Constraints in adults and children: types, how to get rid, competent about health on ilive

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At least sometimes everyone probably does something to calm himself and his imagination. In some cases, however, such actions belong to the category of pathologies – for example, if they occur regularly and are accompanied by obsessive thoughts. In psychiatry, certain systematic actions are considered "force" designated. Obsessive compulsive disorder is classified as obsessive compulsive disorder – they are able to progress, which leads to a person performing more frequent and different actions.

A painful illness can manifest itself sporadically – for example, under the influence of certain circumstances or be chronic.

[1], [2], [3]

Psychologists see constraints as a sign of "Return of what has been ousted": The patient tries from his own thoughts and aspirations "get away", which suggests that they are inconsistent with their own way of life and principles. This leads to the formation of unconscious disorders. The compulsion can prove to be an unsuccessful attempt to remove his thoughts from the head: the patient disagrees with certain personal characteristics.

Constraints around the world are considered to be common types of disorders. They are more or less present in 2-3% of the world population. Patients usually become people with a fairly high level of intelligence – due to their bright and active brain activity, they cannot counteract the problem, so they quickly lose their performance and fall into depression.

The most common coercion in such groups of the population was:

  • People with high intellectual development;
  • People with several higher educations;
  • People with high social consistency;
  • non-family men and women;
  • alcohol addicts;
  • People who suffer from constant lack of sleep >

The prevalence of certain types of compulsions is reflected as follows:

  • Fear of pollution or contagion; 45% of forced patients are afraid of dirt;
  • Constant painful doubts torment 42% of patients;
  • fear of somatic diseases is noted in 33% of patients with convulsions;
  • Fear of asymmetry and disorder is inherent in 32% of patients;
  • Fear of aggression or striving for it is observed in 26% of patients;
  • Fears associated with the sexual sphere are noted in 24% of patients.

[4], [5], [6], [7], [8], [9], [10], [11], [12]

Causes constraints

In many cases, the compulsion arises against the background of the patient’s attempts to eliminate his own anxiety, which occurs under certain circumstances:

  • with a syndrome of increased fatigue, with excessive emotional stress, multiple strains;
  • as a result of the emergence of obsessions – uncontrollable and unwanted thoughts, conclusions and fantasies that exacerbate the state of fear and stimulate vegetative symptoms;
  • with anankastny personal impairment (with weakness of individual brain structures, with significant hormonal changes in the body, with certain characteristics of education, with negative inheritance).

Many different studies and experiments have been conducted on the aetiology of coercion, but it has not yet been possible to determine the exact cause of the disease. Therefore, experts tend to blame human pathology and physiology (e.g. chemical changes in neurons) and the psychological component.

Probable reasons are discussed in more detail below.

  • The reason is genetics.

Scientists have found that in some cases, the reluctance to compel can be inherited from close relatives. When examining the pathology of twins, it was found that constraints have moderate inheritance. At the same time, it was not possible to clearly identify the provoking gene. Specialists have identified only a few genes that can influence to some extent – that’s hSERT and SLC1A1, but that "error" is not proven.

  • The causes come from autoimmune reactions.

Such reasons are more likely in the development of the disease in children – for example, against the background of streptococci A, which damage the basal ganglia. Some experts also suggest a negative effect of preventive antibiotic therapy, which is used everywhere. Pediatricians use the term for such diseases "pediatric autoimmune neuropsychiatric disorders combined with streptococcal infection" on.

