RECOVERY FOCUSED BEHAVIOR THERAPY
The persons affected with OCD and Phobia remain struck in habitual behaviors of avoidance for ensuring safety. In their mind they have a mental picture of their phobic and OCD behaviors. The mental picture that represent phobia can be termed as “Phobia Image’ and the mental picture that represent OCD can be termed as “OCD Image”. The set of behaviors such as changing routes of the street for fear of dog are linked with “Phobia Image” and the set of behaviors such as repeated hand washing are linked with “OCD Image”. Such persons also have healthy mental image which does not contain phobia or OCD. Such mental image is termed as “healthy mental image”. The affected persons know what the healthy behaviors are.
These persons want to get rid of their ‘phobia image’ or ‘ocd image’ and aspire to live in accordance with ‘healthy image’. In order to live by ‘healthy image’ they tend to push away or get rid of behaviors of phobia and OCD. They try to mentally and behaviorally restrain themselves from getting into phobic and ocd behaviors but sooner or later their struggle fail and they submit to the behaviors of ‘unhealthy mental image’. The more they try to resist the behaviors of ‘unhealthy mental image’ more they get into the trap and feel compel to get involved in avoidance and safety behaviors.
This struggle is unnecessary. There is a simple solution to attain the goal. The goal is to live by ‘healthy mental image’. To attain this goal, the affected person should get rid of the mental trap of eliminating ‘unhealthy mental image’. Instead, they should directly focus on the ‘healthy mental image’ and emit behaviors that represent ‘healthy mental image’. Ignore ‘unhealthy mental image’ and its behaviors and focus on ‘healthy mental image’ and its behaviors. I am exemplifying this with real cases.
Case Study-I: A 36 years old female presented with contamination and checking type OCD of six years. She was spending lots of her time in cleaning activities and if things are not cleaned she was getting severe BMR. Most of the time she felt compelled to get into the cleaning activities. Psychiatric treatment was yielding partial and intermittent relief in her. In the first session, I listened to her elaborate story of OCD and then said to her that when she will be fully recovered she will touch all dirty objects, she will have no BMR and there would be no need of cleaning.
I demonstrated before her and touched several objects and told that “when she is fully recovered she will touch all dirty objects as I am touching and there will be no BMR and there will be no need to clean herself”. I demonstrated it with multiple objects. She keenly observed my touching of many dirty objects and conceptualized the goal of ‘emitting behaviors in accordance with healthy mental image’.
Thereafter, I encouraged her to demonstrate me how she will be touching dirty objects when she is fully recovered from OCD. She too followed the same procedure. Touched several objects and repeated that she will touch the dirty objects and there would be no BMR and no need for cleaning.
Within three days she had an extra-ordinary improvement in her OCD and the sessions were terminated after five sessions.
Case Study-II: A therapist shared with me that she had a person affected with social anxiety. He would not speak before others and felt conscious and feared rejection and ridicule. When he was asked to act on his ‘healthy mental image’ how would he speak before others when he is fully recovered; he delivered a speech for 15 minutes then and there.
Case Study-III: Another lady was also reported to have issue of contamination. She was asked to show how she would be handling dirty objects when she is fully recovered; she comfortably demonstrated handling of multiple dirty objects without any BMR and need for cleaning.
Case Study-IV: A young adult is having an obsessive issue of skin disease due to applications of soaps. He tries many soaps and uses lots of water and efforts to clean his face to ensure the safety against probable skin disease due to incomplete soap cleaning. He was required to demonstrate the face cleaning with soap when he would be fully recovered. He comfortably demonstrates the face washing with soap without any BMR and repetitive and ritualistic patterns of face cleaning.
The idea is to emit the behaviors in accordance with ‘healthy mental image’. You must actually show others may be your friends or family members, how would you perform when you are free from OCD or Phobia.
This simple focus shift can do wonders in some cases.
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