CBT or not to CBT

[Guest Chrystal]

I was quite concerned to hear Prof S say on Saturday that unless you had the "if I dont do this, this person will die" type OCD, then CBT will not be any use.

With this mind, what other treatment would be available as I do not have this type problem.

Also it struck a cord with me with a couple of things he said, in particular when he said that the people who had the type of OCD mentioned above ("do this or that and they will die"), that they should go against their fears.

* * * could trigger * * *

He said that you will see if you didn't carry out the ritual or compulsion, then you will see that that person did not die ...... BUT ..... what if that person did out of pure coincidence? or what if, you have a strong belief in fate and that, if you tempt fate, this could well happen? these circumstances or these reasons alone would make me NOT want to stop the compulsions because of this.

I hope i have made sense here.

[Guest Smudger]

He said that you will see if you didn't carry out the ritual or compulsion, then you will see that that person did not die ...... BUT  .....  what if that person did out of pure coincidence? or what if, you have a strong belief in fate and that, if you tempt fate, this could well happen?  these circumstances  or these reasons alone would make me NOT want to stop the compulsions because of this.

I hope i have made sense here.

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Hi Chrystal.

I'm afraid lack of sleep means I'm in no position to help you with the first part of your question at the moment-I'd probably just end up making things even more confusing, but I'm sure someone less sleep-deprived will be along soon who can help!

As for the part I've quoted above, well, if you look at what you've written you'll notice that you've used the 'what if?' example twice, and this is what the therapy is designed to deal with-for it to work you have to be willing to accept that there are no absolutes, and that in order to start overcoming ocd you have to work to loosen its grip on you-that means not pondering every 'what-if' scenario that can arise. It's about not letting the ocd bully you with every possible way in which things can go wrong, and accepting that what happens will happen of its own accord, and that if these things ever did happen (no matter how unlikely), it was nothing that could have been avoided by anything you did or didn't do.

With ocd, there are always more 'what-ifs?', and this is how it keeps control-it wants you to believe that ignoring these potential disaster warning signs will cause the worst to happen, and it relies further on you being a good person and obeying it. The whole point of therapy is to show you (or for you to show yourself) that it's perfectly ok to not listen to the ocd, and that no matter what the ocd says you cannot affect events by not giving into a ritual.

I hope that helps-I tried to make it clear and semi-intelligent, but I'm so knackered I've probably typed out a lengthy recipe for making panckaes out of cement and old tea bags-if so, I'll try again later!

Take care.

[Guest Giggles]

Hiya Chrystal,

I kinda assumed that CBT could be used for all types of OCD, but thats shows my lack of knowledge on it. Sorry cant offer any other methods as thought that along with medication were the main 'cures'

What you said about people having the 'must do this or someone will die/come to harm' etc is what i have and what you said is so true, because for CBT i have been told to take that risk of not doing something certain amount of time, and was chlalenged to think horrible thoughts and wish harm on people to 'prove nothing would happen' but my immeidate reaction was 'how do you know nothing wont happen' its such a risk, but i know thats the risk i gotta take, and he did say to me that if something did happen it would just be a horrible coincidence, but i never undertsood how i would know i didnt cause that? Dont know if this makes sense?

Anyway to answer your question, i dont know of any other methods, hope someone else can help

Take care,

x Giggles x

[Guest Chrystal]

"Dont know if this makes sense?"

Absolutely - ur seeing my point of view!! I would feel the risk too great to take.

As I said, i dont have the 'If I dont do this, so and so will come to harm', but I do have to do rituals and have ruminations to do before I leave home and its a 'just got to do it' thing rather than it having consequences.

[Guest ocd13]

Hi Chrystal.

I'm afraid lack of sleep means I'm in no position to help you with the first part of your question at the moment-I'd probably just end up making things even more confusing, but I'm sure someone less sleep-deprived will be along soon who can help!

As for the part I've quoted above, well, if you look at what you've written you'll notice that you've used the 'what if?' example twice, and this is what the therapy is designed to deal with-for it to work you have to be willing to accept that there are no absolutes, and that in order to start overcoming ocd you have to work to loosen its grip on you-that means not pondering  every 'what-if' scenario that can arise. It's about not letting the ocd bully you with every possible way in which things can go wrong, and accepting that what happens will happen of its own accord, and that if these things ever did happen (no matter how unlikely), it was nothing that could have been avoided by anything you did or didn't do.

