Posted: Sep 29, 2017 5:27 am
I don't have time for a long answer now, but it seems to me that the problem is with him, not with CBT. CBT for social anxiety involves reducing the fears around social interaction via addressing the core beliefs which are holding them up. It helps you construct more realistic thoughts by overriding the skewed perceptions you have created over the years. If he's still hiding from talking to you about what he did, it's probably, like it says in the link, that he fears how you will see him and that will affect how he sees himself. He doesn't yet realise that by avoiding the discussion he is strengthening any negative thoughts you have towards him anyway. Either that, or he does realise, but the fear of what you might say to him, about him, is too much to handle. Unfortunately CBT can't fix someone unless they want to engage. You also say that he was having the therapy, as in it is still ongoing. It's a process, obviously, and as such takes time. So in answer to your question, I can't really see how one could misuse CBT, since it is a model which aims to help the patient become more realistic in their thinking patterns, not just as unrealistic in the opposite direction.
As for your question on OCD, you don't really get OCD 'over' specific objects or actions. It's an anxiety disorder, involving those pesky thinking errors again. You have intrusive thoughts concerning things like your health, your personal responsibility or whatever, and those are so unpleasant and tenacious that you have to try to find a way to stop them coming true. The intrusive thoughts then lead to compulsive behaviours. Importantly, these behaviours don't need to be ostensibly related to the fearful thought which has engendered them. That is how rituals start. For whatever reason, you can become convinced that using your cutlery in the correct way and never using it in the wrong way will mean that nothing bad happens that day, for example. Sometimes the compulsions are related, so say if you pass a kid on the street, you might have intrusive thoughts that you didn't pass the kid by, you ran him over. The compulsive behaviours might then involve repeatedly driving past the scene of the 'accident', or repeatedly seeking reassurance from your passenger that you did not in fact run anyone over. The behaviours are used to induce the feeling of some level of control in your life when so much is out of your control.
As for your question on OCD, you don't really get OCD 'over' specific objects or actions. It's an anxiety disorder, involving those pesky thinking errors again. You have intrusive thoughts concerning things like your health, your personal responsibility or whatever, and those are so unpleasant and tenacious that you have to try to find a way to stop them coming true. The intrusive thoughts then lead to compulsive behaviours. Importantly, these behaviours don't need to be ostensibly related to the fearful thought which has engendered them. That is how rituals start. For whatever reason, you can become convinced that using your cutlery in the correct way and never using it in the wrong way will mean that nothing bad happens that day, for example. Sometimes the compulsions are related, so say if you pass a kid on the street, you might have intrusive thoughts that you didn't pass the kid by, you ran him over. The compulsive behaviours might then involve repeatedly driving past the scene of the 'accident', or repeatedly seeking reassurance from your passenger that you did not in fact run anyone over. The behaviours are used to induce the feeling of some level of control in your life when so much is out of your control.