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Dr John B
Dr John B, Psychologist
Category: Mental Health
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Experience:  PhD in Clinical Psychology, registered clinical psychologist.
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For the last few days, I have been having music repeat over

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For the last few days, I have been having music repeat over and over in my head. Like when you get a song stuck in your head that you can't stop thinking of. I don't "hear" the music, it's just in my head, and I can change the music by thinking of another song if I want. But, the main thing is that there is always SOME sort of music going through my head and can be annoying. I have OCD and am taking prozac (80 mg) and abilify (5 mg) to augment the prozac. I wonder what could be causing this and will it go away? I know the difference between auditory hallucinations (you actually "hear" them) and non-auditory (in your head).

Thanks,

Ben
Submitted: 2 years ago.
Category: Mental Health
Expert:  Dr John B replied 2 years ago.

Hi Ben,

Can you tell me a little bit about what the OCD is like for you? Can you describe any obsessions or compulsions you experience? Had you considered the possibility that the experience of repetitive music in your head may be related to the OCD?

Customer: replied 2 years ago.
Obsessions are like kind like sci-fi kinds of obsessions about very weird things like what if people aren't real, etc. I don't believe the obsessions, they just bother me. Compulsions are tapping, etc. Pretty classic compulsions. Yes, I'm almost an LCPC myself, so I've considered that this could be related to the OCD, although its a first for me having a song in my head that I can't seem to get rid of. Of course, it goes away when I watch tv, or listen to other music.
Expert:  Dr John B replied 2 years ago.
I have certainly worked with clients in the past who have had developed compulsive & repetitive mental rituals involving music and this would be the first possibility I would consider given your description so far. How has the OCD been lately? Anything happen in your life recently that might have lifted your anxiety and exacerbated the OCD? It is quite common for individuals with OCD to develop new rituals over time (sorry if I'm telling you something you already know).
Customer: replied 2 years ago.
Well, I'm doing my internship and working, so things have been pretty stressful lately. Also, I've been depressed prior.

So this doesn't sound like an auditory hallucination to you? I know that those require that you actually hear things, not have them in your head.

Thanks,

Ben
Expert:  Dr John B replied 2 years ago.
Yes you're absolutely right. Auditory hallucinations are usually experienced as sound and whilst there are exceptions they are not usually recognized as being self-generated. If you recognise them as just 'being in your head' then I doubt they re auditory hallucinations. Just to check, do you have any previous history of Psychotic phenomena? Or do you have a family history of Psychotic illness?
Customer: replied 2 years ago.
No history or family illness.
Expert:  Dr John B replied 2 years ago.

Ok, that's good news.

You mentioned that you can stop the repetition through distraction or focusing your attention elsewhere. How do you usually manage your other compulsions when they are flaring?

Customer: replied 2 years ago.
Well, sometimes I just ride them out. But other times I focus on something else to take my attention. I know there are techniques like thought replacement or thought stopping. The compulsions, I usually don't do anything about. What do you recommend for this?
Expert:  Dr John B replied 2 years ago.

We usually see both obsessions and compulsions intensify and diminish as a person's anxiety levels go up and down. So, the first step is to focus on managing your anxiety levels with the expectation that the OCD symptoms will diminish when your anxiety in general is lower. OCD obsessions and compulsions can be viewed as a best attempt at managing intense anxiety so we try to keep the focus off the symptoms and on the underline anxiety difficulty if possible.

 

However, there are many people who develop quite intense and disabling OCD that requires direct treatment of the symptoms. Cognitive Behavioral Therapy (CBT) is widely regarded as the gold standard therapy for intense obsessions and compulsions and the National Institute for Clinical Excellence recommends CBT as an effective treatment for OCD, see here. CBT is a psychotherapeutic approach that aims to solve problems concerning dysfunctional emotions, behaviors and cognitions through a goal-oriented, systematic procedure. Treatment is technique driven, brief, direct and time-limited (normally 10-12 sessions). CBT is used in individual therapy as well as group settings, and the techniques are often adapted for self-help applications.

If you are able to manage the compulsions through good general anxiety management then it would be my recommendation that they place your focus there. If not then I would suggest you try a self-help approach using a CBT based treatment manual. I can recommend a book titled Coping with OCD: Practical Strategies for Living Well with Obsessive-compulsive Disorder and another book titled Getting Over OCD: A 10-Step Workbook for Taking Back Your Life. You can find both of these books on www.Amazon.com .

 

If you decide you need some additional help then I would strongly recommend that you seek out a CBT trained therapist for an assessment and assistance. CBT is usually offered by Psychologists (although not exclusively) and you can contact the American Psychology Association for assistance in finding a suitably trained clinician. Take a look at the American Psychology Association's locator service here . You can use this to find Psychologists in your area and there is a phone number you can contact if you want a referral arranged for you. Also, take a look at an article published by the APA here. It's an interview with a senior Psychologist and covers some of the things you should consider when you looking for a Psychologist.

 

I hope this has been of some help. Please let me know if you have further questions or would like me to clarify any part of my answer. Best of luck!




Dr John B, Psychologist
Category: Mental Health
Satisfied Customers: 557
Experience: PhD in Clinical Psychology, registered clinical psychologist.
Dr John B and 2 other Mental Health Specialists are ready to help you
Expert:  Dr John B replied 2 years ago.
Hi Ben,

I just wanted to check in and see if you had made any progress in bringing the repetitive music under control. If you require and further assistance or if you ever have any questions in the future please don't hesitate to contact me.

Regards,

John

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