With ocd, there are always more 'what-ifs?', and this is how it keeps control-it wants you to believe that ignoring these potential disaster warning signs will cause the worst to happen, and it relies further on you being a good person and obeying it. The whole point of therapy is to show you (or for you to show yourself) that it's perfectly ok to not listen to the ocd, and that no matter what the ocd says you cannot affect events by not giving into a ritual.

I hope that helps-I tried to make it clear and semi-intelligent, but I'm so knackered I've probably typed out a lengthy recipe for making panckaes out of cement and old tea bags-if so, I'll try again later!

Take care.

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For someone who has had hardly any sleep, I found your post very clear and made a lot of sense!

I do have to do rituals and have ruminations to do before I leave home and its a 'just got to do it' thing rather than it having consequences.

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Hi Chrystal,

I am similar to you in that I have found I seem to do things 'just because' or 'so it feels right', but lately I've been digging deeper into why I might be doing these things 'just because' or 'so it feels right'. Therefore I was wondering if your rituals and ruminations do in fact have a deeper meaning attached to them, yet you haven't explored deeply enough as to why??

For example, one of my very very annoying compulsions is if I have taped something and am watching it on telly, I have this constant need to keep rewinding the tape and going over and over certain parts of conversations to make sure I hear it correctly, etc. At face value, it just seems as though I am doing it 'just because' or until it feels right, but when I explore more deeply, I seem to find myself thinking 'what if I don't hear the conversation correctly and I will never ever get the chance to hear it again', or 'what if I die before I get the chance to hear it again and then I will never know'... etc. (how embarrassing I've just admitted to that). Therefore, my compulsions seem to hold a deeper meaning to them - I'm not sure I've hit the nail on the head entirely with working this out for myself, but it seems to be connected to some sort of fear of loss or regret.

Anyway, I hope that makes some sort of sense.

Love Andrea

[Guest Muse_Man]

Hi Chrystal,

CBT can be used for all different types of OCD. At the end of the day all OCD themes are based on irrational beliefs that something dangerous or harmful will occur, which causes doubt and uncertainity.

CBT in my experience is a tool to arm the sufferer with the knowledge to break down the thinking processes involved and understand that these thoughts are automatic, and the response to the thoughts need not be negative or percieved as dangerous.

The risk associated with letting go or ignoring the danger is caused by uncertainity and irrational beliefs, it is not until you test out the beliefs that you find out they are not true. But you say 'what if', the thing is life is all about uncertainity and its something we have to accept. From my experience its the feeling of fear and vulnerability driving the uncertainity and unwillingness to let go, it is important to stand up to these feelings and trust your inner gut instinct otherwise you can never break the cycle of worry.

It takes time to find the trust in yourself and get use to the feeling of vulnerability, but gradually the more and more you expose yourself to the uncertainity the easier it becomes. You recognise there is no danger in these thoughts and you can relenquish all responsibility. Changing the mindset and approach to life in this way will help.

take care,

Stuart

[Guest Chrystal]

"OCD13 : For example, one of my very very annoying compulsions is if I have taped something and am watching it on telly, I have this constant need to keep rewinding the tape and going over and over certain parts of conversations to make sure I hear it correctly, etc. At face value, it just seems as though I am doing it 'just because' or until it feels right, but when I explore more deeply, I seem to find myself thinking 'what if I don't hear the conversation correctly and I will never ever get the chance to hear it again', or 'what if I die before I get the chance to hear it again and then I will never know'... etc. (how embarrassing I've just admitted to that). Therefore, my compulsions seem to hold a deeper meaning to them - I'm not sure I've hit the nail on the head entirely with working this out for myself, but it seems to be connected to some sort of fear of loss or regret."

Wow OCD13: you and I are such alike. I do exactly the same thing with the tape !!! I have to keep seeing a certain something or hear a certain something although i dont have the passing away bit in it all. And also GOOD ON YOU for telling us that.

"Museman: CBT can be used for all different types of OCD. At the end of the day all OCD themes are based on irrational beliefs that something dangerous or harmful will occur, which causes doubt and uncertainity".

...but Prof Sal said that unless you had that kind of OCD, it would be pointless to have CBT as it would not be of any help hence why i posted this post.

"The risk associated with letting go or ignoring the danger is caused by uncertainity and irrational beliefs, it is not until you test out the beliefs that you find out they are not true. But you say 'what if', the thing is life is all about uncertainity and its something we have to accept. From my experience its the feeling of fear and vulnerability driving the uncertainity and unwillingness to let go, it is important to stand up to these feelings and trust your inner gut instinct otherwise you can never break the cycle of worry. "

I dont have a fear per se. I just "have to" do these things.

