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Overcoming OCD is simple


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I suspect some people will be upset with the topic title of this thread but understand I am saying overcoming OCD is simple, not easy. It's not easy. It's hard. It's tough like getting a root canal without freezing -- it can be done but it's bloody awful to go through. No, I'm saying it's not easy but it is simple.

We tend to overcomplicate the road to recovery. We get into in-depth discussions about this theme and that theme and the differences between them and how each should be handled, and how to treat differently this aspect or that aspect, when really we should be focussing our efforts on the core of recovery. What does it take to overcome OCD? I've narrowed it down.

Get informed. Think positively. Ignore obsessions. Stop compulsions. Challenge OCD.

I think these five statements speak to the essence of the message we try to get across on the forum. If I were to write a book about overcoming OCD (thinking about it) I would start with these five statements. Dealing with OCD and getting to a better place need not be complicated. It's simple.

Get informed. Sufferers need a basic understanding of OCD in general and their OCD specifically. Sufferers need to know what an obsession is and what a compulsion is. They need to know what their own obsessions and compulsions are. They need a basic understanding of Cognitive Behavioral Therapy (CBT). Reading a book on OCD is great. There is no need to read every book written on the subject. Asking questions on a forum to gain better understanding of the disorder is okay but asking about every possible facet of the disorder is going to interfere with moving ahead. People need to be informed but they do not need to be a PhD on the subject.

Think positively. This speaks to the C in CBT. CBT has a cognitive aspect and a behavioral aspect. In short, it's about learning how to think differently and behave differently. OCD sufferers think negatively. They have negative thoughts swimming around in their head. The world is a scary, dirty, dangerous place, according to the thoughts. Snowbear has eloquently pointed out in several recent threads that some people hold onto core, negative beliefs that prevent them from implementing the steps necessary to overcome OCD. The solution, the C in CBT, is to think positively. Sufferers need to start making up positive statements and saying them to themselves to counteract the negative thoughts floating around in their heads.

Ignore obsessions. We talk on the forum about ignoring thoughts, about leaving thoughts alone, about letting them be. From a cognitive aspect sufferers should be telling themselves that intrusive thoughts are just thoughts and don't mean anything. They should be informed enough to understand that obsessions just happen, that they just pop into their heads without any effort on the part of the sufferer. They are forced upon the sufferer. Ignoring obsessions means not reacting to the obsessions. Doing nothing. Getting on with your day despite having the thoughts.

Stop compulsions. This is probably the step we talk about the most. It is essential. It speaks to the B in CBT, learning new ways of behaving. Compulsions are reactions to obsessions. Ignoring obsessions includes not performing compulsions. A sufferer needs to be informed about compulsions to understand what their compulsions are so they can take steps to stop performing them. Sure, anxiety levels will rise when compulsions are stopped. That's expected (and should be learned when the sufferer gets informed). Over time it is expected that continued compulsion denial will result in lower and lower anxiety levels. Compulsions do no good. They feed obsessions, drawing attention to obsessions, ensuring they will come back strong and hard next time.

Challenge OCD. This may be the most difficult step of all. It is not enough to stop compulsions. Sufferers need to challenge their disorder and actually do things their OCD tells them are scary, dirty or dangerous. OCD-UK creator Ashley, who suffers from contamination OCD (the world is dirty) plunged his hand in a toilet and then did not wash his hand right away. That is challenging the OCD. That's facing the bully that is OCD and saying, "I'm not going to take anymore." Challenging OCD is equivalent to ERP - Exposure and Response Prevention. It is about facing the deepest, darkest thoughts, challenging them and refusing to perform compulsions.

I look forward to a spirited debate.

Edited by PolarBear
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This is a very informative thread, thank you for posting it. I think there should also be a seperate talk about pure ocd though. I feel like it's easier to catch compulsions that we act out physically versus mental ones. They're very difficult to catch onto because sometimes we've become so accustomed to doing them that our mind automatically does it like a defense mechanism after a scary thought or situation. An example would be yesturday I got uncomfortable thoughts while joking around with a male coworker, we like to goof around and I got a thought questioning how I felt around him. Was I behaving flirtatiously? Were these feelings like a crush? Why was I laughing and acting shy? I got really freaked our cause I don't like him but then the OCD took hold and it was like trying to calm myself down and prove I didn't like him and make myself feel better so in that case it just kicked in as a defense mechanism. Like my mind was so muddled it was confusing to see what was a rational response and what was a compulsion, especially feeling so uncomfortable.

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Nicolette, I agree but a person should be figuring out what their compulsions are in the 'Get informed' step. Compulsions are compulsions, whether they be external or internal. A person can learn that there are internal compulsions, such as ruminating, negating obsessions and analyzing and be able to identify when they are performing them.

