Clara, 35, is the perfect mother. After a long struggle to have a child, she now wonders if she could end up killing him…
Luis, 29 years old, with a girlfriend for years, about to get married, begins to wonder if he doesn't like men more…
Martina, 42, approaches the large window in her office and a thought comes to her: something would happen if I jumped…
These are just three examples of many that we could give. Are Clara, Luis or Martina crazy? Perhaps seriously ill? No, Clara, Luis and Martina are suffering. impulse phobias.
However, all three suffer in silence before the Alleged shame in confessing his thoughts to those closest to him and, often, even to professionals, which delays early detection.
Could any of us suffer from them, at any time? Let's try to clarify this.
What are impulse phobias?
It is about intrusive thoughts – that you cannot do anything to resist, avoid or eliminate – that enter the patient's mind and generate intense anxiety.
In general, these intrusive thoughts are irrational and go against one's own beliefs of the patient, as he considers them morally unacceptable. They are given repeatedlywhich only increases the level of anxiety.
Phobias of impulse They are an ego-dystonic disorderthat is, in which there is a disconnection between what the patient thinks and what he really wants.
Thus, following the previous example, Clara has a desire to protect and care for her son or Martina loves her own life too much to make her phobia a reality. However, both consider that they are fighting his impulses.
What clinical features are present?
The main features are as follows:
- Intrusive thoughtsas I have already said, with belief of loss of control by following the impulse that is indicated to us. Like this: kill him! – Clara's baby – leave your girlfriend, you don't like girls! – in the case of Luis or jump! in the case of Martina.
- The content of intrusive thoughts is usually anticipate an assaultwhether to oneself or to others, although it is not the only content, as we will see later.
- Thoughts become obsessive and recurrentwith a very high interference in our emotions – anxiety, depression – and in our behaviors.
- Intense fear – intense anxiety – when these thoughts appear
- Avoid situations that patients believe can make the thought come true. Thus, Clara would avoid being alone with her son and would ask that knives and any other objects that he might use be put away, or Luis would avoid social contacts with a lot of children.
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What are the causes? And the diagnosis?
They have no direct cause but are part of various disorders. In fact, it can be part of a obsessive disorder – compulsive (OCD) – endorsed by the APA, which includes patients with impulsive phobias in this description.
In this case, what happens is that There are no obvious compulsions (let's imagine a cleaning OCD, the obsession is the idea of being dirty and the compulsion is washing your hands endlessly) nor hidden (telling someone if we have already closed the door to the house even though we have checked it 35 times).
What occurs are mental compulsions (thinking about intrusive thinking again, by the way, at this point, why don't we call it PIO, infinite times, which increases anxiety because, in this way, it goes unnoticed by others.
But, it can also appear in some anxiety and depressive disordersOn the other hand, the high anxiety it causes can also end up generating depression.
Likewise, although most patients are concerned about the possibility of having a schizophrenia or bipolar disorderthis is part of the content of certain impulse phobias, but there is no direct relationship since the type of thoughts that appear in each of these pathologies is different.
Does the content of impulse phobias vary?
It could vary, therefore, we can affirm that there are different types of impulse phobias, depending on their content:
- Fear of the aggression of persons from their family, social or work environment.
- Fear of to attack oneself.
- Fear of run over someone – whether a person or an animal – while driving, which causes the patient to decide to routinely take the same route, ask someone they trust to accompany them… all of which is not only not useful but also increases anxiety.
- Fear of go mad.
- Fear of have a serious mental illness such as schizophrenia or BPD.
- Fear of being attracted to people of the same sex even having the ability to recognize that it goes against their preferences.
- Fear of be offensive with a person because of their political or religious ideology.
- Fear of be a pedophilethat is, to feel attraction to children and adolescents – being an adult – even though the patient feels aversion and rejection at the mere thought.
Yes, this is all fine and good, but am I going to go crazy? Am I going to kill someone?
Well no, neither crazy nor a murderer. Let me explain this properly; We all have PIO – at some point – but The problem starts when they are very recurrentgenerate intense anxiety and a clinically significant feeling of discomfort.
But not, You're not going to go crazysince “madness” is a social construct that does not exist in the usual clinic and, even less, with patients with impulse phobias.
Let's see if you can do it turn into a murdererI'm sure I'm right if I say that:
- You are one of those people who worries, even excessively, about others.
- You can't even kill a fly, and if you do, it makes you feel guilty, just like verbally hurting someone.
- You are a perfectionist, detail-oriented, somewhat rigid in attitudes and behaviors and a bit controlling, in the sense that you need to interact with others in situations where you can maintain control,
- You like to keep your routine under control so any unexpected event that turns your schedule upside down causes you anxiety.
Is that so? If so, I regret to inform you that You don't fit the profile of a murderercriminal nor that of an aggressor.
He thinks that people who are capable of killing someone always have a motive – even if it is economic – to do harm, They are impulsive, aggressive, lacking empathy, they do not feel guilt, much less anxiety. for what they have done, do you see how you are not one of them?
Is there treatment for these types of phobias?
Indeed, and currently, we are moving towards the multidisciplinary and multimodal approach treatments.
First of all, you should go to a psychologist and really explain what is happening to you. Don't worry, this is a professional and he won't judge you. but we are here to help you.
From here, there would come a psychological evaluationfor later establish the intervention plan and start of treatment.
Although In Psychology there are various orientationswhich has been shown to be more effective, with a higher response rate and acceptance in the treatment of impulse phobias It is cognitive-behavioral, like others, also based on scientific evidence.
This It does not mean that other orientations are not validbut it has not yet been scientifically proven whether or not they are effective, probably due to a lack of studies.
In some cases, it will also be necessary to consult with the psychiatrist to include the most appropriate pharmacological guideline, especially antidepressants with anxiolytic profilefor reduce anxiety only if the specialist so recommends.
Guidelines for improving impulse phobias
1.When these PIOs arrive, accept them. During the day, all kinds of thoughts and beliefs appear in the mind and – following the metaphor of the mindfulness guest house – they must be welcomed when they arrive, accepting each one in its own way and letting them go, with the same acceptance, when they leave.
However, People with impulse phobias try not to think about the PIO, they resistthey do not face the situation and, therefore, not only does change not occur, but the PIO appears more intensely.
In the consultation, we do, in this case, a exercise of paradoxical intention and we invite the patient to think whatever you want except a pink elephant, but above all, don't think of a pink elephant – sometimes we also use white bears, camels, dromedaries, the tip of the nose – in any case, try it… let's see what happens…
2. Share your thoughts with your family or friendsDo it gradually, from the person you trust most to the person you trust the least, and try to explain to them how you feel and why you have decided to undergo treatment, but do not tell them the content of the PIO because it will increase their anxiety.
3. Don't avoid family or social situations. If you do this, you give control of your life to your PIOs and remember that you are the one who should direct it.
4. Do not dialogue with the PIODon't ask yourself if you could be able to do it, if you are a bad person for having these thoughts, or if you are going crazy. You already know the answer, right?
5. If you are stressed, Practice relaxation, breathing and mindfulness techniques because stress and anxiety are bad advisors and help you misread your thoughts.
6. Do enjoyable activities to increase your adaptive emotionsthat is, “positive”, since your mood or mood swings influence the appearance of PIO.
7. Seek professional help. Even if you try, you can't escape these loops and mental patterns alone. 's team of online psychologists can help you.