Progress made in China- using Mindfulness techniques to help OCD - a personal account

[Zhou Hong]

Hi, Dear suffers of OCD. I am Zhou Hong, the author of this article. I do not know anything about English, and the paper was translated by the suffers I once helped. I once thought of publishing it in an academic psychological journal but found that the filed of academic wouldn't embrace the article that only includes the author's personal experience. Here I post this article on this forum in the hope of making it possible to help people in the Western world know more about how I treated OCD. I have to say that the techniques mentioned in the article may seem very simple; however, when applied, they are very powerful. So please do not belittle the seemingly simple methods. They will make a huge difference to your OCD and possibly to your life. Please take it seriously. I sincerely hope that this article can help you. This post is about sharing experiences only and not for promotion anyway.

                           Mindfulness Based Cognitive Therapy (MbCT) for OCD

By Hong Zhou & Yang Zhang 

Foreword

    It is well-known that OCD is a mental disorder which is extremely hard to tackle. A great number of psychological and psychiatric practitioners have been unable to understand OCD and there are also obvious defects with the existing psychotherapy techniques. The current psychotherapy theories cannot explain the mental mechanism of OCD precisely and are incapable of sorting out various problems popping up along the way of therapy. For the patients, it is clear to them that they should not analyse the activating events and seek reassurance; however, they still need to solve these problems to get relieved. Exposure& Response Prevention is almost impossible to be implemented under such circumstances. The author spent 16 years conducting relevant research and instructed a good number of OCD patients to apply MbCT on themselves, and wants to share some of his thoughts with other suffers.

 

Pathogenesis of Obsessive Compulsory Disorder

    As far as the mental mechanism is concerned, Rational Emotive Behavioral Therapy (REBF) provides a most essential and thorough explanation. According to REBF, suffers’ fear and anxiety was activated by certain events, but irrational beliefs. Traditionally, REBF claims there are three types of irrational beliefs: a). absolutization; b). overgeneralization; c). tendency toward disastrous consequences. But the authors believe that only the “tendency toward disastrous consequences” can be considered as an irrational belief due to the fact that without it, the other two believes would not incur pain. For example, if someone has the belief of absolutization: “Everyone ought to be kind to me, and it will be very bad otherwise”, this person is set up for mental anguish. However, without this tendency toward disastrous consequences, one might think “Everyone ought to be kind to me; but even if they are not, that is the way it is” there would be no suffering at all. (*1).

    Also when it comes to Mysophobia, people with it are worried about catching diseases such as Hepatitis if they have not had their hands washed properly. From the perspective of REBT, we call catching a disease as “an event”. Illness itself won’t elicit mental sufferings. In fact, we can easily find out the overall emotional status of people with Hepatitis is far better than that of people with Mysophobia. REBT states it is the irrational belief that makes people anxious: “it will be very bad if I get ill.”  Anxieties and worries ensue. The sufferers keep washing their hands trying to avoid getting ill— the extremely terrible consequence. They clean their hands so hard with obsessive thoughts of “it is dreadful if I get infected! I have to prevent this!” Their disaster-associative thoughts get intensified and their anxiety soars. More anxious they are, more washing behaviour they will conduct to reassure themselves—A compulsive loop is thus formed.

    It makes no difference to tell people with Mysophobia that the chance to catch Hepatitis in our daily life is extremely small. For someone who stops fearing Hepatitis, as long as his disaster-associative thoughts are still strong, he is likely to worry about other medical conditions such as High-Blood Pressure and Diabetes since we are destined to age and die.

    Breathing compulsion is a condition that is easily being misunderstood. We tend to attribute its origin to sticking the attention to breath. However, the genuine trigger turns out to be the fear of breathing difficulty. Some people initially experience a breathing problem due to a medical condition, and they start to worry about whether there is something wrong with their respiratory function, which would be really terrible and unacceptable to them. As a result, these people cannot help paying attention to their breathing from time to time. Sometimes they even try to control their breath and when a sense of suffocation occurs, it furthermore enhances disaster-associative thoughts. People with this symptom usually ask: Will I stop paying attention to my breath after my OCD is healed? Breathing compulsion will diminish with practice which allows disaster-associative thoughts to get weakened.  There is a Buddhist mental training method which requires people to focus on their breath during the meditative sitting but these practioners did not suffer from breathing compulsion. Thus, paying attention to the breath is just an activating event.

    Some people with OCD have impulsive urges to harm others and they are concerned about “Am I really going to do that? If so that would be really bad.”  Panic and anxiety is not caused by having the thoughts of harming people but the catastrophic exaggeration of the consequence. In reality there are some criminals who have been premeditating on harming others for a long time, but they do not have OCD. So the very first of step of treating OCD is to realize that OCD is caused by irrational beliefs rather than the external activating events. Otherwise, we have no clue how to cope with it.

