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Compulsion is a pathopsychological syndrome that includes a set of intrusive behavioral behaviors that occur involuntarily, which are repeated with a certain sequence or at random intervals. Compulsions imply imperatively arising actions, which a person, as he himself feels, is obliged to perform. Refusal to perform such a pose causes the individual to feel a sense of fear, anxiety, discomfort - these feelings increase until a person does the specified action.

Symptomatic of compulsion is characteristic of the following disorders: obsessive-compulsive disorder, anancastic personality disorder, obsessions( obsessive imperative thoughts).

Examples of compulsions can be very diverse and include the following stereotypical actions: gnaw nails, nervously squeeze and crumple in the hands of a coupon, tap on the table, shake their feet, draw on sheets of paper endless lines or circles, with the inability to stop. These actions can both relieve nervous tension in a healthy person, reduce anxiety and fear, help switch from anxious thoughts, and testify to the presence of serious personality disorders in the psychological sphere, when without a qualified assistance a person alone can not cope. In the second variant, when there is no possibility to suppress compulsions and compulsive actions become an integral part of everyday life, it gives pain, because a person realizes the absurdity of compulsions and experiences, because he can not cope with them with growing alarm, which he very strongly suppresses. But compulsions "free" from paranoid thoughts only temporarily and the cycle is repeated again and again.

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Compulsions occur in a variety of mental disorders, can be a temporary phenomenon in age-related crises, life disputes, stress, compulsion in pregnancy - when the future mother worries also take place.

The percentage of occurrence of compulsions grows from year to year, because in the era of technological progress and the reduction of "live" communication, economically unfavorable conditions, unrest increases and presses on an ever larger spectrum of the population.

Examples of compulsions include the main features:

- The perception by the person himself of such actions rather than arising in his head on his own, rather than imposed by surrounding influences from outside.

- Repetition is unpleasant, perceived by a person as nonsense.

- Attempts are made to confront, which are unsuccessful, but the person tries to suppress compulsion.

- There are no pleasant feelings of relief.

- Compulsions cause stress, interfere with life, due to wasted time spent.

Treatment of compulsions includes systematically conducted questionnaires, observation of a psychologist, and, if necessary, drug therapy.

Compulsion - what is it?

In psychology, compulsions are seen as manifestations of the "return of the repressed," a person tries to avoid any thoughts or desires for specific reasons, considering that they are incompatible with his life activity or do not suit him, which entails subconscious disturbances. Compulsions can manifest themselves as unsuccessful ousting, or as alienation from such thoughts. That is, a person does not recognize certain personal parts of himself.

Compulsions are fairly common phenomena and are observed in 1.9-3.3% of the world's population. Such people often include owners of a high intellectual level who, due to the action of compulsion, can not use their knowledge and skills completely, which entails a loss of ability to work. The most common compulsions in the following groups of people: intellectual development is above the average, with graduated higher education, the average level of social solvency, bachelors or divorced, biased towards alcohol, with obsessions and anankast personality disorders, in individuals with insomnia.

Compulsions, like actions, are combined with the desire of a person to get rid of the restless state that may occur when:

- Overwork, exhaustion of the moral plan, psycho-emotional heavy loads and often occurring stressful situations. It manifests as a one-time, and in the future develops into a chronic disorder.

- Under the influence of intrusive, difficult-to-pass, imperative thoughts and ideas that provoke an increase in the level of anxiety and activate vegetative shifts. It is these thoughts that arouse fear in man, and compulsions help to free oneself from growing anxiety. Such relief is temporary. The reasons for such thoughts in somatic diseases, traumas, situations bringing a traumatic effect. Examples of such thoughts: the fear of being dirty, the fear of violent acts against oneself or surrounding people, the fear of hurting them, religious fears or superstitions, the idea of ​​observing excessive order and regime, pedantry, the intrusive desire to dispose of some thing and the fear of itlosses.

- Anankastnoe personality disorder, which the person himself is accepted as an integral part of his personality. The causes of this personality disorder lie in the insufficiency and violations of brain structures, hormonal disorders( often in the puberty period), nuances of parental education( presentation of requirements for compliance with high standards of behavior, while respecting the "standards of feeling"), hereditary genetic factor.

- Biological aspects of the onset: brain pathologies( like life injuries and birth defects of the anatomical structure), metabolic disorders of neurotransmitter systems( serotonin, dopamine, norepinephrine, GABA), infectious factor( PANDAS syndrome), severe infectiousDiseases( having properties to overcome the blood-brain barrier), epilepsy, perinatal trauma.

