cashewnutsandraisins

*raises hand* Yep, one of my more prominent themes. You’re not alone

Hi @Ashley and @Gemma@OCDUK Please accept my apology for replying so slowly. To be honest, I was in a bit of a state after that session and it took me a while to get myself back together. I think my biggest concern after that session was it just seemed like a big dose of trying to give me reassurance which I’m thinking is the worst thing to do and that the way he was trying to treat me was along the lines of ‘not really understand how OCD works’ and therefore I started to really panic about how much he could help or if this would be totally ineffective treatment because of his ‘lack of understanding’. I’m on appointment six so far and have since had a much better session. I would say that at the moment I feel like a lot of the CBT side has been useful and I feel like there is sone improvement. I still have my concerns about his ability to overall successfully treat OCD - which he said I fit - and whether I might need to find myself seeking out an OCD specialist after this treatment ends. That’s definitely not to say that I’m in a place where I feel like I’m not getting any benefit/progress from these sessions - just seriously concerned by the reassurance that was offered previously and my uncertainty (no pun intended) around his employment or ability to carry out effective ERP.

Hey @Chels I hope that you’re doing okay. I don’t know how useful this is - so please feel free to disregard - especially if its stuff you’re already aware of. I can’t comment on the medicine side but I absolutely can sympathise with the issues around low/non existent libido which has troubled me greatly over the last year. I’ve had to work on this a lot with my cbt therapist recently. Have you explored the impact of anxiety on causing your libido to lessen? By this I mean that I was in a position where I was so hyper-aware of whether I felt aroused, how often I was having/wanting sex and if not, why not that it put me into a complete vicious cycle with me feeling completely anxious and on edge about it all the time. My therapist got me to see that I was living in a constant state of anxiety - almost fight or flight response - and in that situation feeling arousal is definitely going to be significantly affected. Might be worth considering as a part of this next step for you. As I said, not sure how helpful Ive been but just wanted to try to help.

Hi everyone, I've literally just finished a session with my CBT therapist who I am working with after self-referring to IAPT. My expectation was that we would be working more on ERP today and sitting actively with thoughts. I feel bad posting here as my therapist is lovely and very supportive, however after the session today I do have some concerns about how effective and potentially damaging this therapy could be. I feel that this context is important - he hasn't go so far as to give me an official diagnosis, but has heavily suggested a number of times that this is OCD and GAD. My biggest red flag is that we spent a lot of time today discussing the trigger that first started my theme around homosexuality. This led into a long discussion in which he said all of the evidence would indicate that I am not gay - up to 99.9999999999 recurring etc percent. He did say that he wasn't having this conversation to give me reassurance and that a big part of getting over this is being able to tolerate the un-certainty, but ultimately that my history doesn't match up to the OCD theme I have. Needless to say, despite hearing this, my brain is still fixating on the 'evidence I am gay'. He also said that he didn't think doing ERP around this theme would be helpful as he thinks with all of the interrogation my brain has done over the last year that I have already performed ERP on myself enough. He thinks the more important ERP that we need to try and do is to shift my attention away from a worry and allow myself to sit with the unncertainty. I also thought we would spend more time on my relationship theme as this is currently what is troubling me most. I feel in a way he has opened up a can of worms with the other stuff by inadvertently offering me reassurance, or trying to. The homework he has set me has also somewhat triggered me. He's also me to do this exercise on my relationship; we went through it together on sexuality stuff. I have to write a list called 'I should not worry about this unless one of these things becomes more apparent' - and then fill it in. Some of the things are making me concerned that they are evidence that I am gay already - e.g. having sensations down below, which until today I was working to understand that these are groinal responses. I should say that these exercises might have been set more to help with my problems with worry than OCD. I did make a point at the start of the session of saying 'how do you know if thoughts are legimate concerns' and he said he would help me to create a framework, so this might be why we have done this. I'm in a bit of tiz from it all and feeling very unsure about whether or not this therapy is going to end up causing me bigger problems with enabling my thoughts to spiral and spiral. I had fully prepared myself for ERP and then spending today focusing on not doing compulsions - instead I'm now really worried about what has happened in therapy today and if there is a problem with what has happened. I'd appreciate any advice others may have on similar issues with CBT from IAPT

Hey @malina and @PolarBear Thanks for this. In terms of the OCD versus non-OCD thoughts question I had, you both have given me a bit of a lightbulb moment there. I definitely have spent a whole heap of time feeling that OCD is a separate entity living in my brain and actually I really do now understand for the first time that it is all just thoughts - my reaction is key. That in itself feels really free-ing - as it’s not that I need to live in fear of new thoughts that I can’t control, instead I can control my reaction to any new thoughts that arise. Not necessarily as easy as that, but in terms of shifting my mindset it’s a hugely useful starting point. I’m just under three hours away from my session today. Am absolutely feeling sick as a dog with nerves and fear about it all, but I am going to be brave and try a different approach. I’ve got a plan of action for things to do to get me out and about today so that I’m not just sitting around ruminating so I hope this is going to help. I’m also going to not come onto the forum for the rest of today as I know - when I feel anxious - it can be something I do to relieve my symptons. goodness me, I wish I could wave a magic wand and just make this all go away - but then I know we could all say that too. thank you both again X