    The explanations above help to distinguish the pathological mechanism of OCD and are helpful to its treatment. However, in practice, people with OCD tend to be oblivious to this knowledge. Besieged by symptoms, they naturally attribute the cause of the anxiety to a certain activating event, and end up with getting tangled. To solve this problem, Mr. Yang Zhang invented a “Self-Asking“ therapeutic method in 2013, and when symptoms (uncomfortable feelings) come, one can inquire himself, “Do I think it will be very bad if the problem doesn’t get solved?” “Is the thing as disastrous as I believed?” This can help suffers identify disaster-associative thoughts related with the activating events, emotions and ideas. Also, we would be mindful of how we respond to disaster-associative thoughts so that we would know the causes of our suffering. Back to the two questions, if the answer is Yes, be mindful of it; if the answer is No, also be mindful of it; if the answer is “I am sure”, again be aware of it. Whatever the answer is, embrace it and let it stay, do not attempt to get rid of it.

    For instance, when an idea of harming others pops up, one can ask himself, “Do I have disaster-associative thoughts regarding the issue of harming others?” Via self-asking, suffers can realize instinctively that their OCD has something to do with disaster-associative thoughts. As a result, the intention to avoid “doing harm to others” somewhat abates. The self-asking question could also be, “Do I have disaster-associative thoughts when the urge of harming others occurs?”

    Self-asking is the most important technique to treat OCD. OCD is such a liar that he misleads us by all kinds of hoaxes and deprives us of a peaceful mind. Self-asking, when applied quickly, sees through OCD’s deception. While the Self Asking technique might seem ordinary, we shall be amazed by its effect after applying.

 

Treating OCD

    Mindfulness is a technique taught by Buddha, which is of great effectiveness and can be applied in treating OCD. We now know that OCD is incurred by disaster-associative thoughts and the key to its treatment is to solve the disaster-associative thoughts. Mindfulness also aims at solving the disaster-associative thoughts. The core of mindfulness was summarized by Buddha as “When looking, just look; when listening, just listen” (*2) For instance, whenever an idea of harming others occurs, if we can be merely looking at it and are devoid of disaster-associative thoughts, we won’t have any anxiety or fear.

    For people having fear of looking at others out of the corner of their eye, each time they do, they will develop disaster-associative thoughts: “those who were looked at by the way out of the corner of my eye will be annoyed, and it will be very bad!” For the ones who have taken mindful drills, while doing so, they simply realize, “I am looking at people out of the corner of my eye.” Without disaster-associative thoughts, there is no suffering.

    It is so easy to make mistakes while doing exercises if we do not know about how mindfulness is used to treat OCD. When people practice mindfulness via meditative sitting, they usually assume mistakenly that the result can be achieved only when the inner mind is peaceful and clear and therefore the emergence of distracting thoughts is taken for being harmful to the therapeutic effect. Having disaster-associative thoughts towards all these distracting thoughts, people try to eliminate the distraction and in return make themselves even more uneasy. If we analyse the situation through the approach of REBT, we will understand that the emergence of distractive thoughts is only an activating event. The more disaster-associative thoughts we have, more painful we will become. If we can observe the distracting thoughts as what they really are without having disaster-associative thoughts, we are treating our OCD.

    Some mindful meditation demands that practitioners should try their best not to move during the practice. Some people are so worried that the body’s movement will impair the effect during the practice that they will have anxiety and headache immediately when meditation begins. I explained to someone with this problem that the key to OCD treatment lies in not having disaster-associative thoughts regarding any issue. He replied to me later, “I won’t pay attention to my body’s movements anymore. I can ignore them and I am just focused on whether disaster-associative thoughts occur. With time I am not that anxious.”

 

That is the way it is

    People with OCD have too strong disaster-associative thoughts and it is extremely hard for them to implement the teaching of “When looking, just look; when listening, just listen”. For instance, when suffers observe physical sensations during meditation and feel somewhat uncomfortable, they would have some minor disaster-associative thoughts. These thoughts will interfere with the meditation even if they are somewhat weak and would not cause great pain. When an uncomfortable feeling is noticed, if we could comment: “I am now uncomfortable and that is the way it is”, we will be better implementing “When looking, just look; when listening, just listen”. We can practice “That is the way it is” in our daily life: when we see, listen to, and think of anything. Such as: the tree is quite tall and that is the way it is. Its foliage is quite luxuriant and that is the way it is. My hand is a bit itchy and that is the way it is. Today my symptom is severe and that is the way it is.

    If suffers practice more “That is the way it is” with things other than the symptoms, this would help to alleviate their disaster-associative thoughts. With not-so-strong disaster-associative thoughts when OCD attacks, it is much easier for us to implement the teaching of “When looking, just look; when listening, just listen”.

