Many people think of psychiatry and clinical psychology only in terms of Freud’s work. That’s strange, because few psychologists embrace Freud’s teachings, and that’s a good thing. His model of our psychological functioning is characterized by far too great simplicity.
Worrying, worrying
A phenomenon that occurs on a large scale consists of wandering, unexciting thoughts, or worry. You then talk endlessly with and to yourself about problems or unpleasant events that have occurred, or about disasters that could occur. Typical of this habit is that in an endless procession one calamity is followed by another, and also that there is fruitless repetition in the things you are worrying about. Finally, for many people it is difficult to end this process: you have become a prisoner of yourself.
Because a lot of worrying takes place in bed, the initial search was for some form of physical activity that could be responsible for this, especially in the form of an stimulated sympathetic nervous system. However, there are usually no symptoms that indicate this, so we have to look for the cause in another direction. It is remarkable that worrying usually takes place in words, and hardly in images. The motive for worrying could be that going through all kinds of unpleasant scenarios ensures that you think you are better able to cope with future problems.
Conditioning may play a role in this idea: because every now and then an event occurs that you have thought about or anticipated, the false impression may arise that there was a point in worrying.
Another remarkable phenomenon is that when we form images of fearful or miserable situations, a certain physical activation follows, which is hardly the case when worrying in words. It is not entirely clear what this difference is based on. It is more or less certain that imagination has more influence on the involuntary nervous system spread throughout the body than do language systems in the narrower sense.
You could regard worrying as a kind of defense mechanism, because fear for the future and worrying in words are not accompanied by bothersome physical symptoms. If that is true, worrying has a double function: you try to exorcise the future with associated fearful reactions on a physical level. But generally speaking, worrying is of course pointless.
The next question is of course what to do about worrying. It is often funny that the instruction to worry for at least half an hour at a time results in the person concerned being less bothered by this phenomenon, but it is also clear that many people experience such form of discipline is not possible. Another therapeutic technique that is used involves teaching worriers to allow anxious experiences with the associated physical changes, and not to convert them into gossip that they keep to themselves. In short, possibly concentrate on worrying every day for a fixed period, and that’s it.
Obsessive thoughts and compulsions
Related to worrying are obsessive thoughts and compulsive actions: we often do or think things that we do not want to do or think at all. With obsessive thoughts, a more or less orderly, focused stream of thoughts is interrupted by something unpleasant: you could jump in front of a train here and now, put someone else out of their misery in this way, or burst out into startling blasphemies during a church service.
More innocent, but no less annoying, is that someone wonders twenty times whether he has turned off the bathroom heater and whether the kitchen door is closed.
Obsessions are (often) annoying thoughts that plague us without us wanting to do so. Obsessions often also lead to compulsive behavior. Someone then washes his hands every ten minutes , checks three times whether the window is closed, and so on. Such phenomena do not mark a sharp distinction between normal people and the mentally disturbed: about three quarters of us suffer from this at some point.
One difference is that psychiatric patients exhibit these types of phenomena more often and that they also have a greater tendency to suppress those thoughts and actions. But unfortunately, the latter actually promotes its occurrence.
With compulsions, compulsive actions, it has long been assumed that we do all kinds of strange things based on the implicit idea that in this way we prevent or defuse unpleasant events. Repeated, meaningless rituals are said to have a rewarding effect in some way, which means that they bear some similarity to the possible background of worry.
It is counterproductive to suppress obsessive thoughts and compulsions because it makes the condition worse. It is precisely the generation of resistance to the thoughts that ensures that they are often evoked. When that resistance is no longer there, which means that someone consciously gives in to the ideas but realizes what is happening, the phenomenon often disappears. For the time being, there are indications that therapeutic techniques aimed at this work well.
Compulsive behavior is also attempted to be tackled in this way. If a person wants to wash his hands after touching a dirty object, the urge to do so decreases if the person has to touch the object very often without being allowed to wash. This method works in no less than three quarters of the cases. Moreover, the effect is long-lasting: years later the improvement still appears to be significant.