Fear of materialization of thoughts. Is there a way out of this situation?

One of the most common psychological disorders today is neurosis.
This disease can be a constant concern or be episodic, but in any case, neurosis greatly complicates a person’s life. If you do not seek qualified medical help in a timely manner, this disorder can lead to the development of more complex mental illnesses. Neuroses are reversible psychogenic disorders that arise due to internal or external conflicts, emotional or mental stress, as well as under the influence of situations that can cause mental trauma in a person. Obsessive-compulsive neurosis occupies a special place among neurotic disorders. Many experts also call it obsessive-compulsive disorder (OCD), but some doctors separate the two pathologies.

Why is this happening? The fact is that in Russian medicine, for a long time, obsessive-compulsive disorder and OCD were indeed considered different diagnoses. But the international classification of diseases ICD-10 used today does not contain such a disease as obsessive-compulsive disorder; this list of diseases only mentions obsessive-compulsive disorder. That is why recently these two formulations have begun to be used as a definition of the same mental pathology.

A person in this state suffers from intrusive, disturbing or frightening thoughts that arise involuntarily. The main difference between this disease and schizophrenia is that the patient is aware of his problems. He tries to get rid of anxiety through obsessive and tiresome actions. Only a qualified psychotherapist who has experience working with patients who suffer from this form of mental disorder can cure obsessive-compulsive disorder.

Reasons for development

Among the reasons for the development of obsessive-compulsive neurosis are usually cited stressful situations and overwork, but obsessive-compulsive disorder does not occur in all people who find themselves in a difficult life situation. What actually provokes the development of obsessive states has not yet been precisely established, but there are several hypotheses regarding the occurrence of OCD:

1. Hereditary and genetic factors. Researchers have identified a pattern between the tendency to develop obsessive-compulsive disorder neurosis and unfavorable heredity. Approximately every fifth patient with OCD has relatives with mental disorders. The risk of developing this pathology increases in persons whose parents abused alcoholic beverages, suffered from a tuberculous form of meningitis, and also suffered from migraine attacks or epilepsy. In addition, obsessive-compulsive disorder may occur due to genetic mutations.
2. A fairly large number of people (approximately 75%) suffering from obsessive-compulsive neurosis have other mental illnesses. The most likely accompaniments of OCD include bipolar disorder, depression, anxiety neurosis, phobias and obsessive fears, attention deficit hyperactivity disorder, and eating disorders.
3. Anatomical features can also provoke obsessive-compulsive neurosis. Biological reasons also include a malfunction in some parts of the brain and the autonomic nervous system. Scientists have drawn attention to the fact that in most cases, with obsessive-compulsive neurosis, there is a pathological inertia in the excitation of the nervous system, accompanied by lability in the inhibition of ongoing processes. OCD can occur against the background of various dysfunctions of the neurotransmitter system. Neurotic level disorders arise due to a failure in the production and metabolism of gamma-aminobutyric acid, serotonin, dopamine and norepinephrine. There is also a version about the relationship between the development of obsessive-compulsive disorder neurosis and streptococcal infection. People who have had this infection have antibodies in their bodies that destroy not only harmful bacteria, but also the body’s own tissues (PANDAS syndrome). As a result of these processes, the tissues of the basal ganglia can be damaged, which can lead to the development of OCD.
4. Constitutional-typological factors include special character traits (anancaste). Most patients are prone to constant doubts and are very cautious and cautious. Such people are very concerned about the details of what is happening, they are prone to perfectionism. Ananscasts are conscientious and very diligent people who strive to scrupulously fulfill their obligations, but the desire for perfection very often prevents them from completing the work they have started on time. The desire to achieve high results at work does not allow for the establishment of full-fledged friendships, and also greatly interferes with personal life. In addition, people with this type of character are very stubborn; they almost never compromise.

Treatment of obsessive-compulsive disorder should begin with identifying the causes of the disorder. Only after this will a treatment regimen be drawn up and, if necessary, medication prescribed.

How to get rid of obsessive thoughts

Stopping obsessive thoughts

Most studies confirm that attempts to stop negative thoughts do not bring the expected results; on the contrary, they intensify obsessions. Therefore, you should focus on rethinking your obsessive thoughts, changing cognitive strategies, and reducing anxiety.

Raise awareness

Thoughts and behavior do not arise by chance. They are the result of deeply ingrained thought patterns or triggers that may or may not be conscious. Being aware of these triggers helps people better manage their reactions. Common triggers include:

• Stress
• Reflections on an event that happened in the past
• Significant life changes (graduation, marriage, birth of a child)
• Receiving bad news (job loss, death of a loved one)
• Sudden and unexpected changes

Changing Thinking Patterns

Most intrusive thoughts are rooted in faulty thinking patterns. Although thoughts may seem realistic and reasonable, all thoughts are always subjective and, accordingly, conclusions are too. Cognitive-behavioral psychotherapy turned out to be the most effective in correcting them .

