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Everything posted by Angst

  1. Diagnostic labels have been subject to a lot of debate. The BPS publication Power Threat Meaning sparked off a lot of debate among the BPS clinical psychologist community with its approach to diagnosis. Of the groups of mental health users, people with an OCD diagnosis were most contented with the diagnostic framework which is rooted in late 19th century German psychiatry. Other groups such as those with schizophrenia were critical confirming the Schizophrenia Commission of 2011 chaired by Robin Murray of the Maudsley that the application of the label caused more problems than the original mental illness because the diagnosis is frequently misunderstood and carries much prejudice. There is constant movement in diagnostic categories for example OCD included hoarding but does not now except in rare cases. Also people experience a switch in diagnosis and consequent treatment during their lifetime.
  2. Hi Given that two of your questions about mucus and medication relate to physical ‘complications’ I think you should see a medical practitioner. Given that you are posting on an OCD site you presumably believe the cause might be OCD related. I don’t understand why living with people restricts your choices. I understand why it might embarrassing but this should not stop you from seeking treatment. Good luck on your treatment.
  3. Could well be as they depend on throughput to maintain numbers budgeted for. But it does seem odd that the psychiatrist changed your medication during a telephone review and did not monitor your medication regime change. I think you need to contact you GP if the effects of the medication change cause problems.
  4. I got discharged quite a while ago. I took the opportunity to get the consultant psychiatrist to refer me to a specialist centre. It is surprising that the psychiatrist did not tell you he/she was discharging you. It would be common courtesy. How do you feel about being taken off the antipsychotic? I used to volunteer in a mental health charity and ended up being the chairman. I know from this experience that there are a lot of people in primary care who receive antipsychotics. But GPs are generally unwilling to prescribe them and generally refer the patient back to the psychiatrist. Also psychiatrists do differ in their approaches.
  5. Hi James I had really bad checking and can identify with your post. The rule with checking is the more you check the more you check. I would not have a drink of water hours before going out because of the amount of time it would take to check the tap and stopcock. I would have to get up very early to attend appointments because of checking and still at times missed appointments. It also sounds as if you doing the staring thing looking at a tap or whatever to make sure it is off. This can develop into quite a ritual. A thing a found useful was to stop checking if I was going out of the property for a short time. On the logic that little damage would be done. And slowly stop checking for longer and longer periods when I found be out of the property. With therapy you will experience the wonderful feeling of not feeling that you have to check and get spontaneity back into your life.
  6. Hi Gingham The NICE site wants the same info as you. Called for users to report but none forthcoming.
  7. Symptoms of schizophrenia include social withdrawal, lack of motivation, being somewhat flat emotionally, not be able to find pleasure in life. These are called ‘negative symptoms’. There are surprisingly akin to depression. When people talk about having schizophrenia they tend to talk about the ‘positive symptoms’ such as having hallucinations and delusions. It is strange vocabulary ‘positive’ and ‘negative’ symptoms but it is the way the symptoms are described. You say that you don’t hear voices or have other types of hallucinations such as visual, tactile, smell. Hallucinations are common especially with bereavement. But you seem to have an unusual belief. A delusion about supernatural truth. Sometimes the divide between an obsession and delusion is blurred. A delusion is an unusual belief held with certainty and not prone to any rational analysis. Most people with schizophrenia are not in hospital. Many were many decades ago. Nowadays there wouldn’t be the beds. You are catastrophising on a very biased notion of what schizophrenia is. And the supposed economic and emotional consequences of such a diagnosis. I think the idea has popped into your head. You need to let it go.
  8. The thoughts trigger emotions. It could be anxiety or shame or guilt. They are always negative emotions which make you feel bad or very uncomfortable. It could be that medication will lessen the negative emotions and assist in your refocusing. Switching your attention to more positive or more normal mundane thoughts.
  9. My take on medication is that it reduces the intensity of negative emotion associated with OCD thoughts. So my approach is similar to Northpaul in that medication lifts mood. I also agree with him that situations matter. My worse experience of OCD was when I was a carer. When I had support for this role my anxiety lessened and my mood lifted.
  10. It is well known that there are problems in delivering therapy via the telephone. A big research study called EQUITy (Enhancing the Quality of Psychological Intervention Delivered by Telephone) is in the process of publishing its findings. The aim is to increase the efficacy of IAPT programmes. Training for wellbeing practitioners has already been modified on the IAPT scheme. One problem is the construction of diagrams of how you OCD works used during the cognitive part of therapy. I would phone the charity to see if you can be stepped up to a more intensified and specialised treatment option. For access to secondary care I think the gateway is operated by GPs so perhaps an appointment for an assessment at a CMHT could be made for you. (Community Mental Health Team)
  11. Given that there are books such as CBT for hoarding, psychosis, tinnitus, depression, eating disorders…….there must be differences in the way CBT is shaped for particular diagnoses. The treatment patterns for CBT for hoarding for example differs quite markedly from CBT for OCD and CBT for psychosis also differs quite markedly from CBT for OCD. CBT is a generic approach. Otherwise why have separate diagnoses? The OCD thought pattern relates to obsessions and the behaviour relates to compulsions and the predominant emotion is anxiety. Nonetheless, a therapist with sufficient knowledge and experience should be able to help. It is similar situation in surgery - there are general surgeons and specialised surgeons. And the general rule for surgery is that the more times a surgeon does a procedure the better they get. And in the same way an OCD specialist will have lots of experience dealing with OCD along with periodic training.
