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  1. I remember now you mention it about ‘dual diagnosis’ being about having a mental health diagnosis and a substance use diagnosis. I think low mood is a synonym for depression and I think that you’re right it’s an attempt not to saddle patients with too many diagnoses. I find it’s best to fill up the questionnaires quite fast without pondering too much about each question. They are only a guide to help you and your therapist to see where you are at any particular time. They are used to judge the success or failure of a bout of therapy: if you score lower on them at the end of therapy than at the start of therapy then the therapy is deemed to have helped you. The results are collected by researchers to judge the relative success rates of different therapeutic approaches. I personally would like follow ups months and years later that you have in comparing physical therapies for bodily problems.
  2. You call yourself dual diagnosis soldier so I suppose your dual diagnosis pertains to OCD and depression. I have this dual diagnosis and depression is the most common dual diagnosis with OCD. I found the Beck Depression Inventory questionnaire the most relevant questionnaire to monitor my depression. It is readily available on the web. You have done good work with therapy so far. Is your psychodynamic counsellor helping you? I hope so. Keep us informed.
  3. You have taken one quote from a conversation. The ‘well’ in the quote indicates that the therapist is responding to an issue that you have raised. Any recording will reveal ‘grammatical’ inaccuracies as compared with edited written documents as we spontaneously co - construct conversations in real time. It is good practice to have recorded conversations and part of their function is to report back to the therapist. So do this at the next session. And listen to that part of the session again to hear your raising of an issue, the therapists response, and your response to the response.
  4. Hi Puffin. It is difficult to advise because you don’t say what you dislike when working in a supermarket. Do you have the contacts to go completely self employed? And what are your financial outgoings each month? If you dislike working in a supermarket and have sufficient cash flow to survive why not do something that you enjoy even though it does not pay to get out of the house? It depends on your need for money.
  5. HiPaulAnt Memory is incredibly important in mental well being. Are you ‘digging out’ memories to confirm that you are a moral person or feel no need to feel shame? This is bound to failure as your mood when you do this will tend to be depressive or anxious. Your mood biases your digging out. I experience memory recall which is biased in that the retrieved memories are negative when I am low. I do not dig out memories, but the memories are spontaneously generated. We spontaneously trigger memories every day. Somebody talks about fouls in football and spontaneously you remember the fouls that you are aware off. It is a natural thing. When somebody talks to you: your memory spontaneously tells you the meaning of words in an incredibly fast way. And so forth? If you read some of the stuff by the therapist Paul Gilbert about memory it will help. He developed compassion based therapy which is incorporated in CBT for OCD at the centres of excellence for OCD and cognitive therapy at Oxford and London. Most importantly do not dig out when in a low mood it will be biased in a negative way!
  6. Mark. I agree with the above comments. How are you doing?
  7. I think that your family is doing good work arranging for plumbers to fix faults. Imagine if the faults weren’t fixed! I understand why you dread doing compulsive cleaning. Life is much easier if we do not feel compelled to do compulsive cleaning or in my case compulsive checking. Let a family member do the cleaning of the sink area as this will be a more reasonable response to any potential risk.
  8. Your Dad couldn’t really refuse. The probability of catching anything is low. But I am worrying about having to use public transport on Friday after months of not doing so. So I understand that we do not think in terms of probability but the near certainty of catching something which appears in our minds. This is probably the wrong advice but you could pore bleach down the toilet. Or perhaps better, another family member could.
  9. Hi Mark. The nearest I came to your crisis was not drinking water for some hours before I went out because of the time I would have to spend checking the plumbing before going out. I do not have this compulsion now. You need to drink and if you have not drunk liquid for three or more days you should seek help now. Do you live family or flat mates what do they think?
  10. I know about Ellis. One of the founding fathers of cognitive therapy along with Beck. Don’t know about the other chap. I had good therapy in the NHS as well as bad therapy. So last week I tried to contact a good therapist who went private. Incidentally she is on Ashley’s list of good private therapists. But the trouble with publicising good therapists is that they get booked up! There are a lot of charlatans who trade under the title of therapist. It needs to be regulated and a quality commission monitoring the sector. A hobby horse of mine.
  11. It is a common line in cop movies - I do not believe in coincidences. A false statement. In a room of 23 people the chances that two people have the same birthday is 50/50. Science and statistics prove that coincidences are common. There are probably many links between watching a film and and reading an article - your mind plucked out one in terms of a disease. And what about times when you brain does not perceive a link?
  12. I suffer from regular bouts of eczema which has been exacerbated by additional hand washing. For example when I visited the dentist last week I had to use hand cleaner a number of times before putting on gloves and after taking them off. I also have to use hand cleaner visiting certain shops. I do not have contamination OCD. I do not know whether this is recommended, I wear cotton lined rubber gloves when dealing with things outside such as bins and afterwards thoroughly wash the gloves with soap and water while wearing them. Inside I use E45 and ZeroAQS emollient cream as cleaner after using the toilet and before preparing food. So I have the notion of a safe zone once inside my home.
  13. It is possible to have more than one diagnosis. The most common twinning is OCD and depression. I have a diagnosis of OCD and depression and part of your post reminds me of my duality of diagnosis. CBT is the recommended treatment for OCD while depression has six different recommendations for psychological treatment according to the National Institute for Clinical Excellence. There is no clear leader in terms of treatment success. Though some forms of CBT for OCD have compassion based based therapy included in the treatment. Compassion based therapy was originally used for depression. If you are seeing a therapist it is best to stick to one psychological approach in the first instance and this would be CBT. Both OCD and depression have the same range of chemical treatments they are called SSRIs. Though there are more chemical treatments for depression. I would make out a list of your emotional and practical problems. To make out a list for a GP. I would read the stuff about OCD on this web site and download and complete Beck’s depression inventory which is commonly available on the web. This will help you frame your list if indeed you have OCD and depression. I find OCD to be energising in a negative way with checking behaviours like checking that the door is locked, the gas is turned off and so forth and depression as demotivating and de-energising with difficulties of doing things and getting out of bed. If you are in the UK you can call the Samaritans. Talking to them about how your distress ‘robs’ you of ‘will to live’ will help. They are very busy at the moment and they might be a small delay until you speak with a volunteer. With help you will feel better soon.
  14. Hi Nevermind In paragraph 10 in brackets you say ‘we will be putting in’ an appeal. I take this to mean that you were represented by a trade union rep or official. If the appeal fails you can go to an employment tribunal for unfair dismissal or the civil court for wrongful dismissal. If you did take trade union advice would they pay for an employment lawyer for the tribunal or court as well as representing you at the Teaching Regulation Agency? Have you or your representative seen what is on your enhanced criminal check/safeguarding file. I think it could include what investigations have taken place. Such organisations as Liberty can indicate what can be included. But my feeling is that you need good quality advice from an experienced employment lawyer and how to marshal the evidence from expert witnesses. Best of luck.
  15. I can identify with you experiences. Part of the problem is that the advice changes both in the case of the UK government and WHO - one example being the use of facemasks in public places. This is bound to occur as the virus is seven months old. I have followed the generalised world advice and for example used facemasks some time ago - following from my relatives experiences in Canada and their laws as well as many places in Europe and the Far East. I would prefer central rules from the government about health and safety at work in each employment sector. I know people in the hotel sector following Irish rules rather than individual employers deciding what is safe. Sorry no easy answer. The objective situation is difficult we can only muddle along and hope to keep up spirits up. But is does sound as if you are overreacting in expectation. Those of us with OCD do do better than imagined when faced with real situations.
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