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New OCD Book Club - May - Break free from OCD


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15 minutes ago, taurean said:

Then you don't need that particular tool (the behavioural experiment).  It's use is for those struggling to accept that the OCD isn't true. 

It's a tool for a specific use

I agree. And we shouldn't knock it for that. It's a good tool when used in the right way for the right person. :yes: 

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8 hours ago, snowbear said:

I agree. And we shouldn't knock it for that. It's a good tool when used in the right way for the right person. :yes: 

And that's my thinking too. It can be an important tool at the right time for the right purpose. 

So a very specific method, not a blanket one. 

Great to see that we have scored over a hundred :cricket: on this topic :thumbup:

 

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10 hours ago, Lynz said:

I struggled with this too GBG. I often thought that Theory A/Theory B was flawed in that they say only one is true and the other false, but that's not always the case. For example, if my OCD centred around worrying about having cancer for example, then Theory A would say that my fears are true i.e. I have cancer, whereas Theory B would say no I have OCD which is making me worry a lot about having cancer. Well, that still doesn't mean that I don't have cancer or that I won't get it in the future, hence why I think the concept is flawed and is possibly an example of all or nothing thinking that we are supposed to do away with.

I don't know, I mean I could have interpreted it wrongly but I think it doesn't always work. It may work better for OCD worries centred around things that are illogical like worrying I may end up murdering my family for example, as that is very much unlikely to happen, but if your fears are based on something that could potentially happen or be true then that's where I think the theory falls short.

This is very true about the cancer thing and a very good example of what I'm trying to say (in a very rambly way!) So with the cancer example, say:

  • Joe Bloggs has cancer, a very aggressive cancer that will kill him in months unless he gets treatment
  • He is totally unaware of that
  • He also has OCD around cancer and obsessively checks himself all the time, googles, seeks reassurance, etc., which is very detrimental to his quality of life
  • During his compulsive checking he discovers a lump and has it checked out, which saves his life.

In the above scenario, theory A is one of danger (which is true) and theory B is one of worry (which is also true).  In his case, the compulsions are massively detrimental to his quality of life, but they also save his life.  I think this illustrates why I have a problem with theoryA/B being presented as logically opposed.  I understand the point being made (and it's a very useful one to people starting out learning about OCD) but I just can't go along with this idea that only one or the other can be true.  Logically they can both be true, even if in most cases they probably aren't.

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57 minutes ago, gingerbreadgirl said:

I understand the point being made (and it's a very useful one to people starting out learning about OCD) but I just can't go along with this idea that only one or the other can be true.  Logically they can both be true, even if in most cases they probably aren't.

True, but as mentioned before it has a purpose. Maybe the authors didn't see the questions that might arise. Perhaps they unwantedly took a blinkered view, only seeing the outcome from the exercise that they wanted. 

But I think we have explored the issue very well here. 

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GBG’s thought experiment is an interesting one. But the words ‘obsessively checks’ and ‘compulsively checks’ are relevant. One uncompulsive check would be sufficient at regular intervals. Another thought experiment. When you pay a bill by a the bank’s fast payment method one check to see if you have entered the right sort code and account number is good. If you repeat it endless times it is a compulsion. The definition of suffering from OCD is the amount of time you spend on compulsions. The standard questionnaires measure this. Checking in itself is not bad, compulsive checking is. I check for vehicles when crossing the road. If I recheck and recheck and recheck I immobilise myself.

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2 minutes ago, Angst said:

GBG’s thought experiment is an interesting one. But the words ‘obsessively checks’ and ‘compulsively checks’ are relevant. One uncompulsive check would be sufficient at regular intervals. Another thought experiment. When you pay a bill by a the bank’s fast payment method one check to see if you have entered the right sort code and account number is good. If you repeat it endless times it is a compulsion. The definition of suffering from OCD is the amount of time you spend on compulsions. The standard questionnaires measure this. Checking in itself is not bad, compulsive checking is. I check for vehicles when crossing the road. If I recheck and recheck and recheck I immobilise myself.

I totally agree with this Angst :) I am not for a moment suggesting repeated checking is a good or sensible idea, as you rightly say it is totally immobilising.  I guess I'm just saying (and sorry I keep banging this drum but I think it's an important concept in the book) that I'm not sure I go along with the idea that theory A and theory B are logically opposed.  Maybe I am just thinking about it too much (probably :) ) but I think it's important to buy into this concept for theoryA/B to be beneficial.

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I reckon an awful lot of therapeutic concepts can be contested by philosophical thought experiments.

The theory, as part of the CBT theoretical repertoire, is a device to explore and crystallise the thinking patterns of a patient and are part of the groundwork for the patient to establish new patterns of behaviour.

CBT therapist/theorists seek empirical evidence of efficacy of their techniques and use scientific methods such as probabilitymodels to establish it.It is highly probable that, in your example, that compulsive checking will not be preventive in saving a life.

For me, TheoryA/B is about probability and risk and not having absolute certainty. It helped teach me that repeated checking was counterproductive.

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I think there is another important point from this really interesting conversation, which is we should not get too caught up in one specific approach/exercise. If it's not working, keep moving and explore other CBT approaches, we can always comeback to this one a little later should we need to.

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2 hours ago, Ashley said:

I think there is another important point from this really interesting conversation, which is we should not get too caught up in one specific approach/exercise. If it's not working, keep moving and explore other CBT approaches, we can always comeback to this one a little later should we need to.

Yes I totally agree Ashley :)

I have re-read it over and over again Gemma and I sort of get it now? I think? That’s whats good about discussions, often others can give us some helpful insight and help us to see things differently :yes:

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On 02/06/2018 at 14:50, Ashley said:

I think there is another important point from this really interesting conversation, which is we should not get too caught up in one specific approach/exercise. If it's not working, keep moving and explore other CBT approaches, we can always comeback to this one a little later should we need to.

Excellent point. Why don't we move the discussion on to the vicious flower/ making a formulation part of the book? :) 

Did people find the description of how to do it easy to follow or confusing?

Were you able to generate your own 'vicious flower'? :smileys-gardening-291500:

Did you find the blank worksheet provided helpful or did you just draw your own flower without referring to the blank one?

Were you surprised by how many/how few petals your personal flower had? :smileys-gardening-770106:

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I redid my vicious flower - in fact I did it in the computer and it still rests I think in my loose-leaf file. 

There weren't too many petals, but it was - by using this graphic - easy to see how the anxiety swelled,  awfulisation sought to gain a hold, and a self-perpetuating anxiety wheel could be there in an instant. 

And in my case stick around because of connections - mostly unreal ones - plus my brain conjuring up old triggers from the past to upset me again - then repeat in constantly-repeating phrases. 

It certainly was really vicious. 

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And for me an essential element in the cognitive package, because it helps to see how our own version of OCD works and takes hold. 

How can we successfully challenge what we don't actually understand? 

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  • 1 year later...

I read this book a few weeks back whilst on holiday, it took me 2 days to read. I found it of benefit and used the exercise theory A and B for an OCD episode whilst away. The book to me though reflects more on specific OCD's vice my own so could only relate to aspects, however a good book with good guidance for the wider OCD sufferer.

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