Re: Unique OCD

When I was in 9th at hi-schl my mom was diagnosed with cancer. I felt powerless. Following her surgery she had a lot of pain that required narcotic pain med. at x’s to keep from crying out. This was very hard on me. By start of 10th I was having increased symptoms of GAD, while mom continued to have this chronic pain in her life that was to continue indefinitely. Sometimes, when I felt anxious I began habit of bending forward/into self at waist so that "I wouldn't be out of control" or so that "I wouldn't fail so much at understanding this lesson in class" etc. I knew it didn't really help anything, but I suppose it helped quel anxiety. In addition to mom's health prob. being factor, was very concerned about academics. Also somewhat shy & felt anxious at times in social situations. I had "phobia" of being stared at and judged negatively by people. The waist flexing went away on its own 8 mo’s later but in spring of my 11th yr (3) more habits started. 1st) Squinting eyes very slightly-not enuf that anyone would notice, & holding the tongue away from the floor of the mouth so that it isn't relaxed. These became immediate 24/7 dawn to dusk habits. 2nd) Slightly raise the left eyebrow (not enuf 2 B noticed) often but not 24/7. 3rd) Slightly contracting the L and R gluteal muscles only when walking but not at any other time.  I thought everyone could see & I was SO anxious & embarassed. Turned into a chronic habit along with raising shoulders and contracting chest muscles. After graduating, was able to go to a counselor every other wk who did psychodynamic (Adlerian) therapy. Lasted for 2 yrs. I was not able to break these behaviors during that time. Now, 2 yrs. later, after a family death, and moving states, OCD and tic disorder ruled out. Am taking 40 mg Celexa & trying new Cog. B thrpst. Is this kind of condition considered “self injurous" and require the kind of treatment you described for skin picking? Is strictly psychodynamic thrpst. good/bad idea?
Thx-S

[Ted A Grossbart, Ph.D.]

It sounds like you have been through a lot!  While these problems are not typically taken as part of self-injurious skin behaviors, I think that provides a good model for treatment.  The approach described on http://grossbart.com that you read should be relevant.  I think you need a flexible combination of approaches that address the emotions, thoughts, and specific behaviors.  You need all three and psychodynamic work that does not address the behavior may well be helpful in other ways but not change the behavior.  Behavioral or CBT work that does not deal with the emotions and history (some does, some doesn't) is also unlikely to be as effective.  Hypnosis can often be a useful adjunctive technique as well.

Hope this helps.

tg