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What do you wish your therapist knew more about?


Guest Charlotte

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Guest Charlotte

As you may have heard, in 2014 OCD-UK is hosting a ground breaking new conference for health professionals. It's a fantastic opportunity to spread awareness and improve knowledge of different aspects of OCD amongst therapists and other HCPs.

We are currently approaching speakers and building an exciting agenda. As a service-user led charity, it's important that those of us living with OCD get a chance to shape the agenda.

So...

What do you wish your therapists knew more about?

What would you like them to recieve more knowledge about?

It can be anything - from the very small to the big stuff. We can't promise that we can cover all of them during the conference, but it's important to know what you feel needs addressing.

Please let us know! If you aren't comfortable sharing everything on here, feel free to send me a PM or email me at charlotte@ocduk.org

Lottie :)

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Hi Lottie

Necessary exposures in HARM OCD

That. "Flooding " may not be appropriate.

That the thought challenging and rational response approach in srandard cognitive therapy is not appropriate for OCD intrusive thoughts.

How the brain in. OCD can lock so thoughts don't pass smoothly through the parts of the frontal lobe and resolve, but stick causing OCD behaviours.

That you can't just attribute one of cognitive ther apy's ten types of. dysfunctional thinking to OCD. OCD is entirely separate.

How's that for starters?

Kind regards

Roy

Edited by taurean
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Guest Jules123

Hi Lottie

Just to say that Sensorimotor OCD does exist. There's very little information about it and it is a nightmare trying to find a therapist that knows anything about it and can successfully treat it.

Kind regards

Jules

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Perhaps more knowledge about the peadophillic type of ocd. And also to perhaps try and encourage the person to disclose there thoughts and that they wont be

judged for doing so approach, a kind of its "ok, ive treated ocd for many years, and heard it all before""

To often you see people "afraid" to discuss there thoughts , as they feel they will be judged, so like the gp icebreaker we have on here, pyschologists should have the

same . "its ok to let it all out, im not here to judge, im here to make you better"

just my thoughts

legend

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Good point legend,

I've just been answering a post re kids - very frequently aired here, and a cause of great distress to the sufferers, who usually do love kids and would never dream of carrying out the compulsions .

I'm going to add another thought here, in support of Legend's second point . In private consultations, there isn't the time pressure there may be in NHS or other non-private referrals, which means the therapist can often spend say up to 3 sessions just gradually "teasing" out from the patient in a caring and understanding way a map of what their issues are., which is great since an appropriate therapy can then be introduced.This was my experience with that private therapy.

Where the number of sessions is limited, and the patient hasn't an understanding of how to present their case, or the therapist is rushing, the wrong therapy can be enforced on the patient, who gains no benefit whatsoever, making all the sessions pointless.

So yes, this an area that can be improved.

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I'm with both Jules and Arctic Vixen on the sensory motor OCD.

I did a little research to support Arctic, and that's what i found - in fact it seemed to suggest most good work has been done in the States.

Since we clearly have our own sufferers here, and there must be many more UK and worldwide, i think there ought to be some central resource that therapists can plug into that will guide them in the correct therapy for such things.

Maybe that central resource can also have other drop-downs for helping to marry up the right therapy with the symptoms/issues of other types of OCD? It could feature alternative options that can be tried if first therapy fails, if there are any.

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Guest LauraMac

Perhaps more knowledge about the peadophillic type of ocd. And also to perhaps try and encourage the person to disclose there thoughts and that they wont be

judged for doing so approach, a kind of its "ok, ive treated ocd for many years, and heard it all before""

To often you see people "afraid" to discuss there thoughts , as they feel they will be judged, so like the gp icebreaker we have on here, pyschologists should have the

same . "its ok to let it all out, im not here to judge, im here to make you better"

just my thoughts

legend

Although I don't suffer from this type of OCD, I think legend makes a good point. I hear a lot of people saying they're scared to talk to there therapist about this. My therapist handled it fantastically, as she brought the different types of OCD up. She was saying about OCD just being OCD and that they're just thoughts. That she knows it's just OCD so there's nothing to worry about. She then went on to say some people suffer from thoughts about contamination, harm and pedophilloic thoughts etc. Which meant if it was something I was struggling with, I just had to say, yeah I have problems with that and knew I wouldn't be judged. I think it's the way more therapists should handle it, it meant I knew I could be completely honest with her from word go!

Laura x

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Guest Charlotte

Very quick reply as on phone!

Some great ideas - I will follow these up and do more research into them.

We are certainly planning on tackling risk assessment in OCD - a v important topic, especially with sexual/harm intrusive thoughts.

Keep them coming! :)

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I think that when anxiety sufferers present saying "I think I'm going insane, I'm going mad.....I'm afraid I'm schizophrenic", therapists should be asking "Why...explain what's making you feel this way?" and take time to tease out and explore the thoughts that are causing this fear. Usually it's the sufferers tentative first step in trying to explain they're having thoughts/fears that disturb and frighten them...and yet don't actually go on to explain the nature of the thoughts, they remain ambiguous and retentive out of fear.

If a patient fears insanity, ask why, probe, consider OCD.

Caramoole :)

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Being able to differentiate between OCD and other anxiety disorders is to me vital for a therapist..

As I know from awareness of the wider picture of anxiety disorders in general, having had other psychological problems in the past(but I am pleased to say I resolved them), having been a member of No Panic for years, and having read David Burns's brilliant book "The Feeling Good Handbook" on the CBT approaches for anxiety disorders and phobias, I think its vital that therapists can distinguish between the types of anxiety disorder and the treatment needed.

