Obsession: what is it, how is it manifested and how to heal?

Sometimes people have a strange feeling that they are not at all. This is how you can briefly describe the state of a person with obsessions. Periodically, he ceases to be himself and experiences thoughts and feelings unusual for him, he is overcome by strange and sometimes frightening ideas.

Obsession is a syndrome in which a person from time to time appears obsessive thoughts and ideas. Rejecting them and living on calmly suffering from such a syndrome cannot, he concentrates his attention on them, and this causes unpleasant emotions, a state of stress.

Man can neither get rid of them, nor take them under control. Not always, but often a person moves from bad thoughts to business, materialization occurs. Such actions, which are a consequence of obsession, are called compulsions, and the syndrome itself, if accompanied by thoughts and deeds, is called obsessive-compulsive (or obsessive thoughts and actions syndrome).

The first signs of this syndrome were described in 1614 by Felix Plater. Described in detail what is happening with the man in 1877, Dr. Westphal. It was he who concluded that even if the other components of the human intellect are not violated, there is no opportunity to drive out negative thoughts.

He suggested that the fault of thinking was to blame, and modern doctors also adhere to this point of view. The first successful steps in the treatment of obsession were made by a Russian scientist and doctor Vladimir Bekhterev in 1892.

In 2007, WHO physicians estimated: in 78% of cases, people with obsessive-compulsive disorder have regularly repeated negative and sometimes openly aggressive obsessions. About one in five with such a problem suffers from obsessive intimate drives of an obscene nature. People suffering from neurosis, among other symptoms of obsession, occupy about a third of cases.

Obsessions can affect any area of ​​human life. The most common examples are repetitive obsessive thoughts about your own mistakes, wrong actions, pathological fear of something that appears in periods. In psychology, this condition is called the disease of doubt, and the name reflects the essence quite accurately.

To cope with fears and pathological impulses, a person sometimes has to develop a cycle of actions (compulsions). For example, in case of irrational fear of contracting infections, a person begins to constantly wash his hands (up to a hundred times a day).

Phobic thoughts about the presence of bacteria and viruses around are obsessions, and washing hands is compulsions. Compulsions are always clear, repetitive, it is a kind of obligatory ritual for a person. If you break it, you may experience a panic attack, hysteria, aggression.

Many generations of scientists and doctors tried to create a more or less distinct classification of obsessions, but their variability is so wide that it was very difficult to make a single classification. And that's what happened:

• obsessions are attributed to psychiatric syndromes, since they are based on a reflex arc;
• obsessions are thought disorder (or associative disorder).

With regard to the types of obsessive thoughts or combinations of thoughts and actions, then the opinions of experts are divided.

The German psychiatrist Karl Jaspers in the middle of the last century proposed to divide the obsessions into:

• abstract - not associated with the development of the state of affect;
• barren wisdom - empty pronounced verbal criticism with or without;
• manic arithmetic score - a person tries to calculate everything;
• intrusive, constantly returning memories from the past;
• separation when speaking words into separate syllables;
• figurative (accompanied by fear, anxiety);
• intrusive doubts;
• obsessive craving;
• performances that periodically completely seize the person.

Researcher Lee Baer decided to simplify everything and proposed to divide the whole variety of obsessions into three large groups:

• obsessive aggressive obsessions (strike, beat, insult, etc.);
• obsessive thoughts of a sexual nature;
• obsessive thoughts of religious content.

Psychiatrist and pathophysiologist Anatoly Ivanov-Smolensky proposed the following division:

• obsessions of excitement (in the sphere of intellectual, these are usually ideas, ideas, certain memories, fantasies, associations, and in the sphere of emotions, phobias, fear);
• delayed obsessions, inhibitions - conditions in which the patient cannot make certain movements in his traumatic situations at will.

With the causes of obsessions everything is even more complicated than with the classification. The fact is that very often obsessive thoughts or their combination with compulsions are symptoms of various mental illnesses that have different causes and sometimes no obvious reasons.

