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2013年04月14日 10:25


强迫症的定义:又称强迫性神经症,是指在观念、意向、行为上存在着虽自觉却不合理或毫无意义,但又是被迫无奈地出于自己内心的自我强迫为突出症状的一种神经症。


-、临床表现

 

强迫症的临床表现是自我强迫症状,这种自我强迫症状是出自内心的而非外力所致,是明知不合情理或毫无意义的而仍反复出现,是力图抗拒和排斥的而又不能控制和摆脱。同时,自我强迫症状的出现会导致严重的内心冲突并伴随着强烈的焦虑和痛苦。


自我强迫症状可分为强迫观念、强迫意向和强迫行为。


强迫观念是反复思考毫无实际意义或虽有意义但可以解决的问题,例如“人为什么要结婚,老了怎么办,死会如何”“我是否与众不同,别人在嘲笑我吗?”等,或者不必要地反复怀疑自己所做过的事情,例如锁门后怀疑是否把门锁牢了等,虽经检查仍不能放心。


强迫意向是一种违反自己意愿的,有可能造成严重后果的即将会行动起来的强有力的内在冲动,例如杀人、破坏东西、侵犯陌生少女等,但病人绝不会真正付诸行动,只是不能控制这些意向的出现。


强迫行为是某些强迫观念在行为上的表现,例如反复数数,嘴里不停的嘀咕,沿街走路总要走上街沿,进屋前先在门前立正再迈步进入,反复地用肥皂洗手,明知用力眨眼不舒服仍要使劲眨眼等。



二、鉴别诊断

 

强迫症应与精神分裂症和器质性精神病中的强迫症状相区别。精神分裂症的强迫症状不是自觉地出自于内心,对强迫症状不具有批判力,而强迫症的强迫症状出自于内心,对强迫症状具有批判力,只是无法摆脱而已;器质性精神病(如脑炎等)的强迫症状不是其最主要的临床表现,另有其基本的突出的特殊症状,而强迫症的临床表现则为各种强迫症状。


强迫症的一种简单检测方法,请你根据最近一周以内的下述情况和感觉进行评定: 评分标准分为5级:没有为0分;很轻为1分;中等为2分;偏重为3分;严重为4分。


1. 头脑中有不必要的想法或字句盘旋
2. 忘性大; 
3. 担心自己的衣饰不整齐及仪态不端正;
4. 感到难以完成任务;
5. 做事必须做得很慢以保证做得正确;
6. 做事必须反复检查;
7. 难以作出决定;
8. 反复想些无意义的事;
9. 注意力不能集中;
10. 必须反复洗手,点数目;
11. 反复做毫无意义的仪式动作;
12. 常怀疑被污染;
13. 总担心亲人,作无意义的联想;
14. 出现不可控制的对立思维、观念。

评分方法:将各条目的分值相加,根据我国的正常值标准,总分超过20分,应考虑有强迫症的可能,建议您到精神科或心理咨询门诊作进一步检查确诊。


三、心理咨询与干预


1、认其倾听病人的诉述,以确定强迫症在观念、意向或行为上的具体表现,然后针对病人最容易产生的担心强迫症会演变成其他精神疾病和会失去自我控制的心理进行解释,使其明了强迫症有可能自发缓解,经过适当的心理治疗预后更佳,完全有可能彻底治愈。


2、鼓励病人以意志去克服强迫症状,让病人学会“自控法”,通过自我克制进行自我治疗。自控法有制想法、行为中止法和替代法等几种方式。制想法是用震惊术打断强迫观念和意向的自控方式,例如用一个定时闹钟,让它每3分钟响一次,钟响时大声说“停!”立即驱除头脑里的强迫观念和意向,或者不用闹钟,在头脑里出现强迫观念和意向时突然站起来或作一个其他强烈动作并大声说“停!”予以驱除。多次做到后,便依次改用正常声音、微弱声音直至仅在内心说“停!”来驱除强迫观念和意向。行为中止法是用毅力强行中止强迫行为的自控方式,例如在出现毫无意义的反复用力眨眼、摇头等强迫行为时,心里就默念:“毫无必要,我有毅力控制它。”然后强行中止眨眼、摇头等重复刻板式动作。替代法是用不相容的观念、意向和行为,去取代强迫观念、意向和行为的自控方式,例如在出现强迫症状时,立即去回忆或设想有趣的情景或者立即去从事需要高度集中注意的各种活动,如打乒乓球、弹电子琴、唱歌等。


