few mental afflictions are as humbling
or as terrifying as what is known as
pure OCD or more colloquially intrusive
thoughts in standard
obsessive-compulsive disorder a person
is haunted by a worry that compels them
to repeat an often counterproductive or
fruitless action with manic intensity
hand-washing turning off gas pipes
checking their pulse and so on but in
pure OCD there is no outward physical
action the problem unfolds hence the
name purely in the mind yet it is if
anything an even more distressing
condition the pure OCD sufferer is
tortured by thoughts that they want to
do or have done some of the most
censored and abhorred acts in our
societies acts that they themselves
despise and fear at an intellectual
level they grow convinced of their wish
for example to murder a loved one harm a
child sexually or assault a stranger
they cannot shut out the idea that they
may become or have already shown signs
that they are a psychopath a greatest or
a pedophile
they scan their mind ceaselessly looking
for evidence to confirm that dreadful
apprehension so burdened are they by
these thoughts they may not be able to
go anywhere near children or may take
fright at the sight of a knife in a draw
left alone with a colleague they may
panic that they could lose control and
lunge inappropriately at them at the
station they’re flooded with anxiety at
the feeling that they may push their
partner or their child under a train
having to think of oneself in these
terms
quickly drains life of any of its
pleasure the pure OCD sufferer wakes up
every morning certain that they are one
of the worst people ever to have walked
on the planet but there is not as yet a
foolproof way of treating the condition
but discussions of how to approach it
reveal large differences in assessments
of how the mind operates psychiatrists
tend to prescribe antidepressants in
order to lift the general mood of
sufferers and thereby lessen the
tendency to ruminate to the point of
exhaustion CBT psychologists will try to
argue closely with the intrusive
thoughts so that eventually sufferers
can logically acknowledge that they
truly have no intention of harming
anyone or doing anything obscene but it
is psychotherapists who have what is
perhaps the most imaginative
and unexpected solution they don’t
target the thoughts themselves or argue
with them directly they don’t try to
reassure people logically that they’re
not about to murder a loved one or harm
a child
because they don’t believe that this is
what is actually at stake and judge that
offering reassurance on these points
only legitimates a pattern of thinking
that has no basis in reality they locate
the origin of the problem somewhere
quite different the sufferer of pure OCD
has first and foremost a problem with
self-esteem and shame the unfortunate
person feels at some level utterly
disgusting and beyond the pale and will
in the background have been feeling like
this for a long time somewhere in their
past normally as a result of very
traumatic and degrading childhood
relationships they will have derived an
impression that they did not deserve to
exist their current thoughts are not
plans for the future they are attempts
by the mind to find a match between
their basic sense of self and what would
be needed by their society to concur
with it they are a move to bring about a
form of dreadful inner equilibrium
ensuring that the judgment of the world
falls in line with the judgment of the
self cases of pure OCD are sometimes
diagnosed just after sufferers have
achieved something rather positive in
the eyes of others they have been
promoted or begun a fulfilling
relationship or mastered a project it
should be a cause for celebration but
happiness simply feels unwarranted by
latching on to thoughts of complete
illegality one is assured that one’s
self-esteem will remain at rock-bottom
interestingly in societies that find
religious transgression particularly
abhorrent pure OCD sufferers will be
haunted by feelings that they have
offended God and are about to be outed
as sinners behind pure OCD is a person’s
need to find a reason to feel awful
it isn’t about this or that condemned
act and as the definition of awful
changes so too will the manifest content
of the intrusive thoughts the disease is
anchored in self-loathing not in
blasphemy incipient pedophilia or
murderous intent
this analysis opens the way to treatment
what the sufferer of pure OCD needs
above all else is to begin to repair
their self-loathing and shame they need
to learn through repeated encounters
with an outsider who casts a generous
and sympathetic eye on them that they’re
not the worthless being they take
themselves for their problem began with
a deficit of love and needs to be healed
by a loving act of witnessing pure OCD
thoughts are not wishes they are
symptoms of radical self distrust and
these will start to lift once the
afflicted learn that most vital of arts
our book what is psychotherapy tells us
exactly what going through therapy is like and why it is so important
