Obsessive-Compulsive Disorders: A Case Study

In the text “Relaxing Your Fears away,” the author presents how Joseph Wolpe, a behavior therapist, used a behavioral technique called systematic desensitization to treat anxiety disorders. Systematic desensitization is a technique that is supposed to lower a person’s level of anxiety steadily. The reason he used this technique was to see if this technique actually worked using his prior ideas that two feelings or responses cannot occur at the same time. Wolpe focused on the phobias his patients had and proposed that when his patients were in a relaxed state, then they would not respond with fear when presented with something that gave them anxiety.

The following is an overview about Obsessive-Compulsive Disorder (OCD), one of the most difficult psychiatric illness to be understood. The way of doing certain behaviors, thoughts or routines repeatedly is the essential condition of a person with OCD. In general, it is known and described by someone who is extremely perfectionist and meticulous. Unfortunately, they do realize those habits and be able to stop doing it. Common behaviors are such as checking locks, doors, stove bottoms, and lights, hand washing, counting things, or having recurrent intrusive thoughts of hurting oneself or somebody else.

Fear, an intensive form of anxiety, can be crippling in nature to some people. It is important that we overcome our fears to be able to grow and mature. There are three main ways in which we can manage or resolve fear: behavioral therapy, systematic desensitization, and exposure desensitization. Behavioral therapy was introduced by John B. Watson, a behavioral psychologist, and involved an individual alternating engagements in coping and relaxation techniques to help desensitize that person to the stressors (Seaward, 2015). Systematic desensitization involves the anxious person learning to de-stress from the fear in small, piecemeal increments through which they always feel in control. Exposure desensitization, on the other hand, occurs when the individual is introduced to the real stressor is brief and save encounters with the stressor. Through combinations of the three different ways to

It is believed that as all behaviour is learned then it can also be un-learned. This can be done through behaviour therapies. Flooding is generally used for those with phobias. It involves exposing individuals to situations they are afraid of in an intense manner. There is ethical issues around this therapy as clients are subject to intense fear and anxiety. Systematic desensitisation are more effective on phobias (phobialist 1997). Some of the therapies are not effective on more severe mental illnesses such as schizophrenia and can also oversimplify illnesses by focusing on the symptoms not the cause. Most behaviourists believe that most phobias are from previous traumatic experiences.

Clinician will use Cognitive Behavioral Therapy (CBT) and exposure therapy to attempt and reduce her symptoms. Both modalities will help to change her cognition and fear of leaving her house and being among others. The primary problem of the client is her thoughts that prevent her from leaving the house or interacting with others. These problems are affecting her daily life, she is afraid to leave her house because “they are following me”. The goals are (1) identify trigger thoughts (2) challenge paranoid thoughts (3) replace paranoid thoughts with realistic thoughts. The main distorted cognitions are “they are out there watching me” and “I fear people will hurt me.”

However, although Wolpe wasn’t the first to suggest systematic desensitization as the best method to be used when treating anxiety disorders he was the first successfully apply it. With Wolpe believing phobia are learned he believed he could reduce the anxiety by a conditioning procedure. His theory of suppressing the phobias was the fundamental idea of behavioral therapy where you have learned an ineffective behavior or the phobia in this case and must now unlearn it. With this in mind, Wolpe created and used behavioral therapy as his basis and composed a three step process of desensitizing the phobia. First using relaxation training to create a personal state of relaxation Wolpe then moved to the construction of an anxiety hierarchy where he and the patient developed a list of scenes involving the phobia and finally the actual unlearning processes of desensitization was created. Repeating all three steps as one Wolpe averaged out at 12 sessions. As a result, his session results positively favored his method with a 91% success rate accompanying it and supporting his usage of correctly applying systematic desensitization to phobias or anxiety

A competent therapist will not simply treat a client’s phobia with exposure therapy. Rather, the therapist begins by conducting a functional assessment to develop a treatment plan. Information should be obtained about the factors pertaining to the excessive fears or anxiety. The therapist should determine what situations or stimuli serve as triggers for the anxiety or fear. The way the client responds to the fear should be noted. Further, the therapist should consider the links that exist between triggers and responses. Generally the links are faulty cognitions that must be addressed with the client. This important first step may take between one and six hours and require several sessions. The therapist can then proceed to create a list of the client’s primary problems. To keep the list manageable, it should contain no more than ten problems. The main problems should be listed first. The therapist can decide if any of the problems on the list would be suitable for exposure therapy. The next step before using exposure therapy is to have the client obtain a medical evaluation. Some medical conditions such as thyroid dysfunction, amphetamine use, or drug withdrawal can mimic or increase anxiety. Exposure therapy may be contraindicated for some medical conditions. Using flashing lights during exposure therapy could bring on an epileptic seizure

Systematic desensitization is a brief/graduated method of exposure therapy that gets patients to become increasingly more exposed to an anxiety-evoking stimulus or situation, while engaging in a competing behavior. This therapy had three primary steps. First, the patient is taught a competing response, then events that cause the anxiety are listed in a hierarchy, then the patient is instructed to imagine each anxiety-evoking event while simultaneously engaging in the competing behavior. With that being said, making a list of anxiety-evoking situations or stimuli is called anxiety hierarchy construction. Each hierarchy is to have a general theme and each situation is to be listed from least to most anxiety-evoking.

One mental health disorder that remains of interest to me would be obsessive compulsive disorder. This ailment causes individuals to compulsively feel the need to repeat a certain task numerous times in a row to halt unwanted thoughts, feelings, ideas or sensations. If someone with OCD fails to relieve this state of mind by completing their task, they often feel immense anxiety and occasionally even physical pain. This is due to the fact that the disorder causes those who suffer from it to believe there will be atrocious consequences to follow if they do not. These tasks can range from feeling the need to constantly wash your hands, touch things in a certain way, organize everything very precisely or counting things repeatedly. When a person caves to the pressure the disorder places on them by carrying out the behaviors to rid themselves from then obsessive thoughts, it only provides

It can leave a person not wanting to go back to a certain place, situation, or even be around certain people – causing them to avoid feared stimuli. Exposure based therapy is used to expose people to what they fear the most in hopes of eventually being able to conquer their feared situation. In the current study avoidance has been chosen as a mechanism for people who have been sexually abused, because avoiding aversive situations has been associated with the maintenance of panic disorder symptoms (Comer et al., 2011). CBT is the control treatment but also a collection of ancillary factors between the two treatment conditions. The active ingredient of the experimental condition is exposure therapy. The use of CBT premises in both treatment conditions makes for a strong control group and therefore improves internal

Systematic desensitization is a venerable behavior therapy for fear and anxiety. Usually it entails remaining deeply relaxed while visualizing a series of increasingly fearsome scenes in which the patient confronts targeted events or situations. There are many theories about how systematic desensitization reduces fear; most “theories” are post hoc claims that systematic desensitization instantiates some other training regimen or process such as respondent extinction, habituation, counterconditioning, or self-efficacy augmentation. Joseph Wolpe's original theory of how systematic desensitization works appeals to learned inhibition of anxiety that is based on parasympathetic inhibition of sympathetic activation. Criteria have been developed to

The client states she is having recurrent and persistent thoughts that are intrusive and unwanted. However, in obsessive-compulsive disorder (OCD), these thoughts meet the definition of an obsession. In addition, most recurrent thoughts in OCD are not linked to a traumatic event. Also, compulsions are present in OCD, and are not related to

Throughout history, there have been many different names people assigned to mental illnesses. The first conceptualization of disorders was coined by Hippocrates, who stated that an imbalance of humoral biles led to different diseases (Taylor & Vaidya, 2009). This was where the first concept of melancholia originated, where black bile seemed to overpower the other humors. Over time, melancholia grew to mean more than just sadness, but sadness along with mania. It covered a variety of disorders that involved emotions and actions, including obsessions and compulsions (Taylor & Vaidya, 2009). Manic disorders were then considered to be a type of hysteria, which was linked to women’s disorders. In 1918, during the time of the Spanish flu,

Cognitive-behavior therapy. The goal of cognitive therapy is to teach a person to deal with their fears and reduce anxiety without practicing their routine behaviors. Many times this is just like exposure therapy. The person will be required to think through a situation in a comfy environment and solve it without the use of the ritual.

“The aversion therapy is considered a type of psychological treatment, where patients will be exposed to different types of stimulus and at the same time it will experience some type of discomfort (Lieberman, 2012).”This treatment is based on the principles of classical conditioning; using classical conditioning to get rid of addictions or unwanted behaviours. Patient’s unwanted addiction is paired with a drug that makes them sick.