Obsessive Compulsive Disorder and Addiction Awareness

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By AllCEUs Counseling CEUs and Dr. Dawn-Elise Snipes. Discovered by Player FM and our community — copyright is owned by the publisher, not Player FM, and audio is streamed directly from their servers. Hit the Subscribe button to track updates in Player FM, or paste the feed URL into other podcast apps.

Obsessive Compulsive Disorder and Addiction Awareness
#ocdawareness #obsessivecompulsivedisorder

Cheap CEUs are available for this presentation at
https://www.allceus.com/member/cart/index/product/id/1352/c/

Objectives
~ Define obsessions and compulsions
~ Define obsessive compulsive personality disorder
~ Define addiction
~ Explore common obsessions and compulsions and their function
~ Explore why addiction often co-occurs with OCD
~ Identify interventions appropriate to assist people with OCD, OCPD and Addiction.
Introduction
~ “Obsessive-compulsive disorder (OCD), impulse control disorders (ICD) and substance-related disorders (SUD) overlap on different levels, including phenomenology, co-morbidity, neurocircuitry, neurocognition, neurochemistry and family history” Obsessive-Compulsive Disorder, Impulse Control Disorders and Drug Addiction
~ Activity in the orbitofrontal cortex is associated with cocaine and alcohol craving and obsessive–compulsive disorder
~ Obsessions and compulsions are central characteristics of OCD and addiction
~ Proposed that impulse control and obsessive- compulsive disorders may acquire qualities of the other with time
Introduction
~ Compulsivity in OCD and addictions is related to impaired dopamine and serotonin release
~ Treatment of these disorders must address alterations in the underlying motivations (experiential learning) and neurobiology
Obsessions
~ Obsession
~ Disturbing recurrent and persistent thoughts (if I don’t…) or impulses (I must…) that are intrusive
~ Fears of germs, taboo thoughts, aggressive thoughts, need to do particular behaviors to prevent harm
~ Thoughts do not focus exclusively on real problems (generalized anxiety, eating disorders, addiction, PTSD, postpartum depression)
~ The person attempts to ignore or suppress the thoughts or impulses
~ The person is aware that the obsessional thoughts, impulses, or images are a product of his or her own mind
Common Obsessions
~ Relationship
~ “If I enjoy when my partner is away, maybe I don't really love them.”
~ “Sometimes I look at other people and think about cheating. Maybe I secretly want someone else.“
~ “Sometimes my partner looks at other people. Maybe they want someone else.”
~ “My partner hasn’t texted me all day. They must be cheating on me or not want me anymore.”
~ Harm OCD
~ “If I drive on a bridge I might drive off and kill everyone”
~ “If the doors aren’t locked someone will break in and kill us.”
~ If I didn’t turn off the stove…
~ If I am around other people…

Common Obsessions
~ Health
~ What if this pain is cancer?

Compulsions
~ Repetitive behaviors or thoughts that the person feels driven to perform to prevent or reduce distress or keep something bad form happening
~ The symptoms of OCD are not the result of another psychiatric disorder present or caused by a medical condition or substance abuse (i.e. cravings, diabetes, Chron’s disease).

Common Compulsions
~ Relationship
~ Comparing partner to others
~ Comparing self to others
~ Frequent breakups
~ Needing frequent reassurance
~ Harm
~ Checking
~ Washing
~ Isolating
~ Prayer
~ Health
~ Nutrition
~ Detoxification (Exercise, diet, sauna)
~ General
~ Magical thinking (rituals, mantras)

Obsessive Compulsive Personality Disorder
~ A pervasive pattern of preoccupation with orderliness, perfectionism, and control in a variety of contexts beginning by early adulthood as indicated by 4+ of the following:
~ Is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost.
~ Shows perfectionism that interferes with task completion
~ Is excessively and unnecessarily devoted to productivity to the exclusion of recreation
~ Is overconscientious and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification).
~ Is unable to discard worn-out or worthless objects even when they have no sentimental value. (Hoarding)
~ Is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things.
~ Adopts a miserly spending style
~ Shows rigidity and stubbornness

Interventions
~ Medications for addiction which modulate dopamine system through
~ Opioid (e.g. Buprenorphine and naltrexone)
~ Glutamate (e.g. Topiramate)
~ Serotonin/ 5HT3 (e.g. Ondansetron)
~ GABA (e.g. baclofen and topiramate)
~ Treatment of these disorders must account for alterations in the underlying neurobiology of the condition. For example
~ Naltrexone for people with co-morbid SUD and ICD
~ Topiramate for people with co-morbid ICD and eating disorders
Interventions–Cognitive
~ Explore when the OCD or OCPD began
~ Explore when the addiction began
~ In what ways does the OCD or OCPD
~ Address feelings of unsafeness?
~ Develop a checklist
~ Journaling and exploring probability that something bad will happen
~ Reaching out to a support person (i.e. feel overpowered by emotions or thoughts)
~ Protect from rejection or failure?
~ Explore the beliefs surrounding rejection and failure
~ Enhance hardiness
~ Improve self-esteem
~ Explore where those messages came from and their validity
Interventions–Cognitive
~ How does the addiction help the person?
~ Use chaining to explore how the addiction relates to the obsessive thoughts to trigger cravings and compulsions (using)
~ Fears of germs anxiety  cravings to rebalance neurotransmitters  use
~ Discussion: What is your thought/or the situation  what are your feelings  what are your urges and what is the function of those urges
~ Learn about distress intolerant thoughts (Draw from the hat)
~ Develop alternative self statements
~ Learn about urges and riding the wave
~ Learn about unhooking
~ Develop distress tolerance skills

Interventions
~ Identify and develop a plan to mitigate triggers or vulnerabilities for the OCD or OCPD (logs, plans)
~ Beach Ball Activity: Common triggers for OCs / OCPD behavior intensification
~ Address cognitive distortions that contribute to distress
~ Mindreading, personalization, all or nothing, catastrophizing, availability heuristic (likelihood)
~ Facts, exceptions, probability
~ Mindful awareness activities to improve self-awareness of increasing anxiety or anger levels and promote early intervention
~ Psychological flexibility
~ 4 Stations: For and against behaviors and thoughts
Interventions
~ Exposure and Response Prevention (ERP w/biofeedback)
~ Think the thought or about the situation describe how you feel in session
~ If I don’t clean the kitchen, my husband will die.
~ If I am around people I will get sick and die.
~ Practice re-regulation/distress tolerance activities when prevented from engaging in the compulsive behavior (breathing, talking to a support)

Summary
~ There is significant overlap between OCD and addictive behaviors.
~ Treatment involves
~ Identifying the underlying thoughts
~ Exploring what is contributing to fears of unsafeness (harm, rejection) and powerlessness
~ Identifying the function of the thoughts and behaviors
~ Practice Exposure and Response Prevention to decondition the compulsive behaviors
~ Potentially medicating the neurotransmitter imbalance until the brain can adapt (reroute)

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