Obsessive Compulsive Disorder (OCD) - Do I have it?
Obsessive-Compulsive Disorder (OCD) is a serious anxiety-related condition where a person experiences intrusive and unwelcome obsessive thoughts on a frequent basis, often followed by repetitive compulsions, impulses or urges.
Generally speaking, a person’s OCD will fall into one of the four main categories:
For many sufferers, there is often an over-inflated sense of responsibility to prevent harm and an over-estimation about the perceived threat that an intrusive thought signifies. It is these factors that help drive the compulsive behaviours, because the person with OCD often feels ultimately responsible for trying to prevent bad things happening.
OCD is diagnosed when the obsessions and compulsions:
OCD affects men and women equally, and generally begins to affect people during late adolescence (men) and during their early twenties (women). Sufferers often go undiagnosed for many years, partly because of a lack of understanding of the condition and partly because of the feelings of embarrassment, guilt and sometimes shame associated with what is often referred to as the ‘secret illness’. The sufferer can therefore wait an average of 10–15 years between symptoms developing and seeking professional help.
The thoughts and fears related to OCD can often seem very shocking. It must be stressed, however, that they are just thoughts – not fantasies or impulses which will be acted upon.
For someone with OCD, their logical mind always remains functioning, even if their OCD mind is becoming out of control, particularly exaggerated during periods of stress. Most people with OCD know that their thoughts and behaviour are irrational and senseless, but feel completely incapable of stopping them, often fearing that not completing a particular behaviour will cause harm to a loved one or to themselves. It's important, therefore, during treatment for the therapist to engage the logical rational brain of the sufferer in assessing the risk of the bad thing actually happening and getting them to understand gradually that the risk is so slight or non-existent that it's not worth giving power to. This can be easier said than done, particularly during the early stages of treatment, as no matter how small the risk, the person with OCD will feel responsible for preventing that bad event from happening, and will experience such high anxiety if they do not give in to the compulsion to act.
OCD - My Approach
I help clients to identify the causes of their OCD and work to desensitize them to life events which have made them feel 'unsafe', guilty or untrusting of themselves and/or others. I often use EMDR which effectively enables disassociation from, and de-sensitization to, past traumatic events for those suffering from PTSD - Post Traumatic Stress Disorder. Emotional Freedom Technique (EFT or tapping), and Cognitive Behaviour Therapy (CBT) are also employed. With CBT I focus on changing thoughts and teaching you the link between the thoughts, your feelings and subsequent behaviours. Trust can be a major issue for those who suffer with OCD, so the building of a trusting relationship and rapport with myself is key. I use relaxation techniques including deep breathing, and Clinical Hypnotherapy to gradually help you build this trust and your own self esteem and create distance between yourself and your OCD which we often name as something separate from yourself. I often use NLP techniques to help you access a state of calmness and gain control over your panic attacks. You are taught how to manage your illness so that you can stay in control of yourself rather than giving your thoughts and compulsions the power over your feelings and behaviour.
An eating disorder is an illness that leads people to overeat, to starve themselves, or adopt other unhealthy behaviours around food and body weight. These disorders - binge eating, anorexia nervosa, and bulimia - are not just bad habits. They interfere with everyday life and without proper treatment they can cause serious health problems and tragically even death.
I specialise in working with clients who have eating disorders, whether children, adolescents or adults, men or women. I help them using a range of different therapies including CBT, Clinical Hypnotherapy, and Psychotherapy and will often refer them to a Nutritional Therapist. My role and the role of the Nutritionist will then complement the role of the client's GP in helping them on their road to recovery as quickly as possible. The most important thing for clients to do is to seek help from professionals who will support them back to a healthy relationship with food.
On this page I've included some basic information about Binge Eating Disorder, Anorexia Nervosa and Bulimia which I hope you will find helpful to you.
What is a Binge Eating Disorder?
Episodes of extreme overeating are the hallmark of this illness, which is the most common eating disorder. People who struggle with it, are usually overweight or obese - male or female. In contrast with Bulimia, this illness does not lead people to purge, i.e. to vomit, to fast, or to over-exercise. It can develop at any age but it is often diagnosed in middle age. It can lead to type 2 diabetes, high blood pressure and heart disease.
Binge Eating Symptoms
Many of us overeat from time to time; binge eating is different. People describe feeling out of control when they overeat. They may eat more quickly and until they are painfully full, or binge when they are not hungry. Many people with binge eating disorder say that stress, anxiety, depression, or even boredom can trigger a binge episode. It's common for someone with binge eating disorder to feel guilty, ashamed, or depressed after a binge. This can lead to a vicious cycle in which bingeing causes emotional distress, and then emotional distress causes more bingeing. Guilt and shame cause many people with binge eating disorder to hide their behaviour, which can make it harder to diagnose as it's undetected.
