Angst

Over the years there had been a recognition of forms of abuse - emotional, financial, mental and its effect of our psychology. Misrepresentation and fraud is now the major crime. Teens spend on average 35hours a week on their smart phones with 200 notifications a day with the threat of cyber bullying. There is now the legal recognition of ‘coercive control’. Social work departments and community mental health teams are aware of ‘cuckooing’ where vulnerable people’s homes are taken over by gangs. Initial friendly overtures are made to vulnerable people and then their homes are taken over for nefarious activities. I think such things have always happened but there is greater recognition of these things now. If you are an elder person then Elder Abuse is a good support and if you believe that you are being abused then I would contact Social Services.

Being ‘set up’ is in part cultural in many cultures there are arranged marriages. Gandhi and his wife for example had an arranged marriage at 13. I think it is a good idea to talk over your concerns with your therapist. Sexual identity themes are quite common in OCD.

Have you found diazepam has helped with sleeping? You were prescribed the medicine for a week. As said long term use is not recommended. I have only ever been prescribed such medication for very short periods. I would aim to get another GP to do a medicine review. If you are in England there is the Talking Therapies route as detailed above. GPs are very variable especially when dealing with mental health issues even if it is quite a large proportion of their work. Take care.

It seems to me that you have a breathing compulsion when you perceive bad air. Is the solution trying new breathing techniques or changing your perception of the air?

The decade old posts are correct — suppressing or trying to stop the thoughts are bad ideas. Let them drift away. If I told you not to think about a pink elephant then an image of a pink elephant will more than likely appear in your mind’s eye.

You had really good therapy with the clinical psychologist. It is unusual for them to visit a house. You say it worked well. A problem with therapy is organisational and budgetary. When a course of treatment ends it is difficult to re engage with the same therapist to have top up sessions within a reasonable length of time. So that the lessons of therapy can be reinforced. Good therapy can involve going around a supermarket with a client or visiting a train station with a client or whatever. A context provides real triggers and real responses of fear or disgust and having an objective and supportive therapist can help. Eventually we have to learn to do it ourselves.

I would discuss the issues with Ashley which I think you might have done in the past. There’s always pressures in CMHTs as there is always throughput - the discharge of patients to allow new patients. Good luck of getting the appropriate therapy!

I think it’s probably best if you tell friends and family that you have concentration issues. And I think with any therapist in the future it would be best to mention that you have concentration issues so that you can both work out how to solve the problem.

Will your therapist allow you to record sessions? With some it’s standard practice whilst others seem intimidated by the process. Has your mind always wandered off? People are very observant in interactions and notice things like gaze and other body and facial movements. We respond to what people say and they respond to what we say. Have you thought about doing group work to enhance your skills?

Hi Mini You can have therapy for both at the same time. I did. For me and the therapist the best measure of depression is the depression inventory by Beck. It is easily located. I had depression and OCD in the same period with each one alternating in a day. OCD energised me with checking and depression de energised me with staying in bed. Both have rumination. One of the worst periods in my life. So my experience is a bit different to north Paul’s. Our experiences may be different but the remedies are similar. For me reducing stressors, therapy and medication.

A good book on paranoia is Peter K Chadwick ‘Understanding Paranoia’ 1995. It is out of print but you can get it on eBay. The second chapter is particularly good on why certain people experience paranoia. I had some paranoia some years ago when a line manager was out to get me. I ‘overgeneralised’ the threat. Peter was an experiencer of paranoia and recovered. He was lecturer in psychology after being a lecturer and researcher in geology. And has published in the prestigious journal, Nature. Coincidentally the person who wrote the preface to the book is Peter Chadwick hence the use of the initial K for the book. This other Chadwick has also written on paranoia and has formulated a CBT approach to the subject. The book is an easy read and suggests treatment options. As I said, written by an experiencer who recovered.

Hi Dinosaur There are diagnoses and there are diagnoses from completing a standard OCD questionnaire and then having a clinical interview with a psychiatrist who specialises in OCD to a diagnosis by a psychiatrist/clinical psychologist to a diagnosis by a GP to a diagnosis by a therapist to a self diagnosis. If you get a book such as Break Free from OCD then you self diagnose and follow the book. Why do you want a diagnosis? You need a medical diagnosis from a GP or psychiatrist to apply for a student disability grant in England. If you want some employment protection from unfair discrimination then a medical diagnosis or a clinical psychologist diagnosis would carry more weight I feel in an employment tribunal. You do not need a diagnosis to start therapy. In England you can self refer for therapy in the Talking Therapies scheme. I do not think that this scheme operates in Wales. David Veale a psychiatrist who specialises in OCD and BDD runs Overcoming OCD consultation service where clinical psychologists provide therapy including Vroom therapy.

Hope the session with your therapist went well. I think that it does help to remember the time when you didn’t have these thoughts. You have something to aim for and can compare your thinking then and now.

If you don’t pay for a product then you are the product. We use search engines and social media for free so how come the tech firms make such big profits - we provide information about ourselves so sellers and others can target us. The idea of people watching us through screens started in 1948 with the publication of 1984. There are pictures of the owners of big tech covering up the camera and microphone on their laptops. With smart doorbells, smart speakers, smart fridges…..are we sure the information is private? Stories regularly appear in the press. I don’t mean to intensify your paranoia. But this evening I am shredding documents with my details on them so they cannot be used for fraud. There are security breaches, witness several large retailers over the past few months. Good that you are talking to the therapist about your feelings. The very fact that you can write paranoia and open up a discussion about it shows you have insight. I do think leaving your property with a tinfoil hat is a going further than you need. But you know that!

