If I go back to therapy...how can I keep myself from staying in? (Merged Topics)

[Ryukil]

So, I really only have one obsession right now. The problem is that it's affecting almost everything. It involves getting intrusive sexual thoughts that then "contaminate" what I'm doing (for instance, reading a book or creating an account online) and then me having to "decontaminate" things. It's straightforward OCD nonsense, so treating it with exposure therapy should be simple and something I feel like I can do on my own.

I was going to do this, but then someone suggested I should have a therapist.This stuck with me and I then began to obsess endlessly about whether or not to go to therapy. It was basically a decision-making thing. Instead of actually trying self-therapy, I just spent my days researching whether or not it was okay to do self-therapy.

I got to January, and decided I'd just go to a therapist. I got in. But now the obsession is back, and I feel like dropping out. I worry that I could actually do self-help better, and that going to this therapist is just a waste of time. I'm worrying so much when I'm in therapy (that it's the wrong decision) that I can't function. If I dropped out of therapy, I wouldn't have this obsession anymore.

But if I were to drop out of therapy, I would probably be back to thinking that I SHOULD be in therapy. It's really insane. My opinion on this can change hour to hour. Why is my OCD so bad?

For some reason, I'm really averse to the idea of going to therapy. I feel like it would work better with me setting up and doing my own exposures within my own timeframe...I feel like therapy is more for people who don't understand OCD (who were just recently diagnosed, for example).

I don't get why going to therapy worries me so much. Going to therapy would just mean doing the same thing as I would on my own (ERP) but with the added bonus of having someone with 35 years' experience treating all kinds of OCD who can help me construct exposures correctly and stick to the plan.

[Orwell1984]

I think you need to tell the therapist about this particular obsession. It'll be exposure but the therapist could then give you the tools to deal with said obsession and over time you will gain trust in the therapist. 

[biscuitcat]

Hiya. I say you should just try the therapy and see how it goes. Plus remember therapy isn't a one way street. you do all the hard work just with someone to help and explain things and help you to see things differently. Your constantly thinking about it because you are engaging in this argument in your head (we've all been there, so please don't take this comment as judgement) 

It's a really tiring process trying not to engage in compulsions but it definitely becomes easier and it will help to be able to talk about lots of different things with your therapy, hopefully you will touch upon the OCD but also other stressful areas of your life and it will help you come up with a plan on how to deal with the OCD now, but also future anxieties.

Before I got therapy I was really worried about it purely based on what I had seen on TV, which is nothing like therapy and I found it such a rewarding experience. I was excited for the sessions and it felt so nice knowing I could talk to someone.

[PolarBear]

The first problem is that you start out by saying your only problem is sexual thoughts mentally contaminating things. That is not true. Look at the rest of the post. You go into detail about how you have a major problem deciding what to do with therapy. And that latter priblem is the more immediate problem to solve.

The second problem is that you say you feel you could do ERP better on your own. How many times have we told you that you need more than just ERP? Many times! ERP does not equal CBT.

Once again, the mere fact that you ruminate constantly over choosing a course of action shows that you need a good CBT therapist. You need to tell your therapist what is going on so he can help you.

[taurean]

There are dozens of people who would give their eye teeth to be in the position you are Ryukil re access to a therapist. 

I suggest you stop creating issues about therapy, roll up your sleeves and get connected to your therapist. 

As the others said, be open with him as to what you are thinking and feeling. 

And as they have said, unless you understand why you think and feel the way you do (the cognitive side of OCD)  the behavioural side including ERP will not be ready to happen, not be successful. 

 

[JennieWren]

Sometimes it is hard to let go of our old habits and ways of being. You say you think you'd be better going it alone. But the truth is you haven't, really you've just been mentally procrastinating. Just a suggestion, but does what you might have to 'face' in therapy worry you deep down? Would you rather avoid difficult feelings?

[Ryukil]

So, I have made many posts about therapy at this point. How I was obsessing about whether or not to stay in (which I guess was leftover from when I was obsessing about whether or not to go to therapy back in the fall), how I then got freaked out by being told I should tell myself my intrusive thoughts are "true" and reflective of my real desires, etc. I did eventually come around to seeing how that is a good idea, though, as it sort of just shuts the thought down (of course your anxiety spikes, but I think I got a bit better at doing this). However, telling myself I actually wanted to do these things was still too much...that's something I'm going to have incredible difficulty with. I'm still not sure it's necessary, since my OCD never told me that I would do these things, just that I was "aroused" by the thought of them. So, therefore, telling myself I was turned on by them would be enough, wouldn't it?

