Life experiences and mental disorders
It is now clear enough that when psychological and/or psychiatric problems emerge it is possible to identify the remote causes in the individual life experiences of the individual.
Clearly, being the complex human mind, it is not enough to have lived painful or traumatic events so that a psychic or relational disorder is structured. Certainly, however, these sensitizing experiences can constitute fertile ground on which these problems could emerge.
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The causes of obsessive compulsive disorder
This also applies to obsessive compulsive disorder (doc), whose research in this regard identified typical remote factors of vulnerability, or the possible ones Remote causes.
In particular, it emerged as certain parenting styles, family environments or traumatic events They can act as a substrate from which, in conjunction with other factors, the disorder can be structured.
Specifically, it is not only the events and situations of painful life that is predisposing, but above all how they have been experienced by the individual and how these painful experiences lead, during the development, to the crystallization of dysfunctional ideas on himself, that is, basic beliefs (CDB) (Beck, 2002).
To simplify it is very likely that if I lived in a critical family environment I will internalize an idea of me of an inadequate person.
Life experiences typically traceable in the DOC
From literature (Adams, 2012; Doron & Kyrios, 2005) it is possible to identify particular experiences that act as a basis for the construction of basic beliefs typical of the obsessive compulsive disorder:
- a family environment of origin characterized by attention to morality and moral rules. If these were transgressed there were violent or inconsistent reactions compared to what had been done by the child. The caregiver refers to how inappropriate behavior is, but also how much the child is as a person, through an emotional distance. An aggressive passive facial mimic (“The muzzle”) (Basile, 2018) is typical, following which the child will feel forced to behave in an impeccable way.
- Parental criticism (Pace, Thwaites & Fireston, 2011). A family atmosphere in which one or more components have shown themselves, critics, despicants and have made the child feel disapproved, they can lead the latter to the construction of a nuclear idea of himself as inadequate, not lovable, morally wrong and develop obsessive modalities that lead to preventing future criticism (“I check ten times the gas to be sure not to create damage for which I could feel guilty and therefore judge myself as a bad person”).
- Parents who encourage a large and premature sense of responsibility (Salkovskis, Shafran & Rachman, 1999; Adams, 2012).
- Paradoxically, on the other hand, be “shielded” by responsibilities From overprotective and anxious parents he has the same effect: the child not being used to being with the emotion of guilt and to take responsibility is more likely that he will avoid feeling as such (Salkovskis, Shafran & Rachman, 1999).
- An accident where the child’s actions or omissions have actually contributed to a misfortune. Or an accident where the child seem to seem to have contributed to the misfortune or omissions (Salkovskis, Shafran & Rachman, 1999).
- Having led the child to put his own needs in the background compared to those of others (Careou, O’Connor, Turgeon & Freestone, 2012) or by necessity or, for example, due to a disease of those who should have taken care of him.
- Experiences of inconsistency in reinforcement (Careou Careou, O’Connor, Turgeon & Freestone, 2012), where the child is unable to predict what the other’s response could be and therefore must always be in alarm to predict any mistake.
- A authoritarian parental style (Timpano, Keough, Maheffey, Schmidt & Abramowitz, 2010) is often associated with beliefs and obsessive symptoms.
- The threat of the relational break leads the child to believe that the relationship will be maintained or not according to his behavior which must thus be impeccable. The love of the caregiver is therefore conditioned, going to create those rules of thought typical of the disorder (“if I commit myself well the other will love me” “if I am wrong I will be punished”).
- Severi standards. The family atmosphere is characterized by very high control and expectations that therefore lead to a greater probability of being able to make mistakes, and once again to the belief that if I work perfectly, I can control/maintain the relationship (Doron & Kyrios, 2005).
Give these parenting styles and family environments, the child internalizes the Need to behave in an impeccable way, especially morally, to maintain the relationship with those who should take care of him.
Traumatic life experiences
Until now we have identified experiences that have a decisive role in preparing the fear of guilt and hypertrophic responsibilityor beliefs with respect to one’s amiability, unworthiness or adequacy.
Below are other “traumatic” life events (Nacasch, FiTick, & Zohar, 2011) which can be relevant for the various disorder subtypes, in particular for mental contamination:
- Neglect (neglect), physical and psychological abuses. We know from the clinical experience that these can lead to the construction of self -self -ability images, inadequacy and unworthiness.
- Sexual abuse, harassment or violation of personal limits or boundaries of one’s intimacy.
- Sexual intercourse, kisses or intimate contacts, consenting but not really desired.
- Physical or verbal aggressions, humiliations, betrayals both suffered and acted.
- Actions considered immoral committed or imagined.
- Thoughts/impulses considered unacceptable
- Emotional experiences judged as inappropriate. For example when the person may have experienced emotions of anger towards vulnerable subjects or relief towards a tragic event.
