Okay let me explain. The basis for OCD is not cognitive, its entirely neurological. People without this neurological CANNOT develop OCD of any type. However, cognitive patterns can produce OCD illnesses in people with this neurological abnormality.
Hi Phobologist, my experience, my research tells me that anyone can develop OCD given the right (or wrong) circumstances. For example, put a 'normal' person in a highly stressed environment and you increase the chance of them developing OCD regardless of any neurological condition.
Anxiety, phobias, ocd, depression, dissociation are reactions of the brain. They are not neurologic flaws by themselves. Of coures if you do have an underlying neurological imbalance (hyperactivity in one part) the probability of those reactions increase.
Compulsion isn't as complicated or creative as you think. The neurological basis for compulsion is faulty wiring, not cognitive beliefs. CBT doesnt work very well on compulsions (45% success rate) for that reason. When it does work, I assure you it's because of neuroplastic changes which were inadvertantly made, not because of the therapy's aims. For example, exposure response therapy actually makes OCD worse in many cases. It will only work if preformed according to neuroplastic theory. According to the research I have read, the basis for compulsive behavior is as follows:
[obsessive thought] ----> [anxiety] -----> [ritual] -----> [less anxiety] -----> [obsessive thought] -----> loop
Yeah I agree with the flowchart. CBT always has a fairly low success rate because the feedback loop is so strong and primal. With OCD our brain believes that the rituals are the only thing stopping the anxiety. It's extremely difficult to cognitively change that.
Depression increases obsessive thinking, it doesn't lower it. I don't see any evidence for the cycle you are talking about. How we want to define it is in my opinion, irrelevant. How we deal with it has largely neurological underpinnings, not cognitive ones. The stickier the cingulate is, the easier it is to form compulsions. The greater the abnormality in the amygdala, the more prone we are to anxiety. I suspect that the confluence of these two factors alone, probably explains at least 50% of OCD cases. In other situations such as GSAD, and other phobias, you probably need particular traumas to develop the illnesses.
Okay, let me give you an example of the cycle with social anxiety. Someone who has social anxiety is continually beating themselves up for saying something or not saying something or doing or not doing something and the anxiety just keeps building and building. There comes a point when we 'give up' fighting. We realize nothing is working and we start to accept that we are flawed or worthless. The anxiety actually lowers then because we no longer have to fight as much (we start believing we are flawed) and acceptance of the situation is higher. That's why there is comfort in depression (just like there is comfort in rituals). But then we stabalize and we start moving around again, the anxiety picks up and the fight continues on. It's similar to OCD cycle where the ritual lower the anxiety temporarily as well. I guess by definition you are 'obessive' when depressed, but its a different type and its purpose is to clear away just like rituals.
