DRS1

What are you specifically worried about with the appointment? Is it related to worrying about them not understanding or believing you for instance?

I think that may be a neurodivergent thing in general. As an autistic person, I have regularly done this kind of thing. It can be learned to only mention certain things to other people but I still do it so you aren't alone in that regard. Instead of beating yourself up for it, you can recognize that maybe that was a bit much to he saying to people whom you didn't know and correct it going forward.

Well, why would it be so bad of it was cheesy?

I think this is up to you but to me this kind of seems like the next step up from your current exposure level, especially since you've been doing those exposures for a few weeks. I don't think from what you've said that she is doing this to tick boxes at all and I think its clear to me at least that she does care about you getting better and doesn't want to leave you with some success but still struggling. Ultimately, you have the choice over what exposures you do. No one can force you to do an exposure you are not comfortable with but if you do take that leap and do that exposure and find out that everything is okay then it's going to make a big difference. I suspect there will be a massive disagreement from others on my viewpoint but that would be the way I would approach it based on the way I have approached everything else.

Hi, sorry no one has replied before now. I'll try and take each bit of your post piece by piece: It's actually just your compulsions here that are making you less certain about all of this. When you cut these out like looking on social media and creating those extensive theories, you can try to live to your values a bit more. This is something you would need to work out with a psychologist/psychiatrist That's because there is a difference in understanding and actually taking the risk that it could just be OCD. Talk to your GP and be really open about the fact you are scared and they might be able to comfort you on this If you haven't had CBT with ERP with the NHS before then I'd think it would make sense that you would be offered that first. This would be what you want, not talk therapy. If they try to get you to figure out what the thoughts mean, then you are getting the wrong treatment. I know it's a long waiting list but for me it was worth it CBT and ERP is the same concept throughout any theme of OCD. I think on the forum, we are a bit more careful on saying ROCD, HOCD etc. because it can imply that its somehow different OCD but its just a theme with the same underlying mechanisms underneath. I think working with a therapist to start ERP was useful for me. I was also scared I would do it wrong or not make any progress and just torture myself with it. Post therapy, I have much more confidence in myself to be able to continue challenging OCD but at least in my opinion, it was better to have that help of a psychologist who could support me through making those important steps

It doesn't sound like a good way to respond does it. If anything I'd think you'd want to lean into that and intentionally be triggered by it. I'm not sure they are so experienced in CBT with ERP

The biggest secret of compulsions: The more you do them, they're still as useless but the less certain you become. That's why remaining in compulsive cycles will only ever make it worse.

There's no real answer to that. It's just not how it works. I wouldn't even always dismiss OCD and tell it to go away, I would just acknowledge the fact it is OCD, be sarcastic with it. I think telling it go elsewhere is perhaps showing OCD that you do in fact have a real fear with what's being thrown up. Also on the time scale side of things, how many compulsions do you need to cut out, how quickly can you cut them out etc.? That right now for you will be unanswerable question. Don't try to fixate on how fast you should be getting through it. Take as long as you need to take with it and recognise your achievements

