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Uncertain about how to be uncertain & recovery is becoming confusing


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I have dug a hole so deep, that I'm finding it nearly impossible to crawl out of. Stopping ruminating doesn't feel possible right now. Apparently it is, but this theme around therapy is so strong. Oh god what have I done?

 

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Take a deep breath.

I think your expectations are a little too high at this point. The more deep seated the compulsions, the harder it is for you to dig your way out of the OCD hole. This is going to be a slow, painstaking process. Don't get upset if it doesn't seem like you are moving forward. Any movement you make along the road to recovery is positive, even if you take steps back frequently.

Every time you notice yourself slipping into ruminating, you need to stop yourself and say, "I'm not going to do this right now," then shift your attention onto something else. And two minutes later you'll slip back into ruminating and you stop yourself, say the words and shift your focus again. You do this a hundred times a day if you have to. It will feel like you're just spinning your wheels but you keep going. You keep putting one foot in front of the other. During the process you are teaching yourself that it is okay to not ruminate. It will take a long time to get it right, but it will happen. Slowly but surely you'll start to dig yourself out of the hole. And then it will start to get easier and easier.

You can do this. People do it all the time.

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Thanks PolarBear. It's time I take a risk. What I'm doing obviously isn't working. Something has gone off the rails, like you said, but perhaps it's not my job to even figure out where. I can recognize I'm ruminating, so much to the point of mental and physical exhaustion now. Any bit of "evidence" OCD can find related to treatment, it uses it against me. I have to believe I'm stronger than my doubt. I have to now. There isn't another option.

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Listen to PB"s advice and keep working on this......over and over.  Your brain will keep trying to drag you back into rumination, it will feel a very strong urge, it"s what you"ve got used to doing....but you keep resisting that urge, keep bringing your mind back into the moment and keep doing it.  There's no mileage or benefit to be gained by doing it the old way.  The intensity is strongest when you first start the fight back.....it will recede if you break the cycle.

Wishing you strength.....you are actually stronger than you may believe :)

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  • 4 weeks later...

I have been trying so hard to resist my ruminating thoughts over this, but it isn't work. Not in the least bit. I'm afraid that until I understand what exposures are used for I will never overcome this. I thought the whole idea of therapy was to accept uncertainty. Uncertainty that my TV may be on settings I don't like. Uncertainty that my term paper may not have perfect, accurate grammar/spelling. Uncertainty that I'm not sleeping on the perfect pillow. BUT according to exposure therapy, I'm actually, physically, in reality supposed to expose myself to settings I don't like until my anxiety comes down. I'm actually supposed to write incorrect grammar/spelling and become comfortable with that & let my anxiety come down. I'm supposed to be sleeping on a pillow I don't like until I no longer care what pillow I'm sleeping on.
 

I like the cognitive side of therapy where it teaches you to accept uncertainty. I like sitting & resisting compulsions (such as when my TV is on settings I like & then I get an intrusive thought that something is wrong with settings & then doing nothing to fix that thought, leaving the TV alone).

What I don't like is exposure therapy where its completely different than any other form of therapy & exposure therapy actually asks you to mess things up on purpose.

Until I figure out why exposure therapy even exists & why its even considered an ethical form of treatment & actually effective for OCD I don't think I can let it go.

If exposure therapy works, why is it such a miserable form of therapy. 

I'm so exhausted. 

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You're definitely back to ruminating. Your recent post is proof of that. It's a written down rumination sequence.

ERP is not a miserable form of therapy for the vast majority of people who do it. I can't say what has gone wrong with you, whether you had the weirdest therapist ever or you have just completely miscontrued what you were taught, but you have a completely odd, wrong sense of what ERP is. You're back to thinking about wrong settings on your TV when that isn't what your current theme is. Your current theme has nothing to do with TV settings so why in the world would you do ERP on that? It makes absolutely no sense. I don't know why you are stuck on this but you're thinking is wrong.

