Carooba Manooba

I agree with dksea.

You might find this excerpt from an article of use: "A significant number of my patients enter therapy with the belief that they have the potential to live “the good life.” They take stock of their background and current “assets” – friends, family, finances, connections, etc. – and conclude that if they could rid themselves of their OCD, they would finally be able to enjoy the wonderful life almost within their reach. Unfortunately, the dogged insistence of such patients that life can truly to be that good creates a kind of desperation for recovery which, along with their resentment of the disorder’s presence and challenges only impedes that process. Mind you, I am fully aware of how disruptive to one’s life OCD can be. Being tormented relentlessly about inane, nonsensical topics is terribly painful, unfair, and burdensome. But to idealize life without OCD is to misrepresent the realities of human experience. Indeed, if the OCD were somehow to be magically removed from these patients’ lives, they simply would join the rest of humanity in living flawed lives marked by inconsistency, moments of weakness, and handicaps. In order to challenge these patients’ idealization of life without OCD, I sometimes tell them that as human beings, we are all “stuck in the mud hole.” We are all slogging through the “muck,” we are all equally dirty, and we all “stink,” but we give meaning to our lives by pursuing our goals and overcoming challenges. What does being human really mean? This certainly is one of life’s most important questions, and how we answer it can have a powerful effect upon of our lives. It is my belief that embracing our humanity means accepting our respective craziness and understanding that we all can be inconsistent and weak. But it also means that we all have the capacity for greatness, and we all can reap the rewards of living purposeful, disciplined lives."

Firstly, Happy Birthday! If you feel the urge to clean, try not to and sit with the discomfort (that will come when you try and make a change) as much as you can. You won't recover overnight and will inevitably give in to perform compulsions at some point. But the more you can resist doing the compulsion, the weaker they become down the line. It's great you want to be a good person. This is getting off track, but I personally wouldn't be trying to portray celebs. Don't get me wrong, there are some kind big hearted celebs. But I personally would be trying to emulate those members of society who donate their time to helping others. Time is the most precious commodity on the planet. People who give up theirs to help others are the people I admire the most.

The CT side of CBT is important in the sense of developing new therapeutic responses to intrusive thoughts. It's also important to teach patients in the beginning how the disorder works: "cognitive therapy for OCD (CT) has two primary applications: 1) to help people understand the guidelines of an anxiety disorder's overall game plan (i.e. mental mechanisms); and 2) to provide specific suggestions in the face of challenge." In contrast though, CT when it involves trying to point out the irrational nature of your intrusive thoughts during a spike is detrimental for long term recovery. I believe the Behavioural Therapy side of CBT is most important in the sense that you need to teach yourself via exposure and feeling discomfort that nothing bad will happen. It's one thing to be taught what to do, but you can only recover unless you put that education into practice.

Yes. A response to the intrusive thought that leaves ambiguity is the antidote to preventing rumination.

Leif, re being tired , that is unfortunately part of recovery. The effort you put in to letting go and not doing compulsions is tiring. Recovery doesn't happen in a straight line. I used to have days of energy and days of exhaustion. It's extra difficult like u mentioned on the days you are tired to keep at it. Recovery is more like 2 steps forward one step back. Although at times it can feel like 2 steps forward 1.9 steps back. Rather than looking at your progress on a daily scale, it's better to judge your recovery over a longer period. Providing your getting better overall, then keep at it. There will be ups and downs during the period. Learning to rest and look after yourself in your every day life is super important to give you as much energy as u can.

Hi leif. Goid stuff on using public toilets. You mentioned you are now getting various other challenges. Would you say overall you are getting more spikes (intrusive thoughts) but spending less time on compulsions? If yes, then that is a good sign. The brain is resistant to change. So when you attempt to change like you are confronting your fears of public toilets then your brain starts throwing out all kind of stuff at you to try and suck u back into giving in like previously. You will get an initial increase in spikes, but as you ignore them / deal with them properly, they will fade away.