or as terrifying as what is known as
pure OCD or more colloquially intrusive
thoughts in standard
obsessive-compulsive disorder a person
is haunted by a worry that compels them
to repeat an often counterproductive or
fruitless action with manic intensity
hand-washing turning off gas pipes
checking their pulse and so on but in
pure OCD there is no outward physical
action the problem unfolds hence the
name purely in the mind yet it is if
anything an even more distressing
condition the pure OCD sufferer is
tortured by thoughts that they want to
do or have done some of the most
censored and abhorred acts in our
societies acts that they themselves
despise and fear at an intellectual
level they grow convinced of their wish
for example to murder a loved one harm a
child sexually or assault a stranger
they cannot shut out the idea that they
may become or have already shown signs
that they are a psychopath a greatest or
a pedophile
they scan their mind ceaselessly looking
for evidence to confirm that dreadful
apprehension so burdened are they by
these thoughts they may not be able to
go anywhere near children or may take
fright at the sight of a knife in a draw
left alone with a colleague they may
panic that they could lose control and
lunge inappropriately at them at the
station they’re flooded with anxiety at
the feeling that they may push their
partner or their child under a train
having to think of oneself in these
terms
quickly drains life of any of its
pleasure the pure OCD sufferer wakes up
every morning certain that they are one
of the worst people ever to have walked
on the planet but there is not as yet a
foolproof way of treating the condition
but discussions of how to approach it
reveal large differences in assessments
of how the mind operates psychiatrists
tend to prescribe antidepressants in
order to lift the general mood of
sufferers and thereby lessen the
tendency to ruminate to the point of
exhaustion CBT psychologists will try to
argue closely with the intrusive
thoughts so that eventually sufferers
can logically acknowledge that they
truly have no intention of harming
anyone or doing anything obscene but it
is psychotherapists who have what is
perhaps the most imaginative
and unexpected solution they don’t
target the thoughts themselves or argue
with them directly they don’t try to
reassure people logically that they’re
not about to murder a loved one or harm
a child
because they don’t believe that this is
what is actually at stake and judge that
offering reassurance on these points
only legitimates a pattern of thinking
that has no basis in reality they locate
the origin of the problem somewhere
quite different the sufferer of pure OCD
has first and foremost a problem with
self-esteem and shame the unfortunate
person feels at some level utterly
disgusting and beyond the pale and will
in the background have been feeling like
this for a long time somewhere in their
past normally as a result of very
traumatic and degrading childhood
relationships they will have derived an
impression that they did not deserve to
exist their current thoughts are not
plans for the future they are attempts
by the mind to find a match between
their basic sense of self and what would
be needed by their society to concur
with it they are a move to bring about a
form of dreadful inner equilibrium
ensuring that the judgment of the world
falls in line with the judgment of the
self cases of pure OCD are sometimes
diagnosed just after sufferers have
achieved something rather positive in
the eyes of others they have been
promoted or begun a fulfilling
relationship or mastered a project it
should be a cause for celebration but
happiness simply feels unwarranted by
latching on to thoughts of complete
illegality one is assured that one’s
self-esteem will remain at rock-bottom
interestingly in societies that find
religious transgression particularly
abhorrent pure OCD sufferers will be
haunted by feelings that they have
offended God and are about to be outed
as sinners behind pure OCD is a person’s
need to find a reason to feel awful
it isn’t about this or that condemned
act and as the definition of awful
changes so too will the manifest content
of the intrusive thoughts the disease is
anchored in self-loathing not in
blasphemy incipient pedophilia or
murderous intent
this analysis opens the way to treatment
what the sufferer of pure OCD needs
above all else is to begin to repair
their self-loathing and shame they need
to learn through repeated encounters
with an outsider who casts a generous
and sympathetic eye on them that they’re
not the worthless being they take
themselves for their problem began with
a deficit of love and needs to be healed
by a loving act of witnessing pure OCD
thoughts are not wishes they are
symptoms of radical self distrust and
these will start to lift once the
afflicted learn that most vital of arts
our book what is psychotherapy tells us
exactly what going through therapy is like and why it is so important
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