Article 11: Psychological Characteristics of Gambling Addiction and Systematic Desensitization Therapy for Obsessive-Compulsive Disorder

4. Gambling

Based on the severity of the gambler's behavior, gambling can be divided into two categories: ordinary gambling (also known as normal gambling or social gambling) and pathological gambling or compulsive gambling. The gambling discussed here refers to the latter, meaning gambling behavior that has reached a point where the gambler feels compelled to gamble, severely interfering with their work and family life, and impairing their social functioning.

Regarding the diagnosis of pathological gambling, it is generally believed that the duration of gambling or the amount of money won or lost are not very important diagnostic criteria. What is important is the long-term and increasingly serious damage that gambling behavior causes to the gambler, their family, and their social life.

The earliest and most traditional treatment for pathological gambling is psychotherapy based on psychodynamics.

5. Obsessive-compulsive disorder related to cleanliness

Obsessive-compulsive disorder (OCD) is a typical symptom of obsessive-compulsive neurosis. It is a compulsive behavior in which one always feels that their hands or other things are dirty and washes them incessantly. The person is aware that repeatedly performing this action is meaningless and that being cleaner does not necessarily make them less susceptible to illness. They feel anxious and uneasy if they do not do this.

Adjustment

Systematic desensitization therapy can eliminate "cleanliness obsession." This involves writing down your fears, feared scenarios, and frequently occurring behaviors, from mild to severe. Each day, start by controlling the easiest things you fear. For example, reduce the frequency of handwashing: from 30 times to 25, from 10 minutes to 7 minutes. If you feel particularly uncomfortable, do relaxation exercises or exercise to distract yourself. Gradually reduce the frequency and duration of handwashing until you only wash your hands before meals and after using the toilet, and each time for no more than three minutes. This treatment process takes several months and cannot be rushed; it requires enduring some discomfort, but the results will be satisfying for the patient.

6. Darkness

Atherosclerosis is an excessive and irrational fear of dark environments. This fear often stems from negative associations with darkness in childhood, such as fear of ghosts or being alone. Severe atherosclerosis can affect normal sleep and daily life.

Adjustment

Cognitive insight therapy involves studying dialectical materialism and atheism to understand that ghosts and monsters do not exist, and that fear of ghosts and monsters, leading to fear of the dark, is a childish emotional reaction from early childhood. It is crucial to identify the root of the fear and, from an atheistic perspective, gain self-awareness of this source, thus eliminating the fear from the subconscious.

Systematic desensitization therapy. Based on the degree of fear of the dark, a fear level chart is established. Then, systematic desensitization training is conducted sequentially from mild to severe, with continuous reinforcement, until the patient can sleep in the dark. The process begins with several people talking in the dark, then several people sitting quietly in the dark, then two people sleeping in the dark, then one person sitting quietly in the dark... and finally, one person sleeping in the dark.

7. Hypochondriasis

Hypochondria refers to an individual's excessive concern about their own health or certain bodily functions, to the point that they suspect they have a physical or mental illness, which is inconsistent with the actual situation, and the doctor's explanation and the normal results of objective medical examinations are insufficient to dispel their preconceived notions.

Other causes of hypochondriacal ideas include: sensationalism in some irresponsible medical science popularization magazines, or rash and arbitrary comments and judgments by individual medical staff, which can also cause or aggravate hypochondriacal ideas in patients. Furthermore, most patients with hypochondriacal neurosis possess hypochondriacal ideas.

Treatment for these patients can be carried out simultaneously from several aspects:

(1) Eliminate psychological stress, i.e. prove that there is no disease. A comprehensive and detailed physical examination and necessary laboratory and instrumental examinations should be conducted on patients with suspected illness. If the examination results show that he or she has no physical disease, his or her concerns will be dispelled.

(2) Improve Personality. Hypochondriacs often exhibit personality traits such as stubbornness, suspicion, sensitivity, and caution. They tend to overthink the pessimistic or unfortunate aspects of situations and lack self-confidence, which is one of the main causes of hypochondria. Therefore, hypochondriacs should cultivate a broad mind, strive to develop an optimistic attitude, and improve their confidence in life. They should engage with society and enrich their lives through activities such as gardening, fishing, playing chess, and painting. They should also do some light work and housework, maintain daily physical exercise, communicate more with friends and family, and cultivate a sense of humor, thereby overcoming negative and pessimistic emotions and adverse psychological states, and ultimately curing hypochondria.

