snowbear

Dying/suicide is viewed as the ultimate escape. Having these thoughts on a daily basis just means you're very unhappy with how things are and in desperate need of a change. CHANGE doesn't require any kind of escape. Change comes from standing your ground while doing things differently. Even the smallest difference in how you do things can have a huge knock-on effect with a very positive outcome. What are you going to do differently today, Bruce? And tomorrow? Set yourself small daily challenges to build up the habit of making changes and before long things will be very different (better).

1. Absolutely. I would neither expect nor accept non-evidence based treatment. 2. Not as a first line option, no- never. Any discussion of non-evidenced based treatments should be reserved for those who have failed to respond to the evidence based treatments and even then only treatments which have some evidence of efficacy (though inadeqate to qualify as 'evidence based') should be considered, with the pros and cons openly discussed in some depth. Fuller understanding by the patient is required when considering treatment which is not fully evidence based. 3. I don't think so. Unless the patient raises the option of a non-based treatment when it may be necessary to explain why they aren't being offered this and why treatment A is better. 4. I think a reasonable understanding of any treatment offered is essential for it to be efficacious. Mental health treatments are about changing how you think. That can't be achieved without patient understanding and cooperation. It's not like surgery where you can chop out the dysfunctional/diseased part whether or not the person understands what is being done. Particularly with CBT it is helpful for the sufferer to be to recognise which bits of their therapy are cognitive and which are behavioural. The idea is we become our own therapists so learning from the outset when you're doing C and when you're doing B is essential. Then later you can apply the correct self-therapy. If you don't undrerstand which is which when you do it with a therapist then you'll always need the help of a therapist to progress (and be reliant on the therapist offering the correct/most suitable/personalised combination while you are treated 'blind'. I can'yt imagine a single case likely to be successful at changing how a person thinks if they are blindly unaware of what they are trying to achieve and the processes they need to use to get themselves there.

Had to have my say! Howevert I forgot to put on the survey that, despite my criticisms, on-the-whole the current guidelines are reasonably fair and comprehensive.

You're free to believe whatever nonsense you want to believe. You're free to feel nonsense guilt if you want to. You're free to believe your OCD and conclude these thoughts aren't nonsense. But hopefully there's enough normal thinking going on to convince you to take a chance on it being nonsense so you dismiss both the thought and the guilt without further ado. Only you can choose what you want to believe and what you want to feel. If you do choose to believe your nonsense thoughts and beat yourself up with guilt, only you will suffer. Your mum won't be affected either way, same as her current illness hasn't been influenced by your crazy magical thinking (obsessive thoughts.) Do you really want to do this to yourself?

Perhaps the confusion your comment caused will act as a reminder that sarcasm and jokes don't come across well in a written format, Paradoxer?

There's where you need to be doing some cognitive work, Dave. A drop of urine on your leg means nothing. It isn't significant at all, needs no action, not even washing it off let alone a full body shower. Work on changing the meaning you give to your obsessions.

You won't like my answer, Orwell, but I would be doing you a disservice not to say it. You get over it by letting it go. I know it feels like 'righteous' anger, that you feel totally justified in being angry, that you feel you are in the right and they were in the wrong. That may be true, but thinking like that only fuels the anger and damages your physical and mental health. Thinking like that doesn't change the past, doesn't make them change, doesn't bring justice - and it never will. So you have to make a decision. How long are you going to hold onto this position of 'being right' and staying angry? A day, a year, a lifetime? You can hold onto it as long as you want. Feel like this to your dying day if you choose. But what a waste of your life. Or you can choose to let it go. Choose to move on. How? Change how you think about it. Instead of thinking, 'Letting it go means letting them get away with it' change the meaning you put on it. 'Letting it go means I can be happy and well again.' It takes a bit of work and determination not to keep punishing yourself with anger (in lieu of being able to punish them) but with perseverance you will get there. Like forgiveness, letting go of anger is about YOU, not them. It's about choosing how you want to feel. It's a mindset; nothing to do with justice, nothing to do with 'letting them off the hook'. Just an uncomplicated choice of how you want to think about it and the meaning you choose to give it.

Wonderer is quite right that OCD will latch onto things we fear. However looking for links between what's happened to you and what OCD themes you have is potentially misleading. A lot of therapy time can be wasted exploring 'links' that are irrelevant to fixing either the trauma or your OCD. The only true 'link' is how you respond to stress/anxiety. The way you think rather than what you think. The actual link will be that you make a particular kind of interpretation when given a certain kind of experience. Learn to recognise 'This is how I think when I'm exposed to stress, this is the way I tend to interpret things when I'm anxious'. Changing that response to a better one is how to overcome OCD, not exploring themes or events from your past. It's not what's happened, but how you responded, how you thought about it and interpreted it, which matters.

Just a reminder to everybody that seeking advice about aspects of your OCD via PM from any one individual is not recommended. Remember that we're forum users sharing personal experiences, not therapists formulating someone else's therapy plan. Comparing one OCD case directly to another because it seems similar is fraught with the danger of misconception, misinterpretation and therefore giving misleading advice. Far better to share any concerns or questions on the open forum which has the advantage of multiple inputs and people to step in if the advice starts to go off the rails. There are several reasons why people can feel uncomfortable sharing information 'openly' on the forum, but there are ways around this. Questions can be posed in general terms and personal information can made a little less specific (or even totally abstract) so the point comes across without 'giving too much away'. Sparklemango, have a think about how you might word your concern so you are comfortable with it. I don't know what SIAD stands for, but maybe if you choose to post again you could enlighten us?

