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Stuck in OCD grip and scared to start exposure


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As I've mentioned before, I have an irrational fear of insomnia and the resulting distress it causes me.  My main fear is not the tiredness that it brings, but the massive anxiety and feelings of hopelessness that results from a night of zero sleep.  In addition, the fear is also of this hopeless spiraling out of control with several sleepless nights in a row.  So basically, my fear is my own emotional reaction to my anxiety.  :(  The fear is also that I can't stop obsessing that I'm still awake when lying in bed waiting to fall asleep.

I guess I'm just looking for a bit of guidance and support.  I feel really stuck at this point.  I really haven't even had much insomnia lately due to the medication I'm taking for anxiety, and the Seroquel I take at night if I'm feeling anxious.  The problem here is I'm not exposing myself the the fear and it ultimately persists.  I wake up in the morning anxious with dread that tonight will be the night that the medications don't work and I spiral into anxiety and depression.

Thanks for any help,

Jim

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So let's take a look at this. You get intrusive thoughts that you won't be able to fall asleep. You react by performing a compulsion, which is ruminating. You overthink the possibility that you won't fall asleep, your brain ends up going a million miles an hour and because of that sometimes you end up not falling asleep. It's like a self fulfilling prophecy.

The problem is your ruminating. If you could reign that in you'd be in a much better place. That's what you need to work on.

I'm not going to kid you. Stopping ruminating is really hard. But it can be done. It takes a lot of practice.

Basically what you do is first notice that you are ruminating, stop yourself, then shift your focus onto something else. You want to completely ignore the thoughts that you won't fall asleep. Don't sit there and think, I will fall asleep. That's replacing a negative thought with a positive thought and it can turn into a compulsion.

You can do exposures with this. You sit down quietly. You conjure up the intrusive thought. You purposefully think that you won't fall asleep tonight and you'll toss and turn for hours and hours. Hopefully your anxiety level rises. Then you practice not ruminating. You leave the thought alone and let it float around without engaging with it with compulsions.

Does this make sense?

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Thank you Polar Bear!  Yes that does make sense.  I definitely have compulsions of reassurance seeking when the thoughts appear.  I will try your suggestion and see how it goes.  Ultimately though I need to experience sleepless nights and not freak out.  This is where I really have a hard time accepting and avoiding the compulsion of running for a sleep med.

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