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Tackling Uncertainty And Decision-making Problems In OCD


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As most of you probably know i am limiting my involvement on the main OCD support forums to concetrate on my own recovery.

But as our new forum member mackem1 has some of the issues that I have or had, I have been helping him on his threads - it seemed the only right thing to do - and he struggles with these issues as well as nhis specific OCD type.

So it seemed sensible to make a new iopic out of them as hopefully by reaching a wider audience othjers may be helped too.

Before I upload the piece from word, I would justy like to please ask you not to raise individual concerns direct with me by PM. Post them onto this thread and I or others will no doubt look at them and see iof help may be suggested.

Please also post your own ideas that you find useful in tackling these issues.

Right then, here we go:-

SOME SIMPLE IDEAS FOR TACKLING DEMANDS FOR CERTAINTY, AND PROBLEMS WITH
DECISION -MAKING

How OCD Exerts a Grip on Us

Think of OCD holding a magnifying glass, and scanning for things that support its arguments.

In a non-OCD sufferer, intrusions of an OCD nature don’t appear in their central “field of vision”, they remain in the background out of peripheral view.
When upsetting or negative intrusive thoughts come into that field of vision, they are momentarily considered, found to be unwanted and then fused – discarded. They return back out of core focus of into the background and out of even peripheral vision.

In an OCD sufferer, the brain is under influence of OCD “scanning” for the thing we fear, and when it finds it brings it into core focus and applies the magnifying glass to exaggerate its meaning and awfulise on its consequences. The thought does not fuse and dissolve away, it takes central stage. Anxiety is generated, a vicious cycle of distress commences.

To break that cycle, we must successfully challenge the thoughts, put away the magnifying glass and get that intrusion slipping back into peripheral vision and beyond.

Certainty

One of the trump cards our disorder holds is the demand for certainty.

When we try to challenge the hold it has over us by assessing the arguments for our issues being real, against the arguments for them being put forward by OCD and false, it will play that card.

So if you find you are say 90% convinced you have OCD and that is the source of the problem, it will play on the doubt and uncertainty over the remaining 10%. And it’s very convincing when doing this. People have a number of times said on the forum that they can’t even accept 1% possibility of the event(s) or feelings urges or whatever being real. They feel they should be hurt punished and could be guilty or whatever.

Bur the fact is that they must accept that minimal possibility. We have to see that the remaining uncertainty is being peddled by OCD to support its lies, deceit and distress.

Our toilet cleaner product proudly announces that it kills 99% of all known germs. That’s good enough for me, but is it good enough for an OCD sufferer with concerns about contamination from germs in the toilet?

In order to get better we are going to have to address this uncertainty card, and defuse its power so it can no longer “trump” us.

We need to maybe re-appraise how our OCD operates – the “map” that shows the underpinning fear – having committed a criminal act, wrong sexual preference, harm, loss of control, burglary flood fire or whatever.

We then need to understand how our OCD plays on that through the triggers it uses, and the meaning being given to its thoughts images urges feelings.

Remind ourselves that uncertainty will support its arguments, and look at practical ways of desensitising that call for certainty.

With the example I gave of contamination, the possibility of a 1% unknown germ causing harm has to be reframed as insignificant and we need to start an indifferent approach to that; we know the OCD wants to magnify that possibility, so we need to look at ways of realising the threat is minimal and then moving away from focusing on it.

Some people have exercised this indifference by a “so what” or “maybe, maybe not” approach. These are great ideas, they work when you really stand up to the disorder.

I use another method as well; the “editing out” approach – here is how it works.

Think of something close by that irritates you – the noise of lawnmowers in summer, trains passing at the end of your garden, next door neighbour’s dog barking.

Then think about not hearing those noises – those upsetting distractions – just imagine your environment without those noises and keep working on that.

In due course you will find that their impact is diminishing – slipping away as your mind fastens on to the command to ignore them.

I never notice the trains now – they are just background noise I don’t even acknowledge.

You can apply “editing out” to the call for certainty, (and you can also apply it to the urge to compulse, and to triggers and intrusions).

Problems with Decision-Making

This can be partly an issue with OCD, and partly – often more – an issue for other forms of anxiety.

It’s something which used to badly bother me – as a worrier – until I discovered a simple formula that, once I had really worked on the behavioural side of applying it, has operated brilliantly for me.

What is that simple formula, and how might it be applied in – or outside of – OCD, you ask?

The first thing I do is to assemble all the relevant facts and difficulties about my issue.

