Stress increases, and obsessive-compulsive disorder follows. What do you know about obsessive-compulsive disorder? I brought you obsessive-compulsive disorder in the following psychological counseling cases, hoping to help you.
situation
Zhang, male, 20 years old, a middle school student in Dongying. The student has studied well since he was a child and often gets the first place in the exam. But? I have been dishonest since I was a child. I broke my arm in primary school and often fought with others. I was found almost every day. My father was very angry when the children were led to the door, so he hit me, so I was beaten almost every day, but I still didn't change. It is brave to refuse to obey anyone since childhood. ?
? In junior high school, learning is still very good, but I still don't change my bad habits and often have conflicts with my teachers. Once, I had another quarrel with the headmaster, and he wouldn't let me go to school. Later, my father apologized to the principal, and after many twists and turns, I reluctantly went to school again. ?
My problems have not changed since I was admitted to high school in my life. Just a week after I went to high school, I got into a fight with two other people, which was severely dealt with by the school and severely warned. However, it didn't take long for him to collude with others, seriously injuring another classmate, making him stay in hospital for two months, losing a lot of medical expenses and being expelled from school. After many efforts, I went to school two months later on the premise of writing a guarantee.
complain
? After the fight, we were both sent home. When I got home, I felt very unhappy when I saw my family rushing around for my business all day, frowning. I made up my mind to get rid of my old habits and write down how to behave in the future in my notebook at home. ?
? After returning to school, I carefully followed my rules and was very cautious. In the first few days, I didn't say anything except say hello to my classmates. Occasionally with classmates, I didn't like it before. I just said something superficial. My classmates say that I have changed a lot. After a few days, I felt very uncomfortable, and gradually I began to talk more, but I still paid great attention to my words and deeds. Sometimes I have a little conflict with other students, for fear of offending others, and I start to be suspicious. Sometimes I feel nervous when I see other people's eyes are a little special, or when I talk to others, my facial expression is slightly different from before. I also pay great attention to the teacher's expression when he sees me, and think about what he finds a little. At the same time, I am also very concerned about the views and evaluations of teachers and classmates. I had a little trouble with some classmates. I was afraid that he would speak ill of me behind my back, so I tried to keep good relations with all my classmates. But some old bad habits can't be changed, such as always wanting to behave better than others when something happens. At the same time, since the incident, the villagers' views on me have also changed. So, after I went back to school, I was very careful. I think it will be difficult for me to stay in the village if I am expelled from my family again. So, I thought a lot about it back and forth, and every time I finished a small thing, I reconsidered whether I should do it or not. ?
? Later, I began to feel anxious during the exam. If I see a crack in my writing, I'll stick it with transparent glue. Although it doesn't affect my writing, I still feel uncomfortable and have been thinking about it. I don't know anything in my heart, and I shouldn't think about it, but I always think about it, and my heart is very upset, which affects the exam. Later, when I took the exam, I occasionally felt that my soles were a little uneven and my belts were a little tight, which made me feel very uncomfortable. I've been thinking about it, but the more I think about it, the more I feel. In fact, the sole is flat and the strap is not tight. Since then, I usually think about it in class, so I can't study hard. Later, I saw that the clothes were a little dirty or a little thready, so I thought. This problem lasted for almost a year. ?
? Later, I began to think that others were dirty and things were dirty. I am always afraid that others will infect me with something. Once, the pen accidentally fell to the ground, and I thought, maybe someone spit at the place where the pen fell, or maybe someone stepped on his shoes, so he felt dirty after touching the pen and dared not touch anything. Another time, a classmate had an operation. I know this disease is not contagious at all, but I am still very worried. Sometimes when this classmate touches me, I get very nervous. I wipe the place where I touch my clothes several times before I feel at ease. ?