Yes there are behavioural experiments / exposures to feared things. However, there are also responses to use at other times, as a person can not just continuously stop and do exposure experiments every time an intrusive thought enters their head. The therapeutic responses are designed to leave ambiguity/accept the risk. It's about not engaging in the unwanted thought. The less you engage, the more the thought loses power. "At some point most Purely Obsessional patients almost always come up with the same question: “Am I doing the therapy correctly?” It is very common obsessional reaction to someone doing behavior therapy. The mind tries to throw a monkey wrench into the therapeutic machine by asking the question, “Which is the actual therapeutic response: the performance of an exposure exercise or just accepting the risk?” The ensuing effort to secure the correct answer to this question ultimately can, unchecked, become a time-consuming ritual itself. To illustrate this dilemma, let’s look at the naturally occurring behaviors of blinking and swallowing. For instance, the mind tells the patient to swallow or blink, now! The dilemma is as follows: “If I swallow now, won’t that be giving into the spike? If I resist giving into the command, then I’m avoiding engaging in the naturally occurring action of swallowing. What’s a good patient to do?” The very skilled patient will now accept that all blinks in the future will be the “wrong” blink and accept that all blinks are actually performing a ritual. This choice will influence the brain to stop scrutinizing “getting the therapy right.” Ultimately most Pure-O’s and people with a perfectionistic mentality end up spending a great deal of wasted time making sure that they are managing the disorder in a “correct” way. Living in a world of no answers is essential to being able to make a choice and move on." https://www.ocdonline.com/rethinking-the-unthinkable-3 But the problem is you can't convince someone displaying obsessive compulsive behaviour this. Otherwise there would be no obsessive compulsive disorder in the first place, because you would just rationally answer an intrusive thought and it wouldn't spiral out of control. It's the associated horrible feelings that come with the thoughts that cause the longevity. It's fear of the fear. I would also not avoid driving, but also then as mentioned respond to the intrusive thought of possibly harming someone that "maybe I did", or "yep I reckon I ran right over them". Or let the thoughts come and go. When you don't engage in the thoughts , your mind clears up and you can see them for what they are. Silly thoughts. Or irrational thoughts. ERP often involves creating a hierarchy and working your towards your most feared of fears. But whenever you are ready to immerse yourself in the fear and let it do it's worst, then that is when you see for yourself that there is nothing to fear about these thoughts. The more discomfort you can tolerate , the better the results and the more clarity you start to get. "those clients who have genuinely challenged the demon to do its worst, and are perfectly willing to confront and endure tremendous discomfort, even death itself, have made the most dramatic progress. They, in fact, have experienced the least amount of pain while performing exposure exercises. This exemplifies the critical nature of understanding the mental paradox. The more pain one is willing to endure, the less it is experienced." https://www.ocdonline.com/speak-of-the-devil I hope you get a chance to read this following article. It shows the mentality of facing your fears that give you the best results. It shows how he recovered from panic/obsessive behaviour by letting the feelings of dread to their worst. Be willing to die. Like Jeff the author, I too took years to build up - or you could say sink to a low in life - where you are so utterly fed up with the same obsessive compulsive behaviour and feelings that you are willing to let go and let the fears happen. The result of doing this is that you get clarity. But you need to go through the rain to get to the rainbow. http://panicend.com/

Yes it's good to discuss differences in opinions (providing it remains civil). I'm not knocking you or anyone for doing what you believe is the best for you. I'm all for that. I just strongly disagree with the logical/reasoning approaches your therapist and others I've read over the years. I heavily lean towards the therapists who emphasize the behavioural ERP side of CBT. But it's good to highlight the differences, particular for new people who are trying to learn. And they can decide for themselves which approach to take.. I haven't got time to reply to other topics you brought up. I will do so at a later time. But one thing I will quickly as you is , which cases you believe it's helpful to highlight the irrational nature of their obsessions? I for example obsessed about every theme imaginable. I knew these fears were irrational and unlikely, but to try and point that out (reassure) was not just useless, but made things worse long term. I obsessed about things like grabbing a knife and going around the street stabbing multiple people? I knew this was almost no chance of happening, but trying to convince myself of that was pointless.

Yes there are different findings one can find online when researching. I could counter the above with the following comments: "Cognitive treatment for anxiety disorders relies on helping people identify the irrational nature of their fears and find the evidence of their irrationality. My work with thousands of patients has lent strong support to the idea that the cognitive element is not nearly as important as the more strict behavioral element, which focuses on providing effective strategies for managing the threatening ideas, rather than debunking the specific irrationality of the idea https://www.ocdonline.com/rethinking-the-unthinkable the majority of people with OCD are aware of the excessiveness and absurdity of their thoughts and perceptions. Nevertheless, they continue to experience a great deal of distress from the thoughts. Therefore, helping OCD suffers to see the irrational nature of the thought content is counterproductive. https://www.ocdonline.com/cbtforocd Using traditional CBT techniques to treat OCD, the sequence of therapy would go something like this: activating event A = "The thought of killing my daughter while changing her diaper" occurred; automatic thought (belief) B = "This means I'm a horrible parent and may actually be putting my child at risk by being alone with her;" emotional reaction C = anxiety/guilt; rational responses D = "The chance of harming her is minimal." What evidence do I have that I would ever harm any child, let alone my own? Cognitive restructuring may provide temporary relief from the anxiety that plagues the person. However, obsessions will inevitably focus on other elements of uncertainty that concern the person and will cause the anxiety to resurface. "Excuse me Doctor, all that makes sense but I did enjoy killing ants when I was a child and I heard a news report about a guy who went crazy and killed his children and himself shortly after hearing voices telling him the world is coming to an end." This CBT strategy presumes that the client is not aware of the irrational nature of the thoughts and can, therefore, be frustrating and alienating to those who suffer from them. OCD is less a manifestation of people who have irrational thoughts than it is an anxiety disorder in which people respond instinctually to feelings of being in grave jeopardy. Devoting a significant amount of time in an attempt to explain the irrational nature of the thought content misses the underlying characteristics of the disorder: this is an anxiety disorder, not a thought disorder. https://www.ocdonline.com/cbtforocd" As you mentioned, it's ultimately up to the individual to go in the direction he/she wishes. Most important is to choose a therapy style that will give you the best chance of long term sustainable recovery.