3、必要时可用三环类的氯丙咪嗪治疗强迫症,尤其是强迫症伴有抑郁症状时效果更佳。


4、催眠处理,通过催眠个案,了解其发病的原因,进而进行从个案的潜意识中清除其内在行为命令的一种心理康复,强大有效。



四、曹博士催眠处理强迫症心理情绪


    小小的强迫症(无论何种行为模式)往往能将个案压得身心劳累,喘不过气来,甚至感觉自己立刻就要死了,痛苦不堪。神精治疗往往需要个案吃药,这无疑会影响到个案的身理健康。而一般的心理治疗却又根本起不了作用,因为个案对自己的症状比你(治疗师)要了解的多。而催眠处理却能一枝独秀,挖掘个案生命中深层的原因,加以根正与治疗。下面就我催眠处理强迫症的一些个案举些例子:


1. 黄先生,神精清度分裂,强迫思维,声音赋予,呼吸说话,痛苦难忍,就差没断气了,7年多的强迫史。


对于大学二年级的小黄同学的强迫症治疗,是我最得意的催眠案例。因为这7年来,他上名院求名师,先后在自己省会城市的著名神精科院治疗不果,后上北京的多所知名精神科院治疗也不果,再访上海知名心理治疗机构仍然不果,又转去山东进行长期马氏催眠治疗(国内派,与我们的欧美派不同)仍然无效,神经清度分裂,长期吃药,曾休学一年多,已近绝望,生活不能自理,呼吸困难,身心憔悴,形同僵尸。


也许是因为他自己的强迫思维,他仍然在找国内的知名机构治疗他的问题,于是在网上找到了我们。有趣的是,他打了近2个月的电话给我,反反复复强调他的病症,并要我保证一定能治疗好他的病,他才来。事实上这是对催眠治疗的误解,在我们还没有了解他的身理与心理的具体情况以前,是绝对没有理由可以承诺个案一定可以康复的。(但据小黄同学讲,别的医疗机构都承诺一定可以治愈他的。)我们没有承诺他,最终他还是压宝前来。因为在两个月频繁的电话沟通中,我发现别的治疗机构对他的治疗只是对症下药,没有用心与他沟通,寻找他得病的真正原因(事实上,中国的医学界基本处于这种表层病症医治状态。),所以,我很有信心帮他通过催眠找一些得病的原因,并加以治疗与根除。


小黄由母亲陪来,小伙子身体很健壮的,不象他自己电话里所描述的那么衰,我已经确定心理因素一定占主要原因。简单沟通后发现他还伴有严重的焦虑症与抑郁倾向。首先对他的精神状况做测试,我发觉他的精神状况很稳定正常。继而催眠敏感度测试,也能达到4,5级(6级分法),敏感度相当好,我对治愈他已经有了八成把握。


通过催眠探索,发现问题最早在婴儿时期已经埋下。那时,他3岁,略有记忆,被老爸脱光了拍照留念,觉得很害羞(他是属于早熟的孩子),但无法抗拒(这里特别要提醒年轻的父母们对于自己的孩子一定要有合理的行为,切莫因为孩子小,不懂事而随便行事,往往会给孩子幼小的心灵落下阴影,而影响成年以后的正常行为。)。4岁时,已经发觉自己有性兴奋(意识),特别喜欢抱着妈妈睡觉,却把此意念埋在心里面(年轻的父母你们又将如何对待自己的孩子的索爱呢?)。9岁因偷吃女同学零食被发现而羞愧无比。12岁因数学不好而受到老师的严罚,而在内心埋下自卑的种子(作为人类灵魂的工程师又该如何教育学生呢?)。15岁是恶梦的开始,由于被分到坏班,九个男生一起合伙欺负他,用他的饭票和钱,摸他的生殖器还要他为他们吹萧(一种口交行为),无力反抗,紧张,恐惧,焦虑,被强迫,又强迫自己在内心对抗他们,用呼吸骂他们,幻想成为三国大将,宰灭他们,进而发展到吃饭,运动,呼吸,乃至睡觉都在强迫思维,利用各类声音赋予幻想,呼吸声里都是在说话。17岁问题极度严重,无法上学,休学一年多。18岁后,靠走关系赞助,进了大学,体育系,不敢看班里同学的脸,强迫赋予呼吸声以意义,去和别人打招呼,压气,透不过来,见男生反感,见女生贬低,又发展到无论做什么事,都强迫思维,声音赋予与呼吸说话,简直透不气来,无法活了,开始到处治疗,但每次都捧回一大堆药,却没有找到原因来解决问题。


而催眠处理的真正妙处就在于通过年龄回溯的游戏,找到个案生命经历中一些被错误对待的经历,而加以重新演绎和正面提升,让个案的内心深处的问题真正得到释怀,认可自己的生命经历并超越他。所以,针对上面的问题,我就导演了许多出戏,让他在自己的戏中重新活一次,变得强大和自信,同时受到别人的尊重和正确对待,并贯以正确的人生信念。


