Angst

It doesn’t seem to me that referral to a specialist in OCD carries the risk of diagnosis slip. You are worried that you may have a substitute diagnosis or an additional diagnosis that is false. Psychiatrists work within a classification system be it the US based the DSM one or the WHO ICD system. There have been shifts in diagnostic boundaries for example hoarding used to be categorised under OCD. There are more and more categories of mental distress. The two classification systems work in tandem or used to. Last month the USA pulled out of their WHO membership as Russia pulled out some years ago. The issue you are concerned about is reliability - whether psychiatrists given the same case would offer the same diagnosis. If you ever get a diagnosis that you disagree with then you could ask for a second opinion. I think it is excellent news that you have specialist treatment for OCD. You can fill our lives with negative what ifs. I am pretty certain there will not be a problem.

You are recovering a memory from three years ago. The overboarding is done. You are worried that that there was asbestos and there was a false negative result. Even if your thoughts are true, and I don’t think they are, what are you going to do? Test the kids for lung damage? Would it show? Would you test them every year? Rip off the overboard to see if there is asbestos? It’s gone. It’s in the past. There’s nothing to do. It is OCD thinking.

The common metaphor for recovery is the word journey. And that people’s journeys can differ. As north Paul states part of the journey could be defined as the amount of time compulsions take - a reduction in the intensity of symptoms. It could be going back to work. It could be developing a social network. It could be moving to a new place. So I think one part of the recovery journey is to list the things that you want to do that OCD is stopping you doing now. There is a cut off point where you no longer have OCD in research and therapy. Or it is in abeyance. There are detailed OCD questionnaire which measures the extent of your OCD in terms of the amount of time you spend in doing OCD things and the emotional distress you feel having OCD. I think many of the experiences that OCD people have are quite common. For example, magical thinking is quite common - reflected in many superstitions - it is when these beliefs become very dysfunctional and take up a lot time and are emotional damaging that these experiences get defined, labelled and diagnosed as OCD.

I would take your therapist’s advice. The thing about OCD checking is that it knows no limits. Ultimately you have to take the decision to do no more checks. If you are to get on and do other things. Moreover, it sounds like you a have a hell of a lot ‘backlog’. It sounds like you were able to keep your OCD at a reduced level at your work by not being willing to report things or uncertainty to your manager and deciding other things were a priority. Procrastinating can be a feature of behavioural therapy - I will check tomorrow, come tomorrow you say I will check tomorrow. I did this will front door checking - I’ll check in 15 minutes, then I’ll check in 15 minutes. Until the sense of urgency diminished.

My therapist at the time noted that when I stopped work my worries switched from work related to house related. We are all different. As your worries, Worrier, relate to neither. As we have all said, let the thoughts drift away no matter what the content.

It’s interesting that you feel the urge to check when you are in the process of leaving the job. Did you feel such a strong feeling of responsibility when you were not in the process of leaving? In my experience, the need to check does, in part, depend on the context. For example, if I am leaving the house for days or weeks I do a more careful check than if I am leaving for hours. The rationale being that if there is an electrical fault, gas leak or water leak there will be more time for accumulated damage to occur to my property and other people’s property. (My checking overall is must better now after therapy and changing to a new environment.) So it might be the imminent nature of your departure is fuelling your OCD.

Didn’t you worry when you were a care worker? I don’t know if Worrier is working. Are you?

You say life keeps throwing scenarios at you. Scenarios are things in the future that might affect us. Big corporations and governments do or should do scenario planning. It is a course of action that you will do if something happens. You devise a plan of action if something happens. You do not wait around waiting for something to happen. You get on with your life. It is called contingency planning - if my house burns down I have insurance and the policy is easily found, for example at an individual level. If a foreign government imposes tariffs to destabilise the economy then I will foster internal trade within the provinces and find new export routes to facilitate replacement trade which is happening in a country six thousand miles away. So make a plan. And get on with your life.

So one mistake on agreed search procedure. Do you have many searches? They would have to be random or it would rather defeat the purpose. I would mention to a member of senior staff that there’s been a slip up. Also discuss it with your psychologist. I have intrusive memories which I manage to limit their impact. I was thinking of having specific therapy for them. Recently a friend who is a nurse described how a patient with liver damage on a general ward had his family bring in bottles of whisky. It didn’t do the patient much good……sometimes the drugs can be legal!

Hospitals and psychiatric wards are part of society. Over the past years there has been the extension of the use of illicit drugs in hospitals. Which can cause or exacerbate mental illness so I suppose the search was to do with this phenomenon. There have been improvements in care for example individual rooms with bathrooms. I remember visiting a psychiatric ward where there beds for both sexes. Not so long ago. I think the thing to remember about medication is that once you are well on the road to recovery then the dose will go down. How are your treatments with the psychologist and occupational therapist going?

You are looking for reasons why particular intrusive thoughts enter your mind at a particular time. This constitutes rumination. Each time you visit the memory from 30 years ago you change it. You are the one hyper focusing. Let the memories and thoughts alone. They will pop into your mind. Allow them to pop out by not focusing on them.

There does seem to be a contradiction - ‘I do like it here though’ and wanting to move. There are always dilemmas. Two bathrooms are nice though. My new property has them. In my last property I needed emergency plumbing and had to relief myself in a camping toilet for a week. But this presents a problem - where do you dumb the turds, if you live in a flat without a garden.

