What are the consequences of a thought

Definition and description of the symptoms

Someone with obsessive-compulsive disorder feels dominated by an inner urge to repeat certain actions or to think certain thoughts over and over again.

The actions and thoughts are usually experienced as nonsensical, the thoughts often also as embarrassing and frightening.

However, those affected cannot deliberately interrupt or refrain from doing it. Therefore one speaks of compulsive actions and obsessive thoughts.

A compulsive act, for example, can consist of checking again and again whether the front door is closed or the stove is switched off.

Other compulsive acts relate, for example, to cleaning the home or one's own body.

The attempt to suppress a compulsive act usually causes great discomfort, strong inner restlessness or fear in the person concerned. Most of the time, the compulsive act is linked to the idea of ​​being able to avert impending disaster.

For example, compulsive hand washing can occur against a background of strong fear of illness or contagion.

Obsessive-compulsive thoughts often relate to the possibility of harming, infecting, or killing other people with a disease. Sexual, obscene or blasphemous content is also common.

Thoughts are recognized by those affected as their own thoughts, i.e. as a product of their own mind, but experienced as alien to their own personality, repulsive in terms of content and therefore particularly painful.

Often times, people who suffer from obsessive-compulsive thoughts fear that they may become a reality. As a rule, those affected therefore develop certain rituals that are intended to "neutralize" or avert the "bad" or "dangerous" thought, so to speak.

These rituals can either consist of another thought or an act.

The compulsions and compulsive rituals often take up so much time that other areas of life can no longer be adequately fulfilled, which in many cases also leads to the additional development of depression.

Due to the high psychological stress, those affected try to resist the compulsions and to suppress them, but this is usually unsuccessful.

Often, as described, those affected suffer from the fact that they are not entirely sure whether certain catastrophic contents of obsessive-compulsive thoughts might not occur after all, for example they could actually kill another person. In the presence of an obsessive-compulsive disorder, however, the conversion of the thoughts into reality can be ruled out with certainty;

Backgrounds of origin

The causes of obsessive-compulsive disorder are very diverse and have to be viewed individually.

A biological or genetic susceptibility to the development of compulsions can be assumed. In addition, there are certain biographical and learning experiences as well as currently effective triggers.

It is not uncommon for compulsive actions and thoughts to develop for the first time in threshold situations, e.g. when moving out of the parental home, starting or changing job or being a parent, i.e. in situations of uncertainty and challenge. Psychotherapy can also help in coping with these life situations.

How compulsion arises and is maintained is primarily explained today by individual differences in the assessment and interpretation of one's own thoughts.

It has been proven that content that can typically become obsessive-compulsive thoughts sometimes appears in the stream of thoughts of almost everyone. They are considered a completely normal phenomenon of human information processing.

Such a thought could be "God is lousy" or "I could kill xy", or an image, for example how you or someone close to you falls and bangs your head bloody.

Many people ignore such thoughts, so they rarely appear (what we ignore easily disappears from the

Awareness).

Someone who, for example, has a very high sense of morality and a sense of responsibility, is generally rather strict with himself and is also currently burdened, cannot necessarily let such a thought pass by. Rather, he will be concerned and concerned about its occurrence.

So the thought gets attention and is connected with intense feelings. This can lead to the person resolving not to think such a thing again under any circumstances - which paradoxically leads to a higher occurrence rate of the thought because our brain is unable to intentionally not think about something (a popular example of the The demonstration of this phenomenon is the request "Don't think about a white bear at all!").

The threatening thought is likely to arise more frequently as a result, which means that the person concerned has the feeling of losing control and the anxiety grows stronger. At this point, many affected people begin to counter the threatening thought with something, another thought or an action in order to avert the possible negative consequences.

For example, the repeated repetition of a prayer could serve to "neutralize" the thought "God is bad". In the short term, prayer can reduce anxiety, leading to it being said again the next time the thought arises. In the long term, however, this would lead to the maintenance or increase of the emergence of the undesired thought - especially because a lot of attention is paid to it.

Therapy options

Compulsions can be successfully treated as part of a specific cognitive behavioral therapy.

This is about the gradual abandonment of the rituals and the confrontation with the underlying fears for a realistic reassessment of the actually existing danger.

Any underlying attitudes as explained above are also treated individually therapeutically.

In some cases, certain antidepressants can be very helpful.

Hoffmann, N. & Hofmann, B. (2011).When constraints constrict life. Berlin: Springer.

Oelkers, C. & Schink, C. (2010). Completely casual? How those affected and their relatives can free themselves from coercion. Weinheim: Beltz.

Moritz, S. (2010). Successful against obsessive-compulsive disorder Metacognitive training - recognize and defuse thought traps. Berlin: Springer.

Baer, ​​L. (2003). The leprechaun in your head. The taming of obsessions. Bern: Huber.

ISBN: 978-3456839622

Information and networks online

German Society of Obsessive Compulsive Diseases e.V. DGZ