In obsessional-compulsive disorder, there may be recurrent ideas or images entering the mind, such as phrases, pictures and disagreeable ideas, often obscene.
There may be aggressive impulses to hit or injure someone, suicidal thoughts, a desire to swear in church or to take off one’s clothes.
With phobias, there may be extreme anxiety and an unreasonable fear of an object or a situation. These are regarded by the sufferer as groundless and irrational but he cannot control them.
Some phobias are clear-cut, and psychotherapy can often reveal the repressed anxiety that caused the fear of the phobic situation. The connection may be subtle but easy to recognise.
In other cases, there is no clear connection between what caused the repressed fear or anxiety and the resulting phobia.
In treating phobias, behavior modification and learning techniques may be required. Another method is desensitisation.
In this, the person is exposed, initially in thought, to the situation which he most fears. He starts by thinking of himself in that situation in a mild way, then mentally removes himself before the anxiety is severe. This goes on until he imagines himself in the worst possible situation, without anxiety.
Next, he is placed in the real situation, for a short time and removed as soon as he shows anxiety. Finally, he can be fully exposed and able to cope without anxiety.
Another technique is implosion, the reverse of the slow process of desensitisation.
Here the person is placed, at once, into the worst possible situation he can imagine. This creates extreme anxiety and it is believed the shock is so great that the anxiety disappears.
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