- May 12, 2019
- Psychology of Personality
- Epifantseva Anna
In human relationships, it is very important to feel the fine lines. People without a sense of tact easily turn caring for a loved one into obsession in a relationship. The need to meet, see and hear those who are dear to you is natural. But excessive obsession is a destructive force if it is embodied uncontrollably and unconsciously.
About the syndrome
Obsession syndrome is understood as the emergence in a person of certain ideas or actions that are foreign to him and from which he is unable to get rid of. As a result of struggling with such phenomena, a person becomes exhausted and experiences irritation. For example, having met a black cat on the road, a person who needs treatment for obsessions will turn back and lock himself in the apartment, believing that something terrible will now happen, according to popular belief. To get rid of this illness, psychotherapy is used in combination with antidepressants.
Types of obsessions
The basis of obsessive behavior is made up of intrusive thoughts (obsessions) - drives, fears, memories, doubts, which cannot be gotten rid of or ignored.
Below are the types of obsessive disorders:
– fears (fear of failure), people may feel insecure in their abilities: to fall asleep, to speak safely in public, to be intimately successful, to wake up on time, fear of crying in public, blushing.
– doubts represented by uncertainty in fidelity, or in general in the ability to perform various operations (close the tap, turn off the gas, iron, lock the door), people enslaved by such doubts check many times whether they have completed a certain manipulation;
– phobias characterized by the widest range of manifestations: from fear of flying, fear for loved ones, fear of drawing attention to one’s own person, fear of heights, darkness, death to fear of getting sick (syphilophobia, heart attack phobia, cardiophobia, cancer phobia);
– annoying images, thoughts that are constantly present in the head and contradict a person’s vital morality (for example, obscene thoughts and shameless images among respectable citizens, blasphemous thoughts among clergy);
– annoying memories that have an unpleasant connotation and arise contrary to a person’s wishes;
- actions that consist of repeated repetition of movements against the will (adjusting hair, closing eyes, tugging at clothes, licking lips, grimacing, rearranging objects, immeasurable constant putting things in order, repeatedly washing hands);
– persistent urges, manifested by an uncontrollable urge to read something, count, bite nails, pull out a hair or a hangnail.
The main feature of all obsessions is the absence of a rational component underneath. Frequent causes of obsessions are lack of sleep, overwork, some mental disorders, head injuries, asthenia, and infectious diseases. Also, often the occurrence of the described syndrome can be caused by an overly harsh religious upbringing, an instilled craving for purity or perfectionism. Obsessiveness syndrome in children can often occur as a result of unfavorable family conditions, increased mental and physical stress, poor relationships with peers, loss of a loved one or divorce, and can also be genetically determined.
In a relationship
This phenomenon is most common in human relationships. Men often demonstrate their obsession, sometimes without realizing it. In an effort to get attention from the chosen one, they may evaluate her silence in response to their steps somewhat differently, not as things are in reality, not realizing that they are indifferent to the chosen one.
They start bombarding her with messages and calls without waiting for a response. Such actions often, on the contrary, repel the girl from the annoying gentleman.
Obsessive states
(From the book PSYCHIATRY, edited by R. Scheider. Translation from English: Moscow, “Practice”, 1998)
I. General information. Obsessive states (also called anancastic reactions) are widespread. As a temporary phenomenon, they are observed in most healthy adolescents and adults. Psychasthenic psychopathy is also common - a condition in which the tendency to obsessively repeat thoughts and actions is a character trait. In addition, 2-3% of adults suffer from obsessive-compulsive disorder.
II. Types of obsessions
A. Obsessive thoughts (obsessions) are the incessant repetition of unwanted, often painful thoughts, ideas and desires that cannot be gotten rid of by force of will. There is always a feeling of their violence. The patient understands that obsessive thoughts originate within himself (unlike a patient with schizophrenia, who is sure that someone is controlling his thoughts). The content of obsessive thoughts is unacceptable or meaningless to the patient, so he tries to fight them. This is the fundamental difference between obsessions and overvalued ideas and delusions, observed, for example, in depression: firstly, overvalued and delusional ideas are not accompanied by a feeling of violence, and secondly, there is no criticism of them, the patient does not resist, but, on the contrary, defends his thoughts . Sometimes obsessive thoughts at first are not violent and alien to the patient: excerpts of songs, individual words, or, for example, thoughts of a young man about intimacy with a woman he likes, who may not know that she is the object of desire. Over time, such thoughts may disappear, but they can actually become obsessive and persistent. Typically, obsessive thoughts concern the following interrelated areas of life: 1) morality and religion; 2) aggression; 3) pollution, infection; 4) health and illness; 5) accuracy, striving for symmetry; 6) sexual sphere (especially shameful actions). It can be seen that in all cases, harm to oneself or others is directly or indirectly implied. The topic of pollution or contamination comes up much more often than others. Other common examples: an obsessive desire to return home and check if the door is locked; obsessive urge to say obscenity in public.