It's also not uncommon for someone with binge eating disorder to have weight fluctuations because of attempts to diet between bingeing episodes. But until the bingeing behaviour is under control, weight loss efforts are unlikely to be successful in the long term.
Diagnosing Binge Eating Disorder
Most binge eaters hide their overeating, even from close family members, so getting a diagnosis can be difficult. One sign is a history of bingeing at least once a week for the last 3 months. Diagnosis may also include a physical exam and a discussion about eating patterns, medical history, and family history.
Treating a Binge Eating Disorder
Successful treatment may come from a combination of different approaches. Talking with a therapist, particularly cognitive behavioural therapy (CBT), can help to change unhealthy eating habits and thinking patterns and the use of Clinical Hypnotherapy to educate the sub-conscious mind. Nutrition education and family support can also be extremely beneficial. Weight loss programs can also help to achieve control over binge eating.
What is Anorexia?
People who have this disease develop an irrational fear of gaining weight, which can drive them to become dangerously underweight. It's more common in females, but it does affect males too. It can start after a life change, a traumatic event, in pursuit of perfection, or the desire to play competitive sport and be the best. Anorexia is a serious health probelm, but with support and the right treatment, people can get better.
People suffering from this disease will go to great lengths to lose weight. As well as eating too little food, they may compulsively exercise, or take diet pills. People may continue to lose weight despite symptoms of starvation, and hide their bony bodies under baggy clothing.
Food becomes an obsession with anorexia. They may eat very little but think about food constantly; they may be so focused on food that they can recall whole restaurant menus ingredient by ingredient. They may portion their food carefully, eat tiny amounts of restricted foods, count calories incessantly, and weigh food before eating it.
Though people with anorexia may be dangerous thin, they still see themselves as fat. They are often extremely critical of themselves. Anorexia is recognised as partly developed out of a need for perfection. But the drive to achieve a perfect body spirals out of control until it becomes unhealthy and even life-threatening. There are some more minor symptoms of anorexia such as fine hair growing all over the body, loss of menstrual periods, but longer term problems can cause anemia, thinning bones, damage to the heart, organ failure and even death.
Because anorexia can be life-threatening, it's important to get a diagnosis as soon as possible. Generally speaking, a diagnosis can be made if a person is less than 85% of what is considered a normal weight, if she or he shows an intense fear of gaining weight, and has a very distorted body image. The person's GP may run tests to rule out other diseases before confirmating a diagnosis. A stay in the hospital may be needed for people with serious health complications, dangerously low weight, or thoughts of self harm.
There are three goals with this disease. Restore healthy weight, treat the person psychologically, and reduce unhealthy thoughts and actions that may lead to a relapse. With every approach, food and nutrition counselling is key, and family therapy that includes children and teens can be extremely beneficial.
What is Bulimia?
Bingeing and purging are the hallmarks of bulimia. Though anyone can get bulimia at any age, 85 to 90% of bulimics are female, and it often affects teens and young adult years. Factors that play a role include stressful life events, biology, culture and habits within a family, and social pressures to be thin. The good news is that treatment can stop the cycle of bingeing and purging.
A person with bulimia eats large amounts of food very quickly and then compensates by throwing up, taking pills to have a bowel movement (laxatives), or exercising excessively. Bingeing and purging can happen a few times a week or many times in a single day. People who suffer report that they feel out of control when they binge and keep it secret due to shame.
Unlike anorexia, people with bulimia are usually at a normal weight or just slightly overweight. But they are deeply afraid of gaining weight, and in the grip of the illness, those with normal body weight and size may believe they are actually very over weight - this is called distorted body image. The drive to lose weight can also lead to diet pill abuse.
Bulimia is more than just a problem with food. The cycle of bingeing and purging can be an attempt to control negative feelings. Often people with bulimia struggle with depression, anxiety or substance abuse. They may often be moody or irritable and may withdraw from those around them.
The physical effects of bulimia are a chronic sort throat, worn tooth enamel, swollen salivary glands in the cheeks, heartburn, constipation and other digestive problems, dehydration, irregular menstrual periods, and out of balance blood minerals called electrolytes, which can lead to heart problems.
This can be very difficult to do as people deny and hide the behaviours, and they don't look unwell. The earlier they get treatment, the more likely they are to recover completely. As with any therapy or presenting problem, it's the strength of the desire to change that will determine an individual's success or otherwise.