By the psychological counsellor Randa Baraka. God Almighty says: \"Say, I seek refuge in the Lord of mankind, the Sovereign of mankind, the God of mankind, from the evil of the retreating whisperer, who whispers in the breasts of mankind, from among the jinn and mankind.\" God the Great has spoken truly. This whispering that sometimes takes hold of a person, disturbing his rest, troubling his soul and spoiling his mood, is not strange to the experience of any sensible person. He hastens to drive out these whisperings by seeking help in the remembrance of God if he is among the believers, or by immersing himself in the concerns of daily life that make him forget those whisperings, or by repression in other situations. This whispering is suffered by the normal and the abnormal alike, but it sometimes reaches such a degree of severity that psychological disturbances appear in the sufferer that turn him from the right path, and may lead him to disturbances in certain mental functions. Perhaps what distinguishes whispering in ordinary people from that in the ill is that in the first case it does not extend over a long period and does not affect the soundness of thinking effectively, and any trace of it easily disappears with time and with other preoccupations. Pathological whispering, by contrast, completely controls the conscious functions and comes to the patient constantly, compelling him to think and believe in a particular way, and may lead him to perform certain stereotyped behaviours arising from drives and tendencies that take hold of the individual so that he cannot resist them, such as the person who resorts to washing his hands repeatedly, or changing his clothes repeatedly, or checking his desk more than once before leaving it, and so on. This kind of psychological disturbance has been known, or what has been called neurasthenia and compulsion neurosis. By compulsion neurosis is meant the various forms of fears and obsessive thoughts, although obsession differs from fears in that the anxiety appearing in the first is about not completing the act, while in the second the anxiety is about performing the act. That is, the person suffering from obsession rids himself of anxiety by not departing from his behavioural habit, such as walking along a particular route, sleeping on a particular side or eating in a particular way, while the other, the person suffering from fear, protects himself from anxiety by refraining from the act, so he does not cross streets for fear of cars, does not go up to high places and does not board a plane, and so on. Psychopathology has distinguished between obsessive thoughts (obsessions) and compulsive acts (compulsions), and the credit for distinguishing obsessional illnesses goes to the German Stekel, who divided them into: 1. Obsessive thoughts. 2. Compulsive acts. He dealt with this disorder as a compound of obsessive thoughts and compulsive acts. Obsessive compulsive disorder: obsessive compulsive disorder is one of the neurotic illnesses in which the patient knows with certainty that his thoughts are not correct. The illness usually comes in the form of thoughts, impulses or fears, and may be in the form of continuous or periodic motor rituals, with the patient's certainty of the triviality and irrationality of these obsessions and his sure knowledge that they do not deserve this attention from him, and his continuous attempt to resist these obsessions and not to surrender. But with the length of the illness his degree of resistance may weaken, and social problems and psychological and mental pain may arise from the patient's sense of these obsessions' control and their compelling force. Its symptoms: among the symptoms of this disorder are: 1. The dominance of a particular mental content such as the presence of thoughts, impulses, fears or continuous motor rituals, or the mind turning in a vicious circle. 2. The patient's certainty of the irrationality of the idea and the triviality of his obsession, and despite this he surrenders to it. 3. His sense of the strength of this obsession as a result of the exhaustion he suffers and his constant anxiety and worries, which makes him more attentive and focused on any pathological symptoms affecting his body. The obsessional patient often suffers a disturbance in the digestive system, since the state of mental exhaustion leads to a slowing of the rate of digestion, and this leads to a disturbance in the digestive process from which real visceral disturbances arise. 4. The sufferer's constant headache accompanying his thinking process. This headache arises from his wish to focus on a particular idea and his inability to control the sequence of his thoughts, and from his standing at the point of choosing between the moral act and the immoral act. Despite the headache he suffers, he resorts to hiding its emotional effects and finding justifications for the acts or thoughts he engages in. The causes: among the most important causes leading to obsessive compulsive disorder: 1. Heredity, for about 30% of the patient's relatives have the same disorder. The appearance of the disorder in identical twins is also higher than in fraternal twins. The hereditary factor interacts with the environmental factor, for the influence of a mother, for instance, who is affected by obsession in her behaviour, will be reflected in her children's characters, whether hereditarily or environmentally. 