根据各自研究表明，全球患有强迫症的人大概有1.1%-3%，也就说，每100个人里面，就有1-3个人患有临床强迫症。即使如此，我们普遍对强迫症仍然知之甚少。在我这些年和强迫患者的过程中，我也发现，不管是非强迫症患人还是患者，不管在哪个文化背景。我们对强迫症都有挺多误解和错误的认知。 我们常会听到“某某某”有强迫症，ta挂画的时候总是喜欢追求完美，做到最好；某某某强迫症总是要把家里弄得很干净。当你把这个说法挂在嘴边时，把强迫症当成形容词般使用，你们有没有考虑过，这个真的是强迫症吗？，你知道真正的强迫症是什么吗？你有想过自己是真的生病了，还是只是做事情比较认真吗？真正患有强迫症的人听到你这样说是什么感受？今天的视频就是想为大家解开一些强迫症的迷思。 误区1：“我知道强迫症是什么。不就是不断地重复一个强迫行为嘛。” 问题：强迫症到底是什么？ 要了解这个说法对不对，要先解释一下强迫症到底是什么。 强迫症的英语叫做obsessive-compulsive disorder。 Obsession，强迫思维，很多人以为它单纯指的是强迫性的想法。实际上，它是反复出现的想法、脑中的画面、或是冲动的感觉。它/它们的出现会导致不适的情绪状态，会让你的焦虑感上升。 比如说，常见的强迫思维包括：“这个桌子可能还有细菌，我还得再擦一遍。”“我出门时候的锁是不是没有锁好，我要再回去锁一次。” Compulsion 往往被大家误解为“强迫性的行为“，这里我给它反应成强迫回应，稍后我再解释为什么。强迫回应的定义为： 反复的思维模式或者行为模式，用作试图缓解强迫思维带来的焦虑感，是试图让强迫思维消失。 最经典大家都知道的强迫回应为：对应以上的强迫想法，想破行为就是反复地擦桌子、反复地回去检查门锁。但是，假设这个时候，强迫症患者A的家属不再让患者去擦一次桌子了，B例子的患者也已经上了地铁，没法再回去检查锁了，他们的强迫症是不是就应该自动好了呢？当然不可能。因为当患者的脑海里出现了obsession强迫想法后，往往焦虑感就会提升，导致他们自然而然一定会试图做点什么来降低他们的焦虑感。如果现实情况不允许他们擦桌子，检查门，他们可以也可以在心里默念“也许已经没有细菌了” ，或者一遍遍的回忆和检查，“门一定是锁好了。”来换取片刻的安宁。这样的回应同样的暂时缓解了他们的焦虑感。这也就是为什么，强迫回应即可以是行为，也可以是思维模式。 它之所以存在，是因为强迫思维让患者感到很困扰，患者因此会想方设法把它去掉。这也是为什么我认为更好的翻译应该是“强迫回应“。 当年研究课上，我被心理学教授科普说强迫症患者可以只有强迫思维或是强迫回应，不需要两者都有。这其实也是不太可能的。强迫症之所以困恼着患者，就是因为患者陷入了它的恶性循环。患者的强迫思维闯入大脑中时，焦虑感会上升；做出强迫回应时，焦虑感要不就是会暂时地下降，要不会让来访感觉终于暂时可以从强迫思维里出来了。也就是这样的信号让大脑相信，下一次强迫思维再闯入，这也是唯一的回应方式。来访被陷入了循环，也就慢慢让强迫症占据了生活。试想假如少了强迫思维或者强迫回应的任何一方，这个循环都不会成立。 误区2： 强迫症是个优点，代表你爱干净，追求完美，是个很好的品质。 问题：强迫症是病吗？ 强迫症患者并不可以控制自己的强迫思维和强迫回应，也没有强迫患者会真正的乐在其中。通常，强迫症患者意识到自己有强迫的思维和强迫的行为，并且感觉不受到控制。比如说，一名害怕细菌的强迫症之所以要把桌子擦上很多遍，通常都是源于脑子里的焦虑，担心细菌没有被擦干净。当他们终于可以停下来了，一般已经累得筋疲力尽了。这个时候通常的想法都是：“终于可以停下来了。”而不是，“桌子好干净啊，我觉得好开心！”。 作为强迫症的家属也是一样。别人似乎总是以为，强迫症家属会为家里干净的桌子和椅子表示干净，觉得家里再也不需要找清洁工了。实际上，我遇到过的强迫症家属往往也会被迫卷入这场风波。譬如，强迫症患者往往只对某些物品或者领域比较执着。有的强迫症患者会花很多的时间强迫于桌子的干净程度，对地面的垃圾却毫无反应—这并不会让家属带来家里很干净的干净，反而会让家属觉得很难理解；我曾有个强迫症患者会执着于从外回家后必须换下衣服并且洗澡后才能接触家里的物品；如果有朋友或者家属不小心打破了ta的规则，让脏的衣服接触到了家里的物品，患者只能把接触过的物品全部试图清洗或者扔掉，也会因此和伴侣产生很多争吵、金钱上的麻烦，和生活上的不便。所以说，当强迫症患者被病痛折磨，家属通常也在忍受不一样的折磨。无疑是一种极大的挑战。 误区3：“强迫症患者就是不停洗手、不停检查门锁、把东西都弄整齐。” 问题：强迫症思维和强迫回应都有什么类型？ 上面已经提到，强迫症分为“强迫思维”和“强迫回应”两个部分。相信大家已经猜到，既然是强迫回应不一定是行为，那强迫症的形式也就不会只有“强迫洗手、强迫整齐、强迫门锁。” 实际上，强迫症的形态是千奇百态的。一些常见的强迫症还包括：对自己的性取向感到怀疑并且强迫，对自己的亲密关系表示不确定和怀疑，强迫担心自己曾经有出轨 、伴侣曾经出轨、强迫担心自己是否是恋童癖、强迫担心自己是否想伤害自己的亲人和爱人等等等等。基本上，只要是人性中的话题，都有可能成为强迫症的把柄。 因为强迫症的形态多姿百态，外人对它的理解也不一样。有的强迫症非常显性，很容易被看出来，也就表示他们更有可能被诊断和被重视；而那些在脑海里面的强迫思维，或是大家不太熟悉的强迫症状，往往也是最容易被忽视、被不理解的。比如说，恋童癖强迫症的患者往往更难被诊断：他们往往会隐藏自己的症状，羞耻于说出“我总是担心自己会不会对儿童有不良看法”，一方面担心自己真的是恋童癖，另一方面不理解的大众确实也容易误以为如此，把他当恋童癖处理。 说了这么多，总结是一句话吧。对于强迫症： 你要了解，强迫症的形态是前行百态的。如果你怀疑自己有反复、不受控制的强迫思维或强迫动作倾向，或是发现身边的亲人朋友有类似的症状，都建议你找到专业人士去咨询；如果你已经怀疑有可能是和强迫有关，建议尤其寻找有强迫症专业受训的专业人士。如果你是健康专业人士，也建议你去了解常见的强迫症症状类别，并在有疑问时及时推荐病人/潜在患者/来访去专科得到进一步的评估。 误区4：既然强迫行为并不是来自主观意愿，那你知道了为什么还做？改一下不就好了？” 问题：如果得了强迫症怎么办？/如何像他人解释我的强迫症？ 以上已经提到，患有强迫症的人感受会对自己的思维和行为失控，往往的主观感受也是，面对很多入侵的强迫回应，他们感觉到不受控制，无能为力。很多时候，家属和亲人总会着急的说：“别洗了。”“少洗几次手，强迫症就好了！”“你就是不想改！”等评论。他们感受到的是压力和指责，并不是关心和并不能有效的帮助他们。 来理解强迫症患者的大脑，要从大脑的结构开始说起。