Understanding OCD through a Behavioral Perspective
Obsessive compulsive disorder or OCD for short is a term that we have heard a lot. Most of us use it to tease or label people who are obsessed with organization or cleaning. However in reality OCD is a very serious disorder that can cause a lot of problems in a person's life. OCD is a type of anxiety disorder where a person has unwanted thoughts or sensations which drives them to repeat certain behaviors. The unwanted thoughts are called Obsession and the repeated behavior that follows is compulsion.
OCD can be potentially dangerous as a person can involve most of his or her time in repetitive behavior which can affect their personal and social life.. Sometimes the anxiety caused by obsessions can even lead to self harm or suicide. Let's take the case of Anata. Anata was so obsessed with clean hands that she burnt her hands permanently when she tried to clean her hands using acid.
Historically OCD can be traced back to the 7th century where religious texts show how many have suffered from the temptation of evil by indulging in bad thoughts and actions. Many scholars have listed the signs and symptoms of OCD and tried different methods to treat it. It was Sigmund Freud through his psychoanalytic thought that first associated a possible origin to OCD as suppressed thoughts and traumatic experience. However psychoanalysis could not be used as an effective method.
Behavioral school of psychology and OCD
The behavioral thought of schools was quite prominent during 1940 and findings of classical conditioning and operant conditioning paved the way to treat many disorders. Psychoanalysis could be used to understand the origin for OCD, but it was behavioral therapy that was more effective in treating the disorder. Early Behaviorist study case files to understand obsessive neurosis and tried to find treatments using behavioral therapy. According to Behaviorist the repeated behavior or compulsion is a result of learner avoidance. In the case of people who have OCD they learn compulsion or repeated behavior to avoid the anxiety caused by their obsessions.
Clinical features
OCD has symptoms that are similar to many anxiety disorders. However it can be identified by obsessive and compulsive symptoms. If a person has thoughts that cause them anxiety and if they indulge in ritualistic behavior that follows then it can be confirmed that a person has OCD.
The disorder can be mild or severe.. The Yale-brown Obsessive compulsive scale (Y-BOCS) can be used to find the severity.
Causes
Learnt avoidance: A person learns repetitive behavior to avoid the anxiety that arises due to compulsions.
Observation: In some cases OCD can be learnt by observation. A child can develop OCD by observing his parents, teachers etc.
Stressful events: An stressful event that had previously put a pension under stress and trauma can lead to OCD.
Treatment.
OCD cannot be completely cured, but the urge to indulge in rituals and anxiety can be reduced and controlled through therapy. Behavioral therapy is known to be very effective in reducing the frequency of rituals.
One of the old methods of treatment was Exposure and response prevention (ERP). This method was used to treat phobias. Now ERP is a part of a large system of cognitive behavioral treatment (CBT). The aim of ERP is to break the association between the anxiety inducing thoughts and rituals. The person will be exposed to a stimulus that can cause anxiety. Then the person will be asked not to respond to this stimulus. Over time this repeated exposure can significantly reduce the frequency of OCD.
Another treatment method is Acceptance and Commitment Therapy (ACT). ACT unlike CBT does not focus on reducing the frequency of unpleasant experiences, but it aims to reduce the struggles associated with unpleasant experience and increase the meaningful activities that are linked to personal qualities. It is a novel form of treatment that uses a psycho behavioral approach.
Recent areas of research in OCD
COVID virus hinders Exposure therapy:The new virus increases anxiety in OCD clinicians and can affect exposure therapy. The Behavioral Immune system (BIS) of the specialist induces a mechanism in them to avoid exposure therapy due to the fear of infection. This research finds ways in which specialists can overcome BSI.
Combining CBT and ERP for OCD protocol to find if it has an effect on Psychological flexibility: Usually changes in Psychological flexibility process were because of ACT. The study aims to find if ERP had any impact on flexibility. Moreover research conclusions implied to use the research design in clinical practices.
Reference
https://en.wikipedia.org/wiki/Obsessive%E2%80%93compulsive_disorder
https://www.verywellmind.com/what-are-the-different-types-of-ocd-2510663
https://www.sciencedirect.com/science/article/pii/S0887618520300840
https://www.sciencedirect.com/science/article/abs/pii/S0005789420300617
The behavioral perspective may have paved the way for further research, but that doesn’t stop it from having its fair share of criticisms. One of the key strengths of this approach is that experimenters focus on determining learned habits from observable behavior and have in-depth understanding on how they are learned. By using scientific investigation with environmental interaction, experimenters differentiate between normal and abnormal behavior which helps in effective treatment of impulse control.
ReplyDeleteBut this approach is negatively criticized as the role of freewill, genetics, internal emotions and thoughts are not accounted. Rather it makes inferences on what people do and not what they think/feel. It is initially difficult to distinguish the behavioral symptoms due to similarity with other anxiety disorders.This approach chooses not to study other aspects even though they agree it plays a role. But behavioral therapy is the most effective is reducing frequency and unpleasant experience of the illness. Thus, behavioral approach is extensively used in OCD treatment but has limited success due to its non-inclusive nature.
Psychoanalysis may be used to explain the root of OCD, but behavioral treatment became most successful at managing the condition. According to Behaviorist, repetitive behavior or addiction is the product of ignoring the learner. OCD can not be avoided because it is triggered by various conditions.
ReplyDeleteThe Behavioural approach is focused more towards observation than other influences which becomes one of its drawbacks. This perspective suggests that people with OCD associate some objects with fear, and avoid those instead of confronting them (result of learner avoidance). Thus, ERP treatment is used so that patients confront their fears. However, Behavioural perspective does not explain why people indulge in anxiety producing rituals.
ReplyDeleteERP treatment is known to be highly effective in treating OCD. Spontaneous decay experiments under the ERP treatment gives patients the confidence to confront their fears, so that anxiety can be diminished and eventually disappear. However, more treatment drop outs can be observed for ERP than for other treatment methods.
The behavioural approach is extensively used for treatment of OCD. The behavioural therapy has in fact proved to be very successful. But its major criticism is that it does not look for the cause or the roots of such illnesses as it focuses only on the behaviours exhibited rather than the thought process behind it. And so, its treatment also includes reducing the obsessive behaviours with help of multiple exposures to a particular stimulus and the practice of refraining from exhibiting a particular behaviour. If it includes the other approaches and try to delve deeper into the process, there could be huge improvements in the field.
ReplyDeleteThe article is well researched. It is crisp and yet informative. Behavioural therapy is one such approach that has the capability to bring about positive changes in a shorter duration. The fact that is does not look into the root cause of the disorder might be a reason why this approach is not as effective as when used in other situations.
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