Obsessions and Compulsions Video

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In this ‘Obsessions and Compulsions’ video, Mark discusses the difference between a compulsion and an obsession - that an obsession is generally the thought that drives the compulsive action. So, for example, if you are obsessed by the idea that your house is dirty, you may follow compulsive cleaning behaviour patterns. He talks about the superstitious element to many obsessive / compulsive conditions. So a person with OCD often feels they have to follow the compulsive behaviour to prevent some disaster happening. Mark tells us why it is the emotion behind the obsession that is important, rather than the thought itself. And he also conveys why the advice to ‘try not to think about it’ is possibly the worse advice you can give to someone with OCD as it can actually make things worse. Mark talks about a case study of treating a woman with obsessive thoughts about her health - hypochondria. He also discusses how it is important to help someone suffering from OCD to meet their emotional needs in a healthy way which will protect them against developing a obsessive condition again.

Transcript of Obsessive / Compulsive? video

Having an overriding obsession can, like an addiction, start to impact someone’s life to the extent that they stop getting their emotional needs met in healthy ways. Now, the difference between an obsession and a compulsion is that an obsession is really what you focus on in your mind. So, for example, someone might be obsessed by the idea that their partner is cheating on them, and that might lead to the compulsion - or the behaviour - of continually checking up on their partner’s movements and checking their text messages and even following them when they go out and so forth. The obsessive idea that your house isn’t clean enough or contains germs may lead to the compulsive action of constantly cleaning and over-cleaning and cleaning again.

So obsession is in the mind and compulsion is what the mind causes the person to actually do, the behaviour they engage in. Now, there’s often a ritualistic or even a superstitious element to many obsessive-compulsive conditions. For example, someone may feel that in order to prevent some disaster happening, they need to circumnavigate the bed a hundred times before going to bed - walk around the bed a hundred times, or wash their hands two hundred times before going to work in order to stop something bad happening at work, and so forth.

This is an interesting thing: obsessionality isn’t just about what people think. It’s about what they feel when they think certain things; see, emotionality, which is more important than just what the person is thinking. So if a person is hypochondriacal, if they are obsessed that they’re becoming ill or they have symptoms of grave illness, then it’s not the thoughts of illness and death so much as the feelings of anxiety that we need to deal with. It’s very difficult to try not to think about something. The worst advice you can give to somebody if they’re obsessing is, “Try not to think about it,” because that doesn’t help.

I worked with a woman who was a hypochondriac once, and she would wake up in the middle of the night convinced that she had whatever illness she’d been reading about the night before. She’d even hypnotically manifest the symptoms of this illness. Now, I encouraged her to do something; this may sound rather strange. I taught her to have the thoughts that she might have an illness whilst feeling very relaxed. So we’re separating the emotion from the thinking.

Anybody can think, “I might have an illness.” Stephen King, the horror writer, can imagine all kinds of horrific things, but without actually buying into them emotionally and actually feeling terrified by them. So we can have our imagination here [gestures left] and our feelings here [gestures right]. We can do that with obsessions, as well; might even get someone to imagine their partner’s cheating on them whilst feeling that they’re actually dealing with it emotionally, so it becomes much less threatening for them.

So with this particular hypochondriacal woman, she was able to imagine yeah, she could be ill, but feel relaxed about it - bearing in mind that she had been fully medically checked out, as well! That’s really the root of dealing with obsessive-compulsive conditions - to get the person feeling relaxed, dealing with the emotion behind the obsessive behaviour or compulsive behaviour, and then the thinking kind of sorts itself out, rather than trying to change the thinking desperately.

The other aspect is then to encourage the person to meet their emotional needs in their life in constructive ways. Interestingly enough, an obsession will often arise because the person isn’t meeting their emotional needs constructively in their life, but at the same time it will block them meeting these emotional needs. Once we sort out the emotions behind the obsession, and encourage the person to meet their emotional needs constructively and healthily, then they can begin to really leave the obsessive-compulsive condition behind them and start enjoying life again.

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