Any advice for ERT

[pureosufferer]

Recently started CBT and I'm finding it extremely difficult. It doesn't seem to be working, in fact it seems to be making things worse. Anyone else gone through this?

[taurean]

There is no quick fix with CBT; patience is required during assessment, then learning the cognitive(thinking changes) part first - essential - before learning about, and practicising, behavioural changes.

In my opinion based on my experiences, ERP is only likely to be successful after a full assessment of one's own OCD manifestations, then calming any overpowering anxiety before being ready to practice ERP.

Your forum pseudonym suggests your theme is OCD thoughts - but you need help from the therapist to uncover the mental compulsions which will be supporting and maintaining the emotional response to the thoughts, and helping you with the ways needed to tackle them.

Edited May 2, 2016 by taurean

[pureosufferer]

There is no quick fix with CBT; patience is required during assessment, then learning the cognitive(thinking changes) part first - essential - before learning about, and practicising, behavioural changes.

In my opinion based on my experiences, ERP is only likely to be successful after a full assessment of one's own OCD manifestations, then calming any overpowering anxiety before being ready to practice ERP.

Your forum pseudonym suggests your theme is OCD thoughts - but you need help from the therapist to uncover the mental compulsions which will be supporting and maintaining the emotional response to the thoughts, and helping you with the ways needed to tackle them.

Thanks taurean,

Yes, I suffer from OCD in the form of intrusive thoughts, feelings and urges. I am actually aware of my mental compulsions though and have been doing CBT for several weeks. My compulsions take the form of rumination or sometimes trying to push the thoughts out of my head with a "safe" thought. I do also perform some physical compulsions such as avoidance and when I'm at home, pacing up and down. The CBT I've been doing makes my obsessions far worse and makes it extremely difficult to do the ERP.

[taurean]

Pushing the thoughts away with a safe thought is called "neutralising" and that compulsion only strengthens intrusive thoughts.

Why do you think the CBT is not working? You will need to go to upsetting mental places and carry out upsetting homework as part of the therapy or it won't work, so taking on pain for longer term gain is normal.

Edited May 2, 2016 by taurean

[pureosufferer]

Pushing the thoughts away with a safe thought is called "neutralising" and that compulsion only strengthens intrusive thoughts.

Why do you think the CBT is not working? You will need to go to upsetting mental places and carry out upsetting homework as part of the therapy or it won't work, so taking on pain for longer term gain is normal.

Because of the nature of my intrusive thoughts the ERP is extremely difficult. My OCD has focused on lots of different things throughout the years but the main focus at the minute is something which makes ERP an enormous struggle.

[taurean]

Well you certainly need to get guidance from the therapist in how to tackle the ruminating and neutralising.

Re the ERP I doubt anyone finds it easy,since with thoughts they will likely be around some suggestion of bad acts or catastrophising.

Seems you need to raise this also with the therapist to gain help in getting over the difficulties with deliberate exposure.