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Harm compulsions


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Hi thanks for getting back to me! My friend has had OCD for a really long time, combined with addiction problems and PTSD. He has been having CBT but doesn’t seem to getting much out of it atm. He is on a lot of medication. He’s been through some of the more classic OCD issues but this self harming is really disturbing him because he feels like he doesn’t understand why it’s happening. He’s not obsessing beforehand and isn’t getting any relief from it. Really worrying. All I’ve come up with is that perhaps the compulsive harming is releasing adrenaline so while he’s not getting emotional relief he might be getting a physiological buzz from it...

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Hi JF1 :)

I'm sorry to hear about your friend, it sounds like he's really struggling at the moment. Sometimes when someone has PTSD and OCD they need to deal with the trauma first or at least at the same time as helping their OCD because they can often affect each other. Is he getting help for his PTSD? If he's not getting anywhere with therapy could he look into changing therapist or looking into being referred to one of the specialist centres for OCD? Sometimes we just need a more specialised approach.

You said he doesn't know why he self-harms and doesn't get any relief. Has he tried not harming himself and observing what he's thinking and feeling. I understand that this could be upsetting, but maybe if he understood the reasons behind it, then he would have a better idea of what approach to take to overcome it. Also, has he talked to his therapist about it, have they given him any advice?

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He’s only recently started to try and come terms with his PTSD, he has a away to go with that I think. His therapist asked him what he’s thinking / obsessing about prior but he didn’t feel like it was anything in particular, just the act itself. 
I didn’t know there are specialist centres, do you have any info on them I could pass on please? Thanks for replying, it’s good to be able to talk about it, I love him to bits and it’s pretty heartbreaking 

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Hi JF1 :)

You sound like a lovely caring friend, he's very lucky to have you. 

Here is a page on the OCD-UK website about the specialist services available on the NHS in England and Scotland. 

https://www.ocduk.org/overcoming-ocd/accessing-ocd-treatment/accessing-ocd-treatment-through-the-nhs/specialist-ocd-treatment-services/

I really hope your friend manages to get the help he needs very soon x

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