Treatment and interventions on the causes of obsessive compulsive disorder
Given what has just been described, it is natural to orient themselves towards approaches and techniques that can lead to a job aimed at rewriting the needs frustrated in past episodes, in order to generate emotional experiences that contrast and weaken the basic beliefs at the base of the DOC.
For example, there are now numerous studies that highlight the therapeutic outcome of the Therapy scheme in DOC and show the central role of the work on the change of basic beliefs and maladative schemes and how this helps in the reduction of symptoms (Wilhelm, Berman, Keshaviah, Schwarz, & Steketee, 2015)
The data encourage us to associate standard behavioral therapy, techniques aimed at modifying these beliefs, thanks to the satisfaction of frustrated needs during childhood, to encourage current change.
Techniques used to work on frustrated needs in the past in the DOC
To do this, the techniques most used and with greater tests of effectiveness than the modification of basic beliefs are theImagery Rescripting (IMR), Chairwork and Role Playing.
These are experiential tools, used in different approaches, which allow you to work on current emotional problems by connecting them to painful remote memories, rewriting, through the fulfillment of emotional needs frustrated in childhood, their content.
This type of work facilitates understanding e compassion towards itself Because allowing to understand that what happened in the past was not the patient’s fault.
Furthermore, the change of meaning in the representation of the patient of what happened allows to renovate the beliefs of non -Amability, inadequacy, unworthiness and from the emotional point of view of feeling loved, appreciated and worthy.
How to correct the basic beliefs that derive from past experiences
The messages that are sent to therapeutic work to obsessive patients concern the fact that making mistakes is human, which can be made mistakes without jeopardizing one’s sense of amiability or personal and moral value.
The error is inevitable, admissible, understandable, repairable, forgiving and is not linked to the value of the child or to its respectability.
Also, for the traumatic episodes The work is aimed at cognitive and emotional renovation on what the patient has thought of himself in those moments and how he felt.
The exercises on the painful memories of the past can therefore be integrated with standard behavioral cognitive work (for example with exposure and prevention of the response), and help in the symptomatological reduction and in the prevention of repercussions.
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Bibliography
- Adams, TG, (2012). Multiple Pathways to and From Responsibility Interpretations and Development of Compulsive Symptomps compulsive Obsessive “. In Journal of Experimental Psychopathology, 3.5, pp. 807-824.
- ARNTZ, A. (2012). Imagery Rescripting As a Therapeutic Technique: Review of Clinical Trials, Basic Studies, and Research Agenda. Journal of Experimental Psychopathology, 3 (2), 189-208.
- Basile, B., De Sanctis, B., Fadda, S., Luppino. Oi, Perdighe, C., Saliani. AM, tenor, K. & Mancini, F., (2018). Early Life Experiences in Ocd and Other Disorders: A Retrospective Observational Study Using Imagery with Re-Scripting. Clinical Neuropsychiatry 15 (5): 299–305.
- Beck, J. (2002). Cognitive therapy. Fundamentals and prospects. Mediserve.
- Careareu, Y., O’Connor, KP, Turgeon, L. & Freeston, MH (2012). Childhood Experiences and Adult Beliefs in Compulsive Obsessive Disorder: Evaluating to Specific Etiological Model. Journal of Cognitive Psychotherapy, 26, 3, pp. 236-256.
- Doron, G. & Kyrios, M., (2005). Compulsive Obsessive Disorder: A Review of Possible Specific Internal Representations Within A Broader Cognitive Theory. Clinical Psychological Review 25 (4): 415-32.
- Mancini, F. (2016). The obsessive mind. Take care of obsessive compulsive disorder. Raffaello Cortina publisher.
- Nacasch, N., FiTICK, L. & Zohar J (2011). High prevalence of obsessive-compulsive disorder among posttraumatic stress disorder patients. European NeuropsyChopharmacology: The Journal of the European College of Neuropsychopharmacology 21 (12): 876-879
- Pace, sm, Thwaites, R. & Freeston, MH, (2011). Exploreing the Role of External Criticism in Compulsive Obsexive Disorder: A Narrative Review. Clinical Psychology Review, 31, 361–370.
- Salkovskis, PM, Shafran, R., Rachman, Sj & Freeston, MH (1999). “Multiple pathways to Inflation Beliefs responsibility in Obsessional Problem: Possible Origins and Implications for Therapy and Research”. In Behaviour Research and Therapy, 37, pp. 1055-1072
- Timpano, K., Keough, M., E., Mahaffey, B., Schmidt, NB & Abrahamowitz, J. (2010). Compulsive parenting and obsessive Sympoms: implications of authoritarian parenting. Journal of Cognitive Psychotherapy 24 (3)
- Wilhelm, S., Berman, NC, Keshaviah, A., Schwarz, Ra & Steketee, G., (2015). Mechanism of Change in Cognitive Therapy for Obsessive and Compulsive Disorder: Role of Maladaptive Beliefs and Schemas. Behaviour Research and Therapy. 65: 5-10.
