29 - Possession Control of thought

Possession /Control of thought:

© SPMM Course Possession /Control of thought: Obsessions are unwanted, intrusive, repetitive, senseless thoughts experienced by patients as troublesome and resisted; though the appearance of the thoughts themselves is appreciated to be beyond their control, they are not claimed to be due to external agency. Patients often regard them to be the products of one's own mind but against their values and needs; therefore they are termed as ego-alien. Intrusive thoughts occur before motor (compulsive) acts. But it is not necessary that every compulsion is preceded by an obsession or vice versa. Often during the course of OCD primary obsessions fade while compulsions dominate clinical picture; some compulsions can be mental compulsions like praying, counting, etc. Obsessional slowness can occur either when obsessional thoughts occur as part of a depressive illness or in cases of severe OCD where primary obsessional slowness ensues. Still another pattern is the obsession with symmetry or precision, which leads to a compulsion of slowness. Patients take hours to eat a meal or shave, in an attempt to do things ‘just right’. Unlike other patients with OCD, these patients do not resist their symptoms! The most common obsession is the fear of contamination, followed by pathological doubt, a need for symmetry, and aggressive obsessions. The most common compulsion is checking, which is followed by washing, symmetry, the need to ask or confess, and counting. Children with OCD present most commonly with washing compulsions, which are followed by repeating rituals. Thought alienation is a general term used to describe the experience that one’s thoughts are under the control of outside influences or that others participate in one’s thinking. This term is often confusing and better replaced with components of first rank symptoms – thought insertion, withdrawal and broadcast.