OCD, intrusive obsessive thoughts, self reassurance, CBT, ERP, advice

[Guest hope_le_]

I am waiting to see a CBT therapist, but there is a waiting list and in the mean time i want to practise using cbt techniques to help me with my ocd, I understand the theory behind what cbt aims to do  - but in practice its quite confusing!

my main problem is obsessive intrusive thoughts, which i used self reassurances to make me feel better - (certain phrases/words which comforted me and temporarily reduced the anxiety, eg "im blessed" "You are loved" etc) but now i realise that the reassurances are actually compulsions and makes things worse  so i am trying to stop doing this. however - now im not sure what to do instead?

 

have read in cbt self help articles, that the best thing to do is resist the urge to self reassure  and instead to' let the thoughts pass'  and acknowledge that it is 'the ocd' - however is saying to myself "let the thought pass' and  'its just ocd' another form of self reassurance (so am i essentially just replacing the initial reassurance with the above phrases?) or is it different because im not 'feeding the anxiety by reassuring myself - but simply acknowledging instead that i need to let the thought/anxiety pass and acknowledge the ocd?

i want to make sure i am doing the technique properly - but am so confused at the moment,  i cant do it properly if im doubting if im doing it right? and because im confused i end up getting even more anxious! i dont want to just end up replacing the old reassurances  with a new reassurances! or is it different because i am acknowledging the thought for what it is?(ocd?)

also i was reading up on ERP therapy and it was saying in that  that i should expose myself to the triggers/ let the intrusive thoughts come - and then instead of saying anything at all 'eg let it pass' or 'its just a thought' or 'its the ocd' i should instead just do nothing and let myself feel the anxiety/horrible feelings until it passes of its own accord. This sounds really scary. as when the anxiety gets a grip on me - its so so hard to get myself back up again... but the thing is - when i say to myself 'let it pass' or 'its just the ocd' i find that helps, as i can detach myself from the situation and see it for what it is, rather than getting caught up in the fear/anxiety - but now im scared this might just be me trying to put another mental compulsion/reassurance in place without realising it... 

ps-  in the past i have used the phrase "let is pass" "its just ocd" etc and it helped me overcome my ocd, i was then ocd free for years before a recent trigger made it come spiralling back , but back then, i didnt know anything about mental compulsions - so thought it was fine. and since it helped me overcome my severe ocd last time, maybe its good to use again? but just so worried about potentially just creating new compulsions with these phrases...

so ultimately what im trying to say, it what is the best thing to do when i have a trigger and the intrusive thoughts come?

A) - acknowledge the thought, say to myself 'let is pass' acknowledge it is the OCD and not focus or dwell on it/give into the old self reassurance compulsions?

b) - dont do anything, dont let myself acknowledge that its ocd, dont remind myself to let it pass but just  let myself feel anxiety and hope it will eventually pass of its own accord?

i dont have a therapist i can talk to yet whilst im waiting on the list - so any advice and clarity on this would be a big help, so that i can have confidence in what i am practising without making anything worse, until i can get professional help!

[PolarBear]

Hi hope and welcome to the forum.

Give yourself a pat on the back for recognizing the compulsions you are doing. That's a big step in itself and it's something some people really struggle with. So good on you.

My best answer is that you need to do a hybrid of your top choices. You ate right that saying something like, it's just OCD, could become a compulsion but that's only if you are saying it over and over. Saying it once to yoursrlf is not a problem.

So when you get am intrusive thought, we want you to be cognizant of it. We want you to think, oh yeah that's just an OCD obsession, it's nothing to be concerned about. Then, and this is the critical part, you do no compulsions. You leave the thought alone and just continue on with your day. Yes you will get anxious but the less you pay attention to the thought the quicker your anxiety will come back down.

Make sense?

[Guest hope_le_]

Hi Polar bear 

thanks for taking time to reply to my post, really appreciated, only just found out i have ocd about a week ago and so am really trying to get my head around it! so is what you are saying - is that its ok when i get a intrusive thought to say 'its just the ocd' and let it pass? and get on with my day - and i can do this each time i get the thought without it becoming a new compulsion?

I used this technique to help me with my GAD (general anxiety disorder) and it really helped with that - but wasnt sure if i could apply it to OCD because of the whole compulsions thing. but if you are saying it can help that that gives me hope! is this the technique that you used to help you overcome your ocd? (i notice your status says ex sufferer, well done you by the way

ps - did you have ERP (exposure) therapy as well or just CBT? as what i dont quite understand is how to do both - challenge the thought (which involves thinking about it etc/ whilst at the same time working on the technique of trying to just 'let the thoughts pass" ? 

 

[PolarBear]

So in answer to your first question, yes. You can tell yourself it's just OCD then get on with your day without doing compulsions. Absolutely.

Now CBT is Cognitive Behavioral Therapy, which looks to get the sufferer to both think differently (Cognitive) and behave differently (Behavioral). One of the best ways to alter your behavior (doing compulsions) is to do what is called ERP - Exposure and Response Prevention.

Now when you get the intrusive thoughts that normally bother you, you want to put CBT into effect. That means trying not to freak out over the thoughts, realizing they are irrelevant, not doing compulsions.

But you can also push the matter, challenging your OCD too, and that's done with ERP. What happens in essence is you expose yourself to the thoughts (you purposefully think about them, conjuring them up) and then you practice response prevention, which means not performing compulsions. The idea is to get your anxiety level up and then practice not doing anything and realizing that the anxiety will go down on its own without having to resort to compulsions. Repeatedly doing this will basically get you used to the thoughts and not doing compulsions. Over time it can mean the intrusive thoughts bother you less and less and just become not a big deal anymore.

[Guest hope_le_]

thanks again for replying to me Polar Bear - so from what i understand... - I can use the CBT technique of 'letting the thoughts pass' throughout my day so i can function- and then perhaps do the ERP at a dedicated time, like at a counselling session or at home when i can put aside a hour or so and concentrate on practising the ERP technique (which will then work hand in hand with the cbt, as combined they will both weaken the intrusive thoughts?) ps do you think its possible to conquer the ocd without the ERP element and just use the CBT on its own? 

[PolarBear]

You've got it right. 

I suppose it's possible to recover without doing ERP. See how you do with the rest for a while.

[Guest hope_le_]

thanks polar bear, appreciate your advice x

[Guest ashipinharbor]

On 10/5/2016 at 13:14, PolarBear said:

But you can also push the matter, challenging your OCD too, and that's done with ERP. What happens in essence is you expose yourself to the thoughts (you purposefully think about them, conjuring them up) and then you practice response prevention, which means not performing compulsions. The idea is to get your anxiety level up and then practice not doing anything and realizing that the anxiety will go down on its own without having to resort to compulsions. Repeatedly doing this will basically get you used to the thoughts and not doing compulsions. Over time it can mean the intrusive thoughts bother you less and less and just become not a big deal anymore.

Can you feel like you like the thoughts while doing this?

[paradoxer]

A caveat here - the hybrid is tricky, in a way it's two opposite approaches, cognizance, but accepting the fear - don't let the realization that's it might be OCD be reassurance.