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  1. Hi Nolightleft, Can you consider how you might react if your wife came to you feeling unbelievably guilty about fantasies she had had in the past? Or if not your wife, a dear friend? What would you say to them, what would you suggest they do with this dilemma? Gemma
  2. Hi Buttonheart, I'm sorry to hear how hard things are at the moment and how frustrating your experiences with the NHS have been. I'm assuming that your local CMHT have suggested you go back to IAPT, is that correct? This is a good and a bad thing. IAPT typically have much shorter waiting times than your CMHT, however, they may have less experience dealing with OCD (although this depends) and only offer shorter term CBT. You have a couple of options. You could self-refer back to IAPT, try a course with them and if you are no better then ask them to refer you to the CMHT stating that they have helped you as much as they can. You could alternatively look to see if there is another IAPT locally that you could try. Gemma
  3. Hi 000, In terms of accessing CBT locally, it depends on where you are in the UK. If you are in England then some IAPT services (adult mental health services) take on patients from 16 years old. You can find your local IAPT on the NHS database here https://www.nhs.uk/service-search/mental-health/find-a-psychological-therapies-service/ For some IAPT services it's 17 years old and for others it's 18 years old. You can self-refer to IAPT so you wouldn't need to speak to your GP. For elsewhere in the UK, it would probably be a referral to your local CAMHS, who should be able to help with this problem, as it is clearly OCD. I agree that you should try and stop the cleaning and trimming as much as you can, completely if possible. The feelings of contamination will fade in time. It's obviously easier to tackle OCD with the support of a therapist, but some people find self-help books good too. One good one is Break Free from OCD. Gemma
  4. Hi Jess, People's experiences of medication vary massively, but yes on the whole medication helps alongside CBT. It can make the feelings that come along with OCD and challenging it in CBT easier to cope with. Sometimes the effect of a medication wears off and that might be where you want to change dosage, but it would be completely up to you Gemma
  5. Hi Jess, Welcome to the forums I'm sorry to hear that you're finding things difficult at the moment. You mentioned that you're having CBT, is this through the NHS? Have you had many sessions? It could be worth mentioning to your therapist about how you're feeling therapy is going. Have you been able to challenge some of the OCD as part of CBT? If you feel your medication isn't working for you, you could also consider a review of the dosage or type of medication with your prescribing doctor. It's really common for those with harm based worries to doubt whether or not they will actually hurt someone and OCD always wants certainty that it will never happen. It's hard to answer your question without giving you reassurance, which is just another compulsion. The best advice I can give is to take a leap of faith that you wouldn't harm someone because in truth you really really don't want to. There is an excellent self-help book by Adam Shaw and Lauren Callaghan called OCD, Anxiety and Related Depression that you might find helpful. Adam talks about his own struggles with harm worries and Lauren, his therapist, talks about how she helped Adam confront his fears. Gemma
  6. Hi determination987, It's typical that a dream has triggered some worry and doubt for you. Try your best to stop googling and chalk this up as a dream and nothing more. I think the marker for dwelling on the past needs to be how you feel. If you are thinking of the past full of anxiety and doubt then I would stop what you're doing and focus on the present. If you can think back without strong feelings and without judgement then that's probably OK. I would say that any lessons learnt from the past are typically learnt at the time or soon after, usually reviewing something months or years later is a negative behaviour that will just tie you in knots. Gemma
  7. Hi AliB, The only other alternative is your daughter could use her Right to Choose through her GP to pick another IAPT service which is out of her local area. Many IAPTs don't see those who are under 18 years old, so you would need to check which ones did. This is an option, but you would need to see what the waiting times were for each IAPT, as waiting times are long in many areas. As Lynz said, it's important that your daughter is still on the waiting list for one to one CBT while using SilverCloud so she doesn't have to wait longer than necessary. Gemma
