Saturday, December 5, 2009

Interesting Info

I am learning so much about Obsessive Compulsive Disorder as I reclaim my free spirit. I want to share some of what I'm learning, but please carefully note that I am only relaying and paraphrasing to the best of my simple understanding what professionals have strategically researched.

The exposures I work on on a daily basis come from my hierarchy that my BT and I are continually amending and adding to. A hierarchy is a list of exposures, specific to my fears, in which I rank them on a scale of 0-7; 0 being no anxiety and no urges to ritualize at all and 7 being a full blown panic attack. The goal is to have anywhere from 80-120 exposures on my hierarchy. The treatment team here will authorize a successful discharge once I have habituated to at least 70% of my hierarchy. We, as humans, habituate to things everyday....we acclimate or become accustom to our environments as the situation calls for. In the case of my OCD, I am intentionally facing my fears, allowing my anxiety to spike, and waiting it out until my anxiety comes down on its own. The goal is to have at least 5 trials for 5 different exposures every day. There is "within trial" habituation, in which I wait until my anxiety decreases to half of its peak before walking away or taking a break from the exposure. There is also "between trial" habituation in which the peak that my anxiety spikes to while doing an exposure begins to come down as well. We strive for both "within trial" and "between trial" habituation as they go hand in hand and eventually retrain my brain to remain calm while doing ordinary things. According to research, 70% seems to be the magical number for ensuring long-lasting positive results in the treatment of OCD. There is an 87% success rate one year from discharge if at least 70% of the hierarchy has been completed successfully. Research has found that even with a slight decrease to only 68% completed hierarchy, the relapse rate at the one year mark is drastically devastating. Statistics on the continued success after one year are, apparently, still being researched and at this point are not substantial enough to make any concrete conclusions.
Patients are sometimes discharged from residential treatment to intensive outpatient therapy once reaching 50% of their hierarchy. Intensive outpatient therapy consists of 3-4 hours a day, 4-5 times a week for about 3 weeks or until at least 70% of the hierarchy is reached. Once 70% is reached via residential or IOP, ongoing weekly therapy is strongly encouraged to keep working on the remaining 30%.

Again, I am currently just a patient and have done no research myself. This is just my understanding of Cognitive Behavioral Therapy as it relates to my treatment of OCD.

1 comment:

  1. I have watched the OCD project and enjoyed the show. Much better than 90% of the reality crap that's on TV. I wish you well in your treatment and in your life. I think you have strength, and insight to deal with your OCD and I will follow your blog.