我们的大脑的前额叶中有一个部分称之为orbitofrontal cortex，眶额皮质，主管人类情绪产生的主要神经机制，也与前额叶的其他管决定行为有联系，是与与决策的认知过程有关的一个脑区。当一个人患有强迫症，ta的眶额皮质的活动量会比非强迫症患者高出非常多.也就是说，患者无法对事情做出正确的往常的判定思考，也会常被大脑发出的情绪受干扰，从而做出偏差的决定。打个比方，患者明在理性上知道数字3只是一个数字，并不会带来不好的运气。但紧张的感受和情绪会让他“失去理智思考“，通过一些列的强迫行为来试图确保数字3不会带来不好的运气。 这种焦虑的感受会很真实的存在，患者在当下也会觉得必须要做点什么。很多时候理性的沟通并不会有良好的作用。 这个时候，其实患者需要的更多是有效的治疗和训练方式，通过适合的方法，一步一步去训练大脑做出适合的反映，减少强迫思维袭击时不舒适的感觉（我也会在之后更详细地为大家介绍更多强迫症的治疗方式）如果您或者您身边的亲朋好友有强迫症症状，或者对此有疑问，请正视问题，给患者以及家属找寻具体专业的帮助。如果你身边没有强迫症患者，也请正视强迫症，尽量避免错误信息的传播。

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Announcement: OCD Group is coming up. Contact me for more info and to sign up! Erjing Cui, MA, LMHC Mental Health Therapist Erjing currently provides individual and group mental health therapy for adults (16+). ​ Erjing approaches psychotherapy with a multicultural and social justice framework and believes in exploring and understanding intersectionality and systemic issues with a trauma-informed lens. She mostly utilizes but is not limited to, Acceptance-Commitment therapy (ACT), Emotion-Focused Therapy (EFT), and Exposure Response Prevention ERP (for OCD and related disorders). ​ Other modalities Erjing trained in and might integrate are Cognitive Behavioral Therapy (CBT), mindfulness, Interpersonal Psychotherapy (IPT), trauma-focused CBT (certified), and person-centered therapy. ​ Erjing provides counseling in fluent English, Mandarin (普通话), and Cantonese (广东话). ​ *Erjing currently provides both Telehealth and in-person therapy. See Full Bio Practice Areas Practice Areas Erjing offers individual therapy and peer consultation services in the following areas: Areas of Specificities: Adjustment/life transitions Acculturation challenges Body dysmorphic disorder Cultural conflicts/cross-cultural matters Depression Generalized Anxiety Disorder Grief and loss Obsessive-Compulsive Disorder Racial trauma, microaggression, institutional oppression Self-exploration Social Anxiety Disorder (Social Phobia) Trauma (includes but not limited to developmental trauma, sexual assault, and racial trauma) Obsessive-Compulsive Disorder (OCD), Generalized Anxiety Disorder and related disorders Erjing received her clinical training from McLean Hospital, a psychiatric affiliate of Harvard Medical School. There, Erjing is trained in Exposure and Response Prevention therapy (ERP) to treat Obsessive-Compulsion Disorder and related disorders. Erjing also works at Rogers Behavioral Health as an adult mental health therapist for OCD/Anxiety and Depression. ​ Erjing incorporates Acceptance and Commitment Therapy (ACT) into the treatment of OCD. ​ Multiculturalism & Social-Cultural Therapy Asian American, Asian in America, & Asian Erjing approaches all presenting concerns from a multicultural and social justice framework. ​ Erjing believes that therapy is not only about looking inwards, but a process of recognizing