Ashley

Hi Janejay, The first step is to ask the GP to make the referral via the Derbyshire CCG to the Oxford OXICPT clinic - https://ohspic.web.ox.ac.uk/info-referrers Effectively, encourage your GP to send the referral to the CCG. Some reasons the GP can include for justification: Not able to access local therapy (despite repeated attempts) Advised a minimum of 9 month wait for treatment Derbyshire does not have a specialist OCD team (as recommended by NICE Guidelines in 2005) - confirmed by Ashley Fulwood of OCD-UK (Derbyshire based)

I read the article the other week when it was published and I thought long and hard about commenting, but I am not sure I agree with much of what was written, but I accept that's the authors point of view. But I think the narrative (title) could be unhelpful and misleading to those with OCD and the wider public about OCD. In my opinion (which people are welcome to disagree) that’s not the case, people with OCD have been doing unnecessary rituals and behaviours to prevent perceived dangers, with over-inflated sense of responsibility and risk perception in many cases. The coronavirus pandemic is carrying out recommended rituals and behaviours to reduce the risk of a clear and present danger. i.e. The behaviour is in response to the real risk.

Hey Evolve, I hope you're ok. Try not to beat yourself up, you did what you felt was right, and if that maintained your mental health survival for a few more weeks then it was perhaps the right thing to do in that moment. But it's done, you can't change it so don't let the OCD make you feel guilty. The guilt serves no positive purpose so try and tell the OCD to do one if it pushes that on you! I think at some point every single one of us has accidently breached the recommendations, inadvertedely in some cases. I guess the important part is recognising what we have done, and doing our best to try not to repeat the breach. It's happened, we can't change that, but provided we learn from it and don't make it a regular occurrence then we have to accept and move on, it's all we can do. Look after yourself.

For the 95% of people with OCD you're pretty much bang on. But it's important we don't generalise. I've been doing this job a long time, and over the years I've worked with people with OCD that are kind, caring people but through fate, sometimes linked to OCD I have been communicating with them remotely as they are locked up. In fact one of our forum users wrote a book about his OCD and how he found himself inside (to avoid OCD triggers). Theres also been a couple of people with OCD that I wouldn't want to cross paths with on a night out. They do have a conscience I'm sure, wouldn't hurt their mums but would also happily give someone a slap that stepped out of line. So whilst for the thousands of people with OCD I've worked with match your original description that OCD attacks good people is true, it's not right to say 100% of people match that description.

Lol at Equal opportunities. That made me laugh Polarbear... you are right of course.

I see this a lot, especially in 'anxiety videos'. For OCD it's absolutely not necessary, and usually those promoting this theory are those without understanding in what CBT is and sometimes promoting their own 'treatment manual'. The problem is, even if I understand the root cause of what made me clean for 2-4 hours each time I used the loo, it wouldn't (for most people) help me not clean for 2-4 hours each time I used the loo. That is why Cognitive Behavioural Therapy very much focuses on the 'here and now', the problems we have today and what we want to be able to do tomorrow (i.e. not have the problem). So to answer the thread title, no, tto overcome OCD there is no necessity to find the "root of the problem". I personally wouldn't recommend ERP alone and I am not sure about ACT either (although no harm in that). Whilst I don't believe in needing to find the root cause of anxiety (because every human has anxiety), good quality CBT will have two parts the C (cognitive) and the B (behavioural - i.e. doing exercises like ERP). In order to give the B part every chance to succeed and succeed in long term changes without relapses, it's my belief we first need to do some C work. That C work in part looks at our triggers, what those thoughts mean to us, explore how those thoughts can cause emotions and body sensations, which reinforce the thoughts and perhaps most importantly, sometimes lead to misreading of the thoughts or misinterpretation about the level of threat posed. Effectively looking at the meaning behind our thoughts, but that is very different than needing to get to the 'roof of the anxiety'. So you might be able to get better with ERP/ACT, but my recommendation would be to focus on truing to access CBT (which includes both the C and the B).

Hello Jeremy, I'm sorry that you're having such a challenging time right now because of OCD. You mentioned coming off meds a couple of months ago, I wonder if it's worth you talking to your GP about perhaps going back on them? Obviously I am not a doctor, so this may not be the right choice for you if you are struggling at the moment it may be worth considering go back on meds. That's perhaps one for you to discuss and chat with your GP. But how fantastic you have managed to stand up to the OCD to be with your gf for the last 18 months, fingers crossed you can get some good help and support to ensure OCD doesn't impact on your relationship in the future too. I do have a couple of other more generic thoughts (which you are of course welcome to ignore), but based off what you have written. I think you might need to consider finding a new therapist, partly because by your own admission you are not making any progress at all. You didn't say how long you have been with them, but is it the full year and a half? If so then definitely time to change. A fresh approach, a fresh dynamic can something be a great way to kick start therapy. The other reason is the BDD by proxy comment, whilst I am not a therapist that sounds ridiculous to me. I would suggest the problem is clearly the OCD, which unfortunately is focussing on your girlfriends looks. I could be wrong, but it sounds questionable to me, and coupled with the no therapy progress time to find a new therapist IMO. If you're in the UK then of course one of the specialist OCD treatment clinics may be a good option (although some wait times). I hear this all too common, how OCD changes, especially with people insisting using terms like HOCD and ROCD. This is really important to focus on recognising the problem, not the R part but the OCD part so it is important to not think of yourself as having ROCD, you don't, you have OCD. That's not to say the fact your OCD is focussing on the relationship is irrelevant, part of the cognitive process of helping you understand what's driving the OCD will be to look at that, understand why that causes so much anxiety. A similar process could be applied to your past worries about sexuality and what that really meant to see if there is any common area of concern driving the OCD for both themes. They've not been in vain Jeremy, you're still with your gf after 18 months and that's amazing! Also, all the exposures in the past, can help us make further progress in the future! So they're not in vain. What you may need to do with your therapist, or new therapist is review some of those exposure exercises, make sure you were not subconsciously neutralising. Also all the behavioural exercises in the world won't matter if we are not fully exploring the cognitive aspect of therapy (which I partly mentioned above). Stay strong, you can do this!