    Practice assignment: 1. When symptoms occur one should ask himself: “do I consider its consequence to be really bad?” if it is Yes, then say: I do think it is extremely terrible, and that is the way it is. Do not try to annihilate the “very bad” thought. 2. One can practice more often “That is the way it is” with or without symptoms. For instance, for someone who is concerned whether his hands have been washed clean enough, he can say: my hands are not clean yet and that is the way it is. With symptoms arising, we can prioritize using the self-asking strategy. 3. Practicing sitting-meditation three times on daily basis, between half hour and an hour each time. As there are a variety of meditative sitting techniques available, one can make a choice according to his preference.

    We can see some suffers have a better understanding ability than others via the feedbacks of our therapy. Realizing that their pain and annoyance is caused by disaster-associative thoughts and employing self-asking, these suffers, in about two to three weeks, would be able to identify and react appropriately to 60% of their suffering caused by OCD. While not yet capable of tackling majority of the challenges, they know the right direction toward full recovery. For those who are less able to grasp the points of this therapy, they would manage to get there in one or two months.

    While practicing the exercises, people might encounter a variety of problems which are not referred to in the article. For brevity all the coping strategies cannot be listed here. However, if one can resort to REBT theory and self-asking method, he will find out solutions at last.

 

About the Authors

    Mr. Hong Zhou, born in 1967, a mindfulness teacher from Yuyin Vipassana studio of China. Once suffering from OCD, he began to self-study psychology and Buddhist Vipassana in 2000, and achieved full-recovery in 2003. Zhou has been instructing people with OCD to practice mindfulness since 2008 and he is the first one in China to use REBF to explain the mental operational mechanism of OCD and to create the practice of “That is the way it is”. Mr. Hong Zhou also wrote a book in Chinese, named “Mindfulness Based Cognitive Therapy of Obsessive Compulsive Disorder” specializing the method of “That is the way it is”.

    Mr. Yang Zhang, born in 1980, is a mindfulness teacher from Yuyin Vipassana studio of China. He began to be afflicted with insomnia in 1996 and had been experiencing OCD symptoms for many years. He got in touch with psychology in 2007, learned from Zhou about Mindfulness practices in 2008 and achieved full recovery in 2009. He has been instructing OCD sufferers to practice Mindfulness since 2010 and following Zhou to learn REBF. He created the technique of Self-asking to examine the existence of disaster-associative thoughts.

 

Notes

1.     For more information regarding REBF, one can refer to Albert Ellis’s works.

2.     From The Dhammapada Stories.

 

 

[snowbear]

Hello Zhou Hong, welcome to the forum.

I've had to edit the title of your thread to comply with forum rules and I've sent you a private message explaining why.

In case you're not familiar with the message system yet (blue envelope at the top right hand corner of the page) I thought I'd post here too so you wouldn't think we were taking liberties without a reason.  

[paradoxer]

Zhou Hong. Welcome to the forum.

Xie xie.  

 

 

[Zhou Hong]

Hope that everyone from the catastrophic association, to understand all the problems raised by obsessive-compulsive disorder patients, and soon you will have a new understanding.

 

Edited March 12, 2017 by snowbear
Removed part written in Chinese - English only on the forum please

[Zhou Hong]

On 2017/3/10 at 15:04, paradoxer said:

 paradoxer Do you understand Chinese?

paradoxer ：Are you happy to meet you, are you Chinese?

[paradoxer]

Happy to meet you. No, I'm not Chinese. I just know one or two words (of Chinese). 

[Zhou Hong]

I do not understand, we all know that cognitive behavior therapy is the best way to treat obsessive-compulsive disorder, we discuss the issue of obsessive-compulsive disorder, why do not use cognitive therapy theory to analyze it?
This post is translated by Google.

[paradoxer]

Please understand it's difficult and limited using a translator, but I will try to express my opinion. OCD is essentially the result of a misfiring brain, often compounded by a lack insight into the workings of the disorder. Even an understanding of OCD's modus operandi isn't enough, alone, to combat it. The way forward (as difficult as it is)  is for the sufferer is to be counter-intuitive. 

[St Mike]

Another thing I realised during my struggle with scrupulosity, is that once I stopped drinking, my OCD also improved. I highly suspect alcohol weakens the mind/brain and makes it more susceptible to OCD. Not surprising since alcohol is a neurotoxin. When I learnt to meditate, I was told to abstain from all sexual behaviour and alcohol before meditation. The reason according to the monks is that such behaviour causes the mind to be foggy, unclear, it affects your ability to concentrate and allow intrusive thoughts to stray into the mind, and not just as a moral basis alone.

