rewriting the same word, thinking about positive things), or by some other ritual "anti-jinx."
- Order and symmetry - Sufferers absolutely does not tolerate that the objects are placed so messy or even slightly asymmetric, because it gives him an unpleasant feeling of lack of harmony and logic. Books, papers, pens, towels, videotapes, CDs, clothes closet, dishes, pots, cups, must be perfectly aligned, symmetrical and arranged in a logical sequence (eg, size, color, etc..). When it does not these people spend hours of their time to rearrange and align these objects, until you feel completely calm and satisfied. The obsessions of order and symmetry may also affect your body. Muscles, combing hair, collar and cuffs of the shirt, watch on your wrist, wallet in your pocket, must be once more "perfect" and symmetrical worth repeating rituals put in order or control in the mirror.
- Accumulation / hoarding - It 'a kind of obsession rather rare that characterizes those who tend to retain and accumulate useless and insignificant objects (magazines and old newspapers, empty cigarette packets, empty bottles, used paper towels, food packaging) for fear of throwing something away that "one day or the other could serve ..". This type of behavior, normal to a certain extent as long as they are objects that have a sentimental value, assumes pathological features when the space occupied by "collections" becomes such as to sacrifice the lives of individuals and their families. These special collectors of useless things are generally proud of their collections and do not realize, if not in part, the excess they face, unlike patients with disorders of contamination or control, which are usually critical of their rituals. These are the families not to tolerate the intrusiveness of certain objects and to seek the treatment. These patients also have obsessive thoughts special, but they are terribly upset when you ask them to throw something away.
- Mental Compulsions - does not constitute a separate category of real obsessive, because the nature of the obsessions can be any of the above. Those who suffer from it, but since there is no compulsion material, as in the case of obsessions as well, making precise ceremonial mental (counting, praying, repeating phrases, formulas, positive thoughts or lucky numbers) for preventing the possibility that it will be the content of thought obsessive and therefore reduce anxiety. It 's the case of the person, thinking automatically an offense to the dead, when he sees a grave, or a curse when he sees a reference to the sacred, try to avoid the "inevitable" divine punishment repeating mentally, or sometimes whispering, very specific prayers or magic formulas.

Some patients DOC tend to make constant demands for reassurance for your family and friends about their concerns. For example, if you are afraid of contamination, often ask whether certain objects or certain foods were washed, if no one has touched their things, if others are washed after using the toilet or after handling animals or "dirty". If you fear future misfortunes due to their omissions or oversights (control disorders), ask others if they have closed the throttle, the front door or car, if they turned off the light or electric cooker, if you have not by chance hit someone with a car or if you do not have traces of blood on him. In any case, requests for reassurance assume in all respects the function of a tranquilizing behavior, like the compulsions.

The person who suffers from obsessive-compulsive disorder also tends to put in place a vast number of avoidances of all those situations that trigger obsessive thoughts in an attempt to control and not be forced to do the rituals.
So those who fear contamination with dirt Avoid touching anything that can be even remotely non-sterile, open doors or turn on the lights, especially in public places, with the elbows or feet.
Who's afraid of being contaminated with blood or syringes avoid putting their hands in places where it can not check to ensure that there are no needles, no walking on the grass or on the sand, let alone with open shoes and does not touch anything red or that might vaguely resemble traces of blood.
The obsessive "pure", for example, is afraid of being homosexual, he carefully avoids being in situations where it may be exposed to naked bodies of persons of the same sex, even stops to watch television, read magazines, watch people on the street.
Who obsessive thoughts to avoid aggressive content methodically to have on hand blunt or sharp, sometimes you visually check to someone else to make sure you do not do anything wrong and keeps a safe distance from people fear most of attack.
Those who think that certain numbers, words, colors or other bring bad luck to themselves or their loved ones, avoid exposure to those situations in which it can more easily come into contact with these stimuli. For example, with regard to certain numbers, the patient can not watch more television, the clock or calendars.

An obsession is a thought, a feeling, an idea or a feeling recurring or intrusive.
A compulsion is, however, a mental act or conduct standardized and recurring, such as counting, checking or avoid. The obsessions increase anxiety of a person, and compulsive behaviors reduce it. Nevertheless, when an individual resists a compulsion, anxiety increases.

Until about twenty years ago, Obsessive Compulsive Disorder (OCD) was considered quite unusual and insensitive to treatment. Today it is, however, considered more widespread presence and highly responsive to the treatment. A person with OCD is aware of the irrationality of their obsessions, which warns phenomena as ego-dystonic. The DOC can be disabling: obsessions, in fact, can cause a loss of time and significantly interfere with the person's normal routine, occupational functioning, with her, with social activities or relationships with friends and family.

"Obsession" is defined as a mental content - an idea, a word or a sound, an image, a memory, a pulse - which comes with a mode characterized by the following features:
a) the recurrence or persistence, which led her to grow in importance over the remaining life than ideational conscious;
b) the strangeness and the intrusiveness (for alienation refers to the departure from the usual content of the ideational the person and / or with respect to rational and ethical beliefs of the individual, the intrusiveness is manifest in the mind of the obsession against the will of the subject thereof);
c) the persistence, at least in one of the stages of the disease, the recognition of mental representation as a product of mental activity, and therefore not from the outside or induced by other;
d) the incoercibilità, which makes the invasion activity ideica unstoppable by the will, despite the resistance that the subject attempts, at least in the early stages of onset of the disorder, to oppose;
e) the interference (the intrusion of obsession in mental functioning is overwhelming, inanizzante, slows the operation itself and makes it less productive and effective, and this is a practical reflection at school / work, as well as in social and emotional ).
Obsessions are recurrent themes: contamination, doubt, aggressive, symmetry, counting, physical, sexual, religious and existential accumulation.
The formal characteristics of obsession - persistence, the strangeness, the intrusiveness, the incoercibilità and interference - causing discomfort and anxiety.
The anxiety gradually increases in intensity and becomes intolerable. The individual tries to neutralize it with avoidance of objects or situations that arouse greater obsessiveness (examples: knives that induce aggressive ideas, objects which evoke fears of contamination), or implements repetitive behaviors and / or ritualized - called "compulsions" - to reduce the discomfort (eg: washing of objects or parts of the body, magic rituals that relieve anxiety).
Once this sequence is completed the obsession persists, in an unquenchable vicious circle that denies the relief of the subject and concluded that results in a compromise of the operation.

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