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

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

An obsession is a syndrome in which a person has obsessive thoughts and ideas from time to time. A person suffering from such a syndrome cannot throw them away and live on, he concentrates his attention on them, and this causes unpleasant emotions, a state of stress.

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

For the first time, the signs of such a syndrome were described in 1614 by Felix Plater. Dr. Westphal described in detail what was happening to a person in 1877. It was he who came to the conclusion that even if the other components of a person's intelligence are not violated, there is no opportunity to drive away negative thoughts.

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

In 2007, WHO doctors calculated: in people with obsessive-compulsive disorder, 78% of cases have regularly recurring negative and sometimes openly aggressive obsessions. Approximately one in five with such a problem suffers from obsessive intimate attractions of an obscene nature. In people suffering from neuroses, among other symptoms, obsessions account for about a third of cases.

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

To cope with fears and pathological drives, a person sometimes has to develop a cycle of actions (compulsions). For example, with an 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 you are obsessions, and washing your hands is compulsions. Compulsions are always clear, repetitive; this is a kind of mandatory ritual for a person. If it is violated, an attack of panic, hysteria, aggression may occur.

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

• obsessions are classified as psychiatric syndromes because they are based on the reflex arc;
• Obsessions are considered a thought disorder (or association disorder).

As for the types of obsessive thoughts or combinations of thoughts and actions, then the opinions of experts are divided.

German psychiatrist Karl Jaspers in the middle of the last century proposed dividing obsessions into:

• abstract - not associated with the development of the state of passion;
• fruitless philosophizing - empty expressed verbal criticism with or without reason;
• manic arithmetic counting - a person is trying to count everything;
• obsessive, constantly returning memories from the past;
• division of words into separate syllables when speaking;
• figurative (accompanied by fears, anxiety);
• obsessive doubts;
• obsessive drives;
• ideas that periodically completely take possession of a person.

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

• obsessive obsessions of an aggressive nature (hit, 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 intellectual sphere, these are usually ideas, representations, some memories, fantasies, associations, and in the sphere of emotions - phobias, fear);
• obsessions of delay, inhibition are conditions in which the patient cannot produce certain movements at will in traumatic situations.

With the causes of obsessions, things are 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 do not have obvious reasons.

But there are several hypotheses according to which doctors have compiled a tentative list of factors that can (theoretically) influence the likelihood of obsessions:

• biological factors - brain diseases, trauma, 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, professional, sexual personality deformation;
• social factors - overly strict (often religious) upbringing, inadequate reactions to situations in society, etc.

Let's consider each group of factors in more detail.

The famous scientist Sigmund Freud considered sexual obsessions to be the "work" of our unconscious, because it is there that all intimate experiences settle. Any experiences and traumas associated with sex remain in the unconscious, and if they are not repressed, then their presence can be manifested from time to time, including obsessive syndrome. They invisibly affect the psyche, human behavior.

Psychologist Alfred Adler, a follower and disciple of Freud, argued that the role of sex drive in the formation of obsessions is somewhat exaggerated... He was sure that the basis was an internal conflict between the desire to gain a certain power and the feeling of his own inferiority, inferiority. Thus, a person begins to suffer from obsessive thoughts when reality is in conflict with his personality.

Specialists pay special attention to the theory of Ivan Pavlov and his comrades. Academician Pavlov looked for reasons in certain types of organization of higher nervous activity. He called obsessive thoughts and compulsions relatives of delirium, in all these conditions 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 a disruption in the interaction of parts of the brain, which manifests itself as an obsession. In this case, the reuptake of serotonin is excessive, and the next neuron in the circuit does not receive the required impulse.

There is also a connection between dopamine levels - in patients with obsessive syndrome, it is increased. The amount of serotonin and dopamine increases in the body during sex, while drinking alcohol, and delicious food. And not only all of the above, but even some pleasant memories can cause a rise in dopamine. Therefore, a person again and again returns mentally to what gave him pleasure.

The hSERT gene is also suspected of developing obsessions. In addition, this syndrome often appears in schizophrenia, neuroses, phobias of any type.In addition to all of the above, scientists have found a relationship between bacteria and mental disorders. In particular, obsession can lead or aggravate the course of streptococcal disorder.

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

Depletion of the nervous system is also a prerequisite for the development of obsessive states.... This is possible after childbirth, during breastfeeding, after an acute infectious disease. The genetic theory also has quite convincing data: up to 60% of children in adults with obsessions have inherited the disorder. The hSERT gene on chromosome 17 is believed to be responsible for the transfer of serotonin.

