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强迫症的心理治疗-给力心理
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强迫症的心理治疗

强迫症的心理治疗
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发表时间:2015-02-05 10:55:34 348 0 0

1 强迫症的表现
  每个人的内心都会有一些想法,但是强迫症患者的想法、行为,就可能被做出来,例一:某人在开车的过程中突然想到自己会撞到路边的行人或者树木,他就会认为这样的事情很可能真的会发生,再联想到这件事发生的严重后果,从而产生恐惧,痛苦和焦虑。于是,他想尽方法来控制自己不要有这样的想法,但结果是他根本无法控制,这样就进一步加重了他的恐惧、痛苦和焦虑。例二:强迫计数:患者不可克制地计数,与强迫性联想有关,如见到电线杆计数,见到窗子也要计数,不计数则感到烦躁,难以克制。例三:强迫性洗涤:怕不清洁而罹患某种传染病,强迫症患者接触了某物,则要反复洗手。明知已经清洁,无须再洗,但无法控制。例四:强迫观念:明知某些想法和表现,强迫症的症状如强迫疑虑、强迫对立观念和穷思竭虑的出现是不恰当和不必要的,却引起紧张不安和痛苦,又无法摆脱。
  患有强迫症的患者有其特定的人格个性,最突出的就是“完美主义”,凡事要求“十全十美”。他们的性格特征是为人谨慎、墨守成规、缺乏通融和幽默感、太过理性;内心常常有明显的冲突,徘徊于服从与反抗、控制或爆发两种极端。他们常常对自己、对别人要求很高,结果总是批评别人不好,怀疑和否定自我,缺乏自信心,常因此而无法接受自己强烈矛盾的内心冲动欲望而崩溃。
  人就应该成功控制自己的思想。强迫症患者有很多强迫性思维和强迫行为,但他们总会认为这是他自己的思想所致,自己应该能够控制这些想法。但事实上,之所以称为强迫就是因为自己无法控制,所以他们会因为无法控制自己的思想而产生激烈的内心冲突。
  2 强迫症形成和发展原因剖析
  2.1 强迫想法和焦虑有关。
  2.2 强迫行为(外显的或隐匿的)是随意行为,旨在减轻焦虑和不适。但焦虑减轻导致强迫被强化。
  2.3 为了防止发生强迫想法和焦虑,症人常有回避行为,但回避行为阻止了对焦虑想法和暴露。根据上述心理模型。治疗策略应当是促进症人对恐惧刺激的暴露,同时又鼓励他们会议上暴露的仪式和认知回避而不易发现,这就需要医生进行全面细致的检验和评估。
  过去大多数人认为本病源于精神因素和人格缺陷,近些年来发现遗传因素比较明显。
  (1)遗传:家系调查发现,患者的父母中有约5%~7%的人患有强迫症,远远较普通人群高。另外由于人格特征主要受遗传的影响,而人格特征又在强迫症的发病中起一定作用,故也提示强迫症与遗传有关。在临床上也观察到,约2/3的强迫症患者在病前即存在有强迫性人格。强迫性人格的特征是,胆小怕事,谨小慎微,优柔寡断,严肃古板,办事井井有条,力求一丝不苟,注重细节,酷爱清洁。
  (2)心理社会因素:精神分析学派认为,强迫症是强迫性人格的进一步发展。行为学家则认为,强迫症的产生是由于刺激——反应出现过多重复导致焦虑,使中枢神经系统兴奋和抑制失调,从而导致异常习惯的形成,病理性认识和反射的建立,使冲动、思维和行动拘泥于固定的行为学习模式。
  (3)生化:有人认为强迫症患者5-HT能神经系统活动减弱导致强迫症产生,用增多5-HT生化递质的药物可治疗强迫症。
  3 强迫症心理治疗与预防治疗和康复
  采用心理治疗:解释性心理治疗为治疗的手段之一。对于患者要冷静分析本人的人格特点和发病原因,包括童年有无产生强迫症的心理创伤。如能找出原因,应树立必胜信心,尽力克服心理上的诱因,以消除焦虑情绪。非我疗法、生物反馈治疗、行为治疗如系统脱敏疗法、厌恶疗法、暴露疗法等,都有一定效果。可以试用这样的治疗方法:把病人置于严密监护下,当病人欲进行强迫动作或思维时,家人就以谈话或邀请参加某种活动的方法分散转移其注意力,以阻止强迫动作和思维发生。对病人提出的问题,最好按常识给予答复,说一遍即可,无需重复。
  治疗强迫症,正确的治疗方法应该按其症状的严重程度来分类治疗:对症状比较轻的患者可以直接用心理治疗就可以治愈,而不必使用药物;而对于症状比较严重的患者,比较有效的方法应该是在心理治疗为主的情况下,辅助地使用药物。大概的治疗程序如下:在治疗初期,可以适当地服用一些药物来控制和稳定症状的发展,同时配合心理治疗。而当患者在实践中逐渐获得心理治疗的效果后,一方面继续心理治疗,另一方面则应该逐渐地减少药物,并最终停止药物。
  强迫症是一种反复出现强迫观念和行为的神经障碍疾病。其实,强迫症患者往往是很清楚自己的问题所在的,但是就是控制不住地去想去做,这样的痛苦会让人身心疲惫,因此,要做好预防工作。那么该从哪方面入手预防强迫症的发生?
  首先你必须做好长期作战的心理准备,并且需要你十足的耐心、循序渐进,与强迫症作战。需要对自己的额个性特点和所患疾病有正确客观的认识,对自身现状有客观的判断。因为强迫症就是一种假想症而引起的症状,所以,不要把强迫症看得太重,而是要把他看淡,做到轻视、放宽心,症状自然会慢慢减退。
  不要过分在乎自我形象,不要过于追求完美。不要老是问自己我做得好吗?这样做行不行?别人会怎么看我等问题。强迫症预防学会顺其自然。强迫症的另一特点是喜欢琢磨,一个芝麻大的事情往往会想出天大的事来。因此在思考问题时,要学会接纳他人、不要钻牛角尖、学会适应环境而不要刻意改变环境。
  学会减压也很重要。很多强迫症都是由于压力太大导致的。如今的生活节奏不断加快,生存压力也是不断增大,如果不能很好的自我缓解压力,就会诱发各种心理疾病。因此,在工作中要懂得适当的解压,懂得舒缓自己的情绪,预防强迫症的产生。
  参考文献
  [1] 潘明圆.强迫症浅论[J].中外医疗,2008
  [2] 马天雪.国内强迫症心理治疗效果的元分析研究[D].内蒙古师范大学, 2008
  [3] 汪智慧.强迫症:都市人的心理“陷阱”[J].药物与人,2008
  [4] 谢向东.大学生强迫症的认识[J].中国实用神经疾病杂志, 2006
  [5] 赵娟.脑外伤后抑郁障碍的临床观察和中医治疗[J].中国实用神经疾病杂志, 2006
  [6] 何桂华.强迫症的临床表现、病因及治疗[J].社会心理科学,2004

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