2. The physiological factor, such as the presence of an active electrical focus in the cerebral cortex and its relation to the neurotransmitter called serotonin. This is why the medicines used against obsessive compulsive disorder act on this serotonin transmitter. 3. The nature of the personality, that is the obsessional personality marked by rigidity, inflexibility and difficulty in adapting and adjusting to different circumstances. It has been found that the obsessional personality appears only 20 to 25 years after cases of obsessive compulsive disorder. 4. Social problems, for obsessive compulsive disorder is related to intense anxiety or depression. 5. The clinical symptoms: obsessive thoughts and compulsive acts in the form of motor rituals. 6. A particular idea or the image of some scene, beautiful or repellent, or particular phrases that come to the patient's mind and take hold of him. 7. Impulses that make the patient feel an overwhelming desire to perform acts he does not approve of and which he tries to resist. But this desire takes hold of him insistently and strongly, and these impulses are usually aggressive or suicidal, as when the patient feels a desire to throw passers-by in the street or his siblings from the balcony, or to throw himself from a high floor or from a train or bus. 8. Rumination, where thoughts and questions come over the patient that cannot be answered, and he tries to rid himself of them to no avail, such as the classic question: God created us, so who created God? We have often asked ourselves this question and then driven it from our minds. But the patient dwells on this question or asks why we live and why we die, and nothing else occupies his thinking but this question, and he cannot engage in any other mental activity. Compulsive fears (phobias), which are linked to the thoughts or images and then to the impulses and motor rituals, so that the fears become a means of escaping the compulsive situation caused by the other thoughts. Motor rituals, resulting from a particular dominating desire to perform complex movements. Among the best-known examples are washing the hands hundreds of times, or washing the body after urinating or defecating, or during menstruation. There are patients who stay in the bathroom for three to five consecutive hours to complete the washing process, and of course this process ends in severe exhaustion and a waste of time. Treatment and prevention: about a third to a half of patients improve within five years. Some studies have shown that 1 to 12% of cases of obsessive compulsive disorder turn into an illness resembling schizophrenia, and scholars differ in interpreting the extent of this transformation. Insel believed in 1990 that the psychosis resulting from obsessive compulsive disorder differs essentially from schizophrenia and is likely to be an independent kind of psychosis with its own environmental causes and a course different from schizophrenia, and is called obsessional psychosis, but the patient's personality remains intact. Treatment includes: 1. Psychological treatment: a. The obsessive compulsive patient needs psychological treatment, by explaining the nature of the symptoms, encouraging him and reassuring him that his condition is far from madness, and reducing his fear for his mental faculties. b. Trying to uncover the buried factors that led to these symptoms. 2. Environmental and social treatment: the patient sometimes needs to change his place of work and residence so as to get away from the source of the obsessions, particularly if they are related to a fear of these illnesses or of contamination by germs. Chemical treatment: medicines against anxiety and depression are sometimes helpful, along with medicines that help remove the tension and depression accompanying the obsessions, which makes the patient able to resist it and willing to continue his social activity, among them Prozac. 3. Electrical treatment, although it is not useful in cases of severe depression and dark thoughts. 4. Behavioural treatment: it is the first in treating obsessive compulsive disorder, particularly in cases of fears and compulsive rituals, either by gradual desensitisation or by direct exposure and then abstention. 5. Surgical treatment: used in chronic cases in which behavioural or medicinal treatment is of no use. 6. Supportive treatment and raising self-esteem and self-confidence: frequent seeking of forgiveness and supplication and following sound scientific and medical methods, in addition to seeking the advice of scholars.<\/p>","protected":false},"excerpt":{"rendered":"
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