I don't want to bash my therapist, but I feel like he could've started me out a little more slowly. Like saying "maybe" I was turned on by the thought and all that. He probably should have done a better job explaining this all to me. I was coming from a place where I would tell myself that the "groinal response" feeling of arousal was "just OCD," so to go from that to telling myself I really was turned on by these thoughts was quite jolting. I had never even really heard of this approach, so I guess me thinking I knew everything there is to know about OCD was wrong.

Anyway...I sort of decided to take a break for a few weeks, because I figure I can figure out how to get myself to stay in therapy. Also, I have my friend's wedding coming up in less than two weeks, and I don't want to be all stressed out for that. I figure that I can really figure out what I want to do (stay in therapy or try self-help) and then just do it and see what happens after a few months of work. I figure I can remind myself that, if I go back to therapy, I will immediately feel like dropping out because of my obsession, and I can take some steps to prepare for this. Also, to be 100 % committed upon my return. Maybe this was a poor decision (it probably was) but I don't think it was a horrible decision.

So, as for sticking in: I guess just realizing that therapy is not forever is helpful? It's just temporary...I could probably be done in something like 8 or 9 weeks if I went back, considering I already did 6 sessions with him (two of which were just "intake"). I know putting a time limit on it is not good, but it would help me to move through it if I know it's not forever and actually a relatively short amount of time. It reminds me that, if his approach does not work, I can always try a different approach on my own later. I even look up how long ago a certain day was (say, Christmas) to try and show myself that the amount of days I spend in therapy isn't actually that long.

So, I might be able to e-mail him right now and ask if I can come back on Tuesday (so far I have missed just one session) but I think I really need to make sure this is what I want to do, first. That I'm committed and prepared to just do it and not drop out again. You might think this is wrong, but I have gone back and forth with him via e-mail like 5 or 6 times since starting therapy on January 9. I'll say I'm dropping out, only to change my mind. I'll say I'm sticking in, only to change my mind. Honestly, out of therapy I feel pretty great as that obsession is not bothering me in the same way, but that doesn't mean it's a good idea to quit therapy.

I do sort of think I could get pretty far with self-help. However, I think just being in therapy helps motivate me since if I'm very anxious about something being "contaminated," I can remind myself that I just need to hold out a few more days then I can see my therapist and we can troubleshoot. I think it would be harder to resist "decontaminating" things if I were on my own because I wouldn't have a goal post like that. I suppose I could make them for myself, though, as one technique I've found helpful in the past is to tell myself that I will resist a compulsion for, say, a few days and then reassess later. Of course the goal is to not give into the compulsion, but this makes it easier.

Anyway...I just really need to try something for a few months and see where I am. If I did self-help, I would start obsessing that I should be in therapy. But I really don't want to bother the therapist anymore until I am certain I will stick in it. I know I can't have certainity, but you know what I mean. Hopefully my mind will clear a little during the break, but that's probably not going to happen. I may just be exactly where I am now in a few weeks. 

Any advice? And please don't tell me to e-mail him right now asking to come back...I just think that's a bad idea because I will just immediately flip-flop. Hence this thread, asking how I ignore the compulsive urge to drop out of therapy and stick with it. One of my problems, certainly, is reading tons of info online about how people overcame their OCD, etc. Researching the concept of "agreeing" with the thoughts and all that. Reassurance doesn't work, I'm learning.

[Ryukil]

Sorry, the title of the thread should be "how do I keep myself from quitting?"

[Ryukil]

Lol, I'm very tempted to just send the e-mail now and see if I can go back on Tuesday. 

 

But I know I will just immediately feel the opposite way if I do. I don't want to mess with him anymore. But I also don't want to waste 2 weeks not doing any exposures.

This is really a nightmare.

Edited February 25, 2018 by Ryukil

[Ryukil]

I guess if I did therapy I'd have something to check off the list...then, hopefully, I could do self-help without obsessing about going to therapy because I've already tried it.

[Ryukil]

No amount of reassurance, deliberation, etc., will convince me I'm making the right choice about anything. So what do I do? Just commit to trying SOMETHING for a few months, knowing that I could always try the other thing if I can't make any progress?

