Treatment of Obsessive Compulsive Disorder with Exposure Therapy in Perinatal Population

By Taryn Hancock, MSW, LSW

One of the transformative occasions in a human’s life is changing into a father or mother. The time of conception to the birthing expertise to the lesser-known “fourth trimester” can deliver an array of feelings. Whether or not you’re a birthing father or mother, a companion, a liked one, or a supplier, recognizing how one can help somebody experiencing OCD is step one in treating Perinatal Obsessive-Compulsive Dysfunction.

My objective as a clinician is to coach and produce consciousness to how OCD can affect an individual throughout the perinatal interval. OCD doesn’t discriminate and may happen in essentially the most unlikely of conditions. OCD may be complicated whether or not somebody is outwardly partaking in bodily compulsions or inwardly dealing with a psychological battle; it’s distinctive to every particular person’s triggers and behaviors.

What’s Perinatal OCD?

Perinatal OCD is finest described as a analysis of obsessive-compulsive dysfunction throughout the perinatal interval. The perinatal interval refers back to the interval throughout being pregnant and as much as three years postpartum.

Perinatal OCD consists of a cycle of obsessions that current as undesirable ideas, photographs, or impulses that happen repeatedly, inflicting vital misery for the particular person. As a result of depth and frequency of the obsessions, individuals expertise a spread of feelings and have a tendency to have interaction in compulsions, that are finest described as repetitive behaviors or ideas to attempt to scale back the misery across the obsessive ideas and supply themselves with short-term reduction. 

Examples of obsessions and compulsions can represent as the next:

You will need to observe that something may be an obsession and a compulsion and to pay attention to what methods an individual is making an attempt to realize reduction within the type of repetitive behaviors, rumination, or distraction. OCD manifests in some ways and appears vastly completely different from individual to individual.

Therapy for OCD

Whereas there are a number of modalities of therapy and interventions, I need to concentrate on Publicity Response and Prevention Remedy (ERP) as therapy for each complicated anxieties and OCD as it’s the gold commonplace and evidence-based therapy for such analysis. Publicity Remedy is the concept if we purposefully publicity ourselves to the scary stimuli resembling an individual, place, thought, psychological picture, or bodily sensation it can sometimes elicit feelings resembling nervousness, worry, disgrace, and guilt that trigger an individual to have interaction in each bodily and psychological compulsions or rituals.

There are several types of exposures:

Imaginal – Makes use of imaginal imagery of the scary stimuli, making a worst-case situation. This could embody a story in regards to the feared stimuli or audio recordings of triggering statements.

In Vivo – These are real-life exposures the place we confront the scary stimuli in a deliberate and structured means.

Interoceptives – This sort of publicity recreates the physiological symptomology of a panic assault that may be related to excessive misery from OCD. Panic-like signs are mimicked to habituate and tolerate the discomfort.

You should use a mixture of these kinds of exposures as an individual begins to construct their misery tolerance round publicity work and reduce safety-seeking behaviors. 4 key tips whereas partaking in any publicity are as follows:

1. Particular – You need your publicity to be particular and as clear as potential.

2. Plan – You need to design, focus on, and plan your publicity. *Sometimes, real-life, unplanned exposures happen and we be taught to deal with these as they arrive. 

3. Time Restricted – Set your expectations for not than an hour.

4. Restoration – Enable time for restoration and reflection and use this time to construct proof that helps that OCD may be challenged.

Planning Publicity Therapy

To start out curating your therapy plan for ERP, you’ll have your consumer create what is known as an publicity hierarchy. This can function a information for therapy and a roadmap to fight compulsions. The particular person will create an inventory of feared stimuli and rank it by the extent of misery it causes. An instance of this is able to be a consumer itemizing giving a child a shower as a feared stimulus as a result of obsessions round loss of life, worry of dropping management, or worry of bodily or sexual hurt coming to the newborn. The therapist and consumer will then start to have interaction in deliberate exposures to extend misery, settle for uncertainty, and resist compulsions. Primarily based on the instance said above, the consumer will start to have interaction in gradual exposures of listening to operating bathtub water, writing a worst-case situation about bathtub time, doing bathtub time accompanied by one other particular person, and finally independently. Exposures shall be distinctive to every consumer and can construct upon one another to turn into tougher and improve misery tolerance working in the direction of habituation and inhibitory studying, each wanted to rewire the mind to interrupt freed from the cycle of OCD.

It’s pure to need to keep away from what we worry and to deliver ourselves a way of consolation after we are distressed. This retains us caught within the cycle of OCD and unable to dwell a significant life free from compulsions and obsessions. By recognizing, accepting, and difficult OCD signs, you might be working in the direction of a lifetime of being extra current with those that matter most.

I wish to categorical my appreciation and due to my colleagues and mentors for his or her general steerage and perception on this subject which has made for an inspiring expertise for me.

Concerning the Creator

Taryn Hancock, MSW, LSW

Taryn Hancock, MSW, LSW, makes a speciality of Perinatal Temper and Anxiousness Problems resembling Generalized Anxiousness Dysfunction, Panic Dysfunction, particular phobias, Obsessive-Compulsive Dysfunction, and all subtypes of OCD, Social Anxiousness, and PTSD. Taryn’s medical expertise contains working with adults and adolescents in each Perinatal and Anxiousness/OCD partial hospitalization and intensive outpatient applications. She has superior coaching in psychotherapy via Postpartum Assist Worldwide. Taryn holds a Grasp’s Diploma in Social Work from Aurora College. Along with her academic and medical expertise, Taryn enjoys being a mother to her two youngsters.

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