Angst

Before the internet people had domestic medical books which would list the major illnesses and their symptoms. In the Victorian comic book Three Men in a Boat a character after reading the medical book he thought be had every illness in the world. In the BBC comedy One Foot in the Grave the main character would regularly consult such a book which confirmed his worst fears. These days searches are not confined to our bookshelves and the bookshelves of our library they encompass the World Wide Web. So stop googling now. I have a physical problem now. I have received two test results. I google reputable sites to interpret the results such as NHS and then stop. I write down my questions to discuss with the GP.

Good points. I have recently moved twice in under three years. From partial ownership in a block of flats to rental and finally to ownership in a bungalow managed by a charity. I was lucky to be able to arrange plenty of support for the moves. But it was expensive. Certain forms of OCD can be triggered or worsened by environmental contexts including social contexts. Dealing with the co owners in the block of flats was a nightmare and I had legitimate concerns for safety in a high crime area but nonetheless trendy part of a city. But as is the case with OCD I overgeneralised the risk and did unnecessary checking. This checking amounted to a huge account of time. I recommend as soon as you are at your new place you register for therapy. This morning I realised that I had not locked the back door. Is this a normal sign of carelessness? Living in a low crime area with supportive neighbours has lowered stress.

Different perceptions (of risk) create different types of behaviour so as you say your Dad is not deliberately trying to annoy you. When do you move? Are you plans still in place?

You have done your homework! You know what typically OCD therapy looks like in say Break Free from OCD. The popular book. You could ring up OCD UK to discuss your concerns. We place trust in professionals be they therapists, doctors or nurses or indeed solicitors, accountants and registered gas safe engineers. We correctly consider that there is a professionally recognised approach to a problem. I understand your concern about bringing up your concerns with your therapist. I think a confident therapist would have no problem. But some therapists may be defensive. That is why I think you need to talk through your options. Hence my recommendation to contact OCD UK. This sounds negative - but I think it is positive. Your present therapy is not the last chance saloon. If you find that you need therapy in the future then it’s available on the NHS. Your life, your being, is not based on your current experiences. To repeat: talk through your concerns with the staff at OCD UK. .

As Garfield says memory is not like a video playback because each time we review a memory or supposed memory we alter it. You will not get certainty. And, as said, the more you review the more familiar something becomes. Switch you attention to other things.

I would talk to the therapist about the course of treatment. If you unconsciously think you are a bad person then by definition this thought would not appear in your consciousness. And you do say that you do not consider yourself to be a bad person. So does your therapist have an insight into your unconscious? Some therapist believe that they do. Revealed by slips of tongue and your body reaction to things. A good therapist picks up what you say and how you say it your body posture and facial expression. The best therapy sessions I had was when I was videoed so the therapist had feedback which could be looked at and fed back to me on a screen. I also had my own recorded account of the sessions. But this feature is quite rare in therapy. This experience was at a specialised centre. Do you have any compulsions associated with the intrusive thought? Are you aware of any compulsions? ERP would be ceasing for a while the compulsions. A log of feelings however could constitute homework. As I said, the best thing I think is to discuss things with your therapist.

Makes perfect sense - the ‘sensible’ brain and the non sensible brain. Or the rational brain and the instinctive brain. You know in the sensible brain that there is nothing to worry about but nonetheless you can’t let the thoughts go. You have insight you know that it is OCD but part of you says it’s real. Rational thinking can be hard. It’s well documented in cognitive psychology. Deliberate and slow rational thinking in contrast to fast instinctive, fast thinking. Daniel Kahneman, a Nobel Prize Winner, has written about slow/fast thinking. A lot of the time fast thinking works but those of us with OCD we need to strengthen our slow and deliberate thinking. This is what therapy is about with Theory A and Theory B - with the question is it OCD or something real. I think theory helps. Your rational brain is right!

Awful feeling being scammed. Always good to get three quotes and best of all get a neighbour’s recommendation so you can see their work. I have been ripped up by roofers in the past. It is difficult to check their work.

Many, many people bear illness and great discomfort without catastrophising. It is not restricted to one belief system. Does Buddhistic awareness have the capacity to transform socio political structures? I think we can learn from the political history of Myanmar, formerly Burma; the relation between Tibet and China; and the role of Buddhism in Japan where albeit it is not the major religion. I personally doubt if there is a one to one relation between religious belief and political structures.