My experience has shown that it is usually wasted time to seek a cause of an individal's OCD. But with a phobia, it is extremely important to flush out the "seeding event" that triggered the phobia, prior to designing a hierarchical EPR approach to overcome it.

Dr Burns codified the 10 types of dysfunctional thinking, which therapists utilise in treating anxiety disorders.

Treatment for one of these requires a mood log, recording the thoughts/images at various times of the day/night, the level of anxiety on a defined scale, and then records a "rational response" agreed with the therapist and the patient buys into the rational response then re-rates the anxiety - usually it reduces..

But you will see that this approach isn't going to be appropriate for OCD by and large.; engaging and challenging thoughts only strengthens an OCD cycle of distress.

For some patients it can get more rticky, in that they can have OCD - and another type of anxiety disorder that may need this rational response.

So I think therapists need more awareness in how to differentiate between OCD, phobias, and the 10 types of dysfunctional thinking, depression and its causes , lack of self-worth etc and, if more than one of these are present in the patient, making sure the patient understands the differences, and why different treatment approaches are required.

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OCD medication -studies in nursing mothers- so many women suffer from postnatal ocd and there isn't enough information on this and how safe medication is

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Guest Charlotte

Thank you - more great suggestions. I'll put a list of all of them together and post it on here to make sure that I haven't forgotten anything.

Anyone else?

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  • 2 weeks later...
Guest Carrieann

May I say something, I may not no what I'm talking about but here goes, I went to my talking therapy and had 6 seasons, I went there just to get a few things of my chest and move on with my life. by my fifth season she told me I was OCD with anxiety and wants me to do CBT and get it confirmed, I said to her I can't be OCD because I don't clean all the time, and she said there's different forms of OCD by then our season was over, the next season was our last, we talked about other stuff and not much about the OCD only that I need to go doctors to get referred and meds for my anxiety, ( which I've done). Now I feel like I've been left in the dark with something I've got and don't understand, I wish if they are going to dionoised people with OCD they should give more seasons and some after care so people like me can understand it better and understand why I have bad episodes, I feel like I've been left to deal with this on my own, I don't have family support and my partner doesn't understand either, I can't explain to them because I don't understand my self, they should do seasons for one on one extra support for people with OCD and also a personal group season for the family to understand, then at least our family can support us if we don't have professional help when needed

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Perhaps more knowledge about the peadophillic type of ocd. And also to perhaps try and encourage the person to disclose there thoughts and that they wont be

judged for doing so approach, a kind of its "ok, ive treated ocd for many years, and heard it all before""

To often you see people "afraid" to discuss there thoughts , as they feel they will be judged, so like the gp icebreaker we have on here, pyschologists should have the

same . "its ok to let it all out, im not here to judge, im here to make you better"

just my thoughts

legend

Ohhhhhhhh Legend, we gota get together and go bowling! (to quote that guy in the breakfast club movie) :) this is exactly what I think. As someone who studies Person Centred, and Psychodynamic Counselling, but who has a strong interest in CBT, I was reading that apparently CBT therapists would not have an interest in Person Centred techniques, such as Congruence, Unconditional Positive Regard, and Warmth.... Reading that had me raging! I believe firmly in these things, as a bedrock of therapy, and not just therapy, but human relations! Its also what made my therapy so successful. Without the humanistic qualities that my therapist showed me, there would have been no room for the CBT to work. Thats how I felt as a patient / client.

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Guest fiatver

I would like to see more promotion of Mindfulness Based Stress Reduction/Mindfulness Based Cognitive Therapy and Acceptance and Commitment therapy because it think it's just perfect for OCD sufferers. I think it would be a better way of spending tax money instead of prescribing tranquillizers which in my personal experience only help to reinforce the idea that anxiety is somehow something dangerous and we need to do anything we can to alleviate it. I think helping patients to befriend their emotions and to realise that their are not their thoughts is a lot more useful.

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Guest Charlotte

Empathy is essential Louise! It's sad that you don't find that everyone you see for therapy is empathic - it's the basis of any therapeutic relationship, and any relationship at all!

Thanks guys - I've fed all of this in.

Any other ideas? What do you feel therapists need to have more education on?

Lottie :)

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Guest Sisyphus

I wish my therapist had known more about OCD. I spent the first 2 sessions explaining what it was to her. The rest of the time she just sat grinning at me, occasionally picking me up for using a word she didn't like to describe it, then fed back to me the descriptions of OCD I had provided her in the first 2 sessions. I quit after that cos it was too much to swallow.

So I think it should be a pre-requisite that they know about OCD, and also that people are allowed to describe their experience with a minimum of subjective judgement.

Edited by Sisyphus
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It hasn't happened to me but I know of a young person who has been accused of being "defiant" when she can't comply with the homework and of being "an attention seeker "by her Therapist.

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Guest Mrs.B

I had a big problem with the number three and had a therapist (before I found an amazing one) who joked with me saying 'oh you wont want to come a third time then will you' and went on to laugh! I was disgusted. Fortunately there's also some amazing therapists with a sound knowledge of OCD x

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Guest AnnieX

Therapists, need to be skilled in picking up the points that are important to the patient not just what they as therapists think . There needs to be someway to extract all the ocd issues someone has, it's not always going to happen just because we are in a therapists chair.

I would have liked my therapist to have remembered who I was from one week to the next.

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