Thank you both

Bit of a disclaimer: This is what I find has really been beneficial for me in terms of recovery. I've just finished my 2nd time with therapy (basically to touch up on some things that I struggled to know how to address) and am doing a lot better now than I was at my worst 3 years ago. I used to do 6 hours a day of compulsions, not want to leave my room, avoid everyone, avoid everything and ultimate hate myself because I didn't like myself but also due to the intrusive thoughts and not being able to work out if that meant something about me. This will be a rather blunt post covering the things that I have dealt with so this may not be for everyone but I hope it helps if you read it. For reference, OCD has pretty much always consisted of some sort of harm/sexual intrusive thought or image and some form of perpetual crushing perfectionism. I have OCD, but I am also autistic which brings its own challenges and sometimes the line between the two is a bit blurred being somewhat predisposed to black and white thinking. My compulsions have been typically mental like rumination, trying to argue with thoughts, cancel them out in someway, and others like avoidance, compulsively googling and never finding an adequate answer, repeatedly checking for arousal, turning myself away from people so that my groin is not facing them. So what helped? Acknowledging and Recognising The Tricks Of OCD There is a few "games" that OCD likes to play to get us back into the cycle of intrusive thought -> anxiety/uncertainty -> compulsion -> reduction in anxiety/uncertainty. For me those have been: "But this time it's different" - You may have had an intrusive thought and have managed to deal with it but if you have a variation of that thought then suddenly now you can't handle it the same way you did before because this one is different and therefore you should worry about it "But what if?" - OCD always has another one of these no matter how many times you think otherwise. You could genuinely have a fact and OCD's never going to accept it, it's just going to move to some variation of the situation e.g. "Okay well that can't happen but what about it in this very specific unlikely scenario?" Whack-a-mole - It's one that I've worked quite a lot on with the psychologist that I had and really just demonstrates the nature of OCD. You can batter it down all you want. You've solved the issues, you are now no longer burdened by OCD. However, new situations bring a lot of uncertainty and OCD can come back out of the ether and try its tricks again By recognising these, it can make it easier to make a more rational decision about how you are going to respond to thoughts Ways of Looking At OCD OCD can feel very personal and to a degree like you are bullying yourself. It's also worth stating, intrusive thoughts and images and their content can be really scary and horrible but I've found some ways that have worked for me to in some way make it feel a little less personal and terrifying: Personify OCD There may be some disagreement on the forum on this one but this is just what works for me. It's along the same lines as what Mark Freeman does when it talks about random llamas shouting at you on the street and whether or not you would value what they are shouting. Make OCD that kind of entity. Would you listen to OCD and its nonsense if that was a person outside of your own head shouting this horrible stuff at your or showing you these horrible images? When I do get intrusive thoughts, responding to it like its an actual person "Thanks very much, really appreciated that" with huge amounts of sarcasm has been beneficial too. Laugh at OCD for ridiculous it is. Mock it for how unoriginal it is. Take away its power that has over you. It's terrifying to make the decision to do that but it's made a massive impact for me Approach For Tackling Compulsions There are a lot of different things that I can use for tackling compulsions but the ones I have found the most impactful are the following: Exaggerating the thought/image This is covered in a few self-help books and was something I really grasped from therapy. ERP is not nice but its no worse than being debilitatingly destroyed by intrusive thoughts and OCD. The benefit of course is that you learn to realise that OCD may not be right after all. The idea here is to take a thought or an image, exaggerate the content to the worst possible scenario you could have and then do the response prevention part of that. For me that could mean, having a sexual intrusive image about engaging in unwanted sexual acts so I'd exaggerate it to the worst it could be in horrible detail and then sit with it. Or having a harm intrusive image of stabbing myself and intentionally going back in my mind to replay it and what that would actually be. Typing that out has made me realise just how horrible it was but it works. None of it ever had to mean anything and by showing myself that I could handle not just the intrusive image but the worst possible scenario that OCD could've thrown me, that I could handle OCD and recover. That was my first main moment of knowing that OCD wasn't going to ruin my life for much longer. Groinal Response/Arousal I have read a lot of posts with both people worrying about arousal/groinal response and others trying to help them understand it. I had a breakthrough moment with it in therapy and think it is worth sharing (although I have mentioned in parts before). You don't actually have as much control over your sexual response cycle as you think. You don't get to tell it when you don't want to be aroused and that's because the part of your brain that triggers that whole process isn't interested in what your moral feelings are or what you would prefer to happen. It gets sent a signal effectively to start the process and off it goes, doesn't matter what that signal may have been. We know this is the case because outside of an OCD context, whilst it can be annoying we all can experience unwanted arousal throughout each day. As a male, I'd prefer to choose exactly when and when I don't get aroused but that's not how the body works. I worried about this so significantly. Every time I would get an intrusive thought or image and I would have arousal or I would check for it, I felt awful, almost like it confirmed the worst in me. The more you worry about arousal, the more likely you are to notice it and then the more you do that, the more you pre-empt it. The hypocrisy is in the reality for this one. I bet you that you can handle normal random occurrences of unwanted arousal and not bully or berate yourself for it and certainly not make yourself feel like a monster for it. So why is it any different in OCD? Refer back to the games that OCD plays for that one. An exposure I have done a lot is to sit in the situation and if I do experience arousal then I experience it. It's not something you can control so why should you do everything to go out of your way to not live your life like everyone else because of it? It was something that I worked with the psychologist on to understand what the problem was of why I was struggling with it. I found it unacceptable to experience arousal in the presence of other people and certainly not when I have intrusive thoughts or images that could show up at the same time or potentially trigger the sexual response cycle. What so many people don't realise is by allowing it to be there and be present in what you actually wanted to do, everything calms down. You are doing what you want to do but the arousal just happens to be there at the same time. The arousal is nothing more than a bodily response but once you stop doing those compulsions, you won't feel as hyper focused on it. Last Things This post is getting long so I'll try and sum the latter part of this up more concisely: There may be a reason why the intrusive thoughts are so powerful and it could be that they are rooted in some event or belief that you might have had. This might not be the case for everyone but for me, undoing the roots of sexual shame and guilt near obliterated OCD's ability to make a dent in me with those kinds of thoughts and images. I left it with no leg to stand on Pre-dispositions to black and white thinking and other co-morbidities can be playing just as much a role as OCD does in making you feel miserable. Your problem may be that you have OCD but its worth taking a look at the way you approach non OCD things or the way that you use to approach things prior to OCD showing itself. That could be catastrophising every situation ever and always being extremely pessimistic. A general sense of finding uncertainty anxiety filling (a very common thing for autistic people, not just those with OCD) or something else. It's always worth working on your mental health as a whole The value you put on yourself is everything. If all you do is talk about yourself incredibly negatively and always put yourself down then it's going to make trying to get better that much more difficult. You are already being bullied by OCD, why should you bully yourself further on top of that. How is that going to help you? Hopefully this hasn't been too long and if you got this far that it was something you have been able to take something from.