Symptomatic complex in patients suffering from compulsions includes the following manifestations: a high degree of anxiety, an obsessive desire to do something under the influence of imperative obsessions, excessive suspiciousness, paranoidity, the presence of strong phobias and fears, spontaneous impulsive acts of a manic nature with relative general calm.

Examples of compulsions:

• Compulsions in eating are pathological overeating( "jamming problems" to relieve internal discomfort sensations) or vice versa - starvation before weight loss( anorexia may develop).

• Gambling and excessive gambling, thirst for risk and "adrenaline", stressful situations.

• Excessive and exhausting workaholism is a constant need to be busy, without taking part in external life.

• A race for victory, turning into an obsession that harasses an individual.

• Exhausting physical work.

• Compulsions of an intimate nature, excessive needs, a thirst for polygamy.

• Avoidance of life problems, self-containedness, lack of security.

• Shopaholism is an irresistible desire to buy.

• Fanaticism is a craving to worship, to have an "idol", an idol.

• Organizational aspirations, when every nuance and every minute is signed by a person, not allowing you to rest for a minute.

• The simplest and most frequent manifestations of absolutely healthy people are: nail-biting, clicking or tapping with your fingers, biting your lips, striving to avoid objects only on one side( do not step on the joints on the road, go only along the curb), constantly and abruptlyTwist your head, twist your buttons, blow your hands, wash your hands repeatedly, crumple the paper in your hand, scratch your nose and many repetitive simple movements.

From ordinary habits, compulsions are characterized by increased anxiety and fear, with refusal to perform such an action, that even vegetative symptoms can develop.

The diagnosis of compulsion is performed by a psychologist or psychiatrist and includes the following criteria:

- Compulsions manifest themselves for a minimum of two weeks and occupy 50% of the time space of a person during this time, disrupt the vital functions and drive into distress.

- The patient himself should perceive compulsions as his own thoughts and treat them as critical( the action should not be fun), the attitude towards treatment is positive.

- The presence in the history of at least one unsuccessful attempt to resist the urge.

- Thoughts and actions have an unpleasantly repetitive course.

For the detection of compulsion, the Yale-Brown scale is used - a test questionnaire for determining a personality disorder.

If suspected lesions of brain structures, a magnetic resonance imaging or computed tomography is assigned.

Often diagnose compulsions precisely in psychasthenic persons. The debut of the disease is very characteristic and covers a range of 10 to 30 years. The need for treatment is not realized immediately, the first appeals for help occur mainly in 7-10 years from the onset of the first manifestations, for this reason, the average age of patients is about 30-32 years.

Types of compulsions

Depending on the course of compulsions, they are divided into the following types:

- Temporary compulsions, this type implies a single occurrence of an attack that can be observed by patients themselves in a time span of several days, stretching with the flow for several years.

- Episodic compulsions, in which, basically, there is an alternation of life episodes without the presence of seizures and the state of absolute mental health of the individual, with periods of imperative urges.

- Chronic compulsions, characterized by continuous attacks with progression in the future.

- Simple compulsion. Include in this cohort annoying twitchings( hands, feet, frequent blinking, sniffing), and obsessive acts( repeated touching objects, drawing the same circles on paper).

- Complex compulsion. Includes actions with multi-faceted features and multiple repetitions.

- Physical. Performing specific actions( touching the nose, lancing in the hands of paper).

- Mental. Actions conducted by a person in the mind( counting, pronunciation of any phrases).

Treatment of compulsions

When treating compulsions, first of all, methods of psychotherapeutic influence are used. The essence of such psychotherapy is in changing the attitude of the person himself to his altered state, thereby creating a true internal perception of the disease with the help of live communication with the patient, because compulsions, for the most part, are the result of wrong conclusions of the person, which distorts his further perception of life situations.

Psychotherapy often resorts to such methods: cognitive behavior, psychoanalysis, hypnotic influence, suggestion.

The approach of the psychoanalytic spectrum is quite effective precisely with easily flowing forms of compulsions and at first stages of the disease, but if the disease has already expressed, developed character, then it is necessary to connect the medical treatment, which consists of:

• Antidepressant drugs group affiliation to SIOZsin( Sertraline, Clomipramine, Fluoxetine) and a tricyclic group;

• In more severe cases, antipsychotics-antipsychotics( Aminazine, Truksal);

• In the chronic case, benzodiazepine tranquilizers-anxiolytics( Clonazepam, Relanium, Laurafen, Phenazepam);

• When joining obsessions on the background of general nervous exhaustion - nootropics.

The totality of psychoanalytic and remedial means, allows to achieve the most effective goal - the recovery of a person.

General and physiotherapy methods used by the patient at home: warm common baths, cold compresses with head wrap, infusions of St. John's wort, hardening procedures.



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