Coping with fears and anxieties

Behind every obsessive thought lies a strong fear. Fears vary, but they are often based on feelings of loss, abandonment, or general insecurity. These fears are not always completely irrational. Often behind them lies a certain amount of truth, which a person exaggerates so that fear and anxiety become the only reality for him, requiring complete concentration on the threat.

It is worth noting that fear is necessary for all people as an important component of survival; it is what forces people to be alert and active in their environment. Therefore, the goal is not to reduce fear, but to get used to it, figuratively speaking, “train the fear muscle.” Exposure psychotherapy (prevention of exposure and reaction) copes most successfully with this task Please note that it should be used strictly under the supervision of a professional psychotherapist or medical psychologist in order to avoid unforeseen negative effects. This is believed to be the most effective way to reduce the frequency and intensity of intrusive thoughts.

Additionally, mindfulness and acceptance psychotherapy, desensitization, relaxation methods on the recommendation of a psychotherapist or medical psychologist, and other methods can be used.

In this case, individual psychotherapy is often aimed at:

• creating a favorable space for processing psychological trauma, life difficulties and stressors,
• stabilization of the emotional background, development of adequate healthy emotional reactions,
• identifying individual triggers of obsessive thoughts,
• changing reactions to other sources of stress (relationships, work, self-esteem problems, depression, anxiety disorders) that may contribute to maladaptive thinking,
• developing and implementing healthier coping skills,
• increasing self-esteem and building a working model of keeping it at a healthy level;
• changing and practicing a new way of thinking,
• providing a supportive space to process past traumas
• in more complex cases, psychotherapy will be aimed at treating other concomitant mental disorders (anxiety disorder, depression, eating disorder, PTSD, etc.).

Psychotherapy methods are selected individually in each specific case, taking into account symptoms, concomitant disorders, individual characteristics of a person with obsessions, and are recommended at the first psychotherapeutic consultation.

Drug treatment

Pharmacological treatment may temporarily reduce symptoms, but non-pharmacological psychotherapy or a combination of these approaches must be used to achieve long-term remission. A psychotherapist may prescribe antidepressants, anxiolytics, antipsychotics, antipsychotics or other drugs, depending on each specific case. Self-medication is unacceptable, as is the prescription of medications by other specialists (even with medical education) in order to avoid unaccounted negative side effects and aggravation of health problems.

Symptoms of the disorder

A doctor will be able to diagnose obsessive-compulsive disorder in a patient and prescribe appropriate treatment only if the main symptoms of the disorder have been observed for a long period of time (at least two weeks). OCD manifests itself like this:

• presence of obsessive thoughts. They can be regular or occur periodically, remaining in the head for a long time. Moreover, all images and attractions are very stereotypical. A person understands that they are absurd and ridiculous, but nevertheless perceives them as his own. The OCD patient also realizes that he cannot control this flow of thoughts, as well as control his own thinking. During the thought process, a person suffering from obsessive-compulsive disorder periodically has at least one thought that he tries to resist. Someone's first and last names, names of cities, planets, etc. may persistently come to mind. A poem, quote, or song may be replayed in your brain over and over again. Some patients constantly talk about topics that have nothing to do with reality. Most often, patients are worried about thoughts of panic about infectious diseases and pollution, about painful loss or the predetermination of the future. Patients with obsessive-compulsive disorder may experience a pathological desire for cleanliness, a need to maintain a special order or symmetry;
• Another important symptom of obsessive-compulsive neurosis is the desire to perform any actions that reduce the intensity of anxious thoughts. This behavior is called compulsive, and regular and repeated actions of the patient are called compulsions. The patient's need to perform specific actions is a conditional “obligation.” Compulsions rarely bring moral pleasure to a sick person; such “ritual” actions can only make one feel better for a short time. Among such obsessive actions one can note the desire to count specific objects, commit immoral or illegal acts, repeatedly check the results of one’s work, etc. A compulsion is the habit of squinting your eyes, sniffling, licking your lips, winking, licking your lips, or twirling long strands of hair around your finger;
• Doubts that constantly plague the patient can also indicate the presence of obsessive-compulsive disorder. A person in such a state is not confident in himself and his own abilities, he doubts whether he has performed the necessary action (turned off the water, turned off the iron, gas, etc.). Sometimes doubts reach the height of absurdity. For example, a patient can repeatedly check whether the dishes have been washed, and at the same time wash them every time;
• Another symptom of obsessive-compulsive neurosis is the patient’s fears that are groundless and devoid of logic. For example, a person may be terribly afraid of speaking in public; he is afraid of the thought that he will definitely forget his speech. The patient may be afraid to visit public places; it seems to him that he will definitely be ridiculed there. Concerns may relate to relationships with the opposite sex, inability to sleep, fulfilling work obligations, and the like.