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Guest Chickpea

This thread was more helpful than the two CBT sessions I've had.

I agree with Nicolette as well.

I think, the hardest part for me, is that my fears don't feel like OCD. They feel real, and by not performing compulsions it feels like I'm ignoring something of extreme importance, and that my safety and the safety of others is at risk. It'd be much easier if I instantly accepted my fears as OCD and treated them as OCD.

I always read and hear that anxiety increases when you don't perform compulsions, but I feel more anxious when I ruminate..

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Two things, Rita.

First, it can be really difficult to label obsessions as such. Sure you are inundated with messages that this time it's real, it's important and you need to do something about it. That's the nature of OCD. It's normal for people like us.

It's normal for you to feel anxious when you ruminate. We think we're going to feel better performing compulsions but it doesn't always work out that way. Often doing compulsions makes things worse.

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I think, the hardest part for me, is that my fears don't feel like OCD. They feel real, and by not performing compulsions it feels like I'm ignoring something of extreme importance, and that my safety and the safety of others is at risk.

Look at this again Rita, and you will see everything you say is a classic indication of OCD.

It uses uncertainty to support its suggestion of reality - but it is like a blackmailer without any photographs - it has no proof, only vague suggestions.

It seems resl because the OCD exaggerations or falsehoods reach us through our normal mental channels.

And there is often a suggestion harm to someone could possibly occur.

Abra cadabra, evidence of OCD.

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Excellent thread Polar bear. I like how you've presented it in five steps, simplifying the process, even if we can't make it easy! I do hope you'll write that book. :)

Challenge OCD. Sufferers need to challenge their disorder and actually do things their OCD tells them are scary, dirty or dangerous.

I want to comment on this because what you're saying is true in essence - we do need to challenge the OCD thoughts and beliefs. However, we don't necessarily need to do all the scary, nasty or dangerous things our minds torment us with to be free of OCD.

Putting your hand down a (flushed!) toilet is harmless enough and may be good exposure for some people. That's fine.

But for those whose thoughts include murder, torture, or hurting others the words ''need to challenge by doing'' could cause them considerable distress. So for those people, please note there are other ways to challenge your OCD which don't include doing the things you've been afraid of or have been avoiding.

Challenging the OCD is essential, but the form that challenge takes can vary tremendously.

Think positively. This speaks to the C in CBT. CBT has a cognitive aspect and a behavioral aspect. In short, it's about learning how to think differently and behave differently. OCD sufferers think negatively. They have negative thoughts swimming around in their head. The world is a scary, dirty, dangerous place, according to the thoughts. Some people hold onto core, negative beliefs that prevent them from implementing the steps necessary to overcome OCD. The solution, the C in CBT, is to think positively. Sufferers need to start making up positive statements and saying them to themselves to counteract the negative thoughts floating around in their heads.

Polar Bear is right again; teaching our brains to think in positive ways is a huge part of getting (and staying) well. Cognitive therapy can help us identify and challenge unhelpful core beliefs which are keeping us stuck, and therapists are typically very good at identifying any negative thinking styles or 'cognitive distortions' being used.

Over the last decade psychologists have done numerous studies on the effects of positive versus negative thinking. The results are consistent, across multiple trials, thousands and thousands of people. Negative styles of thinking are strongly associated with mental illness. Positive styles of thinking (which includes flexible and creative problem solving skills) is strongly associated with mental and physical well-being. Yes, you actually live longer if you adopt positive thinking styles!

However, positive thinking styles is not the same as simply thinking positively. Making up positive statements is helpful at getting you in the right mindset, but it's not therapy on its own.

The problem: It's my belief therapists typically explain what negative thinking styles are and tell people not do do them. Which is perfectly good advice in the short term, but doesn't sustain people long term. So you've stopped the negative thoughts, but what do you replace them with? 'Think positive' too often gets misinterpreted as adopting a positive attitude to life. My heart breaks when I meet people who've been through mindfulness training who are determined to be positive come what may - completely missing the point!

But 'not being positive' isn't actually the problem. Not everybody with OCD and depression is a pessimist. In my experience we're mostly people with a positive outlook at heart who manage to keep hoping in spite of everything. We're just thinking negatively in our heads - and fixing that takes a bit more effort than 'looking on the bright side'.

The solution: We need to learn new ways of thinking to replace the negative ones. Not just stop the 'cognitive distortions' of negative thinking. I'm not knocking therapists - mostly they know this, they just aren't passing it on to us! Perhaps because nobody has suggested it to them before? Or perhaps because therapy time is too limited to teach alongside treating?