Hi comfortscorned I think it’s all very OCD. Such as the thought - what if something harmful drops into my shoes. I think that there may be a whole stack of what ifs in your mind. How do you ‘get away’ from OCD dictates? I think that you probably know, given your replies in other people’s threads.

Good idea. Yes there is a less deferential attitude than in the past. I am pretty sure that under previous NHS funding regimes unnecessary work was done. This is going back some years. The NHS dentist did talk about alternatives available in the private sector and NHS sector. I note that in the NHS sector the work is guaranteed for a year and any additional work is covered for two months. I will be looking at my insurance policy which pertains to one practice. I will make a decision on Monday afternoon after looking at my insurance policy. Thanks all!

Thanks for your reply. Both dentists mention my grinding my teeth. Others have mentioned it before.

Thanks for the reply. A nicely balanced approach given my previous/present dentist. He is very keen for me to sign an agreement before consultation that any treatment will be privately funded rather than NHS funded or partially funded. This never occurred before when he would outline NHS and private treatment options.

Thanks for your reply. Could be the case that there are different approaches to the same perceived problem. The gum shield sounds a really good idea. I will ask about it.

On Friday I saw a dentist under a long term insurance policy in London. I see him every six months. I am thinking of closing this insurance policy. He said no work needed doing. On Wednesday I saw a new dentist in the new place where I live. He is a NHS dentist. This dentist said that a molar was fractured and should either be extracted or encased in a cap. The dentist in London had recently stopped doing NHS work as he said that it promoted unnecessary work. The new NHS dentist said that the molar needed attention as a potential infection could occur. The NHS cost of an extraction is £75 or a cap at £326. The price mechanism occurs in NHS dentistry as well. I am not entitled to free care. Both say that I grind my teeth in my sleep. This causes damage. A well known physical feature of anxiety that occurs in an unconscious state - that is sleep. So I have a dilemma - which dentist to trust. I am tempted to go for another opinion. I am new registered with a new NHS dentist. To go to a private dentist would cost circa £150 for another opinion. There are no other NHS dentists in my new locale. Is checking an OCD feature? I am regularly using my tongue on the molar to test whether there is a crack? I am not sure whether there is a serious fracture when looking in the mirror. As I do not know what a serious fracture looks like. What should I do? Who to trust? And how to stop OCD from gripping me.

Out of sight, out of mind. I can understand why you are out of the kitchen while your mother cooks. You say that you need to intervene when your mother does something wrong. Do you think your notion of doing wrong is in fact an OCD notion? How were your shoes getting contaminated? Are there any ways you can reduce the demands of your OCD?

Glad I don’t pay the water bill! You could make the showering into an ERP exercise. A planned reduction in shower time.

I have skin cancer my kids have heart defects the house has subsidence there’s a dangerous freckle on my kid’s leg there’s an asbestos problem from two years ago the ceiling is not boarded You ‘spend your day believing this rubbish’. Because you believe these things they become important. You are on alert for danger - your health, the kids health, the asbestos danger, the subsidence danger. You say that you are hopping from panic to panic. I wonder if on either a temporary or permanent basis medication might help. Do these feelings arise if you have company at home? And are you able to concentrate on doing one thing such completing a complex form or fixing something?

Your anxiety appears to be house centric. You live in the house so there is constant stimulus to respond to. When you are on holidays do you have fears?

It can be difficult to deal with OCD in a social context. Hoarding up until 2013 used to fall under the OCD umbrella. A few types of cases still do. What many hoarders and their families say is that family therapy helps. Now, the body that recommends physical and mental treatments in the UK, NICE, says that family therapy can work with all types of OCD. A family therapist can help to resolve issues - a family group session or sessions where issues and feelings can be addressed. Do you think that this might work?

Hi Phil18 So your wife agrees with the move. She likes the new house. You like being house proud or being perfectionist. Sure things deteriorate over time. But you said in the past that you like touching up the paintwork and such like. When I moved house to a new neighbour I visited the house and neighbourhood on quite a few occasions. Visited the pubs and cafes. I did that with other locations. Followed market price movements. House markets like all markets have buyers and sellers - there is collective knowledge. Why are houses in one area so much cheaper than another area -there are reasons. Graffiti, broken windows, dumped sofas and beds on the street are signs of a problematic neighbourhood. I had lived in my previous neighbourhood, in a large city for decades, I knew where the drug dealing and prostitution and the cannabis farms were located and the nature of gangs in the neighbourhood. I had good friends who were social workers and councillors. They hear the complaints. So do your research on the neighbourhood. As Howard says you can’t individually change the neighbourhood But as the mayor of New York City once said fix the broken windows and such like - once the tone of a neighbour goes down it is hard to reverse.

Yes it is big decision. For two years you have been doing things that you believe kept you and your family safe. Given your beliefs you will be scared. Ideally, there would be therapy preparing you to change your thinking and step by step you would change your behaviour to test that no bad things will happen There is a therapy called CBT. Have you done any therapy? Or read any therapy books on OCD? But ultimately we take a risk and stop doing compulsions. Is there anything that you would feel more safe in not doing?