New OCD Book Club - May - Break free from OCD

[Ashley]

9 hours ago, gingerbreadgirl said:

My one criticism isn't really a criticism per se, but something I think should be made clearer. I think that cogntiive techniques are extremely important but shouldn't be used as a compulsive search for certainty.  In the past I have totally deluded myself into thinking that "just one more vicious flower diagram and everything will slot into place" or "I'll do exposure once I've got all my evidence for theory B" etc.  It can become compulsive and /or a tool for procrastination if done incorrectly, all the while kidding yourself you're making progress.  I think this should be emphasised more in the book

Thanks GBG,

A good point which I will perhaps mention at the support groups in Derby and Nottingham tomorrow and Wednesday (crediting yourself of course). 

[Ashley]

10 hours ago, Ashley said:

Pulling the Trigger

Thanks Roy and GBG, I will make this the book for next month then (I have to tell my groups this week).  I will create a new thread for this book later in the week.

[lostinme]

Sounds good, I’ve got this book too, so ready to get started  but need to finish break free first  

[lostinme]

Is it through this thread that we discuss our thoughts about the book  

[Ashley]

Yes Lost absolutely, for Break free from OCD. I will start a new thread for Pulling the Trigger.

[lostinme]

Ok Ashley, thank you  

[taurean]

What I find particularly pleasing as I look through the book again is its very easy style. 

It may be written by very knowledgeable and intellectual people ; but it's a book targeting everyone in an easy style, with a larger typeface. 

And I have seen nothing to change my opinion that this is a great book to which to steer people looking for useful self-help. 

It covers a lot of ground, but for some things mainly suggests, leaving the reader with the thirst to ask questions to seek out more knowledge, which is good. 

E.g.it doesn't spend as much time as I would like on relapse recovery - it's more about getting people into working the therapy - but it does bring it up. 

And for me a best bit is giving a template for a blueprint people can personalise to their own OCD. 

We can't reproduce that of course for copyright reasons - but for me that is worth the price of the book apart from anything else. And, yes, you guessed it - I have formulated ny own blueprint

I also like the part of the book geared towards friends and family - for us to explain to them, and for them to read and help us

 

Edited May 29, 2018 by taurean

[taurean]

The theory A v theory B behavioural experiment, a big focus of therapy in the book, isn't everyone's cup of tea - though it is mine. 

But it mustn't be misused. The book walks us through it, assembling carefully the evidence before drawing the conclusion. I like this simple explanatory methodology. My current eminently -qualified therapist prefers a more theatrical approach - imagining the issues taken into a court of law and laid before the judge - but I believe in the concept of KISS (keep it simple stupid)  - and it works for me. 

There is of course the danger of the sufferer not being satisfied with the result of the experiment, and entering into compulsions by re-running this experiment, which then will render it flawed. We have to see it as a one-off and accept the result. 

I agree with the idea expressed that seeding events can create an OCD response. Indeed, on the forums this happens from time to time where just one thing happening is identifiable as the original main issue - though other spur manifestations may build as well. 

But there isn't much time spent on causation - and in therapy I was told not to spend time looking for causes; rather accept, then look to challenge and change, so I like this. 

The more you dip into this book, the more valuable stuff you see. We are invited to work out our own "vicious flower"  diagram, noting how we interact with, believe, the OCD intrusion, then enter into an anxiety spiral made worse by catastrophising. I like the pictograms,  they are easily understood, graphically descriptive and the sufferer can really buy into what is going on in their own OCD. 

it is certainly a fine, readable, understandable book. Is it all a person might need to get better just with self-help?  Possibly. It, for me, does keep understanding simple, doesn't cloud issues, explains well suggests well. So maybe... 

But it is certainly, for me, an excellent guide to get immersed in while waiting for actual CBT therapy in person.

 

 

Edited May 30, 2018 by taurean
punctuation

[gingerbreadgirl]

4 hours ago, taurean said:

There is of course the danger of the sufferer not being satisfied with the result of the experiment, and entering into compulsions by re-running this experiment, which then will render it flawed. We have to see it as a one-off and accept the result.

I agree and I think this is a real danger with the theory A/theory B technique without a therapist to guide it and/or the proper understanding of its purpose.  It is very easy for an OCD sufferer in distress to topple into using this as a search for certainty - a tool for rumination and analysis of the content of the thought.

In fact for a long time I was dead against these kinds of cognitive restructures - I felt they were giving the thought credence where it wasn't due, reinforcing it as something serious which needed to be dealt with, rather than mental fluff.  Now I understand much better why the cognitive side is so essential.  But I do still think it should be approached with caution, especially if you are new to it and you don't have a therapist to guide you.

[taurean]

3 hours ago, gingerbreadgirl said:

But I do still think it should be approached with caution, especially if you are new to it and you don't have a therapist to guide you.