New technologies in diagnosing the brain helped scientists study the level of activity in many of their zones. Some zones have been found to be more active than others. If, for example, constraints occur, the basal ganglia, the striatum, the orbitofrontal cortex, the caudate nucleus, the anteroventral gyrus, the thalamus are involved. The chain, which affects all the links listed, controls the primitive behavioral capacity – for example, aggressiveness, sexual attraction, the work of the sweat glands. The stimulation of the chain gives a certain kind of behavior a boost: For example, a person washes his hands intensively after touching something unpleasant. In a sane person after washing their hands, the repeated desire to wash them is exhausted, so that they freely switch to another profession. With compulsive subject "switches" the brain, however, since there are communicative disorders in the above-mentioned brain zones. The patient continues to perform an obsessive action and copies his own behavior. Experts have not yet found out the exact aetiology of such a moment. The problem can probably be explained by biochemical disorders in the brain (reduced activity of glutamate and serotonin).

One of the main theses of behaviorism in psychology is that the repetition of an act in behavior makes its further reproduction accessible. Patients suffering from coercion try to avoid moments associated with phobia, "fight" with their thinking or performing repeated actions to relieve fear. Such "rituals" have been making an uncomfortable feeling easier for some time now, but increasing the risk of obsessive-compulsive ideas in the future.

It turns out that the reason for compulsions can be hidden in avoiding their fears. Pathology is often found in people who are in a stressful state: they move to a new position, lose a loved one, suffer from a chronic fatigue syndrome. For example, a subject who has previously visited a public toilet with no problems starts going to extremes in stressful situations and entering into negative self-hypnosis: "The toilet is dirty, you can get infected, etc.".

Associative phobia also extends to other similar situations: touching door handles, railings, etc. If the patient begins to avoid public places, or takes complex measures to neutralize the "pollution", then such a condition is in the Able to transform into a full pathology.

  • Causes of cognitive nature.

The above behavioral reasons suggest that coercion by "incorrect" Behavior arises. But there is also a cognitive hypothesis that obsession with actions arises against the background of an incorrect evaluation of one’s own thoughts.

Almost all people have unwanted thoughts. In contrast to others, subjects who are subject to constraints greatly exaggerate the value of such conclusions. The development of fear of one’s own thinking provokes attempts to avoid situations in which unpleasant thoughts arise: the corresponding ones "rituals" or conspiracies arise.

Experts tend to believe that compulsive patients exaggerate the importance of their thoughts based on false beliefs that have been preserved in childhood. What is such a belief:

  1. in overestimation of the feeling of personal responsibility;
  2. believing in the materiality of thoughts (which causes a person to gain complete control over them);
  3. exaggerating the feeling of danger (reassessment of the danger);
  4. in hypertrophied perfectionism (refusal to make mistakes, idealization of one’s own actions).
  • The reasons are surrounded by people.

If the subject has a tendency to create compulsions, this mechanism can be triggered by almost any stress or psychotrauma. Studies have given scientists the opportunity to understand that pathology develops in 50-70% of patients against the background of negative environmental influences. Specialists present a number of the most common potentiating aspects that influence the occurrence of constraints:

  • Rudeness, violent acts;
  • Change of place of residence;
  • a serious illness;
  • Loss of a loved one (relative, friend);
  • Problems in the professional or other area;
  • Problems in his personal life.

[13], [14]

risk factors

Constraints are closely related to the subject’s attempts to get rid of their own fear. And it arises in the presence of certain risk factors:

  • Chronic fatigue, moral exhaustion, psycho-emotional overload, regular stress.
  • Dominant conclusions and ideas that lead to increased anxiety and stimulate vegetative manifestations.
  • Anankast personality disorders, perceived by people as an urgent part of his personality. The causes of such violations are:
  1. Bankruptcy or frustration while working brain structures;
  2. Hormone conversion;
  3. some moments in education;
  4. heredity.
  • Biological factors:
  1. Abnormalities and brain trauma;
  2. Metabolic disorders in the neurotransmitter systems;
  3. severe infections;
  4. Birth trauma;
  5. epilepsy.

[15], [16], [17], [18], [19], [20], [21]


To deal with constraints qualitatively, you need to know not only the causes of this condition, but also the mechanisms of its development. This is the approach that doctors consider to be more successful.

