When Too Much Is Not Enough: Obsessive-Compulsive Disorder as a Pathology of Stopping, Rather than Starting

Background: In obsessive-compulsive disorder (OCD), individuals feel compelled to repeatedly perform security-related behaviors, even though these behaviours seem excessive and unwarranted to them. The present research investigated two alternative ways of explaining such behavior: (1) a dysfunction of activation—a starting problem—in which the level of excitation in response to stimuli suggesting potential danger is abnormally strong; versus (2) a dysfunction of termination— a stopping problem—in which the satiety-like process for shutting down security-related thoughts and actions is abnormally weak. Method: In two experiments, 70 patients with OCD (57 with washing compulsions, 13 with checking compulsions) and 72 controls were exposed to contamination cues—immersing a hand in wet diapers —and later allowed to wash their hands, first limited to 30 s and then for as long as desired. The intensity of activation of security motivation was measured objectively by change in respiratory sinus arrythmia. Subjective ratings (e.g., contamination) and behavioral measures (e.g., duration of hand washing) were also collected. Results: Compared to controls, OCD patients with washing compulsions did not differ significantly in their levels of initial activation to the threat of contamination; however, they were significantly less able to reduce this activation by engaging in the corrective behavior of hand-washing. Further, the deactivating effect of hand-washing in OCD patients with checkin

Psychedelics and hypnosis: Commonalities and therapeutic implications

Background Recent research on psychedelics and hypnosis demonstrates the value of both methods in the treatment of a range of psychopathologies with overlapping applications and neurophenomenological features. The potential of harnessing the power of suggestion to influence the phenomenological response to psychedelics toward more therapeutic action has remained unexplored in recent research and thereby warrants empirical attention. Aims Here we aim to elucidate the phenomenological and neurophysiological similarities and dissimilarities between psychedelic states and hypnosis in order to revisit how contemporary knowledge may inform their conjunct usage in psychotherapy. Methods We review recent advances in phenomenological and neurophysiological research on psychedelics and hypnosis and we summarize early investigations on the coupling of psychedelics and hypnosis in scientific and therapeutic contexts. Results/Outcomes We highlight commonalities and differences between psychedelics and hypnosis that point to the potential efficacy of combining the two in psychotherapy. We propose multiple research paths for coupling these two phenomena at different stages in the preparation, acute phase, and follow-up of psychedelic-assisted psychotherapy in order to prepare, guide, and integrate the psychedelic experience with the aim of enhancing therapeutic outcomes. Conclusions/Interpretation Harnessing the power of suggestion to modulate response to psychedelics could enhance their therapeutic efficacy by helping to increase the likelihood of positive responses, including mystical type experiences

Manifestation of incompleteness in obsessive-compulsive disorder (OCD) as reduced functionality and extended activity beyond task completion

Copyright 2011 Zor et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Background: This study focused on hypotheses regarding the source of incompleteness in obsessive-compulsive disorder (OCD). For this, we had to document the behavioral manifestation of incompleteness in compulsive rituals, predicting that an exaggerated focus on acts that are appropriate for the task will support the hypothesis on heightened responsibility/perfectionism. In contrast, activity past the expected terminal act for the motor task would support the "stop signal deficiency" hypothesis. Methodology and Principal Findings: We employed video-telemetry to analyze 39 motor OCD rituals and compared each with a similar task performed by a non-OCD individual, in order to objectively and explicitly determine the functional end of the activity. We found that 75% of OCD rituals comprised a "tail ," which is a section that follows the functional end of the task that the patients ascribed to their activity. The other 25% tailless rituals comprised a relatively high number and higher rate of repetition of non-functional acts. Thus, in rituals with tail, incompleteness was manifested by the mere presence of the tail whereas in tailless rituals, incompleteness was manifested by the reduced functionality of the task due to an inflated execution and repetition of non-functional acts. Conclusions: The prevalence of activity after the functional end ("tail") and the elevated non-functionality in OCD motor rituals support the "lack of stop signal" theories as the underlying mechanism in OCD. Furthermore, the presence and content of the tail might have a therapeutic potential in cognitive-behavior therapy.Peer reviewe

Dissociação e transtornos dissociativos: modelos teóricos Dissociation and dissociative disorders: theoretical models

A compreensão da experiência dissociativa e das origens dos transtornos dissociativos é difícil devido à complexidade da questão. As contradições da classificação são decorrentes das dificuldades de se construir uma teoria da mente abrangente que unifique neurobiologia e psicodinâmica. Os autores discutem as bases conceituais da dissociação com ênfase na integração entre neurobiologia e fenomenologia. O papel do aprendizado é amplamente discutido, assim como as teorias atuais de neodissociação, trauma e sociocognitivismo para os transtornos dissociativos.<br>It is challenging to understand the dissociative experiences and the origins of dissociative disorders. Contradictions of classification are due to the intrinsic difficulties to build up a theory of the mind that unifies neurobiology and psychodynamics. The authors discuss the conceptual basis of dissociation, with emphasis on the integration of neurobiology and phenomenology. The role of learning is discussed as well as the neodissociative, trauma, and sociocognitive theories for dissociative disorders