I agree. I did have a therapist to guide me with the experiment - even though I declined her kind offer to dress it up as a court case

 

[snowbear]

15 hours ago, gingerbreadgirl said:

I agree and I think this is a real danger with the theory A/theory B technique without a therapist to guide it and/or the proper understanding of its purpose.

I second/third that.  

I found theory A/theory B extremely difficult to get my head around.   It made me feel like an imbecile to be unable to grasp the concept.  I kept going off track and tying myself in knots with it.

Finally I worked out the reason it wasn't working for me was it didn't increase the insight I already had (that the contamination isn't real, it just feels real) and so it wasn't ever going to move me forward in any way. 

However, I think the theory A/B method has some merits. It can be a good way to help people get started when they lack the initial insight that it's feelings they are dealing with and not facts.   

[taurean]

I think it is, even without the razzmatazz of turning it into a courtroom scenario,  a somewhat staged method to produce the same effect as the pure and simple knowledge that what we are experiencing seems true, but isn't. 

It will have its supporters and its detractors, but it is an available tool in the CBT chest. 

[lostinme]

I think it’s a good book to read at the beginning of therapy to learn to get some understanding of how OCD works, not only that it also gives some good advice regarding stresses, past experiences etc and how this impacts on how we react to events. However I think it’s a more beneficial read once part way through therapy because I find you understand it more clearly. 

1.I think what stood out important this time was: It’s not the thought itself that causes the anxiety/sadness/upset. It’s the importance and meaning we place on it that causes this( it’s how we interpret it)

2.Its the importance we place on our thoughts that drives both the emotional and behavioural response and not the thought itself. 

3. Our sense of hyper responsibility is a big factor in OCD. Responsibility is the link between the intrusive thought and the response to them. 

4. The solution then becomes the problem.

5.Its not the thoughts that are the problem, it’s what we make of them.

6.Having a terrible thought is bad enough, but we then take the responsibility for preventing anything bad from happening.

7.The more you buy into the idea that you are responsible, the compulsions become more important, time consuming, repetitive. Not only that by checking, reassurance seeking, and avoiding things you buy into the belief that you are responsible and this prevents us from finding out what would happen if we didn’t take these actions.

8.Checking is normal. It’s the amount and extent of checking that determines whether it’s a problem. 

I think there is a lot of good pointers 

 

 

[taurean]

Yes I noticed how it picks up and expands on that feeling of responsibility and wondered how I might mention that. 

But you have nailed that beautifully lost 

[snowbear]

9 minutes ago, lostinme said:

I think it’s a good book to read at the beginning of therapy to learn to get some understanding of how OCD works, not only that it also gives some good advice regarding stresses, past experiences etc and how this impacts on how we react to events. However I think it’s a more beneficial read once part way through therapy because I find you understand it more clearly. 

1.I think what stood out important this time was: It’s not the thought itself that causes the anxiety/sadness/upset. It’s the importance and meaning we place on it that causes this( it’s how we interpret it)

2.Its the importance we place on our thoughts that drives both the emotional and behavioural response and not the thought itself. 

3. Our sense of hyper responsibility is a big factor in OCD. Responsibility is the link between the intrusive thought and the response to them. 

4. The solution then becomes the problem.

5.Its not the thoughts that are the problem, it’s what we make of them.

6.Having a terrible thought is bad enough, but we then take the responsibility for preventing anything bad from happening.

7.The more you buy into the idea that you are responsible, the compulsions become more important, time consuming, repetitive. Not only that by checking, reassurance seeking, and avoiding things you buy into the belief that you are responsible and this prevents us from finding out what would happen if we didn’t take these actions.

8.Checking is normal. It’s the amount and extent of checking that determines whether it’s a problem. 

I think there is a lot of good pointers 

 

 

  That's the list of notes I'd compiled so far practically word for word. Better finish the book and see if there's anything left to add!  

[lostinme]

13 minutes ago, taurean said:

Yes I noticed how it picks up and expands on that feeling of responsibility and wondered how I might mention that. 

But you have nailed that beautifully lost 

Thank you Roy  I think these are just a few of the good pointers, that are good to remind ourselves how this dreaded disorder keeps going. 

[lostinme]

8 minutes ago, snowbear said:

  That's the list of notes I'd compiled so far practically word for word. Better finish the book and see if there's anything left to add!  

Thanks snow  I’ve compiled a list of notes also, that I think are really good points  that are really useful and important reminders  will add some more tomorrow. Still got to finish the book yet though  got a little sidetracked 

[snowbear]

Well, I finally finished Break Free! 

I remembered why I gave up on it first time around too - it didn't teach me anything I didn't already know.

To be fair on the book it does direct those with mental contamination and co-morbidity (me and me again) to seek the help of a specialised therapist, and to be even fairer to the authors, mental contamination was a very newly recognised form of OCD when this book was published and the understanding and treatment of it had yet to become mainstream. (To a degree the differences between direct contamination and mental contamination are still not widely understood by many therapists.) 

