When a distressful thought becomes an obsession: OCD

Thought and Obsession

An Obsession can be defined as a frequent, intrusive and distressful thought.

Our mind and our thoughts are not always under our complete rational control, even if we would like them to be. We can’t always decide rationally which thoughts or images are allowed to come to our mind. Indeed we produce constantly a very large number of thoughts, some of them pertinent to our lives, work, relationships, etc. and some of them not pertinent, sometimes even weird, which can pop up in our mind even when we are focused on something else. It happened to all of us, while working or studying, to start thinking about something else without being totally aware of it (e.g. the grocery list, weekend activities, etc. etc.).

Sometimes the thoughts that pop up may be “weird”; this means that sometimes we can make thoughts that are definitely not congruent and maybe opposite to what we normally think or how we usually behave.

It can happen for example to have an aggressive thought, or a pervert or a deeply heretic one, maybe a homosexual thought if we are straight (or vice versa), or to think something really bad about a person that we love or that something really bad could happen… The potential list is very long, but the main feature is that these thoughts imply a scenario that is deeply feared by the person.

Usually since these thoughts are so far away from our beliefs and lifestyle, we don’t give too much importance to them and they tend to spontaneously disappear. But for some of us these thoughts cause intense anxiety and distress, they tend to pop up with a much higher frequency and they don’t disappear as fast as it happens for other people.

The anxiety caused by these thoughts is so intense that it interferes with the person’s daily functioning and he/she, in the attempt to find relief, may try to suppress them, to create rituals that can help to calm them down, to ask for reassurances or to avoid situations or people related to the thought. Also the list of rituals is potentially very long.

What is happening? And why?

If you recognise yourself or a person close to you in the dynamics explained above, it may be possible that you have developed an obsessive compulsive disorder (OCD).

OCD is a serious and subtle disorder that tends not be recognised in the first place, as the person is often very ashamed of having these bad thoughts. In the long-term, OCD may make the person feel like a slave, controlled and dominated by obsessions and compulsions. If you think that this is your case, then consulting a specialist is highly recommended.

People with OCD, compared to others, tend to be very emotionally shaken by the bad thoughts described above, because these thoughts are totally incompatible with their core personal beliefs and the chance of these thoughts becoming “reality” is therefore to be avoided in every possible instance.
If however we can’t control which thoughts pop up in our mind, we can work on our attitude towards them and our consequent behaviours.

Cognitive behavioural psychotherapy is the form of therapy highly recommended to treat this disorder by the National Institute for Health and Care Excellence.

Irritable bowel syndrome: can psychotherapy help?

Irritable Bowel Syndrome

Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder, affecting around 11% of the general population, that tends to be chronic and is certainly bothersome. Even if usually no inflammation or tissues alteration is present, IBS may be a very disturbing and distressing condition, that significantly worsens a person’s quality.

Irritable Bowel Symptoms

People suffering from IBS may experience a great variety of symptoms:

  • abdominal pain: its intensity is usually mild and not severe, it may follow food ingestion and stop after evacuation
  • cramping and/or bloating
  • constipation or diarrhea
  • gas and/or mucus.

The risk factors of IBS are: being woman, being under 45, having a familiar history of IBS and having a mental health problem.

The causes of IBS are still unknown, but it is very likely that several concomitant factors may play a role.

Furthermore, stress seems to have an impact in worsening the syndrome. In particular, the stress condition caused by suffering from IBS may itself create a vicious cycle, fostering IBS symptoms and consequently creating more anxiety. Moreover, it seems that up to 70-90% of people suffering from IBS may experience psychological difficulties, more likely mood or anxiety disorders.

What is neuroscience telling us?

The tight relationship between our brain and our bowel is not a novelty, but in the last decade neuroscience has given us amazingly interesting new information about it.

It seems that our brain and our guts are in constant communication, both influencing each other through top-down and bottom-up processes. But we are not talking only about digestion-related information: our guts have been defined by scientist M. Gershon like a real “second brain”.

Our “second brain” contains indeed around 100 millions of neurons that are responsible for digestion but also for making us experience the so called “gut feelings”, such as “butterflies” in the stomach. Furthermore, it seems that those feelings can have an influence on our mental states even if no conscious thought or decision-making can be undertaken by our second brain. In particular it seems that some specific macrobiota in our guts may impact the functions of our central nervous system; in mice, an impact on anxiety and stress-related behaviours has been found.

Can psychotherapy help?

If you suffer from IBS and you believe you are suffering from anxiety and stress, you may consider taking care of this to avoid a worsening of your IBS.

