强迫症
强迫症的相关信息和治疗
韦恩·K·古德曼博士著
强迫症(OCD)是一种焦虑障碍,特点是重现性的、闯入性的想法(称为执迷/ O / obsessions)反复重复,感到内在驱使的仪式行为(称为冲动/ C / compulsions)。执迷(O)也可以作为“闯入性的画面”或者“难以压抑的冲动”形式出现。大部分患OCD的人有“执迷”和“冲动”两方面,不过小部分(大约20%)只有“执迷”,或者只有“冲动”(大约10%)。
患OCD的人一般会尽力用仪式行为消除或中和“执迷”的想法,或者避免引起“执迷”念头的出现。大部分情况,仪式行为可以减缓焦虑感。“冲动”本身就会引起焦虑 - 特别是这种冲动非常强烈时。
OCD的一个特点就是患者知道他/她的想法或者行为没意义或者过度了。
然而这种冲动需要太强烈了,以至于人不得不向冲动低头,即便他/她知道它没任何意义。有位女士每晚要花好几个小时嗅家里的垃圾桶,来确定没有值钱的东西被误丢。当被问她在找什么时,她不安地承认“我也不知道,我并没有什么值钱的东西”。
一些长久患OCD的人放弃对冲动的抵抗了,因为他们觉得这样放弃更容易一些。
大部分OCD的患者有各种各样的“执迷”和“冲动”。有的人会把自己的OCD怪成是石棉污染造成,不过仔细面谈以后可能会揭露他/她暗暗数地板砖块和囤积垃圾信件。
关于“执迷”的例子
一般情况下的“执迷”包括对污染的担心(比如害怕泥土,细菌或者疾病),安全/伤害(比如担心造成火灾),难以控制的侵害行为(比如难以控制想去伤害心爱的人),难以启齿的对性欲或者信仰的想法(比如亵渎耶稣的神像),和对对称和精确的苛求。
Obsessive-Compulsive Disorder
OCD Information & Treatment
By Wayne K. Goodman, M.D.
Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by recurrent and disturbing thoughts (called obsessions) and/or repetitive, ritualized behaviors that the person feels driven to perform (called compulsions). Obsessions can also take the form of intrusive images or unwanted impulses. The majority of people with OCD have both obsessions and compulsions, but a minority (about 20 percent) have obsessions alone or compulsions alone (about 10 percent).
The person with OCD usually tries to actively dismiss the obsessions or neutralize them by engaging in compulsions or avoiding situations that trigger them. In most cases, compulsions serve to alleviate anxiety. However, it is not uncommon for the compulsions themselves to cause anxiety -- especially when they become very demanding.
A hallmark of OCD is that the person recognizes that her thoughts or behaviors are senseless or excessive.
However, the drive can be so powerful that the person caves in to the compulsion even though she knows it makes no sense. One woman spent hours each evening sifting through the household trash to ensure that nothing valuable was being discarded. When asked what she was looking for, she nervously admitted, "I have no idea, I don't own anything valuable."
Some people who have had OCD for a long time may stop resisting their compulsive drives because they feel it's just easier to give in to them.
Most OCD sufferers have multiple types of obsession and compulsion. Someone with OCD may complain primarily of obsessive-compulsive symptoms involving asbestos contamination, but a detailed interview may disclose that he /she silently counts floor tiles and hoards junk mail.
Examples of Obsessions
Common types of obsessions include concerns with contamination (e.g., fear of dirt, germs or illness), safety/harm (e.g., being responsible for a fire), unwanted acts of aggression (e.g., unwanted impulse to harm a loved one), unacceptable sexual or religious thoughts (e.g., sacrilegious images of Christ) and the need for symmetry or exactness.