So, the positives:

I think it's a comprehensive guide to OCD with few omissions. In straightforward language it explains a variety of forms OCD can take (ruminating, checking, reassurance seeking, cleaning and perfectionism), how important the meaning given to the thoughts is, how this relates to the individual's personal values, and how the response maintains and reinforces the disorder. It does a good job of myth-busting the genetic/biological/chemical theories as the cause of OCD without discounting the influence they can have as contributory factors. 

The reader is introduced to basic CBT and it gives examples covering some of the common themes. The way the examples are presented reinforces the underlying commonality of all OCD themes and I think anyone reading them in succession is likely to get the gist of how their own theme could be similarly treated - enough to have a go at being their own therapist, particularly with the blank worksheets provided  as a guide.

The explanations of CBT cover the behavioural approach in enough detail for someone to devise their own hierarchy of exposure and it also covers a bit of cognitive therapy (meaning/interpretation, vicious flower and underlying beliefs) though it's not a comprehensive cognitive therapy guide by any means. 

I liked how it introduced advice for friends and family early on, engaging them as observers and helpers at first and expanding with more specific advice later in the book. 

I liked how it included a few specific areas such as parents with OCD, pregnancy, autism spectrum, mental contamination and co-morbidity, though as stated earlier, it didn't go into detail on the last two and merely referred the reader to more specialist help. 

The troubleshooting sections for when therapy doesn't seem to be working were a good balance of empathy and straight talking. Relapse and maintaining wellness post-recovery are also briefly addressed which was useful.

Two memorable phrases to take away as quotes which nicely summarise the the book were 'The solution becomes the problem' and  'The choice to change'. 

So much for the positives! 

The negatives for me were the dependency on Theory A/ Theory B as the main cognitive intervention. I think this helps people gain insight that fear of/worry about their issue is the problem rather than the issue being a problem in itself, but if you already have insight to that and are still struggling then this technique doesn't take you to the next stage of recovery.

How to identify beliefs was touched on but without any detail (core beliefs versus conditional beliefs and how these are related.) I think a few paragraphs on how to tackle troublesome underlying beliefs specifically wouldn't have gone amiss.

The theme of hyper-responsibility was highlighted repeatedly throughout the book. I think it was over-simplified (I have zero increased sense of responsibility myself) but could have been made more relevant/more general with a few tweaks. 

 On balance:  an excellent book, clearly written, not too technical and to be honest the only one I personally recommend to 'beginners' and those seeking self-help. It will be interesting to see if that changes as I read through a few more books over the coming months.

[taurean]

It's a great "starter for ten"  towards understanding and change ; that seems to be generally the view, and I endorse that. 

As I said, is it enough on its own for people to get better?  Well I do think it is that starter, and I have read a number of books and the others really didn't cover so much. 

And when it just touches on something, at least it does and so can lead the reader to want to find out more. 

It is very nicely laid out, very readable - especially specific chapters,  in an easy-going style and without preaching to the reader - it suggests and encourages, I like that.

To get the full benefit from self-help experience I believe it beneficial to read several books, my personal preference being one on obsessive thoughts with mental compulsions, because of my own OCD,  and a CBT workbook which sets specific homework. 

Edited May 31, 2018 by taurean

[Ashley]

Thank you all so much for getting behind this idea of the book club, I do hope more of our users that have not read the book (yet) will have taken some value and input from your reviews and summaries. 

 

For anybody still reading, even if it is two or three months down the line, please feel free to add your Break free from OCD review to this thread.

[gingerbreadgirl]

Hi Ashley,

This is an unrelated tangent (sorry) but @Ashleyhave you read ·"Overcoming Unwanted Intrusive Thoughts: A CBT-Based Guide to Getting Over Frightening, Obsessive, or Disturbing Thoughts"?

I thought it was good - but what I thought was very interesting was that it avoiding referring to OCD, and just referred to intrusive thoughts.  I don't know why the authors took this approach but I thought it might be good for reaching people whose OCD is undiagnosed and who haven't considered they have it, but know they have distressing thoughts. 

Anyway just wondered if you'd come across it at all!

[Ashley]

I haven't read it no, I have seen a couple of websites going down that route which I am actually concerned about, because we need people to know it's OCD. But a potential candidate for next months book?

[gingerbreadgirl]

Reading snowbear's excellent review above has made me think there is a real gap in the market for a more "advanced" book about OCD, for people who already know the basics, have a good grasp of how OCD works, but still struggle to break through.  As snowy rightly says, it could have a more detailed section on how core beliefs impact on OCD, how these can be addressed, how co-existing problems can impact on it (e.g. low self-esteem, generalised anxiety, etc.) 

[Ashley]

You're a writer, get writing ;)  I am sure we will all help you with it. 

[gingerbreadgirl]

haha if I could write a book like that I probably wouldn't spend half my life on this forum asking for advice!