Let us emphasize once again that obsessive thoughts are fundamentally different from overvalued ideas. With obsessive states, the patient is rarely completely focused on any one thought; in addition, intrusive thoughts are always perceived as violent. Therefore, it is obvious that the basis of, for example, anorexia nervosa is precisely an overvalued idea that does not cause resistance from the patient (however, this overvalued idea is often incorrectly considered an obsessive desire to lose weight). It is interesting, however, that in the character of young women suffering from anorexia nervosa, signs of obsessions are often found - excessive diligence in study, physical exercise, etc. The same can be said about transsexuality: although some authors believe that transsexuality is this obsessive feeling of being a woman trapped in a man’s body (and vice versa), in fact, it is rather a constant perverted perception of one’s body (as in body dysmorphomania).
B. Obsessive actions are stereotypical, repetitive, seemingly aimless actions, which often have the appearance of a ritual. There are four main types of such actions: 1) cleansing (most often washing hands and wiping surrounding objects); 2) verification; 3) actions related to clothing: dressing in a special sequence, endlessly straightening clothes; 4) counting (often in the form of listing objects and out loud). A funny children's counting rhyme (“king, prince, king, prince…”) can become a real torment for a patient with obsessive counting. Obsessive counting in some cases is an obsessive thought (counting to oneself), in others it is an obsessive action (counting out loud, for example, in time with breathing). In an obsessive action there is a subjective component - attraction, or compulsion, and an objective component - ritual (real actions caused by attraction, which can be both noticeable and invisible to others, for example, counting in time with breathing). Rituals are always associated with an internal feeling of incompleteness of any actions: “It is better to redo it than to leave it unfinished.” So, the doctor can re-read the test results many times, call the pharmacy back several times to check whether the prescription was written correctly. In adolescence and young adulthood, especially among girls, there is often an obsessive desire to touch the face or straighten the hair (a combination of checking and cleansing).
B. Pathogenesis and differential diagnosis. Mild forms of obsessions obviously have adaptive significance. They distract attention from other, perhaps more unpleasant thoughts and experiences (by type of displacement). Children's games-rituals have a similar connotation - for example, not to step on cracks in the asphalt. Rituals can be a way to suppress anger and control yourself. At the current level of knowledge about the pathogenesis of obsessive states, we cannot exclude that ritual is an exaggerated protective behavior. Perhaps our Self subconsciously senses some subtle defect (neurological or otherwise) and initiates actions (such as checking) that supposedly reduce the negative consequences of such a defect. But if control over these actions is impaired (for example, perseveration with lesions of the frontal lobes), then they become repetitive and obsessive.
Obsessive states are sometimes very difficult. Incessant obsessive thoughts and actions bring the patient so much suffering that their protective role, if any, is lost. The automatic, involuntary nature of the compulsions at times resembles tics. The author has observed many patients with obsessive-compulsive states of varying severity and is convinced that only mild forms of them can be classified as actually “neurotic” and they should be distinguished from real obsessive-compulsive neurosis. There seems to be no smooth transition between mild obsessions and obsessive-compulsive neurosis, and one of the proofs of this is given below - in patients with obsessive-compulsive neurosis, a history of psychasthenic psychopathy is detected quite rarely.
Obsessive thoughts and actions have many similarities with obsessive fears - phobias, but they differ in many ways. All these conditions limit the freedom of the patient, but he is always aware that painful thoughts, ritual actions and unjustified fears originate in himself and are devoid of any meaning. However, the patient cannot suppress them on his own, and attempts to get rid of them only increase anxiety. Severe anxiety may occur at the beginning of a course of behavioral psychotherapy, but if the disease has not gone too far, then it gradually decreases.