The good news: Thinking is really just problem solving by another name. And we can learn how to solve problems differently in exactly the same way we learned how to count to 3 and write our ABC's. Like Polar Bear said, it's not easy, but it's simple.

We need to learn positive thinking skills to replace the void left by stopping thinking in negative ways. That's the tool which will make getting well easier and will sustain us long term in good mental health.

The first step is putting the positive skills we need to learn into a simple format like Polar Bear has done with his post so we can teach ourselves.

I'm working on it...

Edited by snowbear
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Snowbear, of course I do not expect people to challenge their OCD by doing what their intrusive thoughts are about. In fact people wouldn't do that. But even people with Pure O can challenge their OCD.

A person who thinks she'll stab her husband at night can place a knife on the night table. Someone whose obsessions are religious themed can perform blasphemy. Someone with magical thinking ocd can purposefully conjure up images of their kids dying in an accident because she refuses to perform compulsions.

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A wonderful thread.

Keeping things simple is a very successful way to tackle issues in life; OCD is essentially not complex - its core features are simplistic - but the difficulty comes in acceptance and making changes.

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Hi, thank you, this is very interesting.

I have a problem with the first step since I don't see most of my thoughts as particularly negative.

Also, there is no exposure and response that I can think of with this kind of obsessive thoughts with no manifestation.

Edit : these examples about pure o challenges are good but still don't apply to me. Here are some if my latest thoughts (that U surrendered to confessions compulsion):

(1) I sent an emoji if flower to my wife and recalled a girl who once drew a flower to me.

(2) I threw stuff in the bathroom out of anger (had really bad time trying to out baby to sleep and other things). I recalled how my then girlfriend sometimes threw stuff when we are fighting - had to send email to my mom and wife...

(3) we went through a red light, my wife dud because it just turned red in a short road but with the stroller so I wanted to "tell" my wife to my mom about this...

All I can think of here us that I purposely dig things up or annoy my self and fight those compulsions even more but that seems counter productive. For example if I feel guilty I notice cleavages on TV do I go and watch lots if exposure in purpose? That's a part of my OCD that's actually a little under control. I didn't talk about this for some time, relatively speaking and was successful here. But the idea doesn't seem to apply.

+++

This leaves the stopping he obsessions and stopping the compulsions. That is great on paper but I still didn't find a way to do it. If I don't think about the intrusive thought I think about it in the back of my head. I will think about it later in the day and the next day and a week or a month from now. Or longer.

If I forget about it eventually it is only because I'll have other thoughts that are no less annoying and more and more thoughts. So it can't be stopped. I need to confess and get the relief or I will be unhappy with the thought in my brain that keeps trying to get out of the cage.

Edited by dubi
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Dubi......You've fallen into the "Ah.....but mine is different". Common problem but one you just haven't sussed (yet).

I think we all fall into that trap one time or another. I know I did, and it kept me stuck for decades! :crybaby:

I have a problem with the first step since I don't see most of my thoughts as particularly negative.

A lot of people get confused on this.

There is a difference between having negative content (which may or may be present) and using negative thinking processes (which you demonstrate well in your examples.)

When we talk about negative thinking on the forums (and what therapists mean by negative thinking) refers to negative thought processes, not whether the content of the thoughts is good or bad.

Also, there is no exposure and response that I can think of with this kind of obsessive thoughts with no manifestation.

Confession compulsions are just compulsions and can be treated as such regardless of content.

Let's look at what emotion is associated with each of the compulsions you mentioned.

(1) I sent an emoji if flower to my wife and recalled a girl who once drew a flower to me. Emotion: guilt?

(2) I threw stuff in the bathroom out of anger (had really bad time trying to out baby to sleep and other things). I recalled how my then girlfriend sometimes threw stuff when we are fighting - had to send email to my mom and wife... Emotion: anger, followed by guilt?

(3) we went through a red light, my wife dud because it just turned red in a short road but with the stroller so I wanted to "tell" my wife to my mom about this... Confession compulsion. Emotion: guilt?

Your desire to confess seems to be driven by guilt. 'Emotional reasoning' (letting your emotions drive your thinking) is one of the negative thinking processes. It's 'negative' because it's not helping you to deal with the emotion that's driving your behaviour. A positive thinking process to replace it with might be 'Acceptance' which is based in rationality instead of emotion.

All I can think of here us that I purposely dig things up or annoy my self and fight those compulsions even more but that seems counter productive. For example if I feel guilty I notice cleavages on TV do I go and watch lots if exposure in purpose?

No. Maybe exposure isn't the best word to use. How about 'tolerance'? That's halfway to 'Acceptance', right? :)

Your 'exposure therapy' would consist of tolerating the presence of the thoughts, accepting the guilt is there, but not letting it drive your behaviour (confession).

