CASE STUDY 6:
OBSESSIVE COMPULSIVE DISORDER
Chronic Obsessive Compulsive Behaviour, acute anxiety, agrophobia & sleeplessness resolved through intense emotional regulatory treatment procedure derived from addiction treatment model.
Addictions and compulsive behaviours are some of the most resistant presentations a therapist may encounter. I treat addiction as a multi faceted issue; a problem of neurological imbalance, a lack of emotional regulation combined with learned behaviour.
The case below illustrates the results obtained from the application of this therapeutic system, learned and derived from addiction issues as applied to Obsessive Compulsive Disorder.
I hypothesised a parallel between OCD and addiction on the level of emotional regulation and its frustration. The excess emotional tension is being managed via discharge and ritual, rather than substance use. The motor system is externalising emotion into action rather than the emotional regulatory system; the hypothalmic-pituitary-adrenal axis regulating emotions internally. This becomes a positive reinforcement feedback loop. An anxious stressed person becomes stressed and anxious about being stressed and anxious. The brain alone can not rectify this. It is a feedback loop caused by worry compounding anxiety that the person does not know how to escape due to a lack of understanding. They therefore unwittingly become central to its perpetuation, ritualised routines are expressions of the emotional intensity acting on cognitive functions.
The person has long lost the ability to emotionally regulate, pressure is continually topped up (positively reinforced) by worry and intense new anxiety, much like how an infinity pool works.
The anxiety experienced cognitively and linguistically in the language centre of the left hemisphere...'something bad will happen if I don't do this', is true, but not in the way understood. It is a distortion of meaning brought about by a lack of contextual relevance, normally supplied by the right hemisphere, responsible for deep emotional regulation and interpretative meaning creation. Deep interpretation creates deep emotional processing, the left hemisphere requires the right hemisphere for this purpose. They work together and regulate themselves by contradictory self limitation via asymmetry. This harmonisation gives rise to the real Self and emotional processing via the ego.
The therapeutic technique was applied to activate and integrate right hemisphere functioning, focus was on minute details of behaviour, feeling and practice applied in weekly sessions and progressively monitored and adjusted. This stimulates and informs the client while utilising the vast data networks of the brain to interpret, identify and decode. Negative emotion is processed by the right hemisphere, so it is absolutely central to change and integration, not just exposure as is done in traditional CBT approaches.
Utilising techniques that support ‘containment’ and ‘interpetation’ allow for deep emotion to be processed and emerge as new integrated functioning and thus enacting the innate Self state of the body in line with the ego.
Over the period of engagement ritualised behaviour was seen to reduce very significantly and eventually to the point of choice with no underpinning emotional drivers. General anxiety returned to normal levels and the understanding of emotion was learned, thus supporting ‘normal’ emotions not anxiety states. Full functioning in life was attained, return to education and a full social life.
An added benefit of this approach, is that the client becomes completely in tune with a fully understanding of their inner emotional and psychological world. It is this very placement of learning at the centre of the process which enables it to happen. There can be no healthy functioning without a fully cognizant sense of self at the centre of the process.
After spending years in and out of different therapies from the age of 17 with little to no improvement I concluded that I was meant to feel anxious constantly, having experienced anxiety since the age of 14. Within the last two years things felt like they were going from bad to worse. OCD started affecting me detrimentally, which seemingly came out of the blue, though in reality I was struggling with it for a lot longer than I had previously realised, that paired with the increasing anxiety was becoming relentless. I was both mentally and physically broken at this point, running on two hours sleep courtesy of OCD and I hadn’t left my home in over three months. I was aware that the OCD wasn’t helpful and was causing more problems than it solved yet I couldn’t stop the compulsions and they were taking over my life. I was confused, scared, upset, and frustrated with what my life (or lack of) had become.
The last five months of counselling sessions I have had the opportunity to transform as a person. I don’t want to put it lightly in the sense that just talking has magically made the anxiety and OCD disappear – it’s not that simple. I have put hard work in to get to the position I am in today and had the guidance and support I have needed to safely and effectively to become my true self. I have been provided with activities such as keeping a journal for my thoughts as well as been given theory to further research such as ‘The Chimp Paradox’. The entire counselling process was explained to me a step at a time with the appropriate science and theory behind it at each relevant stage, having this further level of understanding allowed me to see that I wasn’t ‘broken’ and gave me the clarity needed to make change where necessary - this is where previous therapies had faltered, giving people activities or exposure exercises to complete isn’t helpful if they are not in the correct mind state to do so and do not understand the reason behind it comprehensively.
Working with the method of combining activities with the knowledge of science and theory allowed for changes to be made and overall was a more flexible process - if things were not working for me particularly well, I had the opportunity to approach it from a different angle and do what seemed best for me at that time. Therapy shouldn’t be a one size fits all – everyone is different and has different experiences. Whilst the core principles of therapy remain, having the opportunity to mould the process to fit the individual is more forward thinking and ultimately shows the best results. The counselling process allowed for incremental changes at a steady pace. Any teething problems along the way were always followed by discussions and further clarity which let me continue to make progress. Having small changes happen over a period provided the opportunity to appreciate and fully understand the process and the person I was uncovering.
When I started this process, I did not know what to expect or if it would even benefit myself, but the last few months has provided me with more knowledge about the human mind and how it works, allowing me to implement it into my life, than years of previous therapy ever did. I’m now a more confident person, who gets a lot more sleep and has a ‘normal’ functioning life. My only regret is that I wish I knew all the information I now know years ago so that I didn’t have to suffer for as long as I did. Nevertheless, I am grateful for my journey and the things I have learnt about myself and continue to learn to keep growing as a person.