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Quitting Therapy

Question:

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p>I have had symtoms of OCD since I was a child. They began at 7 or 8 when I developed an elaborate bedtime ritual and the need to pray “just right” to keep loved ones and myself healthy and away from harm. I didn’t even realize at the time that this was abnormal and it didn’t interfere with my life. The symptoms disappeared as I went into middle school and were replased with more generalized anxiety and depression. In college I began having “bad” thoughts about hurting children and developed an elaborate theory that neurotransimitters were being released into my blood that would cause me to act on these “bad” thoughts. The compulsion associated with these thoughts was to cut myself (very superficially) in an attempt to let out the dirty blood. I know…. sounds crazy and I thought I was psychotic for awhile. I’ve been on Prozac and doing ERP therapy for about 8 months now and am doing great. I still have a lot of obsessive thinking but I am able to recognize it think of the obsessive thoughts as “thought seizures.” Helpful for me because I have suffered from seizures in the past. I recently moved and am having to transfer my medical care to a different doctor and therapist. I am really uncertain about developign a relationship with a new therapist. It’s really hard to discuss my obsessive thinking and the whole “in-take” process is very anxiety provoking for me. Any suggestions? My first thought is to quit therapy since I”m doing so well. Is this a bad idea? How long to people need to stay on meds wiht OCD?

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  • Dr. Schwartz responds to questions about psychotherapy and mental health problems, from the perspective of his training in clinical psychology.
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  • Always consult with your psychotherapist, physician, or psychiatrist first before changing any aspect of your treatment regimen. Do not stop your medication or change the dose of your medication without first consulting with your physician.
Answer:

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p>Do not quit psychotherapy:

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p>Given the fact that you continue to have a lot of obsessive thoughts and that OCD has plagued you since childhood I strongly urge you to continue with both medication and therapy. While it is true that meeting and establishing a new relationship with a therapist and psychiatrist is difficult it still remains important to do so. Life often involves meeting new people and developing new relationships. One of your symptoms is anxiety and the wish to quit therapy has a lot to do with avoiding the anxiety that comes with developing new relationships. It is important for you to move ahead with your treatment and cope with the anxiety of starting new by facing and coping with forming new therapeutic alliances. Again, it is true that it is not easy but it is important.

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p>There is no way to answer your question about how long you will need to remain on Prozac. Of course, the more you learn how to control the obsessive thoughts and how to reduce your anxiety the more likely it is that you will be able to get off the Prozac. However, you will always need to apply your learning to situations that cause an aggravation of symptoms.

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p>In addition to your therapy and medication an additional way to reduce anxiety and control obsessive thinking is to do Yoga. Yoga is extremely helpful in reducing tension. It includes a kind of meditation and deep breathing that further promote relaxation. I have a number of patients who were skeptical about this but decided to try Yoga and have continued because they agree that it helps them a very great deal.

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p>Daily meditation with deep breathing and the use of visualizations is also enormously helpful in terms of promoting an emotional state that keeps OCD symptoms under control. There are many books available either at the public library or in self help sections of popular book stores that instruct people on how to do these things.

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p>The more you supplement your therapy and medication with additional techniques described above the better you will feel because you will have more control over these symptoms.

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p>Actually, OCD is an unsuccessful and unhealthy attempt to exert control over life by engaging in those magical activities and thoughts. Medication, therapy, Yoga, exercise and meditation are healthy ways to exert control over symptoms and feel really good.

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