If I don't think about the intrusive thought I think about it in the back of my head. I will think about it later in the day and the next day and a week or a month from now. Or longer.

Once you've mastered tolerating the presence of the thoughts, they can sit there forever and it won't matter. It won't matter because they won't always upset you by being present the way they do now. The irony is, once they stop upsetting you, they vanish!

I need to confess and get the relief or I will be unhappy with the thought in my brain that keeps trying to get out of the cage.

But the relief is temporary, right? New thoughts keep coming to replace the ones you already confessed. It's like a dripping tap. You have to fix the washer and stop the leak. Wiping up the spilled water drop by drop isn't going to make any difference.And one way to fix the leak is to learn to tolerate the presence of the thoughts. And in this case that means learning to cope with feeling an uncomfortable emotion - guilt.

Negative emotions like guilt, anger, shame and disgust are uncomfortable. You wouldn't continue to wear a jumper than constantly made you itch, you'd throw it off at once. That's what you're trying to do with the guilt - throw it off by confessing.

Only you can't get rid of emotions that way. You have to deal with them at a rational level. (Part of that positive thought process 'Acceptance' which I mentioned before.) I'm not a therapist so I'm not going to start suggesting specific ways of doing it, but you need to discuss the emotional (guilt) side with your therapist, not just the thoughts (confession) side.

Edited by snowbear
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Dubi, about thinking positively, when you have OCD your head is filled with negative thoughts. That's the nature of the disorder. We don't have intrusive thoughts about cute kittens and bunny rabbits. We have thoughts that are always negative in nature and then we think negatively about ourselves. It's common for people with OCD to think, I'm sick, I'm evil, the world is a dirty place, asbestos is everywhere, I am a pedophile... These are all negative statements. The cognitive side of CBT is about countering those negative thoughts with more positive statements.

It might be a challenge for you to figure out what your negative thoughts are, but they are there.

As for ERP, I think all forms of ocd can be tackled using exposures. You have to figure out the right ones. That's where a therapist can help.

Edited by PolarBear
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Do you think GAD and personality disorder can be treat the same way?

Yes.

Positive thinking processes are the key to treating GAD too. People with personality disorder may need some additional help learning to apply the techniques, but the process is the same for OCD, GAD, and depression.

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My question is how long can anyone be expected to ignore obsessions for?

Technically, you ignore them forever. Sounds like a life sentence, right? It's not.

I think what you really want to know is how long it takes for the unwanted thoughts to go away. :unsure:

The answer to that varies from person to person and depends how skilled you are at switching away from negative thinking processes to positive ones. Which is a matter of practise and gets easier over time.

If you've spent decades stuck in a particular style of thinking, it can be hard to change at first. The unwanted thoughts might persist for days, weeks, or months and you feel like you're getting nowhere. :wallbash:

One of the misconceptions people have is that therapy stops the unwanted thoughts. But that's not how CBT works.

What it does is to give you the mental tools to stop the thoughts and feelings hurting you.

And when they aren't hurting you, your brain ignores them and they recede into the background or vanish. :original:

Think of it this way: you couldn't ignore me while I hit you with a big stick, but if I stopped hitting you and sat quietly in the corner you would happily leave me there and get on with your life. Therapy takes the big stick off the thing that's hitting you. (OCD).

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My question is how long can anyone be expected to ignore obsessions for?

Tricia......You've often mentioned that if you don't carry out the compulsions, your anxiety never comes down. Do you feel that you have managed to identify all of the compulsions....the less obvious ones? When you've had OCD for decades it can be very difficult to do this or even be aware of what you're doing.....I know it's the subtler things that I've not recognised that I need further work on.

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Thankyou for posting. We spend far too much time talking a our our thoughts themes feelings, checking if its ocd or gaining reassurance when needed but less time on focusing on what can i do to stop these thoughts and feelings.

I spend so much energy on rumination, reassurance seeking, searching on google and checking im not a 'bad person' that i dont have time or energy to knuckle down on the things that will get me better.

As u say it is very hard and extremely traumatic at times but with good support we can all do it xxxxx

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I have found it easier in recent months to resist rituals such as touching my dressing gown and towel for 20 minutes and I have had less counting rituals. I thought it is time to try and learn how to not carry out the compulsions. But the general anxiety has returned quite recently, I lost my good job almost 4 years ago and last had a gf in 2007. I feel I am more ready for another relationship again and will try to not let OCD ruin it. I have even considered joining a dating site.

Edited by benjamin
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Well Benjamin, I think part of overcoming OCD is taking care of ourselves. We need to have healthy, fulfilled, relaxed lives. That helps us to be able to deal directly with our disorder. Sounds like you are moving ahead. Keep going.

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