I agree with Garfield. Do not contact them at this stage. If offered the job then think about correcting the figure. It sounds as if you are reviewing the interview conversation in your head. I don’t think that this is a good idea as you could enter a period of profound rumination. No point beating yourself up with regrets.

Hi Simon Good examples of ‘flow’ activities such as playing a musical instrument and chess. My PA has on his list of clients a dementia experiencer with whom he plays chess. The client has played chess since he was a boy and there has been deep learning of the appropriate skills. Singing is a good activity as well, especially in a choir. OCD can make us very egocentric where we pay too much attention to our internal thought processes. Since I moved from an inner city flat it is a pleasant form of mindfulness to watch the birds and bees in their activities in a very green spot surrounded by trees, plants and flowers.

Not sure if I understand. An inheritance is in a will of a person who has died. So who are the people who are ‘gifting the money’? Inheritance issues can cause of familial strife. The Charles Dicken’s novel Bleak House is about such issues. It was based on a real case and it continued well after Dicken’s death. In fact, it continued for about a 100 years. It was a vast fortune. In the end there was no money. It all went on legal fees. And I think people can be quite judgemental on how the money is spent. For example, people thinking - when I think how hard granddad worked and the bit of money is going to buy a flash sports car when I have five children to bring up. Emotional issues are quite common in inheritance cases. Are you and your partner in agreement?

Yes good news -reality testing is the key. Even though there’s a voice screaming - no don’t do it and there are strong feelings signalling to you - no don’t do it. The insightful and rational part of you knows you need to do things. The more you reality test the less powerful the thoughts and feelings will become that you should keep your head down and be safe inside.

I have experienced something similar. There is a Mind pamphlet on loneliness and mental health. Your essential care needs such as having a roof over your head with the attendant facilities are being met. I think a good method is to slowly build up your social interactions. I think keeping your mind busy is important. I would do something that you are interested in. Some people play computer games on line. During the worst of the Covid crisis I did a course on corpus linguistics. I’m interested how people communicate and influence others.

Nowadays memories come up frequently on the forum. Memories are vivid and the more you recall the supposed memories the more vivid they will become. Vividness is not a sign of truthfulness. Memories are not like video recordings you can get an accurate representation of the truth the more you review a memory or supposed memory. You are going back in time to see the origins of your fear. Whether a thought of doing something bad transmuted itself into doing something bad. This is called thought - action fusion. We do it in the present and future as well. Whether in the future, if I have a bad thought now, then this means that I will act on that thought. These are intrusive thoughts. So Eltham leave the whole thing alone. Or there is a rabbit hole to go under.

Do we need to know the cause of our variant of OCD to stop OCD? I think in most cases we do not need to know. Our compulsions are to quieten our feelings of anxiety, disgust, shame and guilt. Exposure to feelings teach us that we can survive the feelings and that these feelings are not an accurate representation of reality.

Hi WW If I understand correctly you want your landlord or somebody else to provide a flat where the electrical safety work has been done. If the landlord did this or indeed had a flat available what would stop the deterioration of the new flat? The feature of flats and of all properties is that maintenance work needs to be done. We cannot always predict what needs doing in the future. You can own a leasehold flat for 125 years or 999 years but the lessor or owner of the freehold might still demand access. If you are a co-owner of a block of flats the other owners of the other flats via a communal agreement can demand access to your flat to repair a leak and suchlike. Likewise social tenants of a council or housing association are legally required to allow the landlord to do repairs. All or us with OCD have insight. We are not delusional. You might not like this suggestion but have you had therapy? It might be a case of post traumatic therapy combined with OCD would help. Therapy helped me. I like having a functional property. Have you been in contact with your GP? They might be able to offer medication in the short term dealing with the feelings of intrusion.

Hi Johanna The use of professional organisers is closely related to hoarding. Certain forms of hoarding fall under the category of OCD but most forms do not. The British Psychological Society has a booklet called ‘Hoarding - a psychological perspective’. It is free to download. Hoarding is about acquiring too many objects for the available space, storage and the arrangement of objects and the disposing of objects. There is a cognitive problem that hoarders experience in the storage and arrangement of objects. Hoarders forget what they possess so they may buy unnecessary things. They tend to stack objects rather than organise them into categories. So you need to work with the client on how to organise objects into mutually agreed categories so the client can easily see what they possess. You need to work with the client on how they want to categorise and organise their possessions. You cannot simply impose your own categorisations. I suggest you read the BPS booklet and the references it contains. There can be an overlap with OCD and hoarding - for example the need to repeatedly check that there are no valuables are being disposed of to sell, donate or dump. Work needs to be done with the client on what is valuable.

Hi Emma Your post has sparked off quite a wide range of discussion. DSM and the WHO are classification system of mental disorder. What constitutes mental illness changes over time. In the late 1970s, for example, homosexuality ceased to be defined as a mental illness. It did fix a problem for many people with the stopping of at times compulsory behavioural therapy for people who were deemed as being mentally ill. DSM 4 included hoarding as part of OCD. No longer. The definition of autism has changed over time. It has been defined as a mental disorder. But no longer. The new discourse is about difference and neurodiversity. The disablement discourse is nowadays that society contributes to disablement for example no lifts at stations for wheelchair users. ‘Reasonable adjustment’ is about adapting the environment to fit the person whether the problems of adaptation are mental or physical or permanent or temporary.

Your Dad sounds as if he does domestic chores like me - in not a very skilled way. Some things we have to do because they are necessary and some things that we have to do are compulsions. I think therapy will help you feel less battered by things. Just focus on your new accommodation later in the summer. Will you have your own bathroom and kitchen? Have you arranged therapy at your new locale? Not long now!