Hello, my name is Ashley, I don't believe we have met before?

I thought I was mostly doing ok. I just had a blip, the Royal Mail collect the charity's mail at 5pm each day, and postie asked me for a pen which I passed to him... hands didn't touch but in my OCD head I was like 'urggh' and I went and washed my hands tice in the last 5 minutes. Only 20 seconds both times, but I don't think either were needed (and I threw the cheap biro away). Blip, dust myself down and don't let the blip beat me up.

I am happy to ask this question of a therapist (specialist) friend to see what they would suggest if you would like me to? But off top of my head, exposures could be: Use Google Street view to look at the place if possible If there are photographs, look at those to trigger thoughts multiple times a day (but not respond to them of course) Writing the name of the place or the assault (whichever is the biggest trigger) and looking at that bit of paper hourly. Even say the name of the place out loud if you need to too. On another note, if at the next session the therapist as not gone away and done some research to come up with their own list of therapy examples for you, I would sack the therapist if private, if NHS I would ask to be escalated (blame me for recommending it if you need to).

Just a reference to an earlier post, we have seen a few websites pop up over the last few years claiming to be from ex sufferers offering amazing therapy, loads of glossy website referrals (how genuine I am not sure). Now if someone is fully qualified, trained and with clinical experience they may well be a good therapist. But most of those I am thinking about aren't qualified, trained or clinically experienced... yet they are charging hundreds and thousands of pounds. It's so important to make the point, that being someone with lived experience of OCD doesn't make them an expert in your OCD, it only makes them an expert in their OCD. For many of these people charging thousands of pounds for group or intensive therapy they have no more experience in treating OCD than I do, and I am absolutely NOT qualified to treat anyone. I can offer advice and support people, but I am not qualified to treat anyone. Being an ex sufferer does not make someone a good therapist.

A list of therapists the charity would recommend as being knowledgeable about OCD (most have worked at specialist clinics). I don't know if all of these are still working privately. The list below is not in any particular order. But if pushed I would recommend Liz, Lauren and Debby. Actually they are all fine. Dr Elizabeth Forrester (Petts Wood) - http://www.dreforrester.co.uk/ Dr Anne Marie O Connor at the Mind Works (London) – http://themindworks.co.uk/ Dr Emma Baldock at Mind Works Dr David Veale (Priory Southgate) Dr Blake Stobie Dr Rob Willson Dr Jan Van Niekerk Katie deAth Dr Lauren Callaghan (now in Sydney, but working remotely could work) Debby Cranston If I think of any other OCD specialists we have worked with that work privately (and are ethical) I will add to the list.

Not sure I fully agree with that. I think you can go so far with remote therapy, but OCD sometimes requires that 'hands on' approach to really make progress. I know that there is no way I would have put my hand in toilet water for example with someone telling me to do it over the screen. Still, for some people remote therapy may be enough, if it helps, it helps I have had concerns raised from other people about both. I (and others) blocked the latter on Twitter a long time ago for spouting utter rubbish about OCD. Bray is not a therapist, and if anything was to go wrong there would be no therapist body like the BABCP to turn to. There are much better and qualified with experience therapists to spend your money on (IMO). Minimum requirement must be the BABCP. If someone is not a member of the BABCP, use caution. You can search for a BABCP therapist here - www.cbtregisteruk.com. Whilst being on the BABCP list doesn't make them an OCD specialist, it should ensure that if anything goes wrong you do have an accredited body to complain to and seek support from.

Hello Chris, Amanda is right in that they're both aspects of the OCD. The obsession is the unwanted intrusive thought (or could be an image or feeling or impulse), this creates anxiety and uncertainty, which we sometimes misinterpret, that can lead to emotional responses and physical symptoms sometimes (heart racing, body sensations) which then often reinforces the misinterpretation of the thought to actually mean something which triggers more intrusive thoughts and emotions. Alongside that, any kind of physical or mental ritual, such as endless dwelling to give the thought meaning is the compulsion. The compulsion feeds back into the misinterpretation of the thought, and contrary to popular belief, it doesn't always temporarily give relief from the anxiety, it can actually increase the anxiety. OCD is complex with many facets all feeding into the process of what is OCD. I have a visual illustration of this process somewhere that I can dig out for you if helpful?