  • Every time a patient tries, "rituals" To avoid such behavior is the type of a certain chain of neurons in the brain structures "fixed". If you repeat the same situation, the brain will respond in analogy, which will prevent the decrease in the severity of the neurotic problem.

Coercion has the property of being fixed. If the patient feels relief after verifying that the iron is off, it will continue to do so.

Try a specific action first "job" to avoid causing temporary relaxation in the patient. However, fear will only increase in the future, and this is due to obsessions.

  • With compulsions, people tend to exaggerate their skills. Often, patients sincerely believe in their own ability to prevent various circumstances only through mental power. The "magic" of thinking is that following the different rituals will help avoid something terrible.

Such a belief in "magic" gives a person an illusory feeling of comfort and universal control of the situation. As a result, the patient uses rituals more often, which makes the pathology progress.

  • The patient is convinced of the extreme importance of his own thoughts. The importance of compulsive closure comes from certain individual values ​​that are important to a particular person. Usually the deepest personal fears are expressed in thoughts. For example, every mother is concerned about her baby’s health and life. For this reason, the obsession of thoughts is particularly characteristic of young parents.

The essential thing, however, is that people with pathological constraints are more likely to develop obsessive conditions than healthy people. This is an exaggerated attribution of "importance" to your own thoughts. Specialists say: If you pay too much attention to your conclusions, they will appear even more negative. In healthy people, obsessive states are ignored and skipped.

  • Patients with constraints overestimate the situation and do not tolerate uncertainty. Most patients claim that they have to be sure that there is no danger. Therefore, coercion often plays the role of a species "insurance". Too eagerly fulfilling ritual acts, however, only increases the feeling of insecurity and makes the patient doubt even more.
  • Perfectionism has a big impact on the development of constraints. Patients are convinced that ideally they should solve every problem, and if there is a mistake along the way, it must necessarily be fatal. Therefore, under no circumstances can you make mistakes. A similar mechanism of disease development is characteristic of patients with anorexia nervosa.
  • "twist" is another way to make fear worse. Compulsive patient thoughts are often negative: "Everything is bad", "It only gets worse!". Patients lose resistance to frustration: any kind of fear will "unbearable" and "catastrophic".

With compulsions, a person initially feels a constant and strong fear based on his own thoughts. In the next phase, he tries to escape obsessions, suppress his appearance or deal with certain actions. Naturally "feeding" the patient this way only obsessions.

[22], [23], [24], [25], [26], [27], [28]

Symptoms constrained

The clinical picture of compulsions is characterized by such symptoms:

  • increased fear;
  • Obsession with the desires of any action, under the influence of dominant obsessions;
  • hypertrophic distrust;
  • paranoid characters;
  • Presence of expressed fears, phobic disorders;
  • impulsive actions with manic features, against the background of general relative well-being.

Strong examples of compulsive episodes are:

  • Food constraints – "nervous hunger", painful bouts of overeating or vice versa – refusal to eat, despite the obvious and significant weight loss.
  • Hypertrophic gambling, gambling.
  • Workaholism that denies human participation in other parts of the life chain.
  • An obsessive race, a passion for victory in no way.
  • Intimate constraints, a constant thirst for sex, pathological polygamy.
  • Shopoholizm – compulsive need for inexplicable purchases.
  • The desire to look for idols, idolatry.
  • Simple compulsive manifestations: sgryzanie nails, clicks the fingers, zakusyvanie lips, repeated hand washing to scratch the nose, check valve closed, as well as compulsive rituals (treatment of obstacles only to the right or to the left, only walking on the edge of the pavement and so on.).

Unlike ordinary movements or actions, compulsions are accompanied by an increase in fear, the appearance of fear when it is impossible, or a refusal to perform certain rituals. Maybe the development of vegetative signs (increased heart rate, increased sweating).

Usually the patient ignores the first signs of the disease until the symptoms become more pronounced or until the patient is not advised by the patient of strange painful symptoms.