But there are several hypotheses, according to which doctors made a presumptive list of factors that can (theoretically) influence the probability of obsessions:

• biological factors - brain diseases, injuries, disorders of the autonomic nervous system, endocrine disorders associated with the production and amount of serotonin and dopamine, norepinephrine and GABA, genetic factors, infections;
• psychological factors - personality traits, temperament, character deviations, personality deformation professional, sexual;
• social factors - overly strict (often religious) upbringing, inadequate reactions to situations in society, etc.

Consider each group of factors in more detail.

The well-known scientist Sigmund Freud considered the “work” of our unconscious to be sexual obsessions, because it is there that all intimate experiences settle down. Any experiences and injuries associated with sex remain unconscious, and if they are not repressed, then their presence can manifest itself from time to time, including obsessive syndrome. They invisibly affect the psyche, human behavior.

Freud's follower and student psychologist Alfred Adler argued that the role of sexual attraction in the formation of obsessions is somewhat exaggerated. He was confident that the basis was an internal conflict between the desire to acquire a certain power and a sense of self-inferiority, inferiority. In this way, a person begins to suffer from obsessive thoughts when reality is in conflict with his personality.

Special attention is paid to the theory of Ivan Pavlov and his comrades. Academician Pavlov was looking for reasons in certain types of organization of higher nervous activity. He called obsessive thoughts and compulsions relatives of delirium, in all these states in the brain, there is an excessive activation of certain zones, while others demonstrate inertia and paradoxical inhibition.

Most often, experts rely on the neurotransmitter theory of the origin of obsessions. In particular, a low level of serotonin in the body can lead to disruption of the interaction of the brain, which manifests itself as an obsession. At the same time, serotonin reuptake is excessive, and the next neuron in the circuit does not receive the necessary impulse.

An association between dopamine levels has also been observed - it is elevated in patients with obsessive syndrome. The amount of serotonin and dopamine increases in the body when having sex, while taking alcohol, tasty food. And cause the rise of dopamine can not only all of the above, but even some pleasant memories. Therefore, man again and again returns in his mind to that which gave him pleasure.

Also in the development of obsessions suspect hSERT gene. In addition, this syndrome often appears in schizophrenia, neurosis, phobias of any type. In addition to all of the above, scientists have discovered the relationship between bacteria and mental disorders. In particular, obsessions can lead or aggravate streptococcus disorders.

Human immunity throws strength to fight them, for example, during a sore throat, but the attack of immune bodies is so strong that other tissues suffer, that is, the autoimmune process begins. If the tissue of the basal ganglia suffers, then obsessive-compulsive disorder is likely to begin.

Depletion of the nervous system is also a prerequisite for the development of obsessive states.. This is possible after childbirth, when breastfeeding, after suffering an acute infectious disease. Genetic theory also has fairly convincing data: up to 60% of children in adults with obsessions inherited the disorder. It is believed that the hSERT gene in the 17th pair of chromosomes is responsible for the transfer of serotonin.

Since the name of the syndrome is hidden almost its entire meaning, it should be understood that the main sign of mental impairment is the presence of obsessive ideas or thoughts. For example, a child or an adult has an obsessive idea that he is dirty. In order to get rid of it for a while, a person starts to constantly wash, look in the mirror, smell the smells of his own body.

And at first it helps, but with each subsequent attack of obsession, the usual actions are no longer enough, washing becomes more and more frequent, but it brings relief for a while, thoughts of dirt return treacherously.

The fact is that one person can have several types of obsessive thoughts at once. There are violations in different ways: some spontaneously and suddenly, while others experience certain individual “precursors” some time before the beginning of the obsession.

The emergence of obsessive thoughts, ideas occur against the will of man.But the consciousness as a whole does not suffer and the mind is in perfect order, the patient critically assesses himself and understands the shamefulness or unacceptability of his idea, his desire. However, it is impossible to get rid of thoughts. It should be noted that struggling with the thoughts of the sick in different ways: active or passive.

Active confrontation is trying to do the opposite of obsessive thought.. For example, a person gets the idea to drown himself. To crush it, some active fighters walk to the embankment and stand at the very edge of the water for a long time.