I will refer you back to @malina's post for that one and this one and this one oh and this one. Genuinely, I am sorry that you believe these things about yourself but if you can't be willing to accept that these may not be true then you are never going to be willing to get better. This is really harsh but you are the one keeping yourself this way, it's something you have chosen to do at this point. Step one of getting out of the hole you are digging deeper and deeper into is to stop treating yourself like a piece of garbage. It's so frustrating to hear you continually tear your character as a person apart because I know that it can get better. We do not say these things Cora if we thought you were a lost cause but you need to really take on the advice now and at the very least; forget tackling the compulsions right now, tackle how you feel about yourself first and address that. That's what's giving so much power to the rest of what you are dealing with at this point.

Hi and welcome to the forum. Has he been officially diagnosed yet and if so have they tried online therapy options with him? Also are there any co-occuring conditions that he has that may play a role here? I think the reality is that you can't persuade him, he has to get himself to a point where life as it is for him right now is not where he wants to be and he has to want to get better. It doesn't say in your post but are you aware of the compulsions he is doing other than staying in his room and have you spoken to him about this and what the intensive thoughts he is actually experiencing are? If not and if he does tell you, don't be alarmed about the content of the thoughts. They are just unwanted thoughts nobody wants to have but most humans with or without OCD have the same kinda of thoughts, just that people with OCD take a bit differently as if it means something about them or that something bad will happen. I think it's really important and somewhat overlooked as to why the compulsive behaviours are happening not just that they are happening are noticeable. For reference, I've probably had OCD since I was 8 but over the last 3 years it had got substantially worse all while trying to finish a university degree too and I'm not that much older than your son. I would spend 6 hours a day doing compulsions also pretty much confined to my room and for what seemed like good reasons to me at the time too. To give you an idea of these (these are going to pretty graphic but as is the nature of OCD): Unable to go in the kitchen when my dad was preparing food or even in general because there was knives there and I had intrusive thoughts that I was going to stab myself or other people with it Intrusive thoughts about pushing my mum down the stairs and what felt like an urge to do it so then I'd find any way to keep my arms trapped to prevent me from doing it Sexual intrusive images near constantly of sexual acts involving family members, genitalia, people naked (and that goes for anyone in the street) then ruminating over what that meant for me . These are just a few examples but hopefully that gives you an idea of what others on the forums lived experience is like. It has got better for me. I've been through therapy twice now and compared to three years ago it's made a massive difference. Taking the risk that OCD was wrong was probably the hardest thing someone with OCD could do but it can get better. On this forum we have a lot of people with lived experience of OCD and if he needs a place where he can talk about it that he knows other people will be able to relate to then this is the right place.

That's something you need to work on yourself. Based on the information you have, how do you think you should approach it?

It's no different to any other one. It's all the same. Might be slightly different in the thought presentation but fundamentally its the same pattern and same kind of theme

Really start just noticing when you want to do the compulsion, you don't have to stop the compulsion cold turkey. I approach it from a perhaps more blunt angle which works for me. In terms of ERP, I'd take it, exaggerate it to the worst possible outcome and shove it back in OCDs face. If OCD brings the uncertainty, give it back something OCD didn't account for; something worse than it thinks you are worried about. So if that's the die thought for me, maybe I did mean it, not just said it. Oh and it feels awful initially but after a while you habituate to the anxiety and realise very quickly that you don't care and if you don't care, it doesn't mean anything. You can continue having that thought and do nothing with it.