Specialists identify several symptomatic complexes that are usually related:

  • Fear of getting dirty, getting infected;
  • Fear of harming yourself or anyone;
  • Fear of being punished for an imperfect act or action;
  • Compliance with >

[29], [30], [31], [32]


Constraints do not always go the same way: the disturbances have their own characteristics and properties. For the convenience of their detection and diagnosis, the pathology is divided into several stages:

  1. Time or a single constraint – happens once every few weeks or even a few years.
  2. Episodic coercion – is a change from compulsive seizures and periods of remission.
  3. Chronic coercion – goes on continuously, with periodic improvements in clinical manifestations.

[33], [34], [35], [36]

to form

Mandatory conditions are:

  • simple, consisting of forced movements or tics;
  • Complex, including certain rituals that are created independently.

Furthermore can Constraints to be physical (e.g. constant monitoring of gas valves or an iron off), or mental (turning windows into houses, mental scrolling of a separate phrase).

Tick-like constraint

The term "Tick-like compulsion" is often used in relation to children in childhood. Such injuries are often diagnosed at 2-3 years.

Clinically tick-like constraints are manifested by repetitions of ordinary movements at first glance. It may blink, press or lick lips, touch the chin or nose, cough, etc.

In children with compulsions, aged 4 to 7 years, compulsive movements become ritual-like and can already include complex combinations of movements: repetition of morning or evening preparation files, changing, keeping a certain order of the arrangement of objects. If constraints affect the language aspect, the patient starts repeating certain words or sentences, repeating the same questions, etc.

Around the age of 10-11 years, compulsions can be transformed with the development of obsessive-compulsive disorder.

[37], [38], [39]

Complications and consequences

Compulsions can affect the quality of a person’s daily life. Uncontrolled thoughts and compulsive actions can make relationships with relatives, colleagues at work, friends and even with yourself considerably more difficult: Patients often notice that they are tired of themselves.

In the vicinity of forced patients, many lead an isolated lifestyle, do not work and do not visit public places. Some patients try to leave their home as rarely as possible.

Personal relationships suffer, families break up.

A long-past state of compulsion can put a stamp on the physical and emotional sphere of life. Over time, in absence treatment, the patient becomes inattentive, "fixed" to your problem, willless, apathetic.

Often, compulsions are accompanied by feelings of guilt, shyness, anxiety, which in some cases are the cause of depression. If we take into account that everything in the human body is interconnected, then the emotional problems also affect the person’s physical condition.

The main complications include the addition of other psyche disorders. For example, if you do not pay attention to the presence of constraints, then in the future, the problem may be exacerbated by the appearance of depression, anxiety disorders, suicide attempts. In most cases, such complications are due to the patient’s inability to cope with constraints.

In addition, cases of self-medication are often recorded in patients with sedatives, other psychoactive drugs, which only aggravates the course of the disease.

[40], [41], [42], [43], [44], [45], [46], [47]

Diagnostic constraints

In the initial stages, the doctor makes a complete psychological diagnosis, assessing the patient’s psychological balance, the likelihood of developing psychopathologies, and consequently the occurrence of compulsions.

To diagnose the diagnosis of obsessive-compulsive disorder, the Yale-Brown scale is used provisionally. This is a fairly insightful and common psychological way to determine the presence and severity of the compulsive syndrome.

The further diagnosis is carried out according to generally recognized standards that correspond to the International Classification of Diseases.

The diagnosis of compulsions is made:

  • if compulsive attacks last for at least two weeks and take more than half of the time spoken;
  • When constraints negatively affect a patient’s life and cause a stressful state;
  • if the patient agrees that the constraints are determined by his own thoughts and the obsessive actions do not bring satisfaction;
  • if there is at least one constraint whose resistance is unsuccessful;
  • when the obsession of thoughts and actions is repeated regularly and gives people unpleasant sensations.