I do however have a fear of a certain thing (cant say what - fate and all that) that im close to, passing away and just the thought of that happening drives me bonkers. In saying that tho, it is not related to a compulsion. It is not a 'do this or otherwise that will happen'. Its just a general fear.

"

It takes time to find the trust in yourself and get use to the feeling of vulnerability, but gradually the more and more you expose yourself to the uncertainity the easier it becomes. You recognise there is no danger in these thoughts and you can relenquish all responsibility. Changing the mindset and approach to life in this way will help."

I just cant do this. Just cant. Cant even entertain the thought.

Thanks for your help Stuart.

p.s. can someone tell me how to use the quote !!!

[Guest ocd13]

...but Prof Sal said that unless you had that kind of OCD, it would be pointless to have CBT as it would not be of any help hence why i posted this post.

Did I just switch off or something because I don't recall him saying that???

p.s. can someone tell me how to use the quote !!!

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You click on the 'quote' button at the bottom of the post and then reply. Or you can click on the 'quote' button on multiple posts and then click 'add reply' at the bottom of the screen and it should include all the posts you selected.

Make sure it has brackets quote at the beginning of your selected text and brackets slash quote at the end of your selected text. Not sure I've explained this very well - I find it easier showing people.

[Guest sam38]

I am finding this topic so interesting as I can relate to a lot of what has been said.

Chrystal - It was my understanding also that cbt is used to treat various types of ocd. It certainly appears to be the case in the book I am reading at the moment.

Like Giggles, I do have the type of ocd that has been mentioned (do this or --------will die) and know that the treatment would be for me to prevent myself from performing the rituals etc whilst challenging the thought that something was going to happen. But for me I know that the worst IS going to happen and I do 'things' to prevent it from happening sometime in the future, not straight away. Therefore I cannot prove anything to myself by not these performing rituals.

Muse Man - "From my experience its the feeling of fear and vulnerability driving the uncertainty and unwillingness to let go, it is important to stand up to these feelings and trust your inner gut instinct otherwise you can never break the cycle of worry" - I agree completely but, although deep down I know that my actions will not have any effect on future events, the 'what if' is just too strong and I don't feel able to take the risk.

ocd13 and Chrystal - I am a tape rewinder too! I have to listen to some conversations a certain number of times (usually three) but for me the thought of 'if I don't then ........' certainly comes into it.

[Guest Muse_Man]

Hi Chrystal,

"Museman: CBT can be used for all different types of OCD. At the end of the day all OCD themes are based on irrational beliefs that something dangerous or harmful will occur, which causes doubt and uncertainity".

...but Prof Sal said that unless you had that kind of OCD, it would be pointless to have CBT as it would not be of any help hence why i posted this post.

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Did I just switch off or something because I don't recall him saying that???

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I think Andrea is right, you may have misinterpreted or misheard what Paul said. In Jo's talk she mentioned having CBT for contamination OCD. From what I know, Im no expert, the connection between all the OCD themes and worries that they are caused by automatic thoughts which the sufferer percieves with a heightened level of danger and a threat, hence the response is to carry out safety behaviour in the form of rituals, compulsions or ruminations.

"The risk associated with letting go or ignoring the danger is caused by uncertainity and irrational beliefs, it is not until you test out the beliefs that you find out they are not true. But you say 'what if', the thing is life is all about uncertainity and its something we have to accept. From my experience its the feeling of fear and vulnerability driving the uncertainity and unwillingness to let go, it is important to stand up to these feelings and trust your inner gut instinct otherwise you can never break the cycle of worry. "

I dont have a fear per se. I just "have to" do these things.

I do however have a fear of a certain thing (cant say what - fate and all that) that im close to, passing away and just the thought of that happening drives me bonkers. In saying that tho, it is not related to a compulsion. It is not a 'do this or otherwise that will happen'. Its just a general fear.

Its my belief that the fear is subconciuosly shown and felt as anxiety, which then drives the sufferer to carry out safety behaviour, which will become an automatic repsonse if thats what the body defence system is use to doing. CBT would help you focus on changing that safety behaviour and push you through testing yourself against the "having to do these things".

From my experience I felt i had no control over the compulsions, but at the end of the day in my CBT I discovered that it was me compelling myself to do the compulsions, and it was my responsibility to push myself against the anxiety and change the way I reacted to and percieved danger.

"It takes time to find the trust in yourself and get use to the feeling of vulnerability, but gradually the more and more you expose yourself to the uncertainity the easier it becomes. You recognise there is no danger in these thoughts and you can relenquish all responsibility. Changing the mindset and approach to life in this way will help."