? Later, I thought about the problems I shouldn't think about in my study. If 3 is 0/2 of 65438+6 and 3 is 0/2 times of 65438+6, I doubt it, knowing that they mean the same thing, but I still doubt it, so I look up all kinds of information. In this way, endless doubts make me dizzy and very uncomfortable. Even when shopping, I always suspect that I have miscalculated. ?
diagnose
The typical feature of obsessive-compulsive disorder is the coexistence of conscious self-compulsion and conscious self-counter-compulsion, and the conflict between them brings great pain to patients. It can be seen from the situation reflected by the questioner that he suffers from obsessive-compulsive neurosis: obsessive-compulsive ideas (mainly obsessive-compulsive doubts) are accompanied by obsessive-compulsive behavior.
case analysis
Obsessive-compulsive disorder is a kind of stress neurosis, which is often caused by major real life events. Since Zhang was expelled from martial arts, he had a strong remorse in the face of triple pressure from school, family and villagers. Therefore, since I returned to school, I have been very careful with people, which is completely different from before. However, due to its long-term troubles, it is worried that it can't be overcome, which once again causes dissatisfaction among classmates and teachers. Therefore, I am very sensitive to the reactions of teachers and classmates, so I have strengthened self-restraint. The more restrained I am, the more worried I am about other people's opinions, and the crux of the contradiction arises. With the increase of pressure and the deepening of contradictions, contradictions and conflicts are deformed, from worrying about other people's opinions to paying attention to their own objects and related parts of the body, to doubting others, and finally to doubting the content of learning.
The formation of obsessive-compulsive symptoms is often based on obsessive-compulsive personality. Zhang was originally cheerful and unrestrained, careless and informal. After that, he tried to change his character. Because of the incorrect way of changing and improving, he went to the other extreme, which made his character sensitive, suspicious, withdrawn, rigid and timid. This has compulsive personality characteristics.
Consultation process and guidance
The patient came to the consultation room for the first time in March, 1997, with a sad face and burning in his chest. As soon as I asked him to sit down, he immediately told me: teacher, I am in pain, and I don't know why. I always have doubts about some things. Although I don't think it is necessary, I can't help it, which makes me very painful. Teacher, what do you think? From his simple statement, I have made it clear that this is a compulsive symptom, so I asked several specific questions, but he often couldn't say it or was incoherent. In this case, I said to him: You can solve this problem, but you must finish an assignment. When you go back, you should focus on the following questions and write them down. 1. What are the specific manifestations of your symptoms? What was the specific feeling at that time? It's best to write it down in chronological order. Second, when did this symptom begin? Why? Third, introduce your childhood and present situation. ?
A few days later, he came to the consulting room and handed me his homework. The specific content is as mentioned above. From his detailed account, I further clarified his symptoms and characteristics, and also had a clearer clue to the reasons. After analysis and consideration, the specific consultation scheme and steps were formulated.
The first step is to explain to him that he is suffering from a psychological problem, which is obsessive-compulsive suspicion accompanied by obsessive-compulsive behavior in obsessive-compulsive neurosis. And further explain the characteristics and general formation process of this psychological disorder. At the same time, explain to him that this disease is not a mental illness that people often say, and it will not lead to mental illness and reduce his unnecessary psychological burden.
The second step is to discuss the progress of the disease with the patient. The purpose is to make him clear the cause, uncover the doubts in the patients' hearts and lay a good foundation for further treatment.
The third step is to adopt Morita therapy for specific treatment. First of all, I introduced Morita therapy to him, and repeatedly explained how to study and live naturally with facts. I should take an indifferent attitude towards the symptoms, not avoiding them, not paying too much attention and thinking. When symptoms appear, don't care, don't care, and do what you should do. In this way, the symptoms will gradually be alleviated, and if you persist, the symptoms will be eliminated. Secondly, explain to him the purpose of Morita therapy. Let nature take its course is to break the vicious circle of conscious self-compulsion and self-counter-compulsion. As long as let nature take its course, the contradiction between compulsion and anti-compulsion will be solved and the symptoms will be gradually eliminated. This enhanced his consciousness and firmness in adopting this method.
It is also accompanied by cognitive therapy. Explain in detail how to deal with setbacks, especially the details. The key to dealing with setbacks is to find the root of setbacks and adopt certain and rational ways to overcome them, instead of denying everything. At the same time, we should pay attention to moral and behavioral cultivation.
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