Angst

Hi Mini Your Theory A is a fantasy and stereotypical thinking. They do not get locked up for life. Apart from anything else there are not enough hospital beds. And Polarbear positions himself as an expert on schizophrenia. A week ago I mentioned Rufus May a clinical psychologist and a labelled schizophrenic. If you read his blog you will see a different side. I volunteered for a mental health charity and became its chairman and one of it’s major missions is to provide therapy for people who tend to get labelled schizophrenia - a large proportion second and third immigrants not first generation. I have known teachers, accountants, actors, accountants and quite a few social workers with this diagnosis. They were not locked up. Theory A and B is useful. I have used it when seeing whether checking was appropriate in my domestic environment. But I am highly dubious about using Theory A and Theory D for categories of people as it tends towards stereotyping. Imagine somebody thought they were of another race or ethnic group: would we use Theory A and Theory B then? In your case I would educate myself. Incidentally a person could be diagnosed with both - look at the statistics of comorbidity of mental disorders and illnesses.

I think the causes of mental distress including OCD are biopsychosocial. Conditioning affects our biology. The thing about CBT is that it tends to be about individual cognitions. Yet we are influenced by our past and present social contexts. Certain people in certain contexts tend to get more distressed. And distress affects our physical and mental health including OCD. That is why I think medication affecting our biological self can help us reconfigure our cognitions. Changing my environment - where I live-has reduced my compulsions. There are fewer stressors. The B in CBT stands for behaviour and behaviourism and this states that the environment and our conditioning affects us. Yet we hear little about this.

What to say describes perfectly the nature of obsessions. You are being obsessive about certain thoughts and images. Thoughts and images pop into our minds all the time. It is seems to me that what Handy refers to as ‘intrusive’ thoughts are things that we find to be upsetting and unwanted. Those with OCD take these thoughts seriously and being indicative of their character or of a real risk pertaining in the world. Those without OCD do not take these thoughts seriously and the thoughts drift away. I would not count or estimate how many times a day an upsetting thought or image appears in your consciousness. It allows them too much significance. Do not be censorious regarding your thoughts nor allow the thoughts to alert you to a supposed danger in the world, if you perceive the thoughts to be of an obsessive nature.

I do not experience side effects from psychiatric drugs. But people’s experiences are different. The efficacy of drugs are decided by clinical trials which use inferential statistics and we are in the realm of probabilistic reasoning. I have tinnitus in the left ear which was caused by a serious ear infection that was at risk of spreading to my brain. The infection had destroyed my hearing bones - the smallest bones in our bodies - fortunately after a series of operations the infection was removed and the hearing bones replaced. I still get tinnitus. One treatment recommended is CBT for tinnitus. There is a big debate in the UK about the extent that CBT can eliminate distress in things that may or may not have a physical cause. At the moment it is about the menopause and CBT vis-a-vis HRT. My position is that both psychological and physical therapy can help. I tend to steer clear of binary thinking - black and white thinking-solutions to problems in many instances are frequently multi faceted.

Lots of people do not pass their driving test in their first attempt. Are you saying that you are short of money? If you at the tribunal stage of a PIP claim then presumably your claim was rejected and you are in the process of appealing that decision. This must be stressful. In the past, I have found the site Benefits and Work useful. Their advice and my advice -speaking from experience-is keep copies of all documents and correspondence that you send and that you receive. And send stuff to them by recorded delivery. This in itself incurs costs and poorer people tend not to have the money nor the operating printers and scanners to do such things easily. And recent sharp increases in the cost of sending documents via the post makes it even more difficult. Are you being supported by an agency? I have been on a combination of SSRIs and antipsychotics and this combination reduced negative feelings. Good luck!

It’s objectively difficult to make a purchase decision because of marketing, advertising, people on commission and branding. Because decisions are not based on standard technical criteria but image and ideas of who we want to be. Extensively researched -including our internet history - with targeted ads Purchasing managers, say for aeroplane engines, buy on precise specifications. A few hours ago I collected a coat from a supermarket which also runs a department store. I have to return it as it does not fit. There are no standard specifications for sizes - s, m, l, xl, xxl. That for me is a hassle. A standard specification would also mean cost per weight using a standard formula across all product ranges. Marketeers and estate agents and sales managers and people selling financial products attend courses on cognitive psychology and they know that in the current market 95% fat free - now what does that mean? Improves sales at a higher margin. And of course there are loyalty card!

