| Author |
 Topic  |
|
|
alexis
USA
596 Posts |
 Posted - 04/25/2011 : 16:57:05
|
A recent discussion here centered on two differing interpretations of TMS – is what most people experience really just symptoms of anxiety? Do some or all symptoms stem from acquired distraction responses? Are these a number of different conditions intermingled or sharing symptoms?
Since both hypochondriasis and OCD are discussed as “TMS”, to put some context on this I thought I’d enter into discussion some of the recent literature on where OCD should fit in the DSM-V. Health anxiety and hypochondriasis are frequently classed as OCD related (or OCD spectrum) disorders, and currently OCD is classed under anxiety disorders, but as this survey found (http://ajp.psychiatryonline.org/cgi/content/full/164/9/1313), there is significant movement away from the position that these conditions belong in the anxiety category:
quote:
Regarding whether OCD should be removed from the current supraordinate category of anxiety disorders, approximately 60% agreed and 40% disagreed. There was a significant difference ( 2=17.9, df=2, p<0.001) in opinion between psychiatrists (75% agreed) and other professionals (40%–45% agreed). The most frequent reason for agreeing was that obsessions and compulsions, rather than anxiety, are the fundamental features of the disorder. The main reasons for disagreeing were that OCD and other anxiety disorders respond to similar treatments and tend to co-occur...
A large number of other articles are available for anyone wishing to follow the debate (a good free summary: http://www.dialogues-cns.org/brochures/45/html/45_6.asp).
The main issue at hand is whether anxiety results from compulsions (say compulsive thoughts about disease) or whether the compulsions are a symptom of anxiety. And as described above, there’s no clear consensus about the relationship.
(Edit: Updated link to summary to point to first page of that document)
|
Edited by - alexis on 04/26/2011 19:57:20 |
|
|
art
1903 Posts |
Posted - 04/26/2011 : 10:08:07
|
Hi Alexis,
I know this is of particular interest to you. I think you know where I stand, which is that hypo is certainly an anxiety disorder, and that OCD is as well.
I'm surprised there's an opposing point of view on this, so self-evident does it seem to me. In the case of OCD, anxiety is the engine that makes it go is it not? In the case of compulsions especially, it's the fear of something terrible happening that keeps them alive
I've never met an OCD sufferer who wasn't an anxious type PRIOR to symptoms emerging...
|
 |
|
|
alexis
USA
596 Posts |
Posted - 04/26/2011 : 17:25:04
|
Hi Art,
Yes, that's just where I would expect you to fall. :)
I, on the other hand (like apparently 75% of surveyed psychiatrists) think it's more the other way around - or at least a two way street. OCD is closer to Tourette’s, and it's the uncontrollable repetitive thought (say of injury or illness or the house burning down) which causes the anxiety. And much like some with Tourette syndrome will say out loud the very things they most want not to say, so, unfortunately, do those with OCD or hypochondriasis continue repeatedly to think the very thoughts which will make them most anxious.
It's not that I don't think there is such a thing as anxiety disorder, independent of OCD type behaviors. I even think some here have a primary anxiety disorder. But I think that for those with clearly recognizably OCD spectrum disorders, the anxiety is likely to spring instead from those uncontrolled thoughts.
My worry is that too many people are turning to outdated popular works, like Claire Weekes. I mean, it's great if it helps (and it does help many), but there's a lot of work done in the decades since anxiety was given that kind of central role by people in the field.
Alexis
|
Edited by - alexis on 04/26/2011 17:25:41 |
|
|
|
Back2-It
USA
438 Posts |
Posted - 04/26/2011 : 17:56:50
|
quote:
Originally posted by alexis
Hi Art,
Yes, that's just where I would expect you to fall. :)
I, on the other hand (like apparently 75% of surveyed psychiatrists) think it's more the other way around - or at least a two way street. OCD is closer to Tourette’s, and it's the uncontrollable repetitive thought (say of injury or illness or the house burning down) which causes the anxiety. And much like some with Tourette syndrome will say out loud the very things they most want not to say, so, unfortunately, do those with OCD or hypochondriasis continue repeatedly to think the very thoughts which will make them most anxious.