Passive fighters with obsessions choose a different path - they try to switch attention to other things, avoid thoughts, and in a similar situation, a person not only will not go to the river, but will also avoid water, a bath, a pool.

The intellect remains intact, a person is capable of analysis, of cognitive processes. But the additional suffering is the thought that obsessive ideas are unnatural, and sometimes even criminal.

The distracted obsessions manifest themselves in many ways.

• Barren wisdom - the state in which a person can talk for a long time about anything, but most often - about religion, metaphysics, philosophy, morality. He understands the meaninglessness of these arguments, would be glad to stop, but it does not work.
• Obsessive Repetitive Memories - It is noteworthy that most importantly not important events (wedding, birth of a child), but trifles of a domestic nature emerge in memory. Often this is accompanied by the fact that a person begins to repeat the same words.

Figurative obsessions are often manifested by doubts - a person suffers from the thought of whether he turned off the iron, gas or light, whether he solved the problem correctly. If he has the opportunity to check, then the repeated testing of the same can become a compulsion — an action-ritual necessary for calm, even for a little while. If there is no way to check, then the person constantly goes through his head, what he did and how, he remembers the whole chain of his actions in search of a possible error.

Intrusive anxieties, fears flow even harder. A person can not do the usual things, focus on current tasks, he constantly scrolls in his head the scenarios of possible negative events that may happen to him.

With her, the person painfully wants to do something dangerous or obscene, for example, to kill a child or rape a neighbor in the stairwell. Almost never such obsessions do not lead to real crimes: like fruitless reasoning, they remain only in the head of the patient.

Mastering ideas are characterized by a distortion of reality in the thoughts of the patient. For example, after the death of a loved one and a funeral, the patient may believe that they buried him alive, did not verify his physical death. They can vividly imagine what their relative was like when he woke up underground, they suffer from these thoughts.

Compulsions can manifest an overwhelming desire to go to the grave and listen to the sounds from the ground. In severe cases, active patients begin to write complaints, petitions with a request to allow exhumation.

Emotional disturbances are manifested by heightened suspiciousness, high anxiety. The person is depressed, feels inferior, insecure. Irritability increases, a person may become depressed.

The perception of the world also changes. Many begin to avoid mirrors - it becomes unpleasant for them to look at themselves, they are afraid of their own “crazy look”. In communication with others often appears such a sign as refusal to look in the eyes of the interlocutor. In severe obsessions, hallucinations are not excluded, which are called Kandinsky's pseudo-hallucinations are disorders of taste, smell, in which sounds and tactile perception are distorted.

At the physical level, the obsessions most often have the following signs:

• integuments turn pale;
• heart palpitations, cold sweat;
• dizzy, fainting is possible.

Needless to say, the character of a person suffering from obsessive syndrome gradually changes. In it appear features that were previously completely unusual for this person.

Independently effectively deal with obsessions and to treat them is impossible. You need to contact a psychiatrist or psychotherapist and undergo a diagnosis. If you suspect obsessions, use a special test system (Yale-Brown scale).

The most effective method to get rid of obsessive thoughts and images is psychotherapy. Cognitive-behavioral, expositional psychotherapy is most often used, as well as a method called “method of stopping thought”.

The task of the doctor is to replace the old installations with new, positive ones, to create a fertile ground so that a person will take a great interest in something new, interesting, and be able to distract from old thoughts. Good result gives occupational therapy. According to the situation, the doctor can use the possibilities of hypnosis, NLP, to teach the patient auto-training and meditation.

Sometimes medications also come to the aid of a psychotherapist. - tranquilizers, antidepressants, neuroleptics. But separately such drugs (pills and injections) will not have any effect. Without psychotherapy, they will only mask the symptoms without affecting the mechanism for developing obsessive ideas. Vitamin therapy, mineral preparations, as well as nicotine intake in certain dosages are used as experimental methods of treatment (what the beneficial effect of nicotine is based on in this case, however, is unknown).

The following video tells about the treatment of obsession.