I could certainly try self-help for a few months and, if I can't make progress, then go back to therapy (he said he always takes people back who want to go back, so it's not a problem). Or, I could try therapy for a few months and then do self-help if that doesn't work. But which is the right decision?

My gut tells me therapy, for multiple reasons. However, if I were decide to go to therapy, self-help would clearly be the right decision all of the sudden. There's no winning here, I don't know what to do...

Edited February 25, 2018 by Ryukil

[Ryukil]

Note to self: Please, man...this is just your OCD doing this to you. This is a nightmare, but you can wake up from it. Just step back and see what's going on here. Nothing will come of this endless trying to figure everything out! So just make a decision and stick with it, no matter how bad the anxiety resulting from making that decision is!!!!!!!

[PolarBear]

Go with that last post. You said it all. The rest is you ruminating.

[Ashley]

3 hours ago, Ryukil said:

Just commit to trying SOMETHING for a few months, knowing that I could always try the other thing if I can't make any progress?

Well this is advice you were offered weeks aqo, the question is really on you, are you ready to change? are you ready to commit to therapy (of any kind)?

 

[Ryukil]

How does a person with intense decision-making OCD get themselves to stick with something after deciding? Especially when the anxiety goes so high and doesn't seem to decrease at all for weeks? I mean I was in therapy for weeks, I only felt confident (not super anxious) about it here and there when reminding myself that it would not last forever and all that.

Edited February 25, 2018 by Ryukil

[snowbear]

35 minutes ago, Ryukil said:

How does a person with intense decision-making OCD get themselves to stick with something after deciding? Especially when the anxiety goes so high and doesn't seem to decrease at all for weeks?

Exactly the same as someone who has intense rumination urges learns to sit with the anxiety and not ruminate - it's about shifting out of your comfort zone and doing what feels unnatural/uneasy. 

[Ryukil]

Can I just say that he doesn't use cognitive therapy at all? It's just exposures, and extremely intense ones to begin with at that.

I started reading through Break Free From OCD...wouldn't I be better off following that? 

But anyway...the main thing here is I don't trust myself to push through my anxiety on my own. I could probably come up with decent exposures for myself, using some of what my therapist has told me...but I think being in therapy helps me to stick with it, to ignore compulsions. 

I've never been good at resisting compulsions. Though I guess, at the end of the day, any motivation comes from me anyway so it doesn't really matter if I'm in therapy or not. I just thought that maybe it helps me to do more at a faster pace, like willingly contaminating things, and that may be true, I don't know. "If everything's contaminated, nothing's contaminated" as my therapist would say...

[Ashley]

11 minutes ago, Ryukil said:

Can I just say that he doesn't use cognitive therapy at all? It's just exposures, and extremely intense ones to begin with at that.

I started reading through Break Free From OCD...wouldn't I be better off following that? 

Normally I advocate a CBT approach, but in your case I am not, for you I think you need to choose an approach, any approach and stick with it for a good few months (that in itself is therapy).   

You can fine tune therapy approaches if needed a few months later when you feel able to make changes for the right reasons.

[Ryukil]

I'm very convinced to just e-mail him now and see if I can get in for my normal slot on Tuesday, but I know I would just flip-flop and immediately be like "****! That was the wrong decision!" I don't want to mess with him anymore, you know? Not that I'm intentionally trying to, it's just my anxiety is all over the place.

I don't know if any of you remember (or if I posted about this), but back in 2015 I was obsessed with how to treat my GAD because I had read two different approaches, one book from Paul David and another from Dr. Claire Weekes. Instead of just committing to one and trying it for a few months, I obsessed pretty much every single day for around TWO years straight. Really. TWO years. Well, just about...it was the beginning of 2015 to the end of 2016.

By 2017 I had sort of given up with deciding an approach and abandoned the project. I started writing articles online, which distracted me from that and gave me a new focus...and then I started to obsess about that account being contaminated (it was because of the account's username, though, not because of sexual intrusive thoughts). I deleted it, restarted it, deleted it, restarted it (don't know how many times). Then, an obsession I've had for a while but was always kind of minor (maybe not, but less than it is now) started to grow, the thing with thoughts contaminating what I was reading, writing, or doing. I do think I've had this obsession and off for years, affecting different things. It comes from an OCD belief that, if I get a bad thought and seem to "enjoy" it, and then write something, if I don't delete that writing it means I am "okay" with having enjoyed it. This post from PolarBear describes it well: https://ocdlife.ca/agreeing-with-intrusive-thoughts/