Hi @PolarBear and @malina, Thank you both for responding to me. It means a lot. Rationally, and logically, I know you are both absolutely right. Goodness, I've read enough of other posters threads where you've implored them to realise that the thoughts can seem/feel completely real to know that I am falling into the same trap myself here. I'm just really frightened. Malina, when you say about running from a monster - it absolutely feels like that. I am so scared. I think what makes it harder is that with the thoughts which focus on my relationship, there is a part of me that goes - well how do I know if that's an OCD thought versus something which actually might make me be questioning the relationship? This is definitely something which I am struggling with and I'm really frightened that any time spent with the thoughts will lead to this 'epiphany'. I try to keep holding onto the fact that the thought of my relationship breaking up makes me feel absolutely sick and that - when I'm not in an OCD spin, then I'm actually really happy - although admittedly I struggle a lot with knowing if this is how a relationship should feel like, because embarassingly this is my first proper relationship, even though I'm 33. I think that insecurity has made me vulnerable for the doubts to build and build. I won't go into more detail on this, as I was about to and then realised I was about to give you a whole sentence blatantly confessing and trying to get reassurance. That's why I just don't want the thoughts in my mind - because then I'll ruminate, over-think and analyse and (I'm really scared that I'll) find an answer I don't want. I think you're right PB when you say that I've been supressing thoughts for a long time. Stupidly, I even thought I was doing really well at managing the thoughts and letting them 'sit' but I've come to realise that I do everything I can to eliminate them from my mind. I don't know if this analogy makes sense, but sometimes I feel like OCD is like being Alice in Wonderland. In that I mean, you think you understand the world and you know what's what (yes, this is probably where my issues with tolerating uncertainty start to become clear) but then OCD is like stepping through the looking glass and suddenly you're in a world which makes no sense and is completely alien to everything you've known - and feels so so so REAL. The thoughts feel so REAL. I do what I can to remember the advice on here - the phrase 'you can have intrusive thoughts AND feelings' has practically become a mantra but I do feel an awful lot like I'm trying to avoid stepping through the looking glass, which is why I just am so desperate to avoid these thoughts rather than go through ERP. I understand your advice. It terrifies me, but I'm so grateful for the chance to talk to others who understand. And I know I need to take a leap of faith. On a final note, with my question about how do you ever get to place where you know if something is a real thought and not an OCD thought. Is that something yourselves have ever wrestled with, or come to a conclusion on? No worries if not, but it's a paradox I'm struggling with and just interested to hear the possible experience of others. Thank you both again.

Hi everyone, I’ve put this as a reply to another thread but I - will admit I’m freaking out - and would really value any support and advice on this. I’m not intending for this to be reassurance seeking but I just need to get out of my system how sick in my stomach I feel about starting ERP with my therapist this week. This time will be actively sitting with thoughts whilst in the session. Stuff I’ve done so far is more passive eg watching tv shows id been avoiding. I’m still struggling with sexuality and relationship thoughts. At the moment my OCD is going full force at trying to destroy my relationship. I just want to refuse to do the ERP in the way I should. I am terrified that sitting with the thoughts will allow me time to start believing them or even have an ephiphany that they are real. I mean, jesus, how are you even meant to know what is real or isn’t anymore? I feel like what works best for me is keeping the thoughts supressed and avoiding them so I don’t allow any chance for them to be real. sorry guys, really struggling.

Hi @OCD Scott I think it’s well documented that caffeine can mimic the feelings of anxiety, which might explain how you felt earlier. I have also had my GP advise this when I initially sought help back in early 2020. Since then I’ve reduced my caffeine intake (although not completely) and on the whole I would say that I have noticed having caffeine and it leading to a spike on a few occasions. Would definitely research further but this has been my experience.

I would agree with PB’s question r.e CBT and whether you have looked into it? I say this as I have overwhelming fears of others dying - in particular my boyfriend - and not being able to handle the grief and my therapist is helping me to work through it.

I watched a Youtube video about this - where the therapist referred to it as the 'backdoor spike'. I have very much experienced it too - another way for OCD to try and keep itself alive! I'm going to badly paraphrase the advice another user gave to me - but say you're ill with a cold, then you don't question getting better from the cold and not having those symptons continue - you've just got better. Same should apply with OCD - the fact we don't have the same response shows we are getting better. Much easier said than done I know! But hang in there!