Since almost all of its meaning is hidden in the name of the syndrome, it should be understood that the main symptom of a mental disorder is the presence of obsessions or thoughts. For example, a child or adult has an obsession with being dirty. In order to get rid of it at least for a while, a person begins to constantly wash, look in the mirror, sniff the smells of his own body.

And at first it helps but with each next attack of obsession, the usual actions are no longer enough, washing becomes more and more frequent, and it does not bring relief for long, thoughts of dirt treacherously return.

The fact is that one person can have several types of obsessive thoughts at once. Violations manifest themselves in different ways: in some spontaneously and suddenly, while others, some time before the onset of the obsession, experience certain individual "precursors".

The appearance of an obsessive thought, an idea occurs against the will of a person. But consciousness as a whole does not suffer and reason is in perfect order, the patient evaluates himself critically 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 sick people struggle with thoughts in different ways: actively or passively.

Active opposition is trying to do the opposite of an obsessive thought.... For example, a person comes up with the idea to drown himself. To crush it, some active fighters go to the embankment and stand for a long time at the very edge of the water.

Passive obsessional fighters choose a different path - they try to turn their attention to other things, avoid thoughts, and in a similar situation, a person will not only not go to the river, but will also avoid water, baths, pools.

Intelligence remains intact, a person is capable of analysis, cognitive processes. But additional suffering is caused by the idea that obsessions are unnatural, and sometimes even criminal.

Distracted obsessions are manifold.

• Fruitless philosophizing - a state in which a person can talk for a long time about anything, but most often - about religion, metaphysics, philosophy, morality. He understands the senselessness of these arguments, he would be glad to stop, but it does not work.
• Obsessive recurring memories - it is noteworthy that most often it is not important events (wedding, birth of a child) that come to mind, but little things of a household nature. 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 is tormented by 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 repeatedly checking the same can become a compulsion - an action-ritual necessary to calm down at least for a short time.If there is no way to check, then the person constantly goes over in his head what and how he did, recalls the entire chain of his actions in search of a possible mistake.

Obsessive anxieties, fears are even more difficult. A person cannot do the usual things, focus on current tasks, he constantly replays in his head scenarios of possible negative events that may happen to him.

With her, a person painfully wants to do something dangerous or obscene, for example, 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 patient's head.

Possessing ideas are characterized by a distortion of reality in the thoughts of the patient. For example, after the death of a loved one and the funeral, the patient may believe that he was buried alive, without making sure of his physical death. They can vividly imagine what it was like to a relative when he woke up underground, they suffer from these thoughts.

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

Disturbances in the sphere of emotions are manifested by increased suspiciousness, high anxiety. The person is depressed, feels inferior, insecure. Irritability increases, a person may become depressed.

The perception of the world is also changing. 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, such a sign often appears as refusal to look the interlocutor in the eye. With severe obsessions, hallucinations are not excluded, which are called Kandinsky's pseudo-hallucinations - a disorder of taste, smell, in which sounds and tactile perception are distorted.

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

• the skin turns pale;
• increased heart rate, cold sweat appear;
• dizzy, fainting conditions are possible.

Needless to say, gradually the character of a person suffering from obsessive syndrome for a long time is changing. In it, features appear that were previously completely unusual for a given person.

It is impossible to effectively deal with obsessions on your own and it is impossible to treat them. You need to contact a psychiatrist or psychotherapist and get diagnosed. If an obsession is suspected, a special test system (Yale-Brown scale) is used.

The most effective method for getting rid of obsessive thoughts and images is psychotherapy... The most commonly used are cognitive-behavioral, exposure psychotherapy, as well as a method that is called the "method of stopping thought."

The task of the doctor is to replace old attitudes with new, positive ones, to create a fertile ground for a person to get carried away with something new, interesting, to be able to escape from old thoughts. A good result gives occupational therapy... According to the situation, the doctor can use the possibilities of hypnosis, NLP, teach the patient about auto-training and meditation.

Sometimes medications come to the aid of the psychotherapist. - tranquilizers, antidepressants, antipsychotics... 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 the development of obsessions. As experimental methods of treatment, vitamin therapy, mineral preparations, as well as the intake of nicotine in certain dosages are used (on what, in this case, the beneficial effect of nicotine is based, however, is unknown).

The following video will tell you about the methods of treating obsession.