Freud mentioned that OCD is played out in overt thoughts and actions. Specifically, he mentioned that Id impulses equals to obsessive thoughts and Ego defenses equals to counter-thoughts or compulsive actions. Also, OCD is related to the anal stage of development where people who suffer from it usually has period of intense conflict between the id and the ego. However, not all psychodynamic theorists agree. Psychodynamic therapies seek to uncover and overcome underlying conflicts and defenses using free association and interpretation. Behaviorists likes to concentrate on explaining and treating compulsions rather than obsessions. Exposure and Response Prevention is a type of treatment behaviorist use where it exposes a client to anxiety-arousing thoughts or situations and then prevents the client from performing his or her compulsive acts. Cognitive theorists indicate that everyone has repetitive, unwanted, and intrusive thoughts and suggest that people with OCD blame themselves for normal (although repetitive and intrusive) thoughts and expect that terrible things will happen as a result. People with OCD tend to have exceptionally high standards of conduct and morality and believe thoughts are equal to actions and are capable of bringing harm as well as they believe people have perfect control over their thoughts and behaviors. Additionally, therapy may include, psychoeducation and guiding the client to identify, challenge, and change distorted cognitions. Research suggests that a combination of the cognitive and behavioral models is often more effective than intervention alone. The biological perspective of OCD is abnormal serotonin activity and abnormal brain structure/functioning. OCD is linked to brain structures such as orbitofrontal cortex, caudate nuclei, thalamus, amygdala, and cingulate cortex. They believe that some of these structures may be too active in people with OCD and some research provides evidence that these two lines may be connected. Serotonin along with other neurotransmitters (glutamate, GABA, and dopamine), plays a key role in the operation of the orbitofrontal cortex and the caudate nuclei. Abnormal neurotransmitter activity could be contributing to the improper functioning of the circuit. Some biological therapies suggest the use of some serotonin-based antidepressants can help rebalance the brain circuitry. On average these antidepressants bring improvement to 5080 percent of those with OCD. However, a relapse can occur if medication is suddenly stopped. The most effective research suggests that combination therapy (medication and cognitive behavioral therapy approaches) may be most helpful.
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