How Might We Overcome OCD Repetitive Thoughts/Images?

[taurean]

This article is based on my own sufferer experiences, and books, therapy, and advice from here, that I have read or received.

Personal Experience Of this Manifestation

I first started to experience repetitive images that stuck and just wouldn’t go away when I was 21.

On a work XMAS lunch, I happened to look out of the  window in the washroom, onto a small courtyard below. The view was typical, of no consequence.

But my OCD’d mind effectively took a “screen-print” of the view, it stuck in my mental focus and wouldn’t go away. In fact, it was there all the way on and through Christmas.

Another such experience was looking in a shop window. The view of the items laid out “photographed” onto my mind, and stuck there for all of an afternoon, although I had gone to a talk at our church.

These things weren’t happening all the time and lasted normally for short periods. But either images, or words, would stick – and often when I was not so distracted e.g. on a holiday.

Some years it didn’t happen much, but as I got older it started to happen more frequently and for longer. So, when I reached the age of 50 I sought help and was diagnosed with OCD.

These kind of thoughts and images cause distress anyway since we can’t get rid of them, even if they are benign in nature – just silly, like the ones I described.

But things also got worse for me when a harm theme got introduced into the mix.

Cognitive Behavioural Therapy

I had several therapists over time and got to understand how OCD works. I also realised that distraction, keeping busy and beneficially focused, was helpful – OCD likes a vacuum, and will move in if it sees a chance. But this on