gingerbreadgirl

This sounds like a great plan BelAnna

I'm no expert but I think so Lostie, if you dig deep enough x

I suppose in your sister's case, Roy, the underlying belief may be something like "If I do not assemble then re-assemble that lightbulb then the feeling I get (of incompleteness or whatever) will be intolerable". I think with OCD there is always a sense of threat, even if not immediately apparent, or we would not be driven to do compulsions.

Thanks snowbear. I'm working hard at following your advice. it is making me realise how ingrained these beliefs really are in me and how many things trigger them. I am trying to replace my belief of "I am bad" with "actually I'm fine, there's no need to constantly monitor my goodness. I'll risk it."

more amazing advice snowbear. Can I ask, do you believe it's truly possibly to change core beliefs, even if you've had them for decades?

You have written so many interesting posts on core beliefs snowbear and you have really made me think about how they drive my own OCD and anxiety. The belief "I deserve to be punished" is definitely lurking somewhere in my psyche. I have a few others related to this theme. E.g. "I am either perfect or irredeemible" and "making mistakes is not OK" and "I am basically bad deep down and just waiting for people to find this out". These beliefs fuel 99% of my OCD and I think they came first, and the OCD is more like a symptom than a cause. I have to agree that I don't think these core beliefs are an inversion of my true character per se (like OCD about being a paedophile, for example), but rather schemas I developed about the world as a child which are no longer helpful to me. I am working hard at addressing these. But advice on how to do so is limited, other than on this forum of course. I think the literature on OCD is lagging behind in addressing core beliefs. I think without doing that OCD is unlikely to properly go away.

Just write, do it, don't think about it, don't analyse it, just do it.

I have been thinking about this some more and I think broadly I agree with Caramoole. I think that a minimum understanding needs to be in place first of all. The understanding that OCD can make you feel extreme doubt, fear etc. and that compulsions fuel this cycle. However beyond that I think for me (and this is very much just my opinion, and even that may change over time) that I have done best when I have done behaviour work first. I think that trying to make cognitive sense of obsessions when in the middle of them is like trying to come up with a fire prevention strategy while the room is on fire. Right now you just have to put out the fire. For me personally, cognitive work has been much more useful after taking that leap of faith and getting a handle on compulsions. That said, I do think cognitive work is tremendously important - but for me it has been more useful after my brain has cooled off and I can look at the wreckage. To take this metaphor to the extreme, if you don't develop a fire prevention strategy, the fire will just come back. I think core beliefs play an incredibly important role in OCD and they are often overlooked in books etc. I think once you've put the fire out, then is the time to sit down and look at the underpinning core belifs, cognitive distortions and so on. I am not trying to minimise the incredible importance of the 'C' in CBT - I am working hard at it right now - but for me it is more like B>C>C>C.

well I just had the urge to confess something to my OH, so I said "I want to confess something but know I shouldn't", and she said "DON'T, just don't confess it, stop it." So I waited about a minute then started blurting it out, so she put her fingers in her ears and went "la la la!" and left the room so I chased her round the house to get my confession out! Not a very successful moment and probably sounded v bizarre to the neighbours! Onwards and upwards though...

I totally agree - go for it OCD, you can do this x

It's really interesting hearing everyone's take on this - and it goes to show we really are all different. Just to clarify, I am in no way saying we should do away with the cognitive side - it is crucially important and without it we are heading to relapse.

Well honestly it's the impression I've got (rightly or wrongly) from almost every CBT-based book I've read on OCD. In fact the only one which really does a good job of cementing the two is Break Free from OCD. But even there, there is a lot of talk of doing abundant cognitive work first. Which I am not disagreeing with, just throwing it out there - the times I've had the most success are when I've done the behavioural work first, and thrown myself into it without a solid understanding at all, and then done cognitive work later.

Hi st Mike, yeah that makes sense and I see that they should be done in conjunction. I suppose the reason I raise this is that I think almost too much clout can be given to the cognitive angle in many OCD book I've read, it can make you feel like you need to understand every aspect perfectly before moving on, and to me that seems almost compulsive. I think it can sometimes be used as procrastination (certainly by me ) to avoid the scary work of exposure. I think personally that - provided a basic understanding of OCD is in place - it's better to strike while the iron is hot, and a more nuanced understanding will come together later.

Hi Greentop, It sounds as if you may be suffering with depression as well as your OCD, although I am no expert. Are you seeing a therapist at the moment? It is so difficult to try and pick yourself up when you feel so wretched. But my advice is to start small. Do something small that you once enjoyed that wil occupy your attention and prevent you from ruminating on your anxious thoughts. Like, watch an episode of the simpsons or something. You may not enjoy it, but you may surprise yourself and enjoy it a little more than you expected, and you've then clocked up 20 minutes of not thinking about your anxiety or obsessions. It may give you that little nudge to do something else. I find that having lots of things to fill my time really helps. You could maybe have a think about some things you might want to do or achieve when you're feeling better, maybe set some small goals, even tiny ones if big goals feel overwhelming. I think also, don't fight your emotions too much - don't think "why am I feeling so low? I should feel better!" Just accept however your feel and let it flow through you. I read a great thing recently on this forum (I forget who said it) - but they said that your feelings aren't in the driving seat, you are. You can get on with your life despite having bad feelings. You don't have to be dictated to. Hope some of that makes sense!

I know that with CBT the cognitive work comes first, then the behavioural work. But just to be slightly controversial (because being controversial is fun ) - does anybody disagree with this approach? I have found in the past that I have been totally unable to get my head around the cognitive side until after doing exposure for a period of time. For example, I had checking OCD for years and years which I've pretty much beaten now, and with that I blasted myself with ERP first, and once I'd done that and my anxiety had reduced, I was able to look more rationally at my underlying core beliefs and so on. I know if I hadn't addressed the cognitive side, the obsession would have persisted. But for me it was much more valuable doing so after I'd tackled the behavioural side. If I try and address the cognitive side first, it ends up being more like rumination. The same thing has happened with some other obsessions. I've been unable to grapple with the cognitive side until I've first done some behavioural stuff, even if I don't quite understand it all or believe it's OCD. "Putting the cart before the horse" I've heard it said. Any thoughts?