  8. Hi janeebird, I'm really sorry to hear how much your husband is struggling. If your husband's therapy is due to end soon then I would suggest he asks for further CBT within the same team, possibly with a therapist with more experience in helping those with OCD, or to be stepped up to the next level of care. It depends what service he is with now, if he is with IAPT, then the next step is his community mental health team. Waiting times with CMHT are long, so perhaps a different therapist through IAPT should be the next step. Your husband shouldn't simply be discharged if he is still struggling so much. It sounds like he hasn't had the CBT that has really made a huge difference and therefore it will feel like OCD will be around forever. But your husband is not alone in trying CBT many times and he just needs a good therapist to help him tackle these problems. Have you ever looked into self-help materials together? This can be a good way to learn about and tackle OCD as a team. We do have a couple of fantastic presentations from our online conference in 2020 that you might find helpful in understanding OCD and how to help someone with it. There’s this one by Lauren Callaghan https://www.ocduk.org/conference/conferences-across-the-uk/2020-virtual/conference-map/family/helping-family-member-with-ocd/ and another by Mark Freeston https://www.ocduk.org/conference/conferences-across-the-uk/2020-virtual/conference-map/main/understanding-why-people-with-ocd-do-what-they-do/ Gemma
  9. Hi AliB, Is the 12 month wait for an IAPT service? If so, then unfortunately this will probably we the wait for CBT in your area unless there is another IAPT locally with a shorter wait time. You can search for BABCP accredited therapists here https://www.cbtregisteruk.com/ but we recommend contacting those you find to see if they have a good understanding of OCD. Gemma
  10. Hi Susu, Welcome to the forum It's difficult because all the therapists that we can recommend or ways to find therapists are all UK based, and that may mean that they are only registered to practice in the UK. You can take a look at our advice for finding a therapist here https://www.ocduk.org/overcoming-ocd/accessing-ocd-treatment/accessing-ocd-treatment-privately/finding-a-private-therapist/ and perhaps apply some of what you need to look for, for therapists you find in Thailand. Alternatively, you could work through some self-help materials. A great self-help book we recommend is Break Free from OCD, which is written by three specialists in the treatment of OCD. Gemma
  11. Hi Ironborn, I know that people are encouraged to accept the thoughts and let them come in, but CBT for OCD is more than that. Have you accessed CBT for OCD? A lot of what you have written is a rumination on whether things are real or not. You get the thought 'what if none of this is true or has happened, but what you need to question is, what if things are real and do happen and you're spending your time worrying that they might not have. Challenging OCD or a problem of worry means taking a leap of faith that things are in fact real. Instead of focussing on thinking about whether things are real, start to act like things are, then you should be able to work your way out of this problem and live much more comfortably with the uncertainty. Gemma
  12. Hi NJ321, OCD is just thoughts, doubts, images and urges and us then reacting to them like they are important. The content of the thought you mentioned doesn't really matter, what matters is the huge importance you've placed on having the thought, what it means to you to have had the thought and now the rumination about it afterwards. All that stuff is OCD. Gemma
  13. Hi Sam, I think this is a good way of looking at it. The aims of CBT and ERP are to make us resilient to challenges that might come up in the future. There will always be something we haven't done. For instance, I don't want to parachute jump at all, should I go parachute jumping to show myself I can do it? I don't think so, because in essence I'd be forcing myself to do it, so my overall experience will be negative, so what will I learn really? Good therapy is about choice, doing things that you want to do that OCD holds or has held you back from. Learning that compulsions keep you stuck and in tackling one thing, we know we can tackle other things that come our way Gemma
  14. Hi Sam, I think I can understand what you're saying. When it comes to ERP it's important to remember the response prevention part, that is you don't do the compulsions you would normally do in a given situation. I don't think this situation relates to response prevention, as it isn't a situation that you regularly do lots of compulsions in (because you don't go there ever). ERP should really be in line with our goals, and you don't want to join a nudist spa at all, that's the indicator that you therefore don't need to be able to do it. If going to nudist spas was part of something you had always done and OCD had prevented you, then it might be a different situation. It's possible that this is part of a perfectionist perspective where you want to be able to do everything, but if you place your exposures in line with your goals, then you should be able to see what to tackle and what to happily leave Gemma
  15. Hi BelAnna, You have moved so much in the past six months, so well done! That's hard and stressful at the best of times, let alone when you have OCD too. I hope you can at least recognise that what you're doing is hard and that's why it feels hard. You mentioned that you do lots of different compulsions around fears for your dog, but also around your concerns about norovirus. There's no simple answer on how to cope better. You can try to gauge how best to act from how your family are acting or would like to act. You could also pick a few things to target that you could reduce. Remember compulsions keep our distressing emotions high and limiting them will allow the feelings to pass quicker. In situations like this you're always going to have accept more uncertainty than normal and that's hard, but any uncertainty that you can live with will make you stronger the next time you move Gemma
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