Research has showed high comorbidities of anxiety and mood disorders in IBS patients, the problematic vicious cycle that anxiety may create and the consequent risk of perceiving a poor quality of life.

Psychotherapy may help you with the aforementioned psychological issues, as our mind and our bowel are so deeply interconnected.

Furthermore, research has showed promising results on the efficacy of psychotherapy, in particular cognitive behavioural therapy and therapies involving relaxation techniques, in improving IBS symptoms, anxiety and the patient’s quality of life.

Suggested links

Irritable Bowel Syndrom Network UK

Bibliography

Al-Asmakh, M; Anuar; Zadjali, F; Rafter, J;  Pettersson, S. “Gut microbial communities modulating brain development and function”. Gut Microbes 2012 Jul-Aug;3(4):366-73. Epub 2012 Jun 29.
Blanchard, E; Lackner, JM; Sanders, K; Krasner, S; Keefer, L; Payne, A; Gudleski, GD; Katz, L; Rowell, D; Sykes, M; Kuhn, E;  Gusmano, R; Carosella, AM; Firth, R;  Dulgar-Tulloch, L. “A controlled evaluation of group cognitive therapy in the treatment of irritable bowel syndrome”. Behavioural Research and Therapy, April 2007, vol 45(4):663-648.
Garakani, A; Win, T; Virk, S; Gupta, S; Kaplan, D; Masand, PS. “Comorbidity of Irritable Bowel Syndrome in Psychiatric Patients: A Review”. Am J Ther. 2003 Jan-Feb;10(1):61-7.
Kuo, B; Bhasin, M; Jacquart, J; Scult, MA; Slipp, L; Riklin, El, Lepoutre, V; Comosa, N; Norton, BA; Dassatti, A; Rosenblum, J; Thurler, AH; Surjanhata, BC; Hasheminejad, NN; Kagan, L; Slawsby, E; Rao, SR; Mackin, EA; Fricchione, GL; Benson, H, Libermann, TA; Korzenik, J; Denninger, JW. “Genomic and Clinical Effects Associated with a Relaxation Response Mind-Body Intervention in Patients with Irritable Bowel Syndrome and Inflammatory Bowel Disease” PLoS One. 2015 Apr 30;10(4):e0123861. doi: 10.1371/journal.pone.0123861. eCollection 2015.

Working mothers: when guilt becomes too much

Working mothers

Being working mothers of toddlers is a fulfilling and challenging experience that no one really prepares us to face. Everything is on the move: every day the child grows up a little bit more, discovers new things, new behaviours and its personality is being shaped. This usually makes us want to spend as much time as we can watching them growing up, playing with them, discovering the world with them and enjoying everyday moments.

But after our maternity leave, work calls us back to real life and this can become tricky. Often young families live far from their relatives and taking up a part-time position is not always possible. Very often the only solutions are kindergartens or qualified nannies, and for new mums it can be quite hard to leave their toddlers with strangers for a whole day. As a matter of fact, this may set off a feeling of intense guilt, possibly making the moment of separation very distressful for both the mum and as a consequence the child. In fact, if our child realises the mother’s distress during the moment of separation, he may think that there is something wrong and probably something to be worried about.

What is guilt?

Guilt is a complex social emotion, that implies different cognitive evaluations. To experience guilt indeed it is necessary that at least two people are represented in one’s own mind. In particular, the person who feels guilty believes he may have potentially damaged or harmed another person (voluntarily or not) or have transgressed a moral or a social principle. As a consequence of guilt, the “guilty” person usually tries to restore a sort of balance with the “harmed” one, helping out the person or finding a way to expiate this unpleasant emotion.

Why would mums feel guilty?

As written above, very often it occurs that new mums experience maternity far away from their country of origin and without the support of the original and the extended family. In addition, the most common scenario is mums that work full-time, while simultaneously take care of housework, their partner and their baby. In summary, multitasking is not a choice but a duty! We have to cover so many roles in our daily life and we try to do it in a good way: we want to work well for ourselves/our boss/colleagues or clients, we want to be good partners and for sure we want to be the best mothers for our children. But while in the best case scenario we may be confident about our work and our relationship with our partner, being a new mum is for many a totally new experience that may lead to many doubts and thoughts.

Usually the most common thoughts of new mothers are: am I doing the right thing? Am I interpreting the signals that my baby is sending me in the right way? Is he/she OK in the kindergarten? Is it normal if he/she cries at separation? Am I a bad mother if I leave him/her there all day long? Will there be consequences if I don’t spend enough time with my baby?