Yep and I wouldn't keep reminding yourself that you wouldn't say it either. I've had it before when saying bye to someone that it got turned into die, so I know the situation quite well. You need to accept the uncertainty that maybe you did say it, who knows?

I don't think its a matter of stopping worries but more cutting out the compulsions here. Trying to argue or say a thought that opposes the thought you don't like is what keeps the distress and anxiety around for longer. What can you do instead to respond differently? Maybe the next time you get the thought, try letting it be there or even acknowledging it "maybe I don't love them". By doing so you are responding with doubt to OCD which does not like doubt or uncertainty. If you try to give it what it wants, OCD won't let you be okay with that. The idea here is that you want to stop giving OCD any power over you. If you can show it that it doesn't matter, the less of a problem it will be.

This can be quite a misconception for a lot of autistic people. We don't all necessarily lack empathy but may find it difficult to show it in a social way

This is definitely not helping and I don't think it's that uncommon with OCD. You are clearly aware that the compulsions don't do anything but then when you do the compulsions you don't allow yourself to accept that you have done the compulsion and can move on. I do it and it doesn't help me so I know from experience. Sure, the compulsions are not what you want to do but if you do them, you've did them. There is no point allowing yourself to become stuck in a cycle of guilt over a compulsion you did. You aren't protecting anyone and you aren't helping you.

Not to offer you reassurance but I have had the same issue with not explaining everything to health professionals. In terms of convincing yourself its OCD, that sounds like it's challenging. I think there are things you can look at to notice signs that it could be OCD like heightened anxiety, the urge to do compulsions, and experiencing thoughts, images, sensations you find come out of nowhere and you judge as unpleasant. However, the problem for you is probably the willingness to accept doubt and that you can't know everything. You could be a monster. To OCD, that's a given possibility. Anyone "could" be but that doesn't mean that reflects who you are as a person and what you value. I think that gets lost a lot. Yes it can feel like you lose yourself in the midst of it, but you never actually do. For example, if you did say to yourself that you are a monster and go for the certainty approach, its not going to change it. You will still have doubt over that. Or OCD will just move onto the next thing. As for the groinal responses, the more you put emphasis on the area, the more you will feel every slight movement. I've had to face the fact that I don't get to control when and when I'm not going to be aroused, for the most part. The part of your brain that decides to start that whole process does not care what caused the signal to be sent to it to start the process, it's never concerned about the content or what you value. Like everything else, groinal responses/arousal only means what you make of it. Again as @determination987 has said, it's really about acceptance of all of this. You can accept that you may have groinal responses at times where you don't want to but instead of when it happens, ruminating over it, checking for arousal/how aroused you are, you can choose to notice it for what it is and accept that is there, despite all the anxiety and uncertainty of it.

Why do you think that no one respects you? Also what is it exactly that is being a "man" that is the issue here? I think we need a little bit more info to this one.

Surprisingly more common than you think. It's a game of "do they really understand it because if they did maybe they would say you are X, Y or Z". To some extent, you need to accept that it's not going to matter how much information or details you give, you are always going to think you haven't given enough. There a few example threads that I can think of on the forum that show this exact pattern. To make it a bit better (or worse temporarily), maybe it is OCD, maybe it's not. However, if you recognise the patterns of OCD and it seems like OCD then assume its OCD. It's the whole if it looks like a duck, walks like a duck, talks like a duck then there's reason to assume it is indeed... a duck

That's not really how it works for me. Everyone has a different definition of recovery but for me the fact that I can respond differently and still experience all this and yet at the same time live my life is enough. If you are looking at it as you will be cured of it then you may be setting your expectations slightly differently.

That's because every time it feels real again and feels "different" but it isn't. Getting to recognise the pattern here is the important part. Things like: Have you experienced this kind of thought content before, the thought, anxiety, compulsion pattern etc. If you have dealt with this before, having stuff like that as a reference guide for navigating the rest can be worthwhile. It doesn't mean you won't be caught out by it, but you will be able to catch on to OCDs horrible process and be able to respond differently.

I refer you back to @PolarBear's post ^