The most striking example of obsessive-compulsive neurosis is the fear of getting dirty and contracting a fatal disease after contact with germs. In order to prevent this “terrible” infection, the patient tries in every possible way to avoid public places, he never eats in cafes or restaurants, and does not touch door handles or handrails on stairs. The home of such a person is practically sterile, since he carefully cleans it using specialized means. The same applies to personal hygiene; OCD forces a person to wash their hands for hours and treat the skin with a special antibacterial agent.

Obsessive-compulsive disorder is not a dangerous disorder, but it complicates the life of an individual so much that he himself begins to think about the question of how obsessive-compulsive neurosis can be cured.

Types of intrusive thoughts

Any recurring anxious thought can become intrusive. However, researchers have divided intrusive thoughts into several main subtypes:

• Thoughts of violence: obsessions with harming oneself or others.
• Thoughts about relationships: obsessions related to doubts, fears or compatibility in (intimate) relationships, thoughts about the other person and the relationship with him in general.
• Religious Thoughts: Obsessions related to morality, ethics, and potential blasphemy in a religious context.
• Sexual thoughts: obsessions related to sexual orientation or deviant sexual behavior.
• Contagion thoughts: Obsessions about being infected by germs, viruses, or diseases.
• Thoughts about responsibility: Obsessions about whether certain actions or inactions directly affect others and whether they create any risks.
• Other obsessions.

Some of these obsessions may begin as mild anxiety. However, over time they turn into painful attempts to overcome them.

“For fear of embarrassment, I stopped eating”

Olga, 27 years old, Nizhny Novgorod:

When I was three years old, my older brother and I were walking behind the garages alone and came across a pedophile. I wasn’t scared because he introduced himself as a doctor, and I was taught to be polite to doctors. He didn’t have time to do anything bad to us: our parents called us, and we went home. The next day I told my mother about this. The brother was silent and for some reason angry. Then my mother brought her friend to kindergarten. He questioned us carefully. I was polite, but my brother remained silent. Suddenly I understood why: everyone had been deceiving us these few days. The “doctor” was not actually a doctor, and my mother’s friend turned out to be a policeman. I felt terribly ashamed that I believed that pedophile and was frank with him.

I think this incident was the impetus for the development of OCD. Soon I began to perform rituals: if today everything was fine and I behaved in a certain way, then tomorrow I will do the same. For example, I walked to school step by step, taking a shortcut along the grass, trampled a path, and until the eighth grade I always walked along it. I learned a certain way to brush my teeth, hold a pen and spoon, comb my hair, and buy the same pie and juice for lunch. I spent most of the day talking in my head to an imaginary friend. I don’t remember being afraid of anything for more than ten minutes, because I learned to translate any fear into action.

The more complex the rituals, the greater the buzz you feel after performing them: for a few seconds you have a feeling of your own purity. It's like a drug. Only the majority do not admit this to themselves. It happened that I almost had to sing a song in verse while standing in the cold, so I even froze my hands.

In high school, I started feeling nauseous when I got really nervous. For fear of embarrassing myself in public, I stopped eating before classes and important exams. That's how I became anorexic. The body began to go on strike: menstruation stopped, hair and nails dried out, my chest hurt at night - as it turned out, a nerve was pinched. I was prescribed hormones, they had many side effects, I gained weight, and started having skin problems.

When I stopped taking hormones at 21, I started experiencing withdrawal symptoms. Delusional thoughts began to creep into my head: I took a knife to cut sausage and imagined that blood was flowing down my hand. I began to fear that I would go crazy and start cutting myself or someday kill my own children. When I met pregnant women on the street, I began to frantically remember if I had something sharp in my purse so that, God forbid, I wouldn’t attack them with it.

The main rule in dealing with phobias is that routine cannot be scary. You need to tire your brain out by talking through your fears.

After suffering for a month, I went to the doctor. I came across a very good psychotherapist, the best for phobias in our city. It didn't cure OCD, but it helped me accept myself. He gave me several effective exercises: for example, write down your fears on paper in the most terrible words and read what you wrote out loud several times a day. It was hard at first, but after a month I stopped being afraid of my thoughts. The main rule in dealing with phobias is that routine cannot be scary. You need to tire your brain by talking through your fears.

The psychotherapist explained that the “contrasting” thoughts appeared from the withdrawal of hormonal drugs - the effect was reminiscent of postpartum depression. I also, on the doctor’s advice, wrote a letter to an imaginary friend from childhood and asked why she was torturing me so much. The psychotherapist told me to take a pen in my left hand and write a response to this letter. At first I couldn’t even make a clumsy letter, but then I stitched a whole sheet of paper. I wrote what I didn’t know myself: this is how my subconscious tried to protect me.