  12. The question to ask why do you want a diagnosis? There are lots of self help books for OCD which use CBT where the person follows the practices outlined in the books. Where diagnosis is important is if you want your employers to make ‘reasonable adjustment’ at work in order to make life easier for you. It can in some situations provide employment protection. Certain student grants for disability support require that you have a medical diagnosis from a GP before you go for assessment of your needs. If your OCD is really bad and you need intensive therapy then a diagnosis by a clinical psychologist or psychiatrist is required to attend the specialist centres. There are different types of diagnosis, therefore, self diagnosis, practitioners diagnosis, GP diagnosis and psychiatrist and clinical psychologist diagnosis.
  13. Stress aggravates things. You could have reduced the stress by saying to the family I got a cut on my finger and excused yourself for a while by doing some first aid on yourself. This is something like strugglingadult64 says. We need to take care of ourselves. You got yourself wound up in a customer services situation which can be intrinsically stressful at times and you had a worsening injury. I also agree with the comment that you can be in such emotional and physical discomfort that you can feel I don’t care anymore - it is a form of shrugging your shoulders. Forget about it, and move on.
  14. If anxiety is worrying about what might happen then worrying about past events is a pertinent question. OCD is an anxiety disorder. If your worry is about identity then it affects future events. For example, if you believe that you have done something bad in the past and this is part of your character which indicates that you will do something similar in the future then this is OCD territory. If you feel remorse and guilt about something in the past and believe that you will not repeat it then this to my mind is depression. The way the past impacts on the present is the Gilbert territory in OCD therapy as mentioned before.
  15. I think it is best to put it into context. For me doubt is about the most sensible course of action if a problem arises. I will obsessively cogitate about the best strategy and try and work out the what ifs. There is profound doubt. In regard to my checking OCD, there is a doubt that I have done something effectively it could range from filling up a form to turning off a tap. The anxiety is the highest if the action is perceived as important for example filling in a legal form or the correct number of eye drops for an eye infection. OCD - the o stands for obsession in that your thinking is excessively preoccupied with a problem. The c stands for compulsion you behaviourally do things to ensure that you have done the correct thing. So repeatedly checking forms or repeatedly checking taps or whatever. Anxiety is a forward thinking emotion - the idea that something will go wrong. We obsessively think about how things could go wrong. And do compulsions to try and ensure that things will not or have not gone wrong. So doubt pertains to whether we have taken the right course of action.
  16. Hi You seen to be doing a consumer survey of therapy. It will take a long time as there are many hundreds of therapies. If you suffer from OCD then CBT is the evidenced treatment for this condition. As mentioned on another thread, the ideas of Paul Gilbert have been added to this approach.
  17. There is a free short book on the internet by Paul Gilbert ‘Training Our Minds in, with and for Compassion’. Just do a search. Victoria Bream et al ‘CBT for OCD’ uses Gilbert’s ideas in the latter stages of the book but for shame/anxiety combinations rather than guilt/anxiety combinations. So I would just focus on the Gilbert book and use further references.
  18. People with strong morals and OCD can be hard on themselves. Harder than they would be on others. Paul Gilbert the creator of compassion therapy mentions techniques to be self compassionate. Also our memories are not accurate. Are your memories tinged with a harsh self critical and judgemental tendency. As you say, other people ‘if reminded’ would have a ‘moment of regret.’ When these thoughts happen to me I label them as a form of moral overreaction and move on. I was taught to be self critical when young. The thoughts now appear when feeling low. Part of therapy is mellowing the harsh inner critical voice. That is why Paul Gilbert and his compassion therapy is recommended. It is used in OCD therapy at some centres.
  19. Is the word reassurance relevant here? To reassure a person you try to remove a person’s doubt and fears. In the example given of washing hands the person models their behaviour on another person’s behaviour. This is not reassurance. Reassuring a person would be to say it does not matter that if you have not washed your hands. You would this if a person was worried about not washing his hands. Asking questions is not an example of seeking to be reassured by another person. Asking a question is a very different thing to asking to be reassured.
  20. Assurance is to do with confidence - I gave an assurance that the work would be completed by Monday; reassurance -a statement removing one’s doublets and fears. To imply that re in assurance implies repetition is a misuse of language.
  21. I agree in practice an intrusive thought is an unwanted thought which causes distress. But further, a person becomes preoccupied or obsessed by the thought and can’t let it go. I think we can describe our inner experiences - the words in our inner speech, the images in our minds, the feelings that we experience. But these these things are swamped by general categories such as rumination or intrusive thoughts. For me, therapy is specifying the thought process and the alternative thoughts that might replace them.
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