The direct consequence of those questions is obviously a strong sense of guilt. You may feel guilty at work because you left your kid at the kindergarten or you may even feel guilty towards your job if you spend a day at home with child because maybe he/she is sick…

Anyway, experiencing a bit of guilt is normal as we have so many roles and responsibilities, we try to do our best to multitask and doing everything in a perfect way is really difficult. Making mistakes is normal as well! When motherhood is a brand new experience, the only way to go forward is to put ourselves on the line and just try, make mistakes and learn from them.

But if you have the feeling that guilt is becoming overwhelming, it is generating too much anxiety, it is difficult to handle or it is affecting in a bad way the relationship with your child, then take a step back and try to think about what is happening.

Many times beyond a sense of intense guilt there is a strong sense of responsibility, an excessive perfectionism or fear of committing mistakes. Furthermore, often our own personal experiences as children may play a role as well, triggering old emotions and relational memories that may influence our attitude towards our child. And this influence may not be always positive.

If this happens, considering seeking the help of a psychotherapist may be a good choice, as it could help you deal with this sense of guilt and the aforementioned dynamics, as well better handling that special and unique relationship with your child.

Insomnia: natural remedies

Insomnia Natural Remedies

Insomnia: what it is

Not sleeping as much as we would is unfortunately quite a common problem. Insomnia means having trouble falling asleep (initial insomnia), maintaining sleep during the night due for example to too many awakenings (middle insomnia) or early morning awakenings (terminal insomnia). Read more

The effects of stress in pregnancy

Pregnancy can be a stress trigger in women, as it is a moment of several physiological, psychological and social changes. Due to the intensity of these changes, it’s normal for women to experiment stress in little doses.

What are the symptoms of stress in pregnancy?

Stress implies an intense physiological activation while trying to adapt to significant environmental events (stressors).

Hans Selye, theorising the General Adaptation Syndrome, recognises three different stages of response to a stressor:

  1. Alarm: we react to stressors through an activation of our sympathetic system, increasing the heart beat, blood pressure, breathing activity, endocrine secretions, perspiration, bodily temperature and muscle tension.
  2. Resistance: our body is coping to face the stressor and the alarm symptoms disappear.
  3. Exhaustion: if stressors persist there can be a burn-out of our defences, with symptoms like fatigue, sleep disorders and decrease of immune system. Stress is not pathological per se, as in small doses it helps us to better concentrate and to have a better performance.

Can stress during pregnancy have effects on the baby born?

Some researches highlighted that an intense and prolonged stress could negatively affect pregnancy, possibly leading to a higher risk of pre-term birth and a lower weight of the baby. Specifically, stress could be not directly responsible for those consequences: it could lead indeed the mother to adopt unhealthy behaviours to better cope with it, such as the use of tobacco, alcohol, …

An intense and prolonged stress could possibly have an impact on the foetus motor skills, with a decreased number of movement assessed with ultrasounds. Moreover, other researches found a higher presence of childhood infective diseases, and consequently a higher use of antibiotics, in babies of mothers stressed during pregnancy.

Some scientists observed that baby girls exposed to high levels of cortisol during the first weeks of gestation had a bigger amygdala’s volume. Amygdala is a part of the brain responsible for emotions processing. This could suggest the chance of a higher risk of developing lifespan affective disorders, such as anxiety, depression, or others. The foetus exposure to high levels of cortisol during gestation could then represent a risk factor for later psychological problems.

Last but not least, intense stress/anxiety in new mothers could interfere in bonding and creating a safe attachment with their babies, making it more difficult to respond to the babies’ emotional needs.

Which tools can be used to reduce stress in pregnancy?

After considering the possible consequences of stress, it is very important to recognise when stress becomes too intense and to try to cope with it at our best.

There are several effective tools than can be used to better cope with stress and anxiety, such as relaxation techniques (progressive muscle relaxation, biofeedback or slow breathing technique), meditation (yoga, mindfulness) and psychotherapy. Furthermore, do not underestimate the importance of a constant physical exercise, healthy eating and regular sleep-wake cycles.

Is there a link between stress in pregnancy and the baby’s gender?

A research carried out at Oxford University suggests that the mothers’ work and problems “choose”  the baby born gender.

They found indeed that women stressed during pregnancy are more likely to conceive baby girls. In their sample indeed, women with high levels of cortisol had 75% of chance of not conceiving a baby boy.

These interesting results have to be considered as preliminary, as the high levels of cortisol could suggest not only the presence of stress but also the possible presence of other aspects or life-styles that could affect the baby’s gender.

To read the original article, click here.