131
self-assessment.
If obsessive thoughts are triggered by specific emotions, e.g.
getting mad at your ex-lover sets off 2 or 3 hours of thinking about
the past, what he/she is doing now, and how to mess up his/her life,
you might reduce the emotional response (via desensitization) and,
thereby, reduce the obsessions. Or, you might use thought-stopping,
which is a mental form of response prevention. Ironically, the research
shows that trying hard to suppress forbidden thoughts sometimes
results in thinking the thought even more often (Wegner, 1989). How
to best handle bad thoughts? Baer (2001) specializes with
inappropriate, embarrassing, crude, violent thoughts. He reviews a
long history of such thoughts and deals with the dilemma of "conscious
thought suppression" producing more thoughts, not less. Using the
example of a priest who leers at women's breasts and bottoms, while
thinking about sex with them, Baer recommends dealing with such
guilt-producing thoughts much like one would deal with a fear,
namely, let yourself freely have those thoughts (expose yourself to
them) until they no longer seem so awful or evil that they must be
stopped.
Other advisors would recommend disclosing your bad thoughts to a
safe, understanding person, like a therapist. Coming to see the
obsessive thoughts as "no big deal" in this way also seems to reduce
the drive to have them so frequently. Not surprisingly, general
psychotherapy--talking about bad thoughts--has been helpful in
gaining insight into the "forbidden wishes" and unconscious dynamics
that seem to be frequently involved in obsessions and compulsions. On
the other hand, drugs, including Anafranil and Prozac, have also
helped some obsessive-compulsive cases, causing some doctors to
think it is an organic disorder. The latest twist in this organic vs.
psychological argument is the finding by Schwartz (1995) that
cognitive-behavioral treatment results in similar changes in the brain
as drugs produce.
Self-help can be helpful if started soon enough, but in difficult to
treat, long-term, serious obsessive-compulsive cases with multiple
diagnoses, professional treatment and medication are frequently
needed.