That belief could probably be tackled cognitively, right? Oh well. Eventually I had the account restored, was using it, but then worried I was attracted to a picture of a 15-year-old girl. I sent a PM on my writing account without having "undone" the supposed attraction, so that meant my account was now contaminated and I had to delete. Since then they have ignored any requests to restore it, which I understand. I wonder if I could get my therapist to e-mail them and see if they'd accept that I'm in therapy for my OCD and so won't bother them anymore once it's restored? Or is that too weird? Worth a try, perhaps, since I already explained to them that I have OCD. I was a good writer...lots of people liked my writing and requested content from me...it was so dumb to delete it just because I didn't like my username...

Anyway, everything I have written above probably shows that I need therapy. Possibly I need CBT, but I'm not sure how to find that in America. Obviously, the guy I'm going to is incredibly well-informed on OCD treatment, but yeah in the USA the cognitive aspect just sort of never caught on, I guess? I brought it up with him and he was very dismissive. But yeah, let's not start obsessing about that, I guess...I can read Break Free from OCD on my own, so who cares.

With that Paul David vs. Claire Weekes obsession I mentioned, the whole fear was "wasting time." It was..."I've had symptoms of generalized anxiety disorder for more than a decade, so I better make sure I'm doing the right approach because I don't want to sacrifice any more of my time to this monster." So...I obsessed for TWO YEARS straight about it, basically wasting two years of my life. It's painful to realize that, but it's true. It is more or less the same thing here...I want to take the RIGHT approach so I can start getting better. However, due to the nature of my OCD, the best I can do is just make a decision and stick with it. I guess. Actually, when I mentioned that whole thing to my therapist, he told me that if we were working on that what I would do is make a decision and then tell myself "I am making the wrong decision" and just live with it. Which I think is pretty good advice. If I can accept I'm making the wrong decision, then everything's alright...

[PolarBear]

Oh man you need to stop this ruminating. Youvare constantly going over different approaches to therapy, analyzing, comparing and questioning.

While you are in therapy you should NOT be reading any self help books or websites. None. You should be sticking with what your therapist says and that's it.

[Ryukil]

Anyway, I'm back in. So whatever. I'll just stick with it. And if it doesn't work, I can try self-help later. 

This is really the first time in my life I've done intensive therapy with an OCD specialist, so I should probably just stick with it and see what happens.

[Ryukil]

Why do I feel so much calmer when I'm not in therapy? It's not even doing the exercises, it's just knowing that I'm currently "in therapy."

[Ryukil]

It's just that being in therapy doesn't feel "right."

[Franklin12]

I just wanted to say that I feel for you Ryukil. Other people’s OCD themes can feel so straightforward and ‘easy’ - of course ‘just’ make a decision and stick to it, there isn’t a correct answer to this etc. etc. grey areas blah. 

Today I have to make a decision at work and I have been procrastinated for weeks and it’s starting to drive everyone insane as they are all waiting for me to make the decision. But it’s in no way easy or black and white, and no one can agree on what is right. I am finding it unbearable. This morning it became clear that I have to make a decision today and I have a huge migraine because it’s stressing me out so badly! I would love someone to come and give me a slap round the face and say just make a decision, any decision, its going to have to be the best judgment call at this time and if people don’t like it then so be it. 

But I feel for you because it’s excruciating wanted to make the right decision, but knowing you could easily be wrong! Just decide! Good luck to you.

[Ryukil]

Thanks Franklin...yeah...it's easy to see the solution to things with an outsider perspective...like, I'll bet six months from now I'll look back at this and be so confused as to what I was so worried about.

But yeah, for you, is it a decision you can change once you've made it? Part of my problem is it's so easy to e-mail my therapist and he's very patient, so I can just impulsively decide to drop out by e-mailing him, but then I'll just change my mind and e-mail him back. I think one of my goals needs to be to not e-mail him anymore, unless I have a real question related to therapy.

I sort of wish that this was just a one-time decision, where I make a decision and I can't reverse it. Obviously though no one can force me to stay in therapy, so I don't know. Honestly, I think if I e-mailed him again then that might be it, I think he'll run out of patience soon, since he made me promise to stick in. So if I leave now, I think it will make him wait a while before picking me up again. Maybe it's for the best, though. Maybe I need to go to someone else.

Edited February 26, 2018 by Ryukil