I think you probably have already researched extensively on asbestos. I did a little bit of research when I recently moved into my new house. I was following up on the survey. But are you doing research in a compulsive way? I reckon most of us get intense feelings when we envision the future if we are scared of something. These images are purely an artifact of your imagination because you are imagining things in the future. I have done a little therapy on imagery rescripting for upsetting memories from the past. It can also be used for visual imaginings of the future. You are truly in command in this instance because you can envision positive outcomes We with OCD have a pessimistic mindset. We imagine the worst and see catastrophes in the future. Imagine a positive future and do no more research on asbestos. Image on how good the house will look and the pride you will feel when entertaining friends and family.

It’s a memory of seeing a word and the belief that if you saw the word then you must have seen something morally reprehensible. That is quite a logical jump. Now you are concerned that sometime in the future the police will be knocking on your door. You wanted confirmation that you did not view anything untoward. This is difficult as you deleted your history. You attempted to retrieve your internet history to confirm your innocence. To no avail. So logically you cannot check nonetheless you are upset about the possibility of seeing something illicit. Rationally - you cannot do anything - but let it go. You cannot trust your feelings on this matter. Ultimately with OCD therapy we say sod it. If I’ve left the tap running so what. Life is too short. Imagine the feeling of liberation on not being bound by the rituals and feelings of OCD. I wonder if repeating the word loudly to yourself would desensitise to the emotional impact of the word? Just a thought.

Yes - the recent Post Office case. Thousands found guilty with no evidence or fabricated evidence. False allegations have lead to real mental health problems including suicide. As well as imprisonment and impoverishment. It happens in more cases than portrayed in drama. In your case you are accusing yourself with no evidence - apparently not even your memory or false memory. I don’t know what the event was. Many believed in the accuracy of the accusation -they spent days, weeks, months and years trying to work it all out.

Hi Chris If you are ‘constantly thinking’ about it and conclude that you ‘haven’t done anything wrong’ then I would say that you are ruminating - chewing over in your mind a past event. You are in a self judgemental mode. Sometimes I perceive in my mind’s eye an uncomfortable past event sometimes from a very young age. I recognise it and immediately switch attention. Memories are formed from our senses -eyes, ears, nose, and we remember touch sensations. So if you are seeing in your mind’s eye a scene where you are a participant -say you are looking down on an event or viewing an interaction where you are present - then you know that you have elaborated upon a memory. Your thoughts and feelings are a product of you and what you are doing. Chewing over the event creates feelings of perhaps shame and/or guilt. Some OCD therapists have been influenced by the work of Paul Gilbert and deal with these feelings. In the latter part of a book ‘CBT for OCD’ there are examples of how therapy can be used to deal with feelings of shame. Paul Gilbert is also famous for compassion therapy - compassion for ourselves and others.

Hi Maggers I have been on Fluoxetine. No problem going on it and going off it. No side effects. It was the first SSRI. The brand name is Prozac. It is now a generic medicine, so if prescribed by NHS so you won’t get the brand, Prozac, as it is more expensive. Interestingly, the website northpaul recommends has OCD UK as an organisation for further information. I think it is the first recommended SSRI for children, if they are prescribed a SSRI. When it was first introduced there was a lot of media attention and books published such as Prozac Nation. In Hollywood films such as Fatal Attraction it was portrayed as a ‘happy pill’. It is not, as it takes time to build up in your body. As with all medicines its effects vary. Trial and error plays a role. I would try it and see. I would also recommend the Mind site, if you put into your search engine, Mind SSRIs. Mind was very intrumental in promoting the Yellow Card scheme for indicating any side effects of psychiatric medication. I think it’s pretty safe.