处理完毕的当下,小黄就觉得神清气爽,内心清静,不再感觉思维强迫,声音赋予,与呼吸说话等症状,内心变的安详而喜悦。回去后半个月来电话,告知已经基本好了,感觉人很舒服,也对自己更有信心了,虽然偶而还有呼吸强迫声,但已经不影响到自己了。我也觉得非常的开心,同时也觉得深深的遗憾,其实象小黄这样心理症状问题的人,在中国又何止他一个人,真心希望他们都能得到正确的治疗,而绝对不是吃药了事。



2. 陆小姐,清度人格分裂,强迫思维,强迫数数,恐人,手抖,脸红,14年间隙发作强迫史


    小陆在日本,是一查到我的网站,就直接预约过来治疗的女孩子。她25岁,大学毕业,娇小美丽,聪明能干,有着想当中国最年轻的女外交官的梦想,多年留日的经历,但是长达14年的间隙性发作强迫症痛苦地折磨并妨碍着她的伟大理想,以至于她一碰到重要事件,就会脸红,手抖,说话结巴,而当众出丑(而她平时却从容大方,从不这样)。她明明知道不该这样,却无法克服,因为她觉得体内的另一个我一直就想打败她,不让她成功。


通过催眠测试,发现她的敏感度为4级,非常能接受暗示(其实,这就是当初发病的原因)。她自己已经无法想起,自己为何凡事都会强迫数数的原因了,通过年龄回溯的催眠,回到她10岁时,发现在她读小学时候,由于同桌女生头脑不好,成绩差,考试一直靠抄袭她过关。终于有一天,小陆不愿意给她抄袭了,那女孩说了一句坑害她一身的话:“如果你不能与人很好的相处,你的智力将失去作用”。自从听到那句暗示后,她开始相信,同时不停怀疑,开始强迫自己凡事都去验证那句话,进而发展到反复数数,强迫注意身边任何物体,强迫听身边任何声音……。可我总觉得原因还是不够充分,于是继续深挖她更早年的生命记忆,问题开始浮现……,原来她小时候是与继父一起生活,从7岁时,继父经常会在半夜她熟睡时,躺到她身边,抚摸她的阴部,每每长达半小时之多,她知道,但是恐惧,害羞,被强迫而无法伸张,内心受到极大屈辱,而一直持续了6年,直到她初三毕业,高中寄宿为止。这才是她以后强迫行为形成的真正原因。(当一个人长期被强迫处于某种状态或做某种事情的环境下,他的内心必然养成某种转型的强迫行为,以忘记原先的强迫的痛苦,并保持新的强迫惯性。)10岁,因同桌女孩的一句话而强迫症爆发,不能静心学习;14岁再次爆发,强迫自己注意身边任何嘈音与物品,成绩一落千丈;18岁因与男友分手,而再次爆发思维强迫;22岁工作后,又再次爆发,一遇重要事情就脸红,手抖,说话结巴,(内在另一个自我)强迫自己当众出丑;去了日本,还是不行,被迫回国治疗,强迫症到达高潮,觉得全日本的人都在关注她,等着看她出洋相……。其间接受多年的药物治疗,但是基本无济于事,不能根除病根。在日本其间,了解到可能更需要更深的心理治疗,关注日本的催眠治疗,由于贵得有如天价的费用,而被迫放弃在日本治疗的念头,回国寻求治疗。所以,一找到我们,就毫不犹豫地过来治疗。


既然,原因已经找到,处理也就得心应手。通过身、心、灵的洗涤,爱与能量的注入,以及对于她自己生命经历的重新演绎,她找回来自尊,信心与智慧,不再被过去的经历所影响,内心回归放松,宁静和喜悦的状态。考虑到她得病,并反复长达14年,我决定用来世催眠带引她去到未来,在千人的公众集会上发表演讲,结果她镇定自若,口若悬河,从容大方,获得全场喝彩,内心充满无比喜悦与骄傲。治疗完的当下,满脸红光,对未来充满信心,觉得内心已无障碍,放松而无强迫感,非常喜悦。善哉,善哉,催眠治疗的功德,否则,她就要决定去做神经切除术,真的好险呀。



3. 邵小姐,强迫喉音说别人坏话,自悲,抑郁,想死,近10年的强迫史

 

小邵的情况似乎简单些,凡事都用喉音去嘀咕,声音越来越大,话也越来越难听,得罪同事,掉了工作;得罪朋友,大家笑她神经病,成了孤家寡人;得罪家人,大家巴不得早点将她嫁出去。在自己家乡的医院看过,开药吃,却越来越严重。无法工作,在家玩电脑,找到了我这里。