It works for me. My meditation sessions are much more successful when these basic rules are followed. I have also given up drinking. Saved me quite a bit of money as well.

[Zhou Hong]

On 2017/4/1 at 10:22, paradoxer said:

Please understand it's difficult and limited using a translator, but I will try to express my opinion. OCD is essentially the result of a misfiring brain, often compounded by a lack insight into the workings of the disorder. Even an understanding of OCD's modus operandi isn't enough, alone, to combat it. The way forward (as difficult as it is)  is for the sufferer is to be counter-intuitive. 

We want to treat obsessive-compulsive disorder, we need to know the psychological mechanism of obsessive-compulsive disorder,
We need to know how mindfulness works.

[taurean]

According to my mindfulness based CBT for OCD therapist, mindfulness works by us switching our mental activities from the active "doing" part of the brain, where we consider problems and try to find solutions - hence we also obsess and compulse there - to the benign, just "being", part of the brain, where we can place our mind in stasis - I can do this when travelling or sitting in the spa pool for example - or simply focus in the present, in the moment. 

It is great practice in my opinion for OCD and anxiety sufferers. 

When my OCD is really bad, I need to use CBT techniques and meditation and relaxation to get my anxiety levels down - I need to be calmer to get into mindfulness mode. 

[Zhou Hong]

The purpose of practicing mindfulness is not to let our hearts become calm, so that we can not think of the messy heart.

[St Mike]

Other than Vipassana or Mindfulness Meditation. I also practise Metta or Loving Kindness Meditation. I found Metta or Loving Kindness Meditation very useful in ameliorating the guilt which I suffered due to my Scrupulosity. As mentioned before, the coup de grace came when I forgave myself and let go of the guilt which led to me emerging from the shadow of Scrupulosity.

The practise of Metta Meditation calls for the radiating of loving kindness first towards yourself and towards others. It helps to develop a more forgiving attitude towards yourself and others. The combination of these styles of meditation and lifestyle changes helped me conquered my OCD. I am so thankful to the Monks who taught me how to meditate.

[taurean]

I also practice the love kindness way of thinking , introduced to it by Snowbear. 

It's great because it helps us leave the bad emotions, which OCD plays on, behind. 

Edited May 3, 2017 by taurean

[Zhou Hong]

Happy for your good experience。

[Zhou Hong]

8 hours ago, St Mike said:

Other than Vipassana or Mindfulness Meditation. I also practise Metta or Loving Kindness Meditation. I found Metta or Loving Kindness Meditation very useful in ameliorating the guilt which I suffered due to my Scrupulosity. As mentioned before, the coup de grace came when I forgave myself and let go of the guilt which led to me emerging from the shadow of Scrupulosity.

The practise of Metta Meditation calls for the radiating of loving kindness first towards yourself and towards others. It helps to develop a more forgiving attitude towards yourself and others. The combination of these styles of meditation and lifestyle changes helped me conquered my OCD. I am so thankful to the Monks who taught me how to meditate.

Guilt is because we think badly of what we have done, the right thing to do is to accept our mistakes, not to think badly of them, and then to correct them.

[taurean]

Guilt is one of those bad emotions which OCD loves, and helps it play  out its deadly game. 

It's why if we learn this as part of the cognitive side of CBT, then ease our mind towards positive emotions using positive emotion generation, and couple that with mindfulness - and get into the mindset of autonomously, automatically doing this when an intrusion occurs, we can lessen the grip of the disorder. 

And when it loses power, we gain ability to gently but firmly ease intrusions away. 

Edited May 4, 2017 by taurean

[Zhou Hong]

2 hours ago, taurean said:

Guilt is one of those bad emotions which OCD loves, and helps it play  out its deadly game. 

It's why if we learn this as part of the cognitive side of CBT, then ease our mind towards positive emotions using positive emotion generation, and couple that with mindfulness - and get into the mindset of autonomously, automatically doing this when an intrusion occurs, we can lessen the grip of the disorder. 

And when it loses power, we gain ability to gently but firmly ease intrusions away. 

We do anything that he belongs to induced events, our pain and anxiety is that we think of this thing is bad, this is the theory of cognitive therapy. We are in the process of obsessive-compulsive disorder treatment, any problem encountered with the psychological theory to guide how to solve.
There are many religious precepts, if not equal heart, once do want it badly, will make our life completely destroyed, and finally the formation of religious force. So about six degrees to the Buddhist Prajna pilot million.

[Zhou Hong]

An obsessive-compulsive friend shared: Now I apply this method to all aspects of my life, for example, I check my children's homework, and I am very annoyed. I asked, am I looking at the inspection work very meaningless, boring and wasting my time? Yes, it is. Then I will be aware and feel this annoyance. And check your homework.