Hi Robin43 On a practical level, do you think your GP would refer you to a neurologist. MRI is one and important step to diagnosis dementia along with noting cognitive and behavioural changes. There are of course different types of dementia. And a psychiatric history is relevant. I think very few with a real risk of dementia have the full array of tests. The dementia charities are trying to improve services. I do not see your choice as binary - either/or - do the therapy and do the neurological stuff as well if you decide to do so. A lot of people with dementia are on SSRIs because they suffer from depression and anxiety. The more serious the dementia the more difficult certain forms of therapy becomes as it involves learning new things - new ways of thinking and new ways of behaving. Because memory is affected by dementia There are, of course, therapies and wellbeing practices for those with dementia. But not all get them. Therapy might reduce your anxiety. Learn the techniques now. Do the therapy and embed it into your brain and body. This will help you in the future and now. It will also reduce the chances of developing dementia.

I don’t believe that there are absolute rules as it depends on the situation and the client. For example, when I left the house without doing compulsions I got on with things such as taking the bus to work. But I did this in stages. I left the house for twenty minutes to go to the shop and then returned. I increased the amount of time that I was absent from the house. I did this to slowly habituate to the situation of not checking. My rationale for increasing the time period was that there would be less time for a flood or fire to develop. If a thought occurred to me whilst in bed that I needed to check the front door then I would say that I will check the front door in ten minutes. The notion of ‘sitting with the anxiety’ or lying with the anxiety is more pertinent in this situation as I was in bed. I suppose I might have switched on the radio! On the website it is suggested that ‘flooding’ is a bad idea - stopping compulsions in one big step - but my therapist who has been recommended by many including OCD charities - said that it depends on the person and the situation. In my examples of house related checking, if there had been an actual emergency such as the smell of smoke or the fire alarm sounding any person of sound mind would get out fast!

Hi maggers I agree: throw out the coat. It’s an anxious thought - something bad will happen in the future. The thing about OCD and a lot of related things is that we do things or not do things in an attempt to stop bad things happening. As you say, you know it’s silly but your anxious feelings overwhelmed you. Throwing it out will build up your confidence in your rational mind.

It seems to me that you could label your experiences as health anxiety. There’s a range of self help books on it including one by David Veale. The techniques used are a standard array of CBT techniques. You are thinking about the worst possible outcomes - the folk and professional jargon is catastrophising. I am taking particular care at the moment because we are in the midst of a doctors’ strike and things are icy where I am. I do not want to spend the better part of a day in a & e.

I think that you got the diagnosis right Stephen smith and I think mimi has got great insight and great advice. I found when I was working if I was too scrupulous people took advantage. Unfortunately there were some bullies. When you watch a film say to yourself ‘here I go again’ with a wry smile and switch your attention. Likewise with the confessions say ‘here I go again’ and switch your attention. You’re good at recognising your obsessions now stop doing the confessions, as mini says the anxiety will fade.

Hi Angels When you say that a colleague ‘picked up’ on you worrying and said ‘stop worrying about that’ could it be that that it was just a normal conversation? All of us pick up things from things said and how things are said - by our facial and eye expressions and our posture. It is part of being human. Are you worried that unintentionally revealing your OCD could, in the eyes of others, disqualify you from being a counsellor? It is a contentious area. On a number of occasions I have met Rufus May, a clinical psychologist, who is quite open about the diagnoses he has received in his life and what he had to do to qualify. He has done a C4 documentary and written on the web and publications. A lot of people in the health services are wary about being open. Do you have a clinical supervisor and do you think it would be appropriate to talk to him or her about your feelings?

Hi Robin43 The main OCD website has good tips on finding a therapist. I had one therapist who was a clinical psychologist on the NHS who transferred to private practice who was good but she gets inundated as soon as her name is mentioned. David Veal - a specialist in OCD and anxiety - works in private practice and the NHS. If you google him you will see an organisation of therapists who are trained clinical psychologists. It is based in London but there also do video therapy. Having said this, there are also rigorously trained counselling psychologists who undergo similar training to clinical psychologists and do a professional doctorate - used to be a a professional masters. They are chartered counselling psychologists. (In the same way that we have other chartered professions such as accountancy and human resource management with the attached ethical codes, commitment to regular training to keep up to date and disciplinary procedures if there are allegations of misconduct.) Quite a few are employed in the NHS including the specialist centres. Both are regulated by the British Psychological Association. I would email OCD UK for advice about facilities and therapists in your area. I think they pick up a lot from comments, compliments and complaints from users

Accept what? A new discourse on grief presumably by not being exclusively heterosexual? The well known discourse on grief with its supposed stages you appear to be playing. Not interested. Good night.