I am desperately trying to remember that I am making the choice that this is OCD, despite all the doubt that has beseiged me recently. I'm also having the biggest spike yet with one of my current themes - relationship OCD. I feel like I'm just going through the motions of my relationship. Everything I do there is a little voice in my head going 'but do you really mean that' or 'are you sure that's how you feel really'? It's torture and it's breaking my heart at the same time. I don't feel like I can remember how to just be in my moment and not questioning everything I do. Today has been horrible as well - being with my boyfriend and even starting to feel like I'm living an out of body experience. I get freaked out by not wanting to have sex, or that me and my boyfriend have less sex than we used to do when we first met, and then it becomes a vicious circle because the more I'm freaked out by not needing sex then the less I find it hard to become aroused. Another poster (I'm sorry I've forgotten the name) mentioned about spikes and PMS. I have just come onto my period so I think this is also playing a big problem, but genuinely this whole thing is just making me despair. At the moment, I feel so low. I've started CBT recently, but at the moment - despite how much I am trying to say to myself that I will put the work in and I will get control of this - I just feel that I don't have a cat's chance in hell of ever overcoming this. If other posters also notice the spike around their PMS, do you have any tips?! I'm sorry for a self-pitying wallowing post. I just need to get this out of my system. The worst part is feeling that I can't talk to this about anyone. With all of my other themes I can be open about them (careful not to confess and seek reassurance though) with my boyfriend - who is the only person I've been able to substantially confide in. Because this theme is so wrapped up with him I feel like I just have to grin and bear it. On the outside I am all smiles, on the inside I feel like I am screaming.

@MentalChecker - this is a great post. Thanks for writing it.

Hi @malina Thanks for this. Yeah, I think that chat with the therapist r.e. confessing is going to come out in the wash next session. I was asked to do some homework which invoved writing down all my compulsions. I ended up sending a four page document with all of my compulsions and then examples related to them - which led then to, I would say, a fair sized portion of confessing. I was somewhat aware of what I was doing, but at the same time just couldn't stop myself blurting everything out of my head. It didn't help that doing the homework was really emotional and it got to the point where, rather than go through it and take out the detail, I just wanted to submit it and be able to not look at it again until my next session. But I'm going to acknowledge that first in the next session and say I am aware I did this and I shouldn't, so that he is on the same page as me in how I/we don't go down that road again. Oh yes, the doubting of even having OCD. I literally got a diagnosis of OCD and GAD and I'm still going around doubting it. On the one level I want to laugh at the ridiculousness, on the other it's like 'someone give me a break!'. But, I'm making the decision that this is OCD. That's the key thing.

As a relatively new user (approx 9 months now) I completely agree with you @taurean. I was at my wits end before I found this forum. And suffering in silence for over 25 years with no idea why I was the way I am. I used to describe myself as 'having a monster in my head' and I wasn't saying that to make a joke either. Now I'm in CBT - still feeling the ups and downs of it all, as I guess must of us do each day - but feeling for the first time in my life I understand the 'monster in my head' and that I now have the chance to change things. Thank you for everyone who has played a part in the forum and charity. You do make such a difference.

Hi @PolarBear and @dksea Thank you both for taking the time to give me some advice on this. @PolarBear - yes, good shout. Exposure and response prevention. I did know it's two parts, and was being a bit lazy in my typing here. My compulsions are all pretty much mental - rumination, mental checking, avoidance, testing etc. So I've mostly focused on things I've been avoiding since this started and trying to sit without the thoughts and not doing those - with varying degrees of success. You're right, practice is key. I'm trying and have been keeping a diary marking the date of each exposure and what it was. I'll be honest I'm really nervous about what you've said r.e. cranking it up. I get it, but a) I'm not sure how to crank it up as such i.e. the things I can do and b) I guess - where does the cranking up end? How do you know once you've gone as far as you need to? Although I think I just worked it out as I typed it - not being affected by the OCD thought - DOH! But yes, thanks for the food for thought. It has made me realise that I will need to talk this through more deeply with my therapist. I think we're due to talk it through in the next session, as we ran over with my previous one and ran out of time. I will aim to write my obsessions down this week, as part of this, and see how I go. I've started trying to dip my toe in the water of doing more 'active' things as it were, rather than just watching tv shows i've avoided for almost two years, but writing down the obsessions is a big one and very much something I feel anti-doing, so clearly that is something to try and beat. @dksea - thank you for this kind post. Your cold analogy is great and it's ridiculous in a way how I'm struggling to allow myself to think the same of my mental health. One of the things that seems to be cropping up in my CBT so far is that - on the surface level - I can totally see the logic of everything about intrusive thoughts/OCD and how it works and why rationally everything i'm fearing and/or doing is just silly really. Instinctively though, I'm finding it hard to let myself make that leap of faith, which I guess is playing into these fears of 'what bad thing does feeling ok mean?' and 'am I just making this up?'. I saw on another post that you responded to where you said that ultimately you have to make a decision about treating this as OCD. As scary as it feels, the one thing I keep trying to remind myself is that this all started when I was about 8 years old. Develop horrid intrusive thoughts, feel awful, confess and seek reassurance - a classic OCD pattern. At 8 years old there was no way there could have been anything to influence me into just making up this was OCD - in fact, it hadn't even entered my world that it could be OCD until about 9 months ago. This is the thing i'm holding onto in order to make the decision that this is OCD (and then whatever influence GAD plays as well, as this also was diagnosed by my therapist). I'm seeing this as a line in the sand - a chance to rewire my mind and mindset, so I will factor in what you have said about gradual recovery and feeling better actually being a good thing! Thank you both again so much. Cashew.