Ebru Sinici, Sinan Aydýn, Taner Öznur (2018): Tedaviye Dirençli Obsesif Kompulsif Bozuklukta Pozitif Psikoterapi Etkili Olabilir Mi? Bir Olgu Sunumu. [Can Positive Psychotherapy be Effective in Treatment-Resistant Obsessive Compulsive Disorder? A Case Report]. Klinik Psikiyatri Dergisi

Obsesif Kompulsif Bozukluðunun (OKB) tedavisinde en sýk kullanýlan psikoterapötik müdahale, maruz býrakma
ve tepki önleme üzerine kuruludur. Bununla beraber hastalarýn önemli bir kýsmýnda bu müdahaleyi uygulamak zordur. Bu yazýda tedaviye dirençli obsesif kompulsif bozukluðu olan bir hastanýn tedavisinde kullanýlan eklektik bir yaklaþým olan Pozitif Psikoterapi tartýþýlacaktýr. Yirmi yýldýr OKB tanýsýyla takipli hasta, biri ateþli silahla olmak üzere toplam altý defa intihar giriþiminde bulunmuþtu. Psikofarmakolojik müdahaleler, EKT, anterior kapsülotomi da dâhil çeþitli tedaviler almýþ, tedavilere raðmen yakýnmalarýnda gerileme olmamasý ve intihar düþüncesi olmasý sebebiyle kliniðimize yatýrýlmýþtýr. Pozitif psikoterapi uygulamasý sýrasýnda iki defa tecavüze uðradýðýný paylaþan hastaya Pozitif Psikoterapi aþamalarýnda zamaný geldiðinde EMDR tekniði uygulanmýþtýr. Aþamalar tamamlandýktan sonra yakýnmalarýnda azalma olmuþ, sonrasýnda da davranýþsal ödevlerle iyilik halinin devamlýlýðý kontrol edilmiþtir. Hasta þifa ile taburcu olmuþtur. Bu yazý ile tedaviye dirençli OKB tedavisinde Pozitif Psikoterapinin (PPT) etkinliðini göstermek
amaçlanmýþtýr.

Anahtar Sözcükler: OKB, Pozitif Psikoterapi, EMDR

The most frequently used psychotherapeutic interventions in OCD treatment are based on exposure and response prevention. However, it is difficult to apply this intervention to a significant part of the patients. In this article, Positive Psychotherapy, an eclectic approach used in the treatment of a patient with treatment-resistant obsessive-compulsive disorder, will be discussed. The patient had OCD for twenty years had attempted suicide a total of six times, including gunshot. The patient had received psychopharmacological interventions, ECT, anterior capsulotomy. She admitted to the clinic because of the there was no regression in the complaints and thought of suicide. During the positive psychotherapy sessions, EMDR technique was applied to the patient who shared that she was raped twice. After completing the steps, there was a decrease in complaints, and then the continuity of rehabilitation checked via behavioral tasks. The patient was discharged with wellbeing. In this article, it is aimed to show the effectiveness of Positive Psychotherapy in the treatment of OCD which is resistant to treatment.

Key Words: OCD, Positive Psychotherapy, EMDR