I just cant do this. Just cant. Cant even entertain the thought.

I know it seems tough and mere impossible, but i can ensure you it is possible with the guidance of your therapist, belief in yourself and support of others. It takes time and paitience and doesnt happen over night, theres no pressure as you can take it at a pace which is comfortable for yourself, gradually pushing yourself more and more, map out goals longterm, and turn things into bite size chunks. Everyone deserves to get better, you hold the key, you will be surprised if you try it and be brave, being able to confront and be passive to the what ifs and feeling of dread and control your thoughts more.

Stuart

[Guest Chrystal]

Thanks Stuart. It just seems its too much of a risk to my sanity.

My rituals start from the moment i wake up until i get out the door. I have a 'thing' with the taps in the bathroom, i have a 'thing' with dressing, and then i have a big big thing when actually leaving the house... not checking... but its just a ritual and this takes between 15-30 mins to get right before i leave the house. If I dont do these things then it will bug me big time which means i will not be able to concentrate on work. I have lost too many jobs to OCD and the job i am in at the mo. are great although they dont know about the OCD (not making that mistake again telling 'em).

The point im trying to get across here is difficult to explain altho im feeling happy cos OCD13 and Sam and I have similar traits!

Im sure Prof said that right after he told everyone to write down a name of a loved one and wished they suffered a nasty u-no-wot. Maybe I should write to him or his secretary and ask them what the Prof said. Im sure that is what he said.

[Guest MJP]

Hi Chrystal,

CBT can be used for all different types of OCD. At the end of the day all OCD themes are based on irrational beliefs that something dangerous or harmful will occur, which causes doubt and uncertainity.

CBT in my experience is a tool to arm the sufferer with the knowledge to break down the thinking processes involved and understand that these thoughts are automatic, and the response to the thoughts need not be negative or percieved as dangerous.

The risk associated with letting go or ignoring the danger is caused by uncertainity and irrational beliefs, it is not until you test out the beliefs that you find out they are not true. But you say 'what if', the thing is life is all about uncertainity and its something we have to accept. From my experience its the feeling of fear and vulnerability driving the uncertainity and unwillingness to let go, it is important to stand up to these feelings and trust your inner gut instinct otherwise you can never break the cycle of worry.

It takes time to find the trust in yourself and get use to the feeling of vulnerability, but gradually the more and more you expose yourself to the uncertainity the easier it becomes. You recognise there is no danger in these thoughts and you can relenquish all responsibility. Changing the mindset and approach to life in this way will help.

take care,

Stuart

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I couldn't have put it better myself. Good one Stuart!

Maria

[Guest Muse_Man]

Muse Man - "From my experience its the feeling of fear and vulnerability driving the uncertainty and unwillingness to let go, it is important to stand up to these feelings and trust your inner gut instinct otherwise you can never break the cycle of worry" - I agree completely but, although deep down I know that my actions will not have any effect on future events, the 'what if' is just too strong and I don't feel able to take the risk.

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I found myself that the 'what ifs' are connected to the feeling of anxiety, this made it really hard to confront them as it is creating a sense of dread and doom. I found it easier to confront the obsessive thoughts about doubt and negative ideas easy once I knew this was a physiological feeling, not an omen, some external terrifying force of doom, etc. Exposing myself to this was the only way to let go. The demonstration by Paul at the conference was a great example of how to test myself, where writing on a piece of paper (roughly)...I want to kill xxx loved one. We take risks everyday of our existence, there are clearly some we wouldnt, but there are a lot of dangerous risks we dont even consider or give second thought about. There is an element of uncertainity with all risk which is something we have to contend with everyday.

Thanks Stuart.  It just seems its too much of a risk to my sanity.

My rituals start from the moment i wake up until i get out the door.  I have a 'thing' with the taps in the bathroom, i have a 'thing' with dressing, and then i have a big big thing when actually leaving the house... not checking... but its just a ritual and this takes between 15-30 mins to get right before i leave the house.  If I dont do these things then it will bug me big time which means i will not be able to concentrate on work.  I have lost too many jobs to OCD and the job i am in at the mo. are great although they dont know about the OCD (not making that mistake again telling 'em).

The point im trying to get across here is difficult to explain altho im feeling happy cos OCD13 and Sam and I have similar traits!

Im sure Prof said that right after he told everyone to write down a name of a loved one and wished they suffered a nasty u-no-wot.  Maybe I should write to him or his secretary and ask them what the Prof said.  Im sure that is what he said.