Gingerbreadgirl, the 3rd and 2nd last paragraph of page 3 of that article I linked above touches on the topic of how people start to worry about whether they are doing therapy right/responding in the right way.

I had tried various therapists and medication, but got nowhere. When I really decided to commit to changing my responses, I did however use some of the advice from the therapists , so it's not like they didn't contribute to my recovery. I stopped using medication after reading how important it is to feel discomfort if you want to recover. As it was explained to me, you have to show yourself that you can handle any discomfort level. If you take a substance to dull the discomfort, you aren't teaching yourself you will be ok no matter how horrible you feel. You are more likely to have a lapse or relapse later in life when a stressful live event triggers discomfort - discomfort that you didn't train yourself fully to be ok handling because you dulled the chance to experience it. I did a lot of bibliotherapy (learning from books) . And read lots of articles. The following website and particularly the linked article with the recommended therapeutic responses are what helped me more than anything else https://www.ocdonline.com/rethinking-the-unthinkable But as I mentioned , it's one thing to learn about what to do, it's another to be able to really put it into practice with aggressive care free responses. You have to be so fed up of things that you just are willing to take the chances. As gingerbreadgirl touched on above, I didn't get caught up in doing planned responses whenever I had an intrusive thought. I just used any of the recommended responses I had learned. So sometimes I would use the "maybe such and such will happen" , other times it would be the "letting the thoughts come and go", other times it would be "yep I'm well and truly going to have (whatever I was fearing) happen."

You're welcome. I got to that point after years of anxiety and subsequent depression. Whatever activity I did , the thoughts would still be there. I never laughed. I was in a bad place. I couldn't go on living like I had been. So I figured I had 2 choices. I either commit suicide. Or I commit to changing my responses and how I go about life. I chose the latter and was super aggressive in my approach to changing my life around. And bit by bit there began to be more light at the end of the tunnel. Exhausting and challenging times to let go of your fears. But worth it in the end.

Hopingtorecover, I would suggest you treat your theme like other themes. You could obsess about something like being near someone with the flu and then worry your family members could die from complications arising from the flu. I used to worry and obsess about various medical things and also harm coming to others. It was only when I reached the stage of being truly fed up (not just fed up but seriously fed up) with my obsessive compulsive life that I began to slowly change my responses and be willing to take the chance that what I was worrying about might come true either to me or loved ones. It's horrible to let go of your fears as you feel massive amounts of discomfort, but after years of 24/7 obsessive compulsive behaviour involving every theme imaginable and hitting rock bottom , I just decided it's now or never. I can't live like this anymore. I'm going to start taking the chance my fears could happen , and I'm going to start living a productive life instead. Obviously this change of mindset didn't come to completion overnight , but bit by bit you can start to develop new responses to your fears. So if I would have had the fear you had about seeing a kid scratch their bum and me and my loved ones inhaling threadworms that would never go away , i would begin to respond like " maybe we will inhale threadworms and never get rid of them". Or I would let the intrisuve thought come and go from my mind without answering it. Or i would respond like " yep we all more than likely inhaled threadworms and will live horrible as a result". I realise those responses right now seem awful to consider, but they are what got me free from obsessive compulsive behaviour and back to loving life.

Hi. I don't know the exact details of your therapy and situation, but in general I would recommend that you be open to suggestions made by your therapist, but at the same time don't feel you have to agree with everything she says. I saw a bunch of therapists. Some had helpful advice/suggestions, but I would not always agree with everything they say. After I stopped seeing therapists, I chose to use the best advice I picked up from the various ones I saw. Which ever decision you make, make it and stick to it. Your mind will likely hit you with "but what if.....?" type comments. But stick to your decision and carry on.