what has happened to you means in the context of society and empowering changes that heal. (Includes but not limited to International students, H1b visa holders, refugee, adoptee, and illegal immigrants) Erjing enjoys working with all populations whose families originate in East Asia, South Asia, Western Asia, and Southeast Asia. ​ Depending on your racial identity and cultural stories, each of you has your own stories and struggles while navigating your way of being in the world. Being rooted in multicultural counseling and intersectionalities, Erjing is passionate about supporting the overall wellness of this community. Click here for information on groups! Look Inwards, Outwards & Forwards “I was in a dark place that I no longer am. I honestly think that Erjing was a big part of me not giving up on myself. Without her, I wouldn’t be where I am today. I am eternally thankful.” "In therapy, she pushes me to jump into the uncertainty, but she also doesn’t overdo it. She has helped me tremendously on encountering fears that I would never think I am capable of encountering. She gives me space and patience in therapy and she’s able to understand me well, wherever it is that I am coming from. She understands there are no negative emotions, but there are emotions that are more difficult, which is a huge factor in recovery too, to feel whatever it is that you are feeling. All in all, I wouldn’t be where I am now in recovery without her significant help! " 我和尔婧进行了一年半多的咨询，在这里我学到了很多从没见过的解决问题的技巧和方法，也解开了我很多年的困惑，原来我一直有思维强迫，现在我可以很好的和它相处，并不害怕它了。尔婧让我更相信循证治疗的必要性，对于强迫症最好的方法就是暴露疗法和接纳承诺疗法也希望更多的强迫患者能了解与学习，让勇于暴露成为我们的一种生活态度。 尔婧咨询师是一个有温情很体贴但同时又足够理性和聪明的咨询师，咨询进展中遇到困难时，她提出的建议都很专业很受用，她总是站在我的角度思考问题，在这里我没有遇到过尴尬和不适。对于我来说，我找了很久的咨询师，强迫又是很小众的病，要找到合适的疗法又要找到匹配的咨询师真的非常难，我认为遇到尔婧对我来说是人生中幸运的事情～

About the Provider Licensed Mental Health Counselor in Washington (License #: LH61033109) and Oregon (License #: C7222) Approved clinical supervisor in Washington Mental Health Professional, Ethnic Minority Mental Health Specialist certificated by Washington State Department of Health ​ Erjing provides individual therapy to clients; clinical supervision, and peer consultation to mental health professionals and paraprofessionals. She also offers talks, workshops, and training for schools, agencies, and communities. 中文版 Selected Professional Roles/Experiences Adult mental health therapist for OCD/Anxiety and Depression at Rogers Behavioral Health Vice-president for OCD Washington, an official affiliate of the International OCD Foundation. RYT 200 hours Certified Yoga Instructor Past Mental health therapist at Asian Counseling and Referral Service Clinical training from OCD Institute at McLean Hospital, a psychiatric affiliate of Harvard Medical School Past Researcher for Asian American College Student Mental Health Past COVID-19 hotline volunteer