OCD treatment Essay

OCD treatment Essay OCD treatment Essay Prior to the 1970s and 1980s there was little hope for treatment regarding OCD because clinicians of that era believed that the disorder was an unmanageable condition with a poor prognosis. The prognostic picture for OCD had drastically improved in the 20th century when behaviourally oriented clinicians and researchers looked back to important animal-based research conducted in the 1950s to search for an animal analogue of OCD from which they could conceptualize and develop behaviourally based therapies. In the animal studies, a dog had acquired an obsessive-compulsive habit which was exposure to light which meant an electric shock was coming and jumping across a hurdle to avoid the shock which reduced his conditioned fear of shock and thus was maintained by negative reinforcement. This experiment serves as an animal analogue to human OCD, where compulsive behaviour is triggered by fear associated with situation or stimuli such as toilets, floors, or obsessional thoughts that pose li ttle or no actual risk of harm. (Abramowitz) This fear is then reduced by avoidance and compulsive rituals (for example, washing) that serve as an escape from distress and, in doing so, are negatively reinforced (that is, they become habitual). The entire emotional response was extinguished after several extinction trials in which the height of the hurdle made it impossible to jump over and the light was exposed. When the light was turned on and the dog realized he couldn’t jump over he displayed strong signs of a fear response until he finally calmed down without the slightest hint of distress. This experiment influenced behaviourally oriented researchers in adapting similar treatment to human beings with OCD. They were expected to confront for 2 hours each day situations and stimuli they usually avoided. The purpose of this confrontation was to induce obsessional fears and urges to ritualize. Patients were also asked to refrain from performing compulsive rituals such as washing, for example, after exposure. (Abramowitz ) Contemporary ERP (Exposure and Response Prevention) entails therapist-guided, systematic, repeated and prolonged exposure to situations that provoke obsessional fear, along with abstinence from compulsive behaviours. This can occur in the form of actual exposure or imaginal exposure. Refraining from compulsive rituals is a vital component of treatment because the performance of such rituals to reduce obsessional anxiety would prematurely discontinue exposure and rob the patient of learning two things. First, that the disorder is not truly dangerous and second that anxiety subsides on its own even if the ritual is not performed. Thus successful ERP requires the patient to remain in the exposure situation until the obsessional distress decreases spontaneously without attempting to reduce distress by withdrawing from the situation or by performing compulsive rituals or neutralizing strategies. (Abramowitz) ERP is generally considered the treatment of choice for OCD with approximately 75-85% of patients experiencing a considerable reduction after taking on this type of treatment. There are two types of ways for administering ERP for OCD. Therapist-controlled ERP, as mentioned previously, is used if the response sought is prevention and it is administered by the patient being coached by the therapist, usually in his own home. The second type of ERP is self-controlled ERP which are sessions that are carried out as homework assignments in between therapy sessions. Data on which one of these two are the most effective have not yielded a clear-cut answer. (van Oppen) A more detailed example of therapist-controlled ERP format follows a few hours of assessment and treatment planning followed by 16 twice-weekly treatment sessions lasting about 90 to 120 minutes each and spaced over about 8 weeks. Generally, the therapist supervises the exposure sessions and assigns self-exposure practice to be completed by the patient between sessions.

Characteristics of Shakespeares History Plays

Characteristics of Shakespeare's History Plays Many of Shakespeare’s plays are historical, but only certain plays are categorized as such. Plays like Macbeth and Hamlet are historical in setting but are more correctly classified as Shakespeare tragedies. The same is true for the Roman plays (Julius Caesar, Antony and Cleopatra and Coriolanus), which are all based on historical sources. So which plays are classified as Shakespeare histories and what are their common features? Sources of Shakespeare's History Plays Most of the Bards  English history plays, as well as Macbeth and King Lear are based on Holinsheds Chronicles. Shakespeare was known for borrowing heavily from earlier writers, and Holinsheds works, published in 1577 and 1587, were a key reference for Shakespeare and other authors of his day, including Christopher Marlowe. Interestingly, Holinsheds works were not particularly historically accurate either but instead are considered mostly fictional works of entertainment. If produced in the modern day, both Shakespeare and Holinsheds writings would probably be described as based on historical events but have a disclaimer that they were edited for dramatic purposes. Common Features of the Shakespeare Histories The Shakespeare histories share a number of things in common. First, most are set against medieval English history. The Shakespeare histories dramatize the Hundred Years War with France, giving us the Henry Tetralogy, Richard II, Richard III and King John- many of which feature the same characters at different ages. In all his histories, indeed in all his plays, Shakespeare provides social commentary via his characters and plots. The history plays say more about Shakespeare’s time than the medieval society in which they are set. For example, Shakespeare cast King Henry V as an everyman hero to exploit the growing sense of patriotism in England. His depiction of this character is not necessarily historically accurate. For instance, theres not much evidence that Henry V had the rebellious youth that Shakespeare depicts. Were Shakespeare's Histories Accurate? Another characteristic of Shakespeares histories is, for the most part,  theyre not historically accurate. In writing the history plays, Shakespeare was not attempting to render an accurate picture of the past. Rather, he was writing for the entertainment of his theater audience and therefore molded historical events to suit their prejudices or preferences. Shakespeare'sPlays and Social Commentary More subtly than his comedies and tragedies, Shakespeares histories provide contemporary social commentary. His plays offer a view of society that cuts right across the class system. These plays present us with all kinds of characters, from lowly beggars to members of the monarchy. In fact, it is not uncommon for characters from both ends of the social strata to play scenes together. Most memorable is Henry V and Falstaff who turn up in a number of the history plays. All in all, Shakespeare wrote 10 histories. These plays are distinct in subject matter only- not in style. The histories provide an equal measure of tragedy and comedy. The 10 plays classified as histories are as follows: Henry IV, Part IHenry IV, Part IIHenry VHenry VI, Part IHenry VI, Part IIHenry VI, Part IIIHenry VIIIKing JohnRichard IIRichard III