It's not that I don't think there is such a thing as anxiety disorder, independent of OCD type behaviors. I even think some here have a primary anxiety disorder. But I think that for those with clearly recognizably OCD spectrum disorders, the anxiety is likely to spring instead from those uncontrolled thoughts.
My worry is that too many people are turning to outdated popular works, like Claire Weekes. I mean, it's great if it helps (and it does help many), but there's a lot of work done in the decades since anxiety was given that kind of central role by people in the field.
Alexis
You know, I can quite agree with you that OCD is and can be much like Tourettes. I have OCD only related to my pain syndrome. I obsess on it and uselessly check on my back muscles by feeling my back muscles to see how they are. Makes no sense.
I am one of those people that found Dr. Weekes helpful, because she put things in plain language. I've tried to slog through the newer phobia and anxiety books and they get too lost in the esoteria of it all. So many are like workbooks and require endless work. Frankly, it leads me to more anxiety.
I've also had no luck with therapists. They are ultra interested in your insurance and payments and not much else. I've broken with two now that never bothered to follow up as to why I have not continued to schedule appointments. All my working life, if a customer suddenly disappears you inquire as to why.
Also, they are not very helpful, and certainly not with OCD. And to keep shopping therapist to therapist is quite time consuming and expensive. The entire physco-therapy community is pretty much a joke.
In fact, the entire medical community, with few exceptions, is a joke. Nobody cares. Nobody. You live alone with your pain, and if you are lucky, you don't die alone with it. |
|
|
|
alexis
USA
596 Posts |
Posted - 04/26/2011 : 18:07:58
|
Hi Back2-It,
I wonder if there's anything to be gained from some of the thoughts in ironic process theory and related research areas. I like this quote which shows another perspective on some of Sarno's thoughts. Maybe while a workbook may be too much concentration, if you can talk or blog or in other ways release the conscious controls, particularly if you think there are listeners (why I would prefer anonymous blogging over journaling), you might can break the repetative pattern? Heck, if its hard core genetically rigged OCD drugs apparently help too.
quote:
Another line of evidence suggesting a role for ironic processes in the etiology of some disorders comes from studies of what happens when mental control is rescinded. The best examples of such work are the series of experiments by James Pennebaker and colleagues. When people in these studies are encouraged to express their deepest thoughts and feelings in writing, they experience subsequent improvements in psychological and physical health. Expressing oneself in this way involves relinquishing the pursuit of mental control, and so eliminates a key requirement for the production of ironic effects. After all, as suggested in other studies conducted in my lab with Julie Lane and Laura Smart, the motive to keep one's thoughts and personal characteristics secret is strongly linked with mental control. Disclosing these things to others, or even in writing to oneself, is the first step toward abandoning what may be an overweening and futile quest to control one's own thoughts and emotions.
http://www.wjh.harvard.edu/~wegner/seed.htm |
|
|
|
Back2-It
USA
438 Posts |
Posted - 04/26/2011 : 19:24:10
|
quote:
Originally posted by alexis
Hi Back2-It,
I wonder if there's anything to be gained from some of the thoughts in ironic process theory and related research areas. I like this quote which shows another perspective on some of Sarno's thoughts. Maybe while a workbook may be too much concentration, if you can talk or blog or in other ways release the conscious controls, particularly if you think there are listeners (why I would prefer anonymous blogging over journaling), you might can break the repetative pattern? Heck, if its hard core genetically rigged OCD drugs apparently help too.
Alexis,
Thanks. I have met the enemy, and he is me. I have very much been too secretive and close with my thoughts most of my life. The reasons why have become apparent with delving into my past since I started with TMS last fall.