Little discussion of Rational Emotion Therapy on this thread, despite Ellis’ RET being cited as a cornerstone of the approach. Ellis and Beck laid the foundations of cognitive therapy from the 1950s. Ellis was explicitly influenced by Ancient Greek philosophy especially Socratic questioning. Is this what people mean by rhetoric? It is part of CBT practice. Beck implicitly so. As I mentioned before, statistics were cited as proof of the ‘revolutionary approach’ but where are they published? CBT with a mindfulness element is quite common nowadays but has the proof been published? There seems to be a display of emotion on the thread regarding experts or people who perceive themselves as experts and therapy especially CBT. Personalities and appeals to authority figures have no room in science. Empirical confirmation of a theory of therapy needs to be subject to scrutiny by scientific endeavour. My take on CBT is that it is a good approach but I think the social and material contexts of our experiences also needs to be explored. CBT for OCD worked for me in substantially reducing checking for safety in the material world.

In the UK Dialectical Behaviour Therapy is structured on the Ellis based system called Rational Emotion Therapy and mindfulness. You talk about awfulising but what about the other cognitive biases such as overgeneralisation. You cite statistics but in the UK you need to cite the source for the statistics. Research needs to be evidenced based and published in serious scientific journals to be approved for use in the health service. DBT is approved for some conditions but not OCD as there is no proof. What is ‘natural psychological flow’? Let it be was a popular song in 1970. For non OCD things it is quite reactionary. People died of many diseases when Buddha was alive. Science through things like antibiotics, clean water and sterile operating theatres have improved human lives and prolonged life.

It worth testing your memory. I am in the process of going through NHS for pain in wrists and hands - had the blood tests, waiting for x ray results might need neurological testing and MRI. It’s worth visiting your GP.

Going over an interaction in your mind is a compulsion. Lots of things happen in an interaction, facial gazes, body movements and how we say things with laughter in the voice or sadness of other emotions in the voice. We cannot recall that detail. You say you act like a ‘frightened child’ trying to appease your interlocutor. A rough and ready way to work on this is transactional analysis based on Eric Berne’s work ‘Games People Play’ how the three child ego states are picked up by the interlocutor who perceives that you want a parental reaction. The parental reaction can be supportive or critical. You want a supportive response. You may at times act as a critical parent who wants a compliant child in the person you are addressing. TA is used in the service industries. For example cabin crew are taught to be supportive to passengers who are acting in a child like way who have a fear of flying. There can be crossed transactions for example a critical parental passenger talking down to cabin crew. The crew member however should not act like a child but as an adult and talk through the issue.

I like Snowbear’s distinction between trauma and OCD. I think a diagnosis by a clinical psychologist can be helpful. Memories are frequently discussed on the forum. My checking OCD was largely sorted out by CBT. I still have ‘instrusive’ memories which are more likely in a depressed mood. I was fortunate in having a clinical psychologist with an interest in the psychology of memory. She was the first person who I felt really understood memory. In general my instrusive memories are quite vivid and explicit. But most people with depression have quite generalised autobiographical memories. I think a skilled therapist can sort out therapy. Memories which are problematic can be diagnosed in terms of OCD, depression, PTSD and cPTSD. Certain problems can be trans diagnostic for example rumination is a feature both of depression and OCD. As I haven’t fully sorted out intrusive memories I am interested in EMDR which would perhaps reframe my diagnosis of emotional memories. I would like to meet with a good therapist to discuss this.

I think something of a compulsion to review your old posts and constructing ‘a case’. Sorting things out or ‘putting the pieces together’ is very common type of rumination. I agree with the suggestion to switch your attention to something entirely different. To something outside your own mental space.

You say that you ‘really don’t remember’. Assimilate that statement. You say that you are ‘genuinely depressed’ then do things that alleviate depression - keep active, do not ponder on things, keep doing the routines of everyday life, talk with other people about things not related to depression….You say that you are tired about ruminating about the supposed memory? Then stop thinking about it. Switch your attention. What things do you know with ‘all certainty’? Even in the criminal courts there is the notion of beyond reasonable doubt and in the civil courts there is the notion of the balance of probabilities. Why do you want to believe something with all certainty when memory is fallible? Show compassion to yourself.

