Preface | Preface to the 20th Anniversary Edition

Introduction: Obsessions and Compulsions
A Correct Definition of Obsessive-Compulsive Disorder│What are Obsessions│The Wrong Message│What are Compulsions│The Four-Step Treatment│What is OCD and What is Not│Obsessions, the Devilish Disorder│The Past: Six Case Studies│The Brain That Stops and Frozen│Worries About Worries│Taking Control│It's How You Act That Matters

Part 1, Step 4 Behavioral Therapy

Chapter 1: It's Not Me, It's Just OCD × Step 1: Renaming
You're not crazy, you're in a 'brain lock' │ Confronting OCD │ It's just chemistry │ The impartial observer │ Who's in charge here │ Prescription: Take action │ Stand firm │ Use a recorder │ Keep a journal │ Hughes, beyond the bizarre │ Flying clips │ Compulsive saving, compulsive cleaning │ Should we blame our genes? │ Rebrand decisively │ OCD is a tumbleweed

Chapter 2 Unlock Your Brain × Second Step: Reinvention
"It's not me, it's my brain" │ False alarm! │ This is war │ It's all in your head │ When the gears don't work │ Practical primates │ Unlock your brain │ Don't lose faith │ Finding answers without Freud

Chapter 3: Wishing for something doesn't make it happen × Step 3: Refocusing
One step at a time│If you are doing something different, you are winning│Recording your successes│The relationship between the mind and the brain│Continue to respond proactively│It means nothing│Shake off anxiety│Face the enemy head-on│The power of distraction│Don't worry, I won't│Is obsessive-compulsive disorder an aphrodisiac?

Chapter 4 Lessons Learned from Obsessive-Compulsive Disorder × Step Four: Reevaluation
“God loves me”│Escaping the trap set by obsessive-compulsive disorder│A battle of will│Easy to say, but hard to do│Like losing an ‘old friend’│A lost opportunity│“A little light in my soul”│Words of encouragement for yourself

Part 2: Applying it Deeply in Life

Chapter 5: Bringing Freedom to Life
Behavioral Therapy and Life Afterward

Chapter 6: Obsessive-Compulsive Disorder as a Family Problem
Saying 'No'│When OCD is Used as a Weapon│Who the Heck is This Stranger?│Emotional Exhaustion│To Open Up or Not to Open Up│When Compulsions Are Used to Control Someone│Finding Love│Sharing Within the Family│Understanding, Not Saying Yes│Forgiving Together│Don't Push or Rushing│Jill and Her Two Daughters│Brian and His Wife│Joel and His Parents│Anna and Her Boyfriend

Chapter 7 Obsessive-Compulsive Disorder and Other Conditions
Hidden Intentions│Calling an Impulse an Impulse│Looking Inward

Chapter 8: Four-Step Behavioral Therapy and Traditional Approaches
Applying Exposure Prevention Therapy (EPT) to Obsessive-Compulsive Disorder: A Classic Approach | Applying the Four-Step Treatment

Chapter 9 Appropriate Drug Therapy

Chapter 10: Obsessions and Compulsions Checklist

Chapter 11: Treatment Diary of a Patient with Obsessive-Compulsive Disorder

Part 3: A Guide to Obsessive-Compulsive Disorder Treatment

Step 1: Renaming | Step 2: Reattribution | Step 3: Refocus | Step 4: Reevaluation | Conclusion

Acknowledgements

“Don’t listen to the voice of anxiety.”
A 4-Step Manual for Overcoming Obsessive Compulsions from a UCLA Psychiatrist

Everyone has moments when they wonder if they are being too sensitive.
Usually, we live with our own obsessions.
However, if you cannot control it with willpower alone and have strong thoughts that do not stop even though you do not want them to, or if you perform strange habits that others do not do as if they were a kind of ritual, then this is a disease diagnosed as obsessive-compulsive disorder.
They often engage in bizarre behavior to avoid imaginary disasters, such as taking 30 showers to prevent the deaths of their family members or cleaning 13 times to prevent a plane crash.
People with obsessive-compulsive disorder do not feel pleasure from performing these rituals, but rather feel embarrassed and ashamed.