Constraints do not necessarily arise after a certain obsession: this or that action can be carried out spontaneously by the patient against the background of a sharp disturbing or uncomfortable feeling.

[48], [49], [50], [51], [52], [53], [54]

differential diagnosis

Compulsions should be distinguished from a separate obsessive-compulsive disorder. Constraints are characterized by an egocentric character – this means that the injury does not correspond to the patient’s personal idea of ​​himself. Since this contradiction exists, there is a pronounced suppressed state in the clinical picture. With a compulsive personality disorder, the predominantly egosyntonic character of the pathology is determined. This means that the patient’s behavior and other characteristics correspond to his personal self-image. As a result, the patient often realizes that his behavior is not in the "right" Area. He is unhappy with compulsions, but regardless of this, he continues to feel the need to carry them out, even if he later becomes anxious. In the case of obsessive-compulsive disorders, on the other hand, the patients do not agree with theirs "anomaly" match. They argue, they try to prove that they are only doing correct actions. In addition, such patients experience satisfaction from obsessive thoughts and actions.

In most cases, people with obsessive-compulsive disorder do not want to perform their obsessive actions and do not feel comfortable with their implementation.

Whom can I contact?

Treatment constraints

If the compulsion is expressed lightly or only enters the patient’s life, the patient can try to determine control over his actions independently. You must master the technique of drawing attention from one action to another. For example, you can get carried away by a program or read a magazine, you can arrange jogging or dancing.

Experts recommend, for example, that the ritual be delayed for a quarter of an hour. If this succeeds, the further delay should be increased while the number of ritual repetitions is reduced. This enables the patient to understand that he can be satisfied without compulsive action.

If coercion is not suitable for self-treatment, it is necessary to contact specialists in the field of psychotherapy, psychology, psychiatry.

As a rule, with severe symptoms of pathology, the doctor prescribes medication – mostly these are the medication:

However, it should be noted that even prescribed prescription medication does not have a permanent effect. When the course of treatment is finished, it is possible to reduce the symptoms of the disease. Psychotherapy is therefore more effective in curing compulsions: according to statistics, it helps 75% of patients.

The cognitive treatment enables the patient to convince himself of the irrationality of his phobias, to understand the mental images and to admit his mistakes. The specialist explains how to correctly reverse attention and monitor the reaction to compulsions.

Family treatment is one of the components of complex therapy. Such treatment enables the close patient to better understand the problem, respond appropriately and help the sick person.

Group treatment of the therapist allows the patient to feel inferior and inferior "anomaly" get rid of motivation for recovery.


There is no definition of a specific warning about the development of constraints as there is no single reason for them to occur. Based on this, the advice on prevention relates to the general prevention of personality disorders. Such activities can be divided into primary and secondary.

Primary prevention includes measures to prevent the development of constraints. For this purpose, possible traumatic situations and conflicts both in the family and at work must be avoided. It is important to devote enough time to active relaxation: running, playing with children, playing sports.

Secondary prophylaxis is aimed at preventing relapse of symptoms of the compulsions. This can be accomplished in the following ways:

  • Visiting a psychotherapist – conversations with a specialist often allow the patient to be appropriately attuned to various psychotraumatic situations;
  • Follow the doctor’s recommendations completely;
  • Regularly perform general restorative treatment, rest sufficiently, and sleep;
  • to prevent the use of alcoholic beverages and the use of narcotic drugs;
  • Make changes in dietary principles.

Diet also plays an important role in preventing compulsions. For prevention, it is recommended to avoid coffee and other stimulating drinks (strong black tea, energy, etc.). The menu should include products rich in tryptophan: fatty fish, liver, colored vegetables and fruits, hard cheese, mushrooms, bananas, beans, seeds and nuts.

If you are inclined to disturb a mental state, you need to see a doctor regularly, consult with various specialists in the field of psychology and psychopathology. A qualified doctor can identify and correct deviations in good time before the patient loses control.

[55], [56]


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