All these exercises helped me a lot in dealing with fears. I was a normal person for about a month and was able to take a break from OCD - until new fears appeared.

Now at least I am afraid of real things: I have fear for my loved ones, which I am still trying to drown out with rituals. I redo everything that was done with bad thoughts. I find it difficult to buy new things and accept gifts. When I put something on for the first time, I have to have a good thought in my head.

It's hard for me to find a job because I don't know how to make choices without compulsions. The vacancy may not be suitable because I don’t like some word in the title, or the association is bad, or some figure in the salary doesn’t suit me. I guess that the universe doesn't care where I work. But there is a selfish child inside of me that says that every choice I make is like a butterfly effect.

But shame spurs me on. When loved ones say: “Go to work! Stop sitting on my neck,” I can go to any job. Shame is sobering. When I complain to friends about how hard my life is, I probably want understanding, but it doesn't do any good. Friends answer: why do you think that others have it wrong, that your problem is the most important and difficult? After this, the tension subsides. My friends keep me on my toes by demanding that I be normal. Nothing comes easy to an OCD person, so let it be difficult, with a fight. But it is given.

Vladimir Plotnikov, psychoanalyst, head of the TalkTime psychological assistance center:

Recognizing OCD in yourself is quite simple. An almost 100% sign of developing obsessive disorder is obsessive thoughts in the spirit of “am I going crazy.” The second unmistakable point is obsessive actions, without the implementation of which a person feels overwhelming anxiety. For example, the desire to wash your hands every 15 minutes or step over cracks in the asphalt. Character disorders that accompany obsessive-compulsive neurosis are much more difficult to identify in oneself - a high degree of reflection is required, and one of the most common character traits of obsessive neurotics is distrust of oneself and the world. Quite often, OCD is accompanied by increased anxiety or somatic problems - hand tremors, palpitations, as well as senestopathy - intolerable discomfort in the body that is difficult to verbalize.

OCD can be treated quite successfully. We can say that all classical models of psychotherapy are created for OCD in one or another of its manifestations. A stable effect can occur within a year of psychotherapy or psychoanalysis. In cases of OCD, psychiatrists often prescribe all sorts of pills to help reduce anxiety, but in no case should you limit yourself to drug treatment. The lack of psychological work may result in an even more severe exacerbation in the near future.

Alexandra Barkhatova, leading researcher at the Scientific Center for Mental Health, psychiatrist of the highest category:

OCD is quite common. However, official statistics are far from the real picture, since people living with OCD do not identify it as a mental disorder and do not consult a doctor. OCD is a neurotic disorder, the main symptoms of which are the repetition of thoughts and actions. OCD can occur on its own as an independent disease, or it can manifest itself as part of more severe disorders, in particular, the schizophrenia spectrum. Treatment will depend on the identified causes. If obsessions are associated with stress, socially unfavorable situations to which the patient reacts, light psychocorrection and psychotherapy are sufficient. If we are talking about schizophrenia, it is necessary to carry out a whole range of measures, including psychopharmacotherapy, psychotherapy and possibly even electroconvulsive therapy or transcranial magnetic stimulation.

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“I do not exhale in the presence of my loved ones, so as not to harm them”

Polina, 22 years old, Kemerovo:

When I was four years old, a dog bit me and left me with 13 scars. Soon I began to do everything symmetrically: touching objects with my right and left hands the same number of times, biting my lips on the right and left. I could lose count and bite my lips until they bled to achieve balance. It’s the same with steps and paving slabs: you need to step on the same number of steps and alternate your foot for the first step on each flight. Asymmetry makes me uncomfortable. I write and work with both hands for the same reason.

At the age of five I developed a phobia related to breathing. If I inhaled while looking at something unpleasant, painful, ugly, then I need to exhale towards the sky. Looking at my loved ones and relatives, I don’t exhale, because I think that I inhaled a lot of things and could harm them.

I hold my breath so often that I get dizzy. I tried to convince myself that my breathing would not change anything in the world. Did not work out

With age, fears only intensified. I got married. Before leaving for work, I inhaled, looking at my husband, and ran to close the door, afraid to breathe - this became a ritual for me. Otherwise, I thought that he would leave and not return. Soon problems began in the family. It turned out that the husband is completely dependent and lives one day at a time, like a dragonfly from a fable. I loved him and was afraid to leave, although it was the logical outcome of the relationship - to leave the one who sat on my neck. He left on his own when I stopped performing the ritual. In my head I understand that this happened because I expressed everything to him, but part of me says that this is because of the ritual.

Now I hold my breath so often that sometimes I get dizzy from hypoxia. No one close to me knows about my problems. I tried to convince myself that my breathing would not change anything in the world. Did not work out. I would go to see a specialist, but I don’t know where to find him.