Gemma@OCDUK

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

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

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

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

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

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

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

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

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

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

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

Hi David, Thought blocking is a compulsion, so letting them flow would be better. Gemma

Hi David, I would say that most people with OCD have an OCD inner voice that brings up doubts, worries, images and feelings that make us feel incredibly distressed. The key with breaking the cycle of OCD is to work out what we are doing to maintain the problem. That could be blocking thoughts, neutralising thoughts, checking our memory, avoiding things and much more, because it's these behaviours that keep all the thoughts and doubts going. Gemma

Hi Summer, It's hard to give individual advice on medication as everyone's experiences are so different and we are not medical professionals, however we do have a fantastic presentation on medications in OCD that you might find helpful here https://www.ocduk.org/conference/conferences-across-the-uk/2021-virtual/main/medication-and-ocd/ Hopefully, this should answer some of your questions, Gemma

Hi PleaseHelp, I know it's tough right now but you will get there, you just need a little support to help you do it. Like PolarBear said the treatment recommended for severe OCD is a combination of CBT and an SSRI. If you don't feel like the medication is helping you, then speak to your prescribing doctor about it, they might suggest a change of medication or a dosage change. Usually, you will have to wait at least 4-6 weeks before reviewing your medication, so if it hasn't been that long, then try your best to be patient with yourself. There isn't an SSRI medication that is better than the others, and our experience suggests that medications work so differently for each individual that you can't really compare experiences. All you can go off, is how you are feeling day to day. Gemma

Hi Emsa, Unfortunately, there aren't any spaces left for Leicester. However, there are spaces for Belper on 11th May and Grantham on 20th May Gemma

Hi bass89, Typically, either a clinical psychologist or psychiatrist can do formal assessments and diagnoses. Can I ask why you feel you need a diagnosis? I know that many people doubt whether or not they have OCD, and this can lead to them pursuing a diagnosis. Many people with OCD don't have a formal diagnosis and usually the priority is to access the correct treatment which you have. In terms of CBT, is there a reason you feel it has never helped? Have you had multiple rounds of CBT? Gemma

Hi Cam, This just sounds like OCD doubt and you're trying to be certain about the origins of the image. Unfortunately, you simply can't have the level of certainty you're looking for. In the short term, it would be distraction. When the doubt pops up, try your best to refocus on what you were doing. This will give your emotions a chance to reduce. In the long term, this problem needs tackled in CBT, with techniques referenced in the presentation I shared. The whole problem needs looked at rather than focusing on specific compulsions for specific worries, as this will lead to the OCD just moving on to other worries over time. Gemma

Hi Cam, This sounds like an OCD trigger and something that needs to be treated as such. Confessing won't make this situation any better and will only prolong your suffering by making OCD worse. If you haven't already looked at our presentation on HOCD and ROCD, then I would really recommend it here https://www.ocduk.org/conference/conferences-across-the-uk/2021-virtual/breakout/hocd-and-rocd-same-but-different/ It could be good for both you and your partner to watch. Gemma

Hi dgold, Here in the UK we follow the NICE guidelines in the treatment of OCD, which is generally CBT and SSRI medication. Guidelines for medication includes SSRIs, then if unsuccessful sometimes Clomipramine, and after that possibly an SSRI augmented with a low does of antipsychotic medications. The reason we follow the NICE guidelines is that the treatment recommendations are evidence based. At the moment, Mematine is not a recommended medication for OCD so not something we can recommend at this time. Gemma

Hi determination987, This is a lovely post, really inspirational and who doesn't love a bit of Bridgerton for escapism Gemma

Hi dgold44, You are definitely not weak and useless, you're just struggling with OCD and so many people will be able to relate to what you're going through. I notice that you're based in Nevada, here in the UK we recommend Cognitive Behavioural Therapy (CBT) with Exposure and Response Prevention (ERP) as the gold standard treatment for OCD. A great self-help book that you might find helpful is Break Free from OCD, as it can teach you how to begin to tackle OCD with the help of CBT techniques. Gemma

Hi Fred, This sounds a lot like OCD doubt. Are you accessing any support for OCD at the moment? Gemma

Hi Donna, This very much sounds like OCD. You feel the need to say things that people have said to you in the EXACT way that they said them. Not only are you expecting absolute perfection from yourself in repeating their words, you're also checking to make sure that everything is OK. Unfortunately, the more you keep doing this, the more you will feel the need to do it and the more OCD will nit-pick on how precise you've recalled what friends have said. Where I would start, would be to understand why you are confessing, what are you trying to achieve, I am assuming some sort of reassurance. Then you need to ask yourself if you think you're achieving your goal. Do you feel sure, relaxed, confident? If the answer is no, then it's worth trying something else and ignoring that nagging voice that you need to confess. Gemma

Hi Cherril, Unfortunately, the workshops are for parents of children under 18 years old only. You might find it helpful to take a look at some of our conference presentations that do offer tips for loved ones struggling alongside OCD. You can access them all here https://www.ocduk.org/conference/ Gemma