You are ruminating about a memory dilemna. You say your memory is unreliable. The opposite of pride is shame. If your memory is affected by Covid why not acknowledge this and adapt?

You can’t stop thoughts and memories popping into your head. The memories can be true, false or distorted. I think what we recall can be affected by mood. I recall more negative things if depressed. Intrusive thoughts and memories are unwelcome intrusions that cause distress. I think imagery has a profound effect that’s why it’s so effective in advertising. And memories tend to be visual and frequently carry emotion. When intrusive memories occur I recognise them, but do not dwell. Move on. And if necessary, visualise images that are beautiful.

You want the certainty of an accurate recall of an event. I am saying that you will not get that certainty. Especially, as you say, that your recall is murky. Each time you are tempted to sort out what’s real and what’s false, reject the temptation. This is rumination - chewing over in your mind what’s the truth. Switch your attention to other things that are positive.

I regularly use a plunger on the kitchen sink. Do you think your OCD is caused by your situation or caused by your perception of things? Would changing your accommodation eliminate your OCD? I think one to one therapy would help.

Leave the whole thing alone. Each time we revisit a memory we subtly change it. You are talking about autobiographical memory which is the thing most people mean when talking about memory. It is the memory of past events in our lives. If you put BBC -science - false memories into a search engine you will read that we all have false memories. People with OCD tend to have negative false memories which might carry negative emotions such as shame and guilt. Lots of people can have positive false memories as well. When thinking about and projecting into the future people with OCD tend to have catastrophic expectations which generate feelings of fear or anxiety. Looking back or looking forward there tend to be a negative bias.

What caused the smoke? If it happened in my home, I would want to find out what was happening and the smoke alarms would be sounding off. Or did you have the windows open and somebody had a bonfire? Do you think you had a panic attack? I used to get them a lot when my OCD was at its worse. There are techniques which involve breathing exercises to deal with panic attacks. I found them useful. You mentioned in a previous post that you were concerned about long term brain injury from toxic substances. In your last post you say that you are concerned about ‘permanent damage’ caused by the smoke. Do you think that there is a interlinking between OCD and health anxiety? And that your major fear is long term physical damage to your body? As others have said, losing weight because of not eating things perceived as contaminated and the stress that your body has to deal with are very costly to your health. Are you receiving therapy at the moment?

I can identify with your experiences when my OCD was at its worse. Do you have a set of objects that you perceive are contaminated? Or do new objects pop into your mind during the day? Are the objects contaminated with same substance e.g. lead or are there a variety of contaminating substances? When my OCD was at its worse there were a set number of things which I had to check. Sometimes the list would expand but not by a great number. So I was to approach therapy on a piecemeal basis - reduce or eliminate the compulsions on one thing and then more on to the next thing. This created a hierarchy of things to achieve from the least demanding to the most demanding.

Comfortscorned - good example with the door example of developing a procedural memory - a motor skill set - of opening the door without using the handle. As you say developing this compulsive skill has no practical value. It simply takes up cognitive and neural space. Northpaul - procedural memory is a long term memory - we learn skills including domestic skills very consciously until they become automated or semi automated and part of what is called implicit memory. Therapy is about learning new cognitive skills such as how we think and pay attention to things. And learning new ways to behave. But learning can also be the unconscious assimilation of cultural norms. For example when we learn to speak our native language we learn how to position our tongue and shape our mouth and control air flow to utter the various sounds of our language. A baby or young child does not do this learning consciously. We also learn how to project laughter in our voice and sadness and fear and other emotions through pitch by changing in subtle ways how we enunciate.

Procedural memory is when you do things without consciously thinking about what you have to do. It involves motor skills with things like tying knots such as shoelaces or riding a bike which requires coordination and balance skills. When we start to do things like tying shoelaces we are very conscious of our actions but with practise it becomes automatic. When, for example, domestic tasks are done automatically this is part of procedural memory. Many craft skills involve procedural memory. Our hands and limbs do things automatically It could be that your procedural memories have become much more elaborate then they need to be over a period of time with the development of OCD rituals. And with additional stress the automated response to do things weakens.