Hi sufferer, First of all, you do have rituals associated with this - you're ruminating, you're looking for signs everywhere and you've fallen prey to magical thinking. These are your 'rituals'. Secondly, it's important to recognise that a 'premonition' isn't any kind of prediction. Premonitions are feelings, they have no power to predict the future and they don't represent what will happen. A premonition represents only how you are feeling at the time. Your anxiety that something might go wrong has become a 'convincing feeling' that it will, all of which you've interpreted as 'intuition'. Believing a 'premonition' (feelings) reflect the future is evidence of magical thinking, same s believing a magpie has any significance is magical thinking (superstition.) I'm sorry to hear your daughter needs an operation as nobody wants that for their child. But your husband and parents are right that this 'intuition' and 'premonition' is just your anxiety getting out of hand. Trust the judgement of those whose thinking is more rational and try to accept these thoughts and feelings for what they are - natural parental concern combined with a desire to be able to control something which is out of your hands.

Exactly the same, yes. You haven't stopped ruminating at all, you've just slightly shifted the focus. All the things you listed are part of the same obsession. It's not just a case of stopping thinking about anything related to cheating. You need to do that of course, but you also need to change what it means to you/ for you. A therapist can help you understand the meaning you've given to your obsession, how this keeps you stuck, and how there are other meanings you could apply that will be just as valid but set you free from the OCD thinking.

This is part of the problem, Headwreck. Holding onto ideas of deserved guilt, shame and worrying about how others would judge you is another compulsion. Not being able to let it go comes from the compulsion to have certainty and the desire to feel blame-free. You will remain stuck in the cycle of wanting answers and struggling to live with the doubt for as long as you keep telling yourself its important to be either not-guilty or to be punished (when actually neither is necessary for you to be happy in your relationship and OCD free.) You've had lots of advice from the forum, but I think you would now benefit from some one-on-one guidance from a therapist. Read Lynz's last post carefully - it's excellent advice. You've nothing to fear and everything to gain by confiding in your doctor. Keeping it secret is only damaging your health further.

Possibly, for once someone has an obsession they will often look for meaning to explain their actions. But I think it's more subtle than just 'cause and effect'. When you get the thought 'I could die of a heart attack' that thought doesn't occur in isolation (even if it's all you are consciously aware of at the time.) Your brain is simultaneously firing in several areas and collating all that it 'knows' about heart attacks and how you feel about them. I'm not saying you should go looking for details on this additional information as inward examination can too easily turn into rumination in OCD, but if you were to examine them you'd find that you've made a connection between heart attack and something else which gives it meaning/significance for you. Touching a doorknob 3 times to prevent a plane crash isn't the least bit illogical if you have a (subconscious) belief that performing some kind of ritual has the ability to offset fate. Humans have held these kind of beliefs since they first walked the earth and though most of us now believe at an intellectual level there's no such thing as supernatural powers the primitive response is still there at an emotional level. OCD taps into that superstitious feeling, which is how perfectly sensible people can get caught up in illogical rituals. Anyway, I think we've gone a bit 'off piste' so I'm going to leave it there. You may still think I'm wrong and that's fine. Everybody is entitled to their opinion and I'm just stating mine as you are free to state yours. Getting back to helping Headwreck, I still say that it's the meaning/significance given to the thoughts which determines whether they will become an obsession and how long it will last. So reviewing the meaning and changing it to something more realistic/appropriate at the earliest possible time will help reduce/stop the endless cycle of ruminating.

We shall hopefully agree to disagree then, dksea. Though I suspect it's that I haven't explained it sufficiently well and have been slightly misunderstood. No, not necessarily. Only if your fear was your health in general. Fears often arenvery specific and therefore can seem illogical, such as worry over one health concern and not another. But the logic is there in that you will have assigned a meaning to having a heart attack, a meaning you didn't assign to having cancer. It's not the heart attack/cancer you fear but the perceived consequences of it. It could even be one specific consequence that you have come to connect with a heart attack which other people might totally discount or not connect st all. But for whatever reason, you give significance to it - and it's because you perceive it as significant that you react with fear/OCD. Because on some level you're mulling it over, giving it significance and meaning. If it was meaningless to you there would be no response. It doesn't have to be related to anything else, or anything that's going on in your life. People can develop obsessions over a random, spontaneous thought that comes out of the blue. It becomes an obsessive thought only because they latched onto it, wondering what it meant, giving it meaning, looking for meaning - it always comes back to meaning and interpretation. Always. Religious people are more likely to have a crisis of faith than non-religious people, so religious obsessions are more common in those who have faith. (If you have no faith you tend to give less meaning to the normal doubts and questions about faith/lack of faith.) But as I said above, it's the meaning the person gives the thought at any specific time which matters. So any theme, any doubt is possible in any person. The meaning we give to things and the significance they hold for us changes through life. That's normal as our personal circumstances alter and our life experience grows. Perceived consequences can also change - lessen or increase - which is why new obsessions can arise on a theme you've never had before, or vanish overnight on a theme you've worried about for decades. It's the fact that meaning/significance/perceived consequences IS open to change which is the basis for all CBT. Therapy is voluntarily changing the meaning you gave to your thoughts; accepting the interpretation you made at one time is not absolute or permanent, but is open to many different interpretations and that you are free to change it without consequence at any time. One of the things that keeps people stuck is they accept the interpretation/meaning can be changed, but they continue to believe in adverse consequences if they were to take that step - so they continue their 'preventative' or 'protective' compulsions (perceived safely rather than real safety.)