Hi Dave We are in a long chain again. It is exactly the same as the ones before - I am gay oh no you’re not, it’s OCD. I and a very few others including those involved with OCD UK, have said that you are involved in black and white thinking (a common cognitive bias) as to binary notions of sexual preference. As the few of us have said - from the Kinsey Report into male sexuality in the 1959s - see the published research, the film the tv series life is not black and white. This Christmas the well known kids tv show has a black gay man as Doctor Who with a transgender theme. Financed by Disney - an always conservative body with regard things like sexuality since its beginnings. As DRSI says porn is not satisfactory you need real human contact. I won’t label you but get out into the world rather than testing yourself by looking at screens in your bedroom. Take therapy. Therapy is a risk. Successful therapy takes courage and involves taking risks. I don’t know you or your sexuality. See what happens.

If I remember correctly, Nevermind had private conversations with Ashley, the chief executive of the charity. Perhaps you should email Ashley. I think it is about risk assessment procedures set up by regulatory agencies and safeguarding bodies as well as employers and social services. In these cases you need a man or woman who knows the territory. I do remember cases on the forum very similar to yours.

I agree with DRSI -it’s about how you react to the image. Seven years is a long timd. None of us can be in your head seven years ago. A hallucination is in the here and now where one of your senses - touch, vision, hearing, or smell - experiences something that nobody else can feel, see, hear. The effect of an hallucination is immediate and sensory and we only know it is a hallucination after the event through rational analysis. Because it floods our sensory awareness. It happens a lot for example during bereavement. It has happened to me. You are recalling a visual event from seven years ago. It is a meaningless event. I, and think everybody else, could not accurately recall a brief flash of imagery. Drop it. Let it all go. I personally do not believe in the supernatural which is perhaps a strange thing to say during Christmas. I am a rationalist and sceptic. So my reassurance is from the viewpoint of rationality.

Guilt and shame are frequent topics on the forum. I see guilt as the feeling that you have broken a moral code. And shame that you have broken a social code. The feelings of shame are social embarrassment in that the critical gaze of the community will be focused upon you, as the tabloid newspapers say ‘name and shame’. Our lives are influenced by codes of morality. It is inescapable. NICE and the NHS use ethical policies determined by utilitaranism - the greatest benefit to the greatest number - this is expressed in economic terms in terms of the cost of a drug as to whether it will be feasible to prescribe on the NHS or it will be too expensive. The money would be better spent in order to raise the general level of happiness. In the NHS the criteria for receiving an operation include things like expected life expectancy after the operation. I personally prefer this morality rather than people having treatment because they have the cash to do so. The morality of wealth. The access to talking therapies was decided on utilitarian and economic arguments - that the cost of therapy would be recouped by people being able to return to work. Kant had a good moral principle. To put it crudely, treat people the way you would want to be treated. We may fail but it is a good goal. So don’t feel worthless - it is a difficult world. We try our best and move on. Don’t carry the world on your shoulders!

The feelings expressed on this thread go back a long way to at least the 17th century. After the English civil war and the establishment of the Republic under Oliver Cromwell the extensive festivities of Christmas were abolished. I do not see how Santa Claus, Christmas trees and such like have anything to do with the New Testament. But the retail industry and service industry do depend on the Christmas spending. Isn’t Black Friday the time when the retail industry goes into the black? Into profitability?

Hi Belanna Sorry to hear that you are depressed. I could not live with my sibling because of the put downs and zero sum games and if she doesn’t get her own lway she throws a hissy fit. A friend of mine has five children none of whom talk to one another hence he and his partner are having five separate Christmas celebrations with his sons and daughters and his grandchildren. Christmas can be a time of great celebration but the Samaritan help line gets very busy too. I have talked to the Samaritans because talk helps. I have been watching Two Doors Down a Scottish sit com which is largely a comedy of put downs. I think our environment is very important. The housing benefit limit has increased in England. Has it in Scotland? So you should be able to get more reasonable accommodation now. You could get a package of support to help you. As somebody said, you have done a lot of moving in the past year or two so don’t underestimate the number of choices available to you.