Kabul ve Kararlılık Terapisi Perspektifinden Obsesif Kompulsif Bozuklukta Yaşantısal Kaçınma

Öz

Obsesif kompulsif bozukluk (OKB), obsesyon ve kompulsiyonlarla süregiden ve işlevselliği olumsuz yönde etkileyen, tedavi edilmediğinde kronikleşebilen psikiyatrik bir rahatsızlıktır. OKB’de ilaç tedavisi ve maruz bırakma-tepki önleme tekniklerini içeren Bilişsel Davranışçı Terapinin etkililiği kanıtlanmış görünse de tedavi bırakma oranları ve takip sonrası kalıntı belirtilerin görülmesi, araştırmacıları farklı tedavi yaklaşımlarına yöneltmiştir. Bu bağlamda ortaya çıkan üçüncü kuşak terapi yaklaşımlarından biri olan Kabul ve Kararlılık Terapisi (KKT), OKB tedavisinde yenilikçi ve etkili bir yaklaşım olarak giderek daha fazla ilgi görmektedir. KKT, temelde hayatın doğal akışı içerisinde var olan acılardan kaçınmak yerine onları kabul ederek kişinin yaşamını kendi seçtiği değerler doğrultusunda yönlendirmesini amaçlamaktadır. KKT yaklaşımı ile OKB tedavisinde, bireylerin psikolojik esneklik seviyelerini artırmaya yönelik müdahalelerle hastalığın prognozuna olumlu katkı sağlanabildiği görülmektedir. OKB hastalarında obsesyonların yarattığı kaygıdan kaçınmak için kompulsiyonlara girişmenin yanı sıra çok çeşitli yaşantısal kaçınma stratejileri izlenebilmektedir. KKT yaklaşımı ile, bu stratejilerinin azaltılarak olumsuz içsel yaşantıların kabulü yoluyla obsesyonların yarattığı kaygının giderilmesi ve kompulsiyonların ortadan kaldırılması sağlanabilmektedir. Bu derleme makalesi, OKB’de yaşantısal kaçınmayı KKT çerçevesinde ele almaktadır. Son yıllarda yayımlanan güncel çalışmalar ekseninde, KKT’nin OKB tedavisinde yaşantısal kaçınmayı nasıl hedef aldığı ve yapılan müdahalelerin OKB semptom şiddeti ve psikolojik esneklik arasındaki ilişkiye etkileri tartışılmaktadır.

Anahtar Kelimeler

• Obsesif kompulsif bozukluk
• kabul ve kararlılık terapisi
• yaşantısal kaçınma

Experiential Avoidance in Obsessive-Compulsive Disorder from the Perspective of Acceptance and Commitment Therapy

Öz

Obsessive compulsive disorder (OCD) is a psychiatric disorder characterized by the persistence of obsessions and compulsions, which negatively impact functionality and may become chronic if left untreated. Although the efficacy of pharmacological treatment and Cognitive Behavioral Therapy (CBT) involving exposure and response prevention techniques has been proven in OCD, treatment discontinuation rates and residual symptoms following treatment have led researchers to explore different therapeutic approaches. One such approach gaining increasing interest is Acceptance and Commitment Therapy (ACT), a third-generation therapeutic model, which is proving to be an innovative and effective treatment for OCD. ACT primarily aims to guide individuals toward leading a life aligned with their chosen values, by accepting the pains that exist in the natural flow of life instead of avoiding them. In the treatment of OCD, with the ACT approach, interventions aimed at enhancing psychological flexibility have been shown to positively impact the prognosis of the disorder. In addition to engaging in compulsions to avoid the anxiety caused by obsessions, OCD patients may follow a wide variety of experiential avoidance strategies. With the ACT approach, these strategies can be reduced and the anxiety caused by obsessions and compulsions can be eliminated through the acceptance of negative internal experiences. This review article addresses experiential avoidance in OCD within the framework of ACT. Based on recent publications, the article discusses how ACT targets experiential avoidance in OCD treatment and the effects of interventions on the relationship between OCD symptom severity and psychological flexibility.

Anahtar Kelimeler

• : obsessive-compulsive disorder
• acceptance and commitment therapy
• experiental avoidance

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