(3) Psychotherapy. Cognitive insight therapy is more effective in treating hypochondria.

8. Pyromania

Pyromania is a rare impulse control disorder characterized by recurrent, uncontrollable urges to commit arson without any apparent rational motivation, and a strong fascination, interest, and curiosity about arson and burning scenes. Some statistics suggest that approximately 3% of non-profit arsonists can be diagnosed with pyromania, with men far outnumbering women.

The diagnostic criteria for pyrokinesis are:

a. Meets the diagnostic criteria for impulse control disorder.

b. Has a strong desire to set things on fire, a keen interest in starting fires and burning, accompanied by a sense of tension before the act and a sense of relief afterward.

c. Has a good capacity to think about or imagine arson and its surrounding circumstances.

d. Arson caused by other mental disorders can be ruled out.

Pyromania begins in childhood, and treatment is more effective in childhood. Timely and rigorous intervention is crucial and often achieves both therapeutic and preventative results. Adults frequently deny arson and exhibit alcohol dependence and lack of self-control, often requiring behavioral therapy under conditions of confinement and supervision, but the outcomes are often unsatisfactory.

9. Kleptomania

Kleptomania is a recurrent, uncontrollable urge and behavior of stealing. It affects a very small percentage of all thieves, less than 5% of shoplifters, and is more common in women than men.

Kleptomaniacs steal not out of personal need, nor for the economic value of the stolen items. They often discard, keep, or return the stolen goods. They don't steal out of anger or revenge; they experience a gradually increasing sense of tension before stealing and feel depressed and anxious about the imagined scenarios.

Kleptomania often begins in childhood or adolescence, progresses slowly, and is rarely treated. A small number of patients may experience some improvement by receiving introspective psychotherapy, psychoanalysis, systematic desensitization, aversion therapy, and medications such as fluoxetine.

Personality Disorder

Personality disorder refers to a significant deviation from normal personality traits, leading to a consistent pattern of abnormal behavior that reflects an individual's lifestyle and interpersonal relationships. It typically begins in childhood or adolescence and continues into adulthood or throughout life. If the deviation from normal personality is caused by physical illness (such as encephalopathy, brain injury, chronic alcoholism, etc.) or secondary to various mental disorders, it should be termed personality change.

Symptom criteria: An individual's inner experiences and behavioral characteristics (not limited to the period of a mental disorder episode) deviate significantly from the range expected and accepted by their culture as a whole. This deviation is widespread, stable, and long-term, and includes at least four of the following criteria:

a. Abnormal deviation in cognition;

b. Abnormal deviation in emotions;

c. Controlling impulses and abnormal deviations from satisfying personal needs;

1. Antisocial personality disorder

As adults, they may become emotionally shallow and cold-hearted, short-tempered, lack self-control, dishonest, irresponsible, and incompatible with others; they may have a poor sense of law and discipline, be highly impulsive and aggressive; be selfish and have an inflated sense of self-worth; lack planning and purpose, frequently change jobs; lack conscience and are unaware of their own personality flaws; lack remorse and shame, and are unable to learn from experience; commit various forms of crime, and tend to engage in drug or alcohol abuse.

Such individuals are generally reluctant to seek medical help, making them extremely rare in outpatient clinics. They are often imprisoned or sent to labor camps for violating social laws and regulations. Sometimes, they are forced to seek medical attention, and most appear tense and depressed, believing they are discriminated against and hated by those around them. This perception and emotional state can persist, even into old age (late adulthood) when their delinquent behavior decreases. They cannot maintain long-term, intimate, and faithful relationships with family, friends, or spouses (female partners), have chaotic sexual relationships, frequently change marital relationships, and are indifferent to their children.

These individuals typically experience a 2% reduction in antisocial personality disorder with each passing year starting at age 21. Later, while their disruptive behavior decreases, they tend to develop hypochondria and depression.