and administrator for Yong Xin Kang Yi (See New York Times's coverage ) Past founder and organizer of Psychology Immersion Camp for pre-college students Past 1-1 experience working with first-generation college students, the homeless population, and victims of domestic violence in various settings. Selected Certification and Trainings Education ​ Master of Arts in Mental Health Counseling from Boston College Bachelor of Science in Psychology and Political Science from the University of Illinois at Champaign-Urbana (graduated with Honor) Studied in University of Cambridge The Collaborative Assessment and Management of Suicidality (CAMS) Model presented by the David A. Jobes, Ph.D. (April, 2022) Advanced Empathy Training by co-founder Dr. Robert Elliott (2021) Sexual Assault Therapist certified 2020 Emotional Focused Therapy (EFT) Level II, by founder Dr. Les Greenberg Mastering ACT III certification by Robyn Walser, Ph.D. 2019 Emotional Focused Therapy (EFT) Level 1 certification by co-founder Dr. Robert Elliott. 2019 Ethnic Minority Mental Health specialist 2019 Mental Health Professional 2019 APA (American psychological association) Minority Fellowship award, 2017 Selected Talks and Publicity Links . Cui, E. (2022, November). Professional Networking Event for Providers of Color. OCD Online Conference 2022. Cui, E. (2022, November). People of Color Support Group for OCD . OCD Online Conference 2022. Cui, E. (2022, July). People of Color Support Group for OCD . OCD Conference 2022. Cui, E. (2022 March). “我有强迫症”- 强迫症的四个误区 - Four Myths about OCD. " OCD Washington. (video 1) ​ Cui, E., et al. (2021, November). Diversity Roundtable: Diversity in Action . IOCDF OCD Foundation. (video 2 ) ​ Cui, E. (2021, Fall). Providing Culturally Competent OCD Treatment for Asians, Asian Americans, and Pacific Islanders. OCD Newsletter, Volume 35, Number 3. International OCD Foundation. Cui,E., Morse, S., Mostoufi, S. (2021, July). Barriers and Bias: Cultural Competence in the treatment of OCD . IOCDF OCD Conference 2021 Cui, E., De Leon, C., Xie, L., Sze, R. (2020, December). How to Recognize and Support My Child Experiencing Depression . Presented at Mental Health Forum Series, Bellevue School District, Bellevue, WA. (video 3 ) Cui, E., Wang, L., Yung, H., Xie, L., Wang, M., Ho, J. (2020, June). Family Wellness Forum for Mandarin Family in Bellevue School District. Presented at, Bellevue School District, Bellevue, WA. Cui, E. (2020, April). Coping with COVID. 疫情下的心理健康. Bilingual presentation for Denise Louie Education Center, Seattle WA. ​ Media Involvement/Coverage New York Times , Reuters , The World and 20+ other media covered our volunteer work at Yong Xin Kang Yi (Heart against COVID) 心语说 | 走进心理咨询师这个行业（上） 心语说 | 走进心理咨询师这个行业（下） Postcast: Dealing with Xenophobia. 一三说20期: COVID-19下亚裔在美受歧视，排外情绪Xenophobia我们该如何应对？--几位心理咨询师的分享 ​