Jeffrey Schwartz, a professor of psychiatry at UCLA School of Medicine, has treated more than 1,000 patients with obsessive-compulsive disorder over the past decade.
Obsessive-compulsive disorder is a surprisingly common condition that affects about one in 40 people, and for most people, it is a symptom they commonly see around them.
A man who washes his hands over 100 times a day and makes foam just by getting water on his hands, a woman who constantly checks to see if they are unplugged and ends up putting the coffee machine and iron in her bag before going to work, a woman who hasn't seen her family for 16 years and couldn't even go to her mother's funeral because she thought everything was contaminated, a man who cleans up traffic accident scenes every dawn because he has a pathological fear of battery fluid leaking...
Through one-on-one counseling and group therapy, and by applying the four-step self-help method to these individuals, numerous success stories have proven that the majority of individuals are able to manage their daily lives much better and feel more at ease.
People with OCD often find relief when they see brain scans (showing overheating in the lower frontal lobe) and realize that their OCD isn't a personal problem, but rather a result of faulty messages from their brain.
Treatment begins with realizing that the problem is not me, but my brain.

Breaking the lies of anxiety and becoming mindful,
4-Step Self-Behavioral Therapy

In a concrete way, Jeffrey Schwartz introduces a four-step self-behavioral therapy.
The first step, renaming, is to give the unwanted thoughts and impulses an accurate name.
“This is an obsession, this is a compulsion.” You have to say this firmly and repeatedly to keep it in mind.
The goal of this stage is not to control obsessions and compulsions, but to control your reactions to those thoughts and compulsions.

The second stage of recurrence is the answer to the question, “Why do these thoughts and impulses persist and bother me?”
The answer is that the brain's gears are stiff and brain areas are not functioning properly.
The goal of this step is to carefully examine and clearly recognize that the thoughts and impulses that keep coming back to you are due to your unruly brain.


The third step, refocusing, involves shifting your attention away from the bothersome thought and engaging in other behaviors.
Even just a few minutes is fine.
Anything is fine: walking, exercising, reading, listening to music, playing games, knitting.
It can also be helpful to keep a journal of what you accomplished.
This allows you to repair your brain's broken gear shifting mechanisms, and with practice, your brain will begin to function more efficiently.


The fourth step, reevaluation, is a natural consequence of the previous three steps. It involves reassessing OCD as something worthless and distracting, rather than taking it at face value.
Having suffered from OCD can also lead to a positive self-evaluation, such as becoming a more attentive and compassionate person or realizing that God loves me.

This treatment is not a magic formula.
Giving an impulse a precise name doesn't mean it will disappear.
Excessive expectations for immediate improvement are the biggest factor leading to early treatment failure.
Obsessive thoughts never go away overnight.
The goal of this treatment is to control your reactions to obsessions.
It's about gaining control and changing your brain by using new knowledge to regulate your behavioral responses and learning to say, "This isn't me, it's OCD."
If necessary, you may be able to get help with appropriate medication.
When you change your behavior, your brain, which was previously dormant, will start working.


Wanting to escape from the swamp of obsession
A book for everyone

Chapter 6, which deals with obsessive-compulsive disorder as a family problem, is also worth noting.
Obsessive-compulsive disorder is truly a family problem.
If obsessive compulsive disorder is left untreated, people tend to become increasingly distant and isolated.
Because I can't tell anyone this terrible secret.
In most cases, the impact is passed on to the family.
The first thing families of people with OCD need to practice is saying "no."
Family members who have become part of the OCD patient's condition may become facilitators who perform or turn a blind eye to the compulsive behaviors requested by the patient in order to maintain peace in the home.
The author advises families of patients with OCD to seek behavioral therapy rather than help with the OCD.
Additionally, people who have not been diagnosed with OCD but who have compulsive habits that are bothersome and annoying, even if not severe, may also likely benefit from this treatment.

The four-step self-behavioral therapy that Jeffrey Schwartz talks about is ultimately about mastering and controlling myself to change my problematic brain.
There is one thing you must remember at this time.
You have to work hard on your own.
Nothing gets better if you rely only on drugs and doctors.
You need to analyze your choices and actions, accept and evaluate your thoughts, and then decide what to do.
By distancing ourselves from our brains and practicing mindfulness, we allow our inner guide, an impartial observer and wise advocate, to guide us along the way.
If you want to let go of your obsessions and find freedom in life, I hope you will find the answer in this book.