Трихотилломания и дерматилломания. ( в чем смысл расстройства?)


Searching the Internet , any information that does not find standing on these conditions. Very often some advertising sites about beauty and health. Any special literature was to describe the meaning and mechanism of these conditions and how to deal with it. Of course there is mention of the fact that these problems from the obsessive-compulsive disorder need cognitive behavioral therapy. Folk remedies, cosmetic treatments and hair treatment in different ways.

some sources and even official we can read that it is a compulsive desire to cause myself harm, that is, autoaggression

Here I want not agree with this, as it is a description of the behavior, not the goal . That is what we are seeing, not what a person does.

Such a definition is fundamentally flawed as it confuses all the cards and leads to incorrect conclusions . But , of course, the pulling of the hair , and damage on the skin can be and act autoagressive , but this is different and is not relevant to trichotillomania and dermatillomania.

Campbridge behavior has obvious damage ( cuts, burns, and even plucking strands of hair, etc.). His goal is to cause yourself physical pain deliberately or in the heat of passion to reduce ( dampen) emotional pain. ( most often seen in borderline personality disorder) synonyms – selfharm, parasuicide.

If trichotillomania and dermatillomania a very different picture.

first , the validity of these, the vast majority begin unconsciously, and only in some point of time, people notice that he had started to pull hair and pick skin. But he's not with an effort of will to desist until they cause visible damage. ( this similarity with OCD, since the mechanism of these actions is compulsive character), in contrast to selfharm or parasuicide that have impulsive in nature , where people can not to do or not to start doing and may stop in the beginning.

second, the purpose of trio and dermatillomania -enjoyment . It ( the pleasure) here acts as a compensator anxiety. And it doesn't have to be stressful.

Thus, we have two essential functions of these delusions.

Spontaneous ( not controlled ) compulsive behavior based on having fun. the Fact of the unconscious desire to delight, these pathologies are different from the rituals of OCD the fact that the latter is based on fear and have the goal of ridding yourself of the obsessive fear.

so. Two factors that need to rely on to solve these problems.

( it's about the symptom, it is the main factor that is perceived as a problem, the elimination of the "soil" which was "grown" this symptom is solved in the framework of the modality in which the therapist works. Unless of course, this soil is relevant, as the causes can be, and compulsive behavior remained an independent problem).

Compulsive spontaneity and fun.

( the other delusions, such as: shopomaniya, gambling, some kind of a kleptomaniac -just have these factors, but without overt spontaneity. Compulsion and pleasure , here are the basic).

the Combination of these two factors ( compulsivity, and pleasure) and determines the complexity of problem solving, trio and dermatillomania. It is difficult to stop compulsive actions deliberately, and to give pleasure even more complicated. Independently practically it is impossible, therefore pharmacotherapy, cognitive therapy and any "spoken" in this case, you do not have a lasting effect.

If in compulsion, based on fear, we can overcome compulsive a paradoxical way, reinforcing the fear . Then, in the case of pleasure, it will lead to an even greater desire to pleasure.

Fear and pleasure.

If about fear, we know a lot, because we need to get rid of it. Then the pleasure we don't care, but to always seek him.

Our brain can extract fun out of anything, just give him the opportunity. And pain too, but there is a limit. But here is a small and portable physical pain, when repeated becomes a pleasure. ( this is connected with the production of opiates, which are supposed to neutralize the pain). Here is what happens in the process of formation of tricho and dermatillomania.

There is such a phenomenon. It's called "Aha-effect" opened it in the experiments, Wolfram Schultz. Its meaning is that we begin to experience the fun before it actually start to receive. That is one of the only views about the upcoming fun. If we have a constant habit to pull hair or pick skin, the process of enjoyment starts even before we started to do it. But since it's a habit, the idea that starts the process , is not captured by the mind because of its speed. ( in CBT this is called an automatic thought). That is why the pulse at pleasure, in most cases, is not noticed. And when we notice it, the fun is already in full swing ( dopamine is doing its job) and to stop the process is not obtained, there must be an external factor that will interrupt the process. ( this, for example, understanding the scale of the disaster. A lot of hair or a bunch recovering areas of the skin). That is, at some point , call it "something" , that is "something" interrupts the fun. ( fear, irritation, maybe wine, no matter what. It is important that stops.

Why not to stop the fun when the stronger factor?. (Incidentally, this is also a question of subjective evaluation. This , apparently, depends on the strength of pleasure.

There is a very good experiment about the destructive force of pleasure.

"Rats implanted electrodes in those areas of the brain responsible for pleasure. And gave them the opportunity to manage the obtaining of pleasure, to activate the electrode by pressing the pedal. Rats have made themselves real "dopamine storm" . But they were dying of thirst and hunger, as not been able already to refuse to pedal. Why eat and drink if you can have fun directly".

( interesting fact, he explains why it is important instinctive processes of survival: food, quenching thirst, sex, and you know what else is associated with pleasure).

Back to the symptoms.

What to do with the fun and spontaneous compulsions?

it is quite simple. You need to get rid of spontaneity, compulsion and to turn fun into torture.

Since we have several factors in the "one" we need a technique that will affect all of these factors simultaneously. And with that, this technique must be located in the logic of the symptom, in order not to create resistance, and around it.

We can turn the pleasure into a torture ourselves, and we don't need to do anything other than enjoying only slightly change the pattern of behavior.

Imagine that You are a person who loves chocolate ( same lot) . But you eat chocolate spontaneously, that is when there was a desire. And you limit yourself to ( for various reasons). Let's say You eat 1 candy bar a day . well, or even a small chocolate bar.

And now You offer to do the same. But not when You want ( spontaneously) , but strictly by the hour . For example every 2 hours , well-defined and not very large portion of chocolate. It all depends on how much do You eat chocolate for pleasure. ( the point here is not to overeat chocolate).

Knows what will happen?

first , You take away the spontaneity, you are eating on schedule. This creates the effect that you deliberately acquire control over lack of control of their actions.

second, You ropinirole enjoyment ( here, the word "refining", used to mean radical transformation) . Refined pleasure is not fun, not spontaneous, and prescribed.

and then, when You eat chocolate every two hours, even less than usual, all the pleasure of chocolate quickly turn into a real torture chocolate.

(You'll create a parallel ( or new, are not) neural connection to this process and when it is strengthened will the dominant principle, formulated 100 years ago by A. A. ukhtomskiy)

That's it for this scheme, with the addition of even small tricks in the short-term strategic therapy is built technique with the symptom of trichotillomania and dermatillomania. And on a similar technique constructed with other compulsive ( and not chemical) dependency-based fun.

Said above it is not advisable to use for independent work, I have not written a specific exercise, I just described the principle of operation. How and what to do to get the desired effect the best thing to do under expert guidance. Since the exercise must be selected individually and depends on the intensity of the symptom, the mean time to complete and the overall condition at a specific moment.

Other articles about the features of OCD in my publications.

Therapy obsessive-compulsive disorder, hypochondria, dermatillomania, trichotillomania, etc.
the Recording of telephone ; +7 929 500 9179. E-mail [email protected]
Valery Razuvaev

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