PART 4/11 As the first target for intervention, I chose a typical obsessive thought for L. During the break between the first and second consultation, I prepared several questions without the goal of getting a specific answer. Their role is to generate internal dissonance and strengthen understanding of the absurdity of these thoughts. People with OCD often do not fully trust intrusive thoughts, but underestimate the importance of doing this regularly. Challenging NM - I tied my shoelaces incorrectly - someone could die - How do you know if your shoelaces are tied correctly? - Who determines whether they are tied correctly? - If " different” - then how do you know about his rules? - If you, then could you have made a mistake in formulating them? The desired dissonance was caused. Slight embarrassment and confusion partially confirmed this. Next, we immediately moved on to challenging the central meta-belief, where standard questions helped us in many ways. Challenging the MKU - My thoughts are strong and prophetic, they have been confirmed in the past. - How many thoughts come to mind every day? - Why are these particular thoughts important? - Possess Are they powerful or is it you who give them such meaning? - Why do some thoughts have power and some do not? - Can your actions/thoughts, on the contrary, save someone? - Is it possible not to react to a thought in any way? - Can thoughts be wrong? , even if they have some confirmation? New MKU - My thoughts are not particularly powerful Although trust in a new metacognitive belief is never absolute, and this case was no exception, it is still an important step, the beginning of a new way of thinking, a beginning that will achieve your success. This success will be reflected in the extremely simple phrase that was said at the end of our work and will be heard again in the last part of this series. Next we discussed the importance of exposure - to stop reacting to obsessions with compulsions, despite the fear. This is important because our psyche learns at different levels. The first is theoretical, cognitive, mental. The second is practical, behavioral, if you like, by the “poke” method - trial and error. In this way, the psyche finds a way to reduce stress from frightening thoughts. Sometimes this method is devoid of any logic; a person commits actions that are absurd in his own opinion, because... they help in a “magical” way. As soon as relief occurs, the psyche records (forms a reflex) all completed actions (rituals) as useful, and the threat as real. The law of operant conditioning is simple: the more rewarding a behavior is, the more likely it is to occur. Agree that a way to avoid the death of a relative is very useful. Thus, it is necessary to give other information to the psyche, not only in word, but also in deed. At the end of the second meeting, the following tasks for independent work were proposed: continue to regularly challenge both obsessive thoughts and the meta-beliefs behind them. Also, every time you perform a ritual, hold and pronounce the thought that pushes you to this behavior. The important task that this recommendation solves, as well as some of the “risks” that I took for the sake of the client, will be described in the next part. If you have any questions or need to better understand your neurosis, you can always ask me a question on the website or in the VK group: Freedom from OCD