Then put my mind to it in a relaxed way. Now in OCD, I don’t go compulsing – asking for re-assurance, googling - asking others, raising questions on here to ask others to make the decision for me; I apply my own brainpower to work out these possible solutions.

It will take a few goes until others relax into this exercise, and find the wonderful benefits as ideas start to form in the mind.

So:

I consider all the possibilities.

I determine the solution that is clearly best.

I then implement the solution.

Then I dismiss all anxiety about the outcome.

So for everyone out there agonising about making decisions, whether in OCD or outside of that, tries this method.

Of course, if you have genuine uncertainties about finding the right solution (e.g. does it meet regulatory compliance at work), find an appropriate authority to consult. In the work environment this should be easy. In the home environment partners friends or professionals may be appropriate (we certainly needed the invaluable help from our independent financial advisor to choose the right pension options).

But we do need to start the process of becoming used to making decisions ourselves wherever possible and sensible.

And this simple method has helped me and a number of others that I have told it to. I even taught it to my Director at my retirement lunch – he thought it brilliant and intends to deploy it.

Taurean March 2015

Edited by taurean
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Certainly a lot there to take in and apply to my indecisiveness.

You are right about my indecisive almost wimpy dithering about increasing the dosage of Citalopram from 10mg to 20mg. Everyone it seems is effected differently by meds so knowone cab really advise me what to do.

I need to think it through myself and make a decision. This is very difficult but I will try

Edited by mackem1
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That's good and hopefully the thread can help you. I have made it pretty detailed and explanatory

There are two main ways to keep a copy of a thread. For one with just one page, right click on mouse and press print- your printer should print that page.

To print another page in a 2-page thread, go into that page first then right click and print.

Or you can open a worde document in an mother window, go back in here, highlight and right click then hit copy, then back into your word doc right click and paste.

Of course you can print selected pieces onto a word doc by just highlighting those parts before copy and pasting.

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Here is an extract from a piece by Zorro - an ex-sufferer - posted today on Azamour's thread about people who have recovered from OCD.

Zorro has kindly given me permission to copy and paste this over as it addresses the certainty issue well.

"For me (and listening to other people who have recovered) it's been a case of hitting rock bottom before deciding to take the risks/accepting uncertainty. No-one is obviously keen to start accepting uncertainty. However, life just got to the stage where it was simply un-liveable. So you begin to choose to spend less time engaging in the thoughts. You go from spending hours ruminating on a thought, to minutes, to seconds. And as you spend less time on the thoughts, your mind clears up and life is great. It's an up and down roller coaster ride. Certainly not a straight line to recovery."

Thanks again Zorro

Hope this will inspire others to take the journey, notwithstanding the difficulties in accepting the uncertainty..

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Very nice post and extremely useful tauren. I have copied it and pasted in a text document.

I think editing out is the perfect approach for me because I tried applying "maybe, may be not" approach and ocd continues to argue about the may be part where I am not agreeing with it. But distraction works for me. Now a days I just acknowledge the thought and wait for it to go. It goes away after a certain amount of time.

Edited by Nil
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I have copied both your topics to word. Very useful because as we know I do have issues with certainty and have tried mindfullness with little success. But like everything else with OCD it needs hard work as I found out today doing an exposure car trip

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That's great news mackem - you have something solid now to get your teeth into.

All the best and do keep your wife informed of where you are at and what you know you need to work on - she has a big vested interest and should be pleased that you have identified the areas you need to tackle specifically.

Tell her key personal helpers in the fight againmst thinking distortions and OCD are pateince and persistence(as well as the support from significant others) - small steps lead to bigger leaps, and often just establishing why things aren't working and looking into why and tweaking things can make a good difference.

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Hello

Sorry to trouble you. I have been reading the part about editing out.I for once Am not being indecisive but just not clear if I could use editing out for my intrusive thoughts.

For example the what if I jump out of the car thought or a self harm thought. Is the idea you concentrate on the thought and gradually it will diminish?

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I think editing out works well for some things; its another tool to try.

I use it when passing through the underground and I don't wish to focus on the posters in case I get spooked by something unpleasant.

So I pass through the interchanges focusing my mind away from the posters - I am aware of them but not focusing on them.

I don't know whether it might work with these two issues.

Before you go into ERP with the jumping out and self-harm, I might suggest you remind yourself that the real you has no desire to do this; it is OCD that is turning your normal core values on their head and suggesting you do want to carry out those acts.

Another way to diminish the power and intensity of the thought is to add a prefix to it " I am having the thought that"......... this makes it clear its just a thought.

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