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As my therapist asked me, what is your priority, your mental health and quality of life or living in fear, stress and worry? I understand what you mean by the risk of losing your sanity and you want to keep your good job, I contemplated these ideas a lot. But i was reassured by my therapist that I would not go mad, because I have OCD. I became extremely anxious stopping the compulsions and I seemed to be going out of my mind. But I wasnt really, this was the affect of extreme anxiety and worry, not having anything to cling onto in terms of safety behaviour to make me feel secure. Risk is always a hard to judge, at the end of the day its down to the person and how they feel comfortable.

I think Ashley would be able to clear that up for you about what Prof. Paul S. said in the conference. I think he said the opposite, as in CBT is difficult to deal with this type of thinking.

I couldn't have put it better myself. Good one Stuart!

Maria

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Thanks Maria

[amewat]

had to post an say to muse man that i totally disagree with some of the things ure saying . no offence of course

CBT can be used for all different types of OCD. At the end of the day all OCD themes are based on irrational beliefs that something dangerous or harmful will occur, which causes doubt and uncertainity.

i do not belive that something dangerous will happen or something harmful will happen so its not all ocd themes at all. i wash my self cause i feel unclean not because i fear anything happing to me or dangerous happeining.

From what I know, Im no expert, the connection between all the OCD themes and worries that they are caused by automatic thoughts which the sufferer percieves with a heightened level of danger and a threat, hence the response is to carry out safety behaviour in the form of rituals, compulsions or ruminations.

again i dont feel danger or threat, i carry out compusions due to the feeling of being dirty or things spreading or family being dirty i do not fear anythign happeing at all.

chrystal could u email the professor cause id like to no if he did say that about ocd and cbt cause i have exactally wat hes talkin about if he did.

[Guest Chrystal]

IMPORTANT: PLEASE READ:

It has come to my attention that in fact I was wrong thinking that CBT was only used for certain forms of OCD. In fact CBT can and is used for ALL forms of OCD.

I therefore apologise profusely for my original post and also for any comments I made which misled anyone.

Again very very sorry.

[Guest Muse_Man]

had to post an say to muse man that i totally disagree with some of the things ure saying . no offence of course

i do not belive that something dangerous will happen or something harmful will happen so its not all ocd themes at all. i wash my self cause i feel unclean not because i fear anything happing to me or dangerous happeining.

again i dont feel danger or threat, i carry out compusions due to the feeling of being dirty or things spreading or family being dirty i do not fear anythign happeing at all.

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No offence taken Sorry that was a general whitewash I was applying there based more on my own experiences...though I still believe deep down subconciously something, maybe a feeling of fear, is driving OCD sufferers due to an elevated sense of danger causing them to carry out safety behaviour such as compulsions. If we react to something with compulsions, then we must feel unsafe in some way. Maybe the fear shows itself in the form of doubt. I cannot say this this is right for everyone becuase I dont what everyone feels.

Im not sure what it is but something inside, some emotional feeling is driving the uncontrollable doubt OCD sufferers contend with. With me its the anxiety and feeling of vulnerability deep inside which drives my doubt and need to carry out compulsions, not sure if that can be applied to all OCD themes.

IMPORTANT:  PLEASE READ:

It has come to my attention that in fact I was wrong    thinking that CBT was only used for certain forms of OCD.  In fact CBT can and is used for ALL forms of OCD.

I therefore apologise profusely for my original post  and also for any comments I made which misled anyone.

Again very very sorry. 

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Hey Chrystal, I was going to say that it was very easy to mishear things said in the conference due to the heat and long day. I know when listening to a new subject its easy to miss certain points or not take everything in. Anyway you have started an interesting discussion Remember what Prof S. said, the experts dont really know anything.

Take care,

Stuartx

[Guest Anon]

Muse Man,

I think you've raised some very important points above. You're obviously like myself in that you clearly give a lot of thought to the root causes of your OCD. You might find it interesting to take a look at a book called 'Beyond Fear' in which the author (Dorothy Rowe) dedicates a whole chapter to 'Turning Fear into...Obsessions and Compulsions'.

[Guest Muse_Man]

Muse Man,

I think you've raised some very important points above. You're obviously like myself in that you clearly give a lot of thought to the root causes of your OCD. You might find it interesting to take a look at a book called 'Beyond Fear' in which the author (Dorothy Rowe) dedicates a whole chapter to 'Turning Fear into...Obsessions and Compulsions'.

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Thanks for the tip, maybe it will help Will consider checking it out

Take care,

Stuart