Dr. Phil Kronk: Do you have real worries or obsessive ruminations?

      Worry does not empty tomorrow of its sorrow, it empties today of its strength.” “Corrie Ten Boom

      “Sorrow looks back, Worry looks around, Faith looks up.” Ralph Waldo Emerson

There are enough things to worry about in the everyday world—finances, raising children—without the added burden of having intrusive, unwanted obsessive ruminations.

Such worrisome over-thinking can become all-consuming, emotionally devastating and socially destructive.

Along with compulsive behaviors, such obsessions are part of the diagnostic category of an “Impulsive-Compulsive Disorder.” They are felt to be brain-based and localized in brain circuits that are mis-firing.

As I have said before in past columns, intrusive, obsessive thoughts are similar to a fever. They are a warning sign that something is wrong with your body. The negative feelings that one has about having obsessive thoughts or behavioral compulsions must not make you feel embarrassed, shameful, guilty or socially isolated. They must be acknowledged as being a medical problem that must be treated by a combination of medication and cognitive therapy.

A person with an obsessive-compulsive disorder should seek the help of both a physician and a clinical psychologist.

Obsessive-compulsive disorder often waxes and wanes over time for many who suffer from it. In the short run, cognitive therapy can help quiet the thoughts down. I tell patients it is similar to turning down a radio, so that it blends into background noise.

I always recommend that treatment for obsessive thoughts first involve learning how to relax oneself through progressive relaxation techniques. The next step is to counter the negative messages of the thoughts, by realizing that they are brain-related symptoms. These negative thoughts need to be countered with positive, affirmative statements that you and your therapist work on together.

The goal is to change one’s own relationship to one’s intrusive thoughts. And to learn what are real worries.

Psychologists have written about “real” worries. They involve, for example, bereavement and grief. (In fact, others often tell us that we have been grieving too long. They are wrong!)

PTSD is another diagnostic disorder with worry in its make-up. Its therapeutic relief is complex and not easily done. One must respect the rate at which the victim heals.

Gender Identity Disorder involves another form of over-thinking that needs to be better understood and accepted by the general public. The question, “Am I stuck in the wrong body?” is not easily answered.

Another overwhelming, anxiety-producing thought that patients share is the question, “Is this life I am living real?” or “What if I wake up and find that this is not reality?”

Some fear that they will wake up some day and find that the reality by which they live is not real.

Sometimes, I find that such fearful doubting is due to a significant depression. Sometimes, it is due to an unexpressed past trauma. Sometimes, it is a refusal to look at an upcoming negative life event, such as financial reality.

Obsessive individuals also worry if they are in the right reality. The answer I give them is supportive and non-authoritative. I tell them, no matter what reality you find yourself in, you should try to be happy and secure with the one you find yourself in. Being doubtful is not a reason to feel unhappy.

Obsessive worrying can include “content that is odd, irrational, or of a seemingly magical nature.” Another way to differentiate obsessive worrying from normal, or even other types of anxiety, is by the fact that compulsive behaviors are often present.

As the psychologist, Adam Phillips, Ph.D. is famous for saying, “The past influences everything, but dictates nothing.” I find solace in such a belief in hope. I try to share such a hope for all who suffer from what seems like over-whelming fearful and negative thoughts.

[This is the second column this month on a series about obsessive thinking and compulsive behaving. A future column will look at the impaired brain circuits thought to be underlying this disorder.]

Phil Kronk, M.S., Ph.D. is a semi-retired child and adult clinical psychologist and clinical neuropsychologist. Dr. Kronk writes a weekly online column on mental health for the Knoxville News Sentinel’s website, knoxnews.com. He can be reached at (865) 330-3633.