The OCD thing is a great problem for me and it's helping to keep me locked and focused on stiffness that might be gone if not for the focus.
In recent weeks I have recognized that it is the OCD that is really most of the problem, and then the question becomes what to do with it? That is why I have started with a new therapist, one who is very attentive and takes notes and actually has yanked some things out of the muck about me that I never saw. I guess I have to hold my condemnation of all therapists for the time being.
The realization of having OCD bad is why I have also flirted with the idea of meds again. But I'm leery because I know that they are not ultimate answer.
I read through your original post and found it very interesting and it bolstered some beliefs I have had. My OCD feeds my anxiety which keeps the whole mess front and center.
Thanks again. |
Edited by - Back2-It on 04/26/2011 19:25:32 |
|
|
|
alexis
USA
596 Posts |
Posted - 04/26/2011 : 19:39:08
|
Back2-It,
That's fantastic you've found someone who seems to work well so far. Best of luck.
Alexis |
|
|
|
Back2-It
USA
438 Posts |
Posted - 04/26/2011 : 20:03:36
|
quote:
Originally posted by alexis
Back2-It,
That's fantastic you've found someone who seems to work well so far. Best of luck.
Alexis
Thanks. The help I need to get I have to find within, and I admit I am tired. Not all days are like this for me. I can see progress and I do believe in my heart that someday this will all be a strange but horrible memory. |
|
|
|
wrldtrv
666 Posts |
Posted - 04/27/2011 : 15:53:51
|
"My worry is that too many people are turning to outdated popular works, like Claire Weekes. I mean, it's great if it helps (and it does help many), but there's a lot of work done in the decades since anxiety was given that kind of central role by people in the field".
The argument whether ocd should be classified as an anxiety disorder aside, I think Claire Weekes dealt mostly with plain old pain and anxiety, so the above statement is irrelevant to her work. Having read many books on anxiety over the years, I keep going back to Claire Weekes because, though 40+ years "out of date" her work speaks to more clearly and precisely than any others. |
|
|
|
Back2-It
USA
438 Posts |
Posted - 04/27/2011 : 17:17:47
|
As time goes on I can see that Weekes book and more her CD helped me with some anxiety.
OCD may be a different matter, and I'm just starting to address that factor. They are kissing cousins of some sort, but a family most could do without.
Still, her work is accessible, just as Sarno's work is for the masses.
"Bridges Freeze Before Roads" |
Edited by - Back2-It on 04/27/2011 22:07:34 |
|
|
|
alexis
USA
596 Posts |
Posted - 04/27/2011 : 17:56:13
|
Hi wrldtv - I definitely agree Weekes is helpful and for the most part still very relevant. And if you are interested in self treating a primary anxiety disorder or managing the anxiety symptoms of another disorder, I couldn't recommend anything else more highly.
Her works are a great applied tool; I just caution against assuming that the theoretical aspects are all the latest. At that time a lot wasn't known about OCD or the way the cognitive processes are integrated with the autonomic nervous system, so there are some related topics, relevant to "TMS" type symptoms, that people who may have other issues aren't going to get if they treat books from that long ago as their main source of info. |
Edited by - alexis on 04/27/2011 17:57:19 |
|
|
|
wrldtrv
666 Posts |
Posted - 04/27/2011 : 20:29:11
|
Alexis, I see I had a typo. I meant "panic and anxiety" not "pain..."
Anyway, I agree that she wouldn't have been up to date on ocd, but since she didn't cover the topic in her books, it doesn't matter. Of course, she also wouldn't have been up to date on cbt since I don't think Aaron Beck and others had come up with it yet, but she still showed a remarkable insight into the way people think, and the cognitive and behavioral techniques (eg, "floating" and talking to your anxious brain...) were really her own form of cbt. |
|
|
| |
Topic |
|
|
|
Hypochondriasis, OCD and Anxiety