记得,那次他们全家好多人一起涌入我的中心,仿佛催眠师是魔术师,会吃掉她们年轻的女儿,并要求一起参与催眠过程。当然,催眠探索是个人专利,无法给外人观摩;另外,催眠中,个案的隐私将一览无余地呈现出来,也不方便外人了解,所以我拒绝了。但她的父母们却说,我们看着孩子长大,没有我们不知道的隐私(诸位父母其实不了解,孩子往往有许多不为父母所知的秘密。)。最终我说服他们,等在厅里休息。小邵22岁,中等个头,学历只有初中。我担心她的认知可能不够,但是通过催眠测试,她的敏感度却高达5级,我觉得已经有九成把握处理她的问题。


催眠探索的过程,这里就不再赘述,发觉对她造成较大影响的,有四个阶段的事情。早在11岁时,与同班男生玩做爱游戏(其实是小孩子玩家家,并无真实性交。),但是被别的同学旁观,事后受到多方的责怪与谩骂,觉得无地自容,羞愧,委屈,又无力抗拒,因而开始在喉咙里用意念骂人,久而久之成为习惯,这是喉音的真正成因;13岁时发育,产生真正的性欲,经常用手抚摸外阴,自慰来享受快感,同时又觉得羞愧,又无法戒除,因为产生强迫思维与行为;19岁进工厂,因听别人传言她与师傅的谣言,一看到师傅就脸红,身体发抖,继而发展到站立不稳,要摔倒,又羞于与别人交流,澄清事实,继而不断用喉音与人说话或责骂别人,最终无法继续工作而退工回家;从此以后,见到任何人都用强迫自己用喉音交流或谩骂别人,继而声音越来越大,冲出喉咙,让别人听见了,更是羞愧难当,以至于无法正常生活,明知不对,无法改变,甚至想到轻生。


其实,小邵的经历并不是什么很大的事件,只是依她当时的认知与能力无法正确处理,而家长,老师与同学们也没有给予正确的帮助,导致她日后问题的形成。通过催眠处理给她输入正确的信念与认知,她就被很容易的治疗好了。


最后,再多说一句,但一个人出现行为或心理偏差时,应该首先想到心理治疗,在排除心理因素后,再转去生理治疗(神精科治疗),吃药或动手术,一旦进入生理治疗,你一般无法回复到原来的正常状态,一定要谨慎从事。



4. 程先生,强迫思维,狂想症,恐惧,缺乏信心,失眠,10多年强迫史


    程先生,大学本科毕业,知名外企技术骨干,30岁,一米八的个头,满脸微笑,一表人才,却被强迫思维折磨,失去女友,夜不能寝,对未来充满恐惧,没有信心。对于他的治疗我就不说了,将症状罗列,供大家看看:

A.看见老人,想到自己早晚那样,觉得不可思议;

B.看见夫妻带着孩子,马上联想到性,觉得不可思议;

C.对结婚与另一陌生人一辈子生活在一起,觉得不可思议;

D.对时间有停滞感,对吃饭,上班,回家,睡觉等一辈子简单重复,觉得不可思议;

E.无法想象自己以前女友嫁给他人,自己常因此发呆,觉得不可思议;

F.凡事都考虑人生哲理,觉得不可思议;

G.对全世界的人每天都做同样的事(吃饭,睡觉,工作),觉得不可思议;

H.强迫联想,“逃”联想一双脚,“吃”联想一个人拿着饭碗,觉得不可思议;

 

其实,很多强迫症个案都有类似问题。通过催眠探索,发现他是童子身,30岁还没有性行为,这是强迫和焦虑的根本,至于为何还有恐惧和信心缺乏,就给一个简单答案吧:他的小弟弟是畸形的。好了,不多说了,自己去思考吧。


处理完成,他提升了人生的认知与境界,现在已经作为专家输出到国外从事高端技术工作了,不时打国际长途回来,和我探讨一些人生哲学问题。我建议他去多读佛经,以提升人生的大智慧的,他也不再强迫与焦虑了。



通过以上案例,我们发现,强迫症多半伴随许多别的心理症状,而且发病历史一般非常长,反复发作,即便打针吃药也很难治愈(以往传统医学的对症下药是不适合强迫症的心理治疗的),故而是心理疾病中最难治的一种,而且由强迫而转焦虑或抑郁等症状非常普遍。究其原因,还是要找到形成强迫症状当下的那个事变,只有这样才能真正治疗内心的强迫,而通过年龄回溯的催眠探索,能真正找寻生命早年的不当经历而加以康复,确实是一种强而有力的手段。当然,催眠治疗也不是一了百了的魔术,还依赖于个案的心灵认知的水准与提升。也就是说,催眠治疗师是船,而真正渡河的还是个案自己。


我在这里真心的等候你,陪你一起共度生命之河!

 

(特别强调,催眠探索个案心理问题,具有个案独特性,不具备民众的普遍性,属于生理疾病仍需去医院接收治疗,催眠处理只是心理疏导辅助手段,虽然常有效果,但也因人而异)


载自曹子策催眠著作《催眠术与心理治疗》(安徽人民出版社),欢迎转载,并请标明出处。

 

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