Unlike obsessive thoughts and actions, with simple phobias (obsessive fears associated with specific objects or situations), the patient does not experience obvious anxiety or discomfort unless faced with a frightening object. Therefore, simple phobias usually do not cause everyday anxiety, since traumatic situations can be avoided. For simple phobias, as a rule, mental desensitization in combination with mental relaxation is effective.
With social phobia, it is not so easy to overcome anxiety, since it always arises in the presence of other people (the patient is afraid that everyone will watch him, judge him, that he will be constantly embarrassed or will do some funny and ridiculous things). But even in this case, subjective experiences and decreased ability to work are rarely as pronounced as with obsessive-compulsive neurosis.
III. Psychasthenic (anancastic) psychopathy (in ICD-10 and DSM-IV - obsessive-compulsive personality disorder). As already mentioned, transient obsessions are common in both children and adults. The diagnosis of psychasthenic psychopathy is made if these traits are a character trait. People suffering from psychasthenic psychopathy have a pathological passion for perfection, and this makes their existence difficult: any action must be so perfect that it cannot be completed. At first, this character trait can be expressed moderately, does not affect social adaptation, and is often even liked by parents and teachers, but later it becomes more and more unbearable.
Individuals with psychasthenic psychopathy are also characterized by straightforwardness, inflexibility, stubbornness, frugality, excessive conscientiousness, and indecisiveness. Such people devote almost all their time to work, paying a lot of attention to minor details, are prone to hoarding and have difficulty parting with any little thing, their concept of morality is exaggerated almost to the point of fanaticism. As a result, sometimes the behavior as a whole changes: the person seems sticky and inhibited. More often, however, psychopathy occurs in a milder form. In this case, the behavior from the outside looks normal; such people are punctual, reliable, conscientious, save money, always finish what they start, their mood seems even from the outside - all these qualities are certainly positive and increase self-esteem. “To my friend, punctuality was not just a character trait, but a way of life...” (Tom Stoppard on Bertrand Russell; Jumpers, New York: Groove Press, 1972, p. 25).
The symptoms of psychasthenic psychopathy change over time, and decompensation due to stressful situations is typical for it. However, it usually does not develop into obsessive-compulsive neurosis: although it was previously believed that 50% of patients with this neurosis have psychasthenic psychopathy, according to modern data, this figure does not exceed 5-10%. With decompensation of psychasthenic psychopathy, as a rule, one or another affective disorder develops, and not obsessive-compulsive neurosis.
IV. Obsessive-compulsive disorder (in ICD-10 and DSM-IV - obsessive-compulsive disorder)
A. General information. Obsessive-compulsive neurosis is a disorder in which obsessions literally haunt a person and poison his entire existence - communication, work, rest. Attempts to deal with obsessions are usually unsuccessful, and this further increases anxiety.
The etiology of obsessive-compulsive disorder is unknown. The role of genetic factors cannot be ruled out. Among identical twins, there is a high concordance for this disease, while fraternal twins are more often discordant. The prevalence of obsessive-compulsive disorder neurosis in parents of patients is 5-7%, and among the general population - 2-3%. Obsessions are typical for boys with Gilles de la Tourette syndrome: 25-35% of male patients suffering from this disease meet the criteria for obsessive-compulsive neurosis. It is not yet clear whether this combination is genetic; Perhaps there is a common gene that causes Gilles de la Tourette syndrome in boys, and obsessive-compulsive disorder in girls.
The average age of onset of obsessive-compulsive disorder is 20 years. Often there is a sudden onset in adolescence, without previous symptoms. A third of the cases are children (under 15 years of age); Their average age is 7-10 years, the minimum is 3 years. Boys get sick on average earlier than girls. Occasionally, obsessive-compulsive disorder begins after 40 years of age (less than 10% of cases). The onset of the disease is often preceded by stress (pregnancy and childbirth, death of a family member, sexual failure), but in 70% of cases the provoking factor cannot be identified. Trichotillomania (obsessive hair pulling) usually begins in adolescence or young adulthood; Women are more likely to get sick.
The course of obsessive-compulsive neurosis is chronic, wave-like, even if the onset was acute. Spontaneous improvements (remissions for more than a year) are observed in less than 10% of cases. In mild forms of obsession, little annoyance occurs to the patient; in severe forms, complete loss of ability to work is possible. Many people hide their illness: obsessive thoughts seem so stupid, terrible and indecent to the patient, and rituals so pretentious that he is afraid of being disgraced if someone finds out about them.
B. Treatment. The main methods are medication and behavioral psychotherapy. It is extremely rare, in very severe forms of the disease and ineffectiveness of conservative treatment, to resort to psychosurgery.
1. Drug treatment. The use of serotonergic drugs for obsessive-compulsive disorder has not only clinical, but also some pathogenetic justifications. Firstly, the level of 5-hydroxyindoleacetic acid, a product of serotonin metabolism, is increased in the CSF of patients. Secondly, the serotonin antagonist metergoline causes exacerbation in treated patients and worsens the course of the disease in untreated patients.
The duration of drug use has not been established. If only drug treatment is carried out, then after its cessation a relapse usually occurs. Drug treatment (in the absence of side effects) should apparently be continued until the effect of psychotherapy appears. After this, the drug is gradually withdrawn.
Combining psychotherapy with serotonergic drugs often produces better results than either method alone. Some patients, however, refuse psychotherapy, and sometimes it is not feasible for other reasons. In these cases, medications are prescribed for an indefinite period. In this case, constant monitoring is necessary in order to promptly identify the delayed toxic effect of drugs due to their accumulation.
2. Behavioral psychotherapy for obsessive-compulsive neurosis is based on a combination of provoking obsession and preventing ritual. Provoking a compulsion reduces the distress caused by the compulsion, while ritual avoidance reduces the time spent performing the ritual. For example, consider the following case: our patient is afraid that if he lifts the toilet seat before urinating, he will definitely contract AIDS (even at home). However, being a well-mannered person, he still raises the seat every time before urinating. He can calm the anxiety that has arisen only by washing his hands for 5 minutes. The patient hates this ritual because it takes time and is noticeable to others. When obsessiveness is provoked, the patient is asked to specifically lift the toilet seat with his hands (in this case, one should not grasp the seat with toilet paper or lift it with the toe of a shoe); thereby, as it were, “increasing” the risk of contracting AIDS (in fact, it is impossible to become infected this way). The patient’s anxiety increases, and at this moment they give a new task: reduce the hand washing time to 4 minutes. Behavioral therapy, of course, should be accompanied by psychological support and a detailed story about AIDS in order to ease the patient's anxiety and increase the mood for recovery. When repeating tasks, both the anxiety associated with touching the toilet and the time required to complete the ritual gradually decrease. The patient begins to understand that he can cope with his painful feelings even without ritual.
25% of patients refuse behavioral therapy: it causes them too much anxiety. Among those who completed the course, in half of the patients the severity of obsessions and the ritual time are reduced by 70% or more, in another 40% of patients - by 30-69%. In 60% of patients receiving behavioral therapy, symptoms, as a rule, remain stable for 6 years or more, and if they increase, then at a moderate pace. If only drug treatment is carried out, then almost always a relapse occurs quickly after its completion.
Mental relaxation, which is often considered a method of actively inhibiting anxiety, is actually a passive component of behavior therapy. It can have an indirect effect, serving as a protective mechanism that patients resort to when painful sensations arise. However, some patients, on the contrary, prefer rapid and complete provocative therapy without trying to reduce anxiety - the so-called immersion method. The intensity of anxiety, however, does not affect the outcome of treatment.
Traditionally, psychoanalysis, other non-behavioral methods of psychotherapy, and hypnosis are used in the treatment of obsessive-compulsive neurosis. However, when used independently, their effectiveness is low. They can be resorted to only if the main methods of treatment (drug and behavioral therapy) are unsuccessful. All patients need psychological support: an explanation of the nature of the disease, sympathy, and the creation of a mood for recovery.
Literature
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About the signs
Obsession is a phenomenon that is expressed in constant control over the object of attention. An annoying individual may constantly wonder who called his other half and get angry when she spends time apart. These characteristics will manifest themselves in constant jealousy and fear of loneliness. Sometimes such an individual isolates himself from the rest of society, becoming completely fixated on one person. All this one day leads to a breakup, when the other half simply does not want to experience such stress anymore.
For people with a sense of tact, the absence of a response to their step towards a person will be a sign to stop. Having taken a step, you should wait for a response. And only if it does, does it make sense to do the next one.
But for people with obsessiveness problems, it happens differently. They can storm their partner with a flurry of steps towards them, not noticing that he has been responding for a long time, and if he responds, it is very sluggish. An obsessive person may think that the problem is not with him, but this is often a big misconception. No one needs people who are completely conquered, and this applies to both sexes.
Most of all, people value self-sufficient individuals who have their own space and respect their own personality. Such people are passionate about their world and do not try to break down all the doors of someone else in order to fill their life with them. They are so interested in themselves that there is simply no need for it. The paradox is that such people attract those around them, who may never get into this world.
Results
- Women, alas, very often impose themselves on men and, of course, do it in vain. The main reasons for destructive behavior are the fear of being left alone, the desire to attach, the infantile desire to shift one’s problems onto someone else.
- Obsessive love burdens another person - he feels control over his life, constrained by circumstances, which cannot please him. Normal healthy relationships are built only on free choice.
- Give up the habit of imposing, do not push for pity - in the long run, this model of behavior will still not give you anything. Even if a man is with you, there will be no happiness, you yourself may be disappointed, scandals will begin.
- Love is a bright feeling, not a cure for problems, an escape from oneself. If your soul is empty, a man will not fill it.
Hello, dear readers! The eternal question of the struggle between a man and a woman is who should take the initiative and call first. Today I want to talk about whether it is necessary to remind a man about himself, how to do it competently and not become another obsessive fan. In addition, we will talk to you about why guys don’t dial the number themselves and take the initiative.
Examples of obsession
Obsessiveness often manifests itself in typical life situations. So, if a girl and a guy agreed to meet, the man can ask again every hour: “Is everything okay? I'll see you in the evening?". It makes no sense to constantly disturb your partner with questions and messages. It is important to note your partner's reaction before writing or suggesting anything.
This is the difference between an annoying and persistent suitor, the lack of understanding of which men so often complain. A persistent person monitors his partner’s reactions and, based on them, builds his further behavior. The annoying one simply, without noticing anything, begins to cause discomfort to his partner.
And messages and calls can begin from the first minutes of communication: several dozen of them can arrive, remaining unanswered, they can only multiply. Often, obsessive men from the very first seconds begin to make demands and talk about their grievances that the woman minds her own business and does not answer him, the sun-faced one. When faced with such a phenomenon, you need to be aware that this is a negative sign that characterizes a person as a very dependent person.
Very often, an obsessive man tries to evoke pity: “I thought I had met my fate, but you can’t even answer. What should I do!". Sometimes the same individual can refer to illness, fainting and poor condition, thereby trying to provoke pity and attract attention to his person. It's a son game, but do you need a man as a son?
Often this form of communication ends with the woman being persecuted by her partner. Clinging, he will do everything possible to keep the woman close to him, even against her will. There are a great many such cases: installing a surveillance program, tracking down your partner everywhere. This term is called “stalking”. Often these actions have a very depressing effect on the victim, because a man who has literally gone crazy behaves inappropriately and can follow the victim for months, in rare cases attacking her.
In civilized Western countries, “stalking” is considered a criminal offense, and such individuals are sent to prison. In the Russian Federation, it has not yet been recognized as a criminal offense. Therefore, when entering into a relationship with a person who shows signs of obsession, you should think about whether you need this?
If such a phenomenon has already begun, the only way out is to completely ignore it. If obsession already violates security boundaries, you need to involve family and friends, contact the police, and make all the actions of the obsessive person public. Usually such men are afraid of using force.
Why doesn't the man call first?
John Gray's book "Men are from Mars, Women are from Venus" made a splash in relationship psychology. Explain in simple and understandable language why we so often do not understand each other and why we have conflicts. If you want to become a real relationship guru, then you cannot do without this book.
Now let's try to understand what prevents the feather guy from calling and reminding him of himself. The first and quite common reason is that he simply is not interested in you. Yes, it’s hard, offensive and painful to realize this. But it happens that you simply didn’t like the girl. And since he doesn’t know how to say it casually, he just . In this case, reminders about yourself will be extremely inappropriate.
Another option is that he liked you too much and now he’s selling himself out. Like, let her run after me and be afraid of losing me. Whether it’s worth connecting your life with such a gentleman is up to you to decide. But a man who cannot sincerely and directly say about his sympathy is no longer trustworthy.
He has a girlfriend, and your meeting was just a passing hobby. In this case, there is nothing to even think about and there is no need to remind yourself in any way. Even if you are thinking of writing him an angry SMS, expressing all your resentment, believe me, it is not worth it.
