Trying really hard with ERP, feel like I'm not getting any better

[pureosufferer]

Hi guys,

I've been a pure o sufferer my whole life, although I do also have some overt compulsions such as pacing up and down and avoidance etc.

I had several years mostly untroubled by OCD during which time I was really happy. In March it all flared up again however. Since then I've been doing CBT, specifically ERP, except for a period of 6 weeks this summer when I went back to the UK (I work abroad) and started a course of Fluoxetine. This was the worst possible thing I could have done. The ERP was not particularly working anyway but the fluoxetine threw me right back to where I started. Now I am starting to feel very dejected. I really try my hardest to do ERP every day, as often as I can. It's very difficult to do, fighting overt AND mental compulsions at the same time. Often I find I can only fight 1 compulsion, which makes it extremely difficult to fight the other. For example if I try not to use avoiding behaviour and let myself be in close proximity with a trigger it is sometimes nigh on impossible not to try to push the intrusive thoughts out of my head with a "safe" thought. The same is true vice versa.

I simply don't feel the therapy is working no matter how hard I try. Complicating this is the feeling that I somehow like the thoughts. This feeling is sometimes very strong and can often feel overwhelming. This makes doing the therapy much harder and scarier. I constantly feel like I'm lying to myself and that I'd enjoy the thoughts if I only let myself. The therapy has started to work in one way - the feeling of panic is gone. Now I just feel despair. My therapist and other sufferers I've spoken to say I should try to just "let the thoughts be in my head". I try this also as part of my therapy.

This whole thing in combination, no panic, attempting to deliberately expose myself to triggers while not performing physical OR mental compulsions and letting the thoughts "just be" even while having an overwhelming feeling that I must be enjoying the thoughts is unbearable. It's been months now and I'm not getting any better. I constantly worry I have stopped caring and just given in to the thoughts, accepted they're real or something. It's making me feel so depressed and hopeless. This has been going on for most of the year and I'm not any better. 

 

Any advice guys? I am desperate. My therapist and family all just keep telling me "just keep doing what you're doing, it'll get better" but it ISN'T getting better. I just want it to stop. I really can't bear it. How long do I have to do this for before it starts working?

 

Edited October 23, 2016 by pureosufferer

[Ashley]

Hi,

Did you read my pinned topic?   You mentioned CBT specifically ERP?   Which is it CBT or ERP, only we don't recommend ERP as a lone treatment.  Generally if you are doing behavioural exercises and the anxiety, fear, panic remains or gets worse that's indicative to me that you were not ready for the exercise or there's some neutralising compulsion going on.

If you mean the therapy as been going on for a year, I would be tempted to review that and consider looking for an alternative therapist if things have not progressed at all.

[pureosufferer]

I'm not sure what you mean. I have been doing CBT but the therapist has told me that ERP is the first step. He has spoken to me about moving on to the next step but thinks I'm not ready yet. As the next stage can be severely distressing. But I thought that ERP WAS part of CBT (maybe the major part?)

[Ashley]

16 minutes ago, pureosufferer said:

I have been doing CBT but the therapist has told me that ERP is the first step.

I totally disagree with your therapist.  Please read my pinned thread, you will understand what I mean.    In my opinion for the behavioural side of therapy to be effective, you need to understand and do the cognitive aspect first.  It sounds like you are just doing ERP, not CBT.

16 minutes ago, pureosufferer said:

But I thought that ERP WAS part of CBT (maybe the major part?)

ERP is a part of therapy, but should be part of a structured package within CBT that included cognitive therapy too. In my opinion, doing the B without the C first is almost pointless and could be unhelpful and even set a person backwards, which seems to be what you suggest is happening to you.

Doing ERP without preparation and cognitive work is the most distressing thing. I have no idea where your therapist is coming from.  If you suffer from Pure I would suggest the cognitive is far more important than the behavioural.

Also, with any therapist, CBT or behavioural if you have been with the same therapist for a year, time to find a new one (unless real 90% progress is being made).

 

[pureosufferer]

I am in a difficult situation as I work abroad and can only do therapy via Skype (there is zero knowledge about OCD in the country in which I live) and I have spent quite a lot of money for this therapy. This therapist was recommended to me by a friend of mine who is a GP back in the UK. Can I ask what the cognitive part entails? I just want to be sure that I haven't actually done any before I bring this up with my therapist.

 

[Ashley]

44 minutes ago, pureosufferer said:

Can I ask what the cognitive part entails? I just want to be sure that I haven't actually done any before I bring this up with my therapist.

Perhaps have a read of my pinned topic and this page on our website - http://www.ocduk.org/cognitive-behavioural-therapy

But, like I mentioned above, even if you have done some cognitive work, something is not working so chances are the therapist is not getting this right at all, so still time to change.