Right now you should be focusing on not doing compulsions over your current theme, which has to do with perfectionism related to doing your therapy perfectly. Your biggest compulsion in that regard is ruminating. You know that. That is what you need to work on. It's not going to be easy. If and when the time comes for you to need to do ERP we can discuss it at that time, but not now. I'm not going to get drawn into a long debate with you again about ERP, because it simply doesn't matter right now.

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If my thinking is wrong, I want to fix it. My therapists keep telling me that I should sit with I may or may not be doing the therapy correctly. That doesn't make sense though. Why would a therapist encourage & say that it's okay to do therapy incorrectly?

Even if my OCD isn't centered around TV settings right now, it could & very well may be centered on TV settings in the future. And if it comes to that, that'll mean I'm supposed to habituate to settings I don't like/distressing settings at that time. So you see I actually am supposed to habituate to wrong settings if my intrusive thought is "my TV may or may not be zoomed in" & if that thought keeps occuring that means I need to do an exposure and become comfortable with my TV being zoomed in instead of on settings I like, like having all of my TV screen showing. I like my TV to have all of the screen showing, but according to exposure therapy I should not.

I don't know how I can explain how I'm confused any clearer. I can see what you are saying Polar bear, but by technical definition, exposure therapy is about habituating to things you don't like. That's the whole definition of desensitizing. You don't like/fear something, well then you are supposed to habituate to it.

Maybe I'm wrong, but by definition I'm not sure how.

 

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You are wrong. You keep coming back to ERP is supposed to be about habituating to what you don't want. That's crazy. By that logic, you should wipe your butt with your wrong hand all the time because that would make you anxious and you should habituate to wiping your butt with your wrong hand. Then you should start writing with your wrong hand so you can habituate to it and eat with your wrong hand and on and on. Where does it stop?

I'm not going to talk about TV settings because that is not what you are dealing with right now. It doesn't matter if your theme changes in the future. We'll cross that bridge when you come to it.

Yes, it is okay to sit there and think its okay to do your therapy incorrectly, because you are so concerned about doing it perfectly that you have lost focus. It doesn't mean you have to try and purposefully screw up your therapy. It just means it's okay to make mistakes. You can center yourself and start off again without damaging yourself or your chances of full recovery.

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First, it isn't called 'exposure therapy'. It is called ERP or Exposure and Response Prevention. It has two parts: Exposure and the Response Prevention. The Exposure part is where you expose yourself (make happen) what your obsessions are about. Basically, you expose yourself to that which you fear. The second part, response prevention, is all about not performing compulsions. So you expose yourself so you can practice not performing compulsions.

You once used the example of someone being told to eat candy off a toilet seat. There's something missing there -- what compulsion were they to practice not doing? Washing their mouth out? Brushing their teeth? What? Because it is not enough to just expose one's self. You also have to practice preventing the response (compulsion).

Examples of ERP include:

1. Someone who washes their hands (the compulsion) after touching a 'contaminated' item. The sufferer as exposure touches a contaminated item and then does NOT wash their hands, sitting with the anxiety until it reduces to a more comfortable level.

2. Someone who always does things in symmetry (example: if they touch a wall with their left hand they have to touch a wall with their right hand). The person purposefully touches a wall with their left hand (the exposure) and then does NOT touch a wall with their right hand (response prevention).

You do NOT do exposures just for the sake of doing them or just because doing that thing would make you anxious. You choose your exposures carefully, based on what your OCD theme is.

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So if I'm watching my TV and I get an intrusive though that the settings are off & refuse to give into the compulsion of checking, would this count as ERP or only resisting compulsions? Because in this scenario, more than likely, my settings are fine just the way I left them when I initially set them. I'm aware it's the ocd playing tricks.

What trips me each and every time when thinking about exposures, is that according to the ERP model, I'm supposed to physically set my settings off how I don't like them and then sit with that anxiety without changing my settings back to how I want them. 

Some people have told me that ERP is the same as sitting with the thought and doing nothing. Some people have told me that it isn't enough to just stop compulsions, but I should also expose to settings being off for a certain amount of time. 

I'm aware this isn't my OCD theme, but perhaps you can see where the confusion comes in?? 

I think it's enough to leave my TV be, no matter if I'm obsessing about it or not, but by definition this would only be RP (response prevention) so I feel the urge to make sure there is an exposure as well to complete the whole ERP process.

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Maybe my question is what would my exposure look like if when I tried to watch my TV, I was checking all the time to make sure it wasn't zoomed in. The OCD person is pretty sure the TV isn't zoomed in, but the urge to check is strong and keeps him from watching TV.

So what would be an appropriate exposure? Should the OCD person just resist compulsions or also expose himself to off settings on the TV???

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38 minutes ago, saddaniels said:

So if I'm watching my TV and I get an intrusive though that the settings are off & refuse to give into the compulsion of checking, would this count as ERP or only resisting compulsions? Because in this scenario, more than likely, my settings are fine just the way I left them when I initially set them. I'm aware it's the ocd playing tricks.

What trips me each and every time when thinking about exposures, is that according to the ERP model, I'm supposed to physically set my settings off how I don't like them and then sit with that anxiety without changing my settings back to how I want them. 

Some people have told me that ERP is the same as sitting with the thought and doing nothing. Some people have told me that it isn't enough to just stop compulsions, but I should also expose to settings being off for a certain amount of time. 

I'm aware this isn't my OCD theme, but perhaps you can see where the confusion comes in?? 

I think it's enough to leave my TV be, no matter if I'm obsessing about it or not, but by definition this would only be RP (response prevention) so I feel the urge to make sure there is an exposure as well to complete the whole ERP process.

I feel like I'm getting dragged into a discussion that is bound to go nowhere. But I'll try, paragraph by paragraph.

1. It would count as resisting compulsions. No ERP necessary, no ERP done.

2. According to ERP you do NOT have to set your TV settings off normal or how you don't like them and sit with that anxiety. You are just wrong here. No one is going to be expected to screw up their TV settings and watch it until they habituate. No one. You get an intrusive thought that your TV settings are off, you resist doing compulsions. If anything you are exposing yourself to the possibility that your TV settings are off but you surely don't screw them up intentionally.

3. Yes, ERP is about sitting with the thought and doing nothing (no compulsions). You need not expose yourself to the actual settings being off. You only need to expose yourself to the possibility that they might be off, without doing any compulsions. OCD sufferers hate uncertainty, but it's something you have to get used to.

4. I can see where your confusion comes in but it's because you have a twisted view of what  ERP is and how it should function.

5. No, you would be exposing yourself to the possibility that your TV settings are wrong. That's what your intrusive thought said, that your settings are wrong. Your compulsion would be to check and fix the settings. You don't do that. You live with the uncertainty. But NO ONE is expecting you to watch screwed up TV settings.

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Nobody knows the answer to their fears before they start therapy. The person with contamination fears can't know that their hands are clean enough; the person with the false memory can't know if it's true; the person who worries that they are a peadophile cant know that they aren't. You can't know if you are doing your therapy correctly. 

Thats the whole point. If you knew, you wouldn't be in this predicament. You wouldn't have OCD. You would simply be getting on with life, dealing with stuff as it comes along.

You, like others on this forum, are keeping yourself stuck by trying to find out the answer rather than trying to get well. You have added an extra layer onto your issues by turning your obsession into the therapy process, but the advice remains the same.

Until you let go of the need to know, you will remain stuck. 

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4 hours ago, Franklin12 said:

Until you let go of the need to know, you will remain stuck. 

That is probably the most important piece of information in this thread.  You may feel that your questions are relevant but really they are a classic example of that "need for certainty" that sufferers crave, feeling that if they could just be sure on this point things would be okay. Wrong.

 

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What you summed up is what I want to believe PolarBear. I get confused as to why my therapists had me do exposures where I physically, actually, did screw with the settings. They had me do it for like 5 minutes and then sit with the anxiety. Here, I feel like they were wanting me to habituate in this exposure trial to screwed up settings. Maybe not though. I don't know.

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Look, I can sort of understand you screwing with the TV settings for five minutes, sitting with the anxiety, then switching back to normal and getting on with your day. I can see that. But what you've been talking about is screwing up the settings even when it's not a problem and 'habituating' to it, as if you're supposed to ultimately sit there and watch your TV forever with the wrong settings. That's just not right and would serve no purpose.

However, all that said, your current theme has nothing to do with TV settings and you shouldn't be worrying about them. You should be concentrating on what's in front of you.

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Why care though?  Go with the Bear, seems to us here to make perfect sense. 

I didn't agree with the proposed treatment plan from my first therapist - a very eminent psychiatrist and clinical psychologist. I looked him in the eye, told him I was convinced he was wrong, and terminated the therapy. 

He was very annoyed, but I was sure I was right - and I didn't have back up you have from this wonderful community. 

My subsequent psychiatrist, and therapist, confirmed he was wrong. 

Regular topics and posts on here occur when people are unhappy with what their therapist is telling them  - by no means are they right all the time. 

 

Edited by taurean
typo
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Guest OCDhavenobrain

I get the impression that you think uour theraphist is cruel to you. That is a good sign, you dont want a theraphist who wants to speak about it and dig deep into the matter.

See it this way, we have a diagnosis where recovery is possible, that is not something everyone with a diqgnosis are fortunate to say.

 

It is basically up to you my friend to do the work, yes it sucks and you have anxiety, you wouldnt have ocd if you didnt got anxiety of the thoughts. Nobosybever would get this stucked in thoughts like us if it didnt came with feelings.

 

It's all up to you. You have surely had other compulsions in your life, how do you feel about them now? i myself can look back and say that i had compulsions which i thought was the end of my life, i am however not any longer concerned about those specific compulsions. You reallh think this compulsion about the tv is it? The ONE which will either damn you for ever or get you the final relief?

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  • 2 weeks later...

So, if I'm getting this straight, the only reason my therapists asked me in the past to put my settings off intentionally was to recreate the anxiety I'd get when I'd think my settings might be off?? 

I'm not getting used to my TV being zoomed in, or my settings being off from how I like them. I'm getting used to the uncertainty that they may be off??

Problems I keep running into:

1. My therapists had me intentionally put my settings off in the past & told me to sit with that anxiety. I'm still confused as to why they didn't just ask me to watch my TV & resist checking.

2. Its called ERP. Seems like what I am doing is only the RP part. Therefore, I feel like I've failed because I need to put an "exposure" in there somewhere.

 

The ruminating has lessened,  but I'm still feeling the need to do something based on my above problems. Doing nothing at all seems too far fetched for my brain.

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I have Had ocd rituals with the tv I had  put the sound down to 24 but what I learnt is leave the tv on a programme and let the anxiety be there and evently it will  leave.

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7 hours ago, saddaniels said:

So, if I'm getting this straight, the only reason my therapists asked me in the past to put my settings off intentionally was to recreate the anxiety I'd get when I'd think my settings might be off?? 

I'm not getting used to my TV being zoomed in, or my settings being off from how I like them. I'm getting used to the uncertainty that they may be off??

Problems I keep running into:

1. My therapists had me intentionally put my settings off in the past & told me to sit with that anxiety. I'm still confused as to why they didn't just ask me to watch my TV & resist checking.

2. Its called ERP. Seems like what I am doing is only the RP part. Therefore, I feel like I've failed because I need to put an "exposure" in there somewhere.

 

The ruminating has lessened,  but I'm still feeling the need to do something based on my above problems. Doing nothing at all seems too far fetched for my brain.

Your whole post is written down ruminating. And I'm not going to answer it. No answer we give you will satisfy you for long. You'll be back again with more ruminating and reassurance seeking. Leave it alone. Just drop the subject.

Edited by PolarBear
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I know I'm doing it, yet at the same time, this issue feels extremely important to figure out. I am so very confused as to why my therapists had me put my settings off and sit with that anxiety. Like you said PolarBear, my intrusive was originally "What if the settings are off?" If anything I should be sitting with the uncertainty. Maybe even eventually come to the realization that "What if the settings are off?" is just a thought. The settings probably are not off.

What I should never be doing is habituating to settings I don't like. Yet, in the past, trained behavioral specialists had me do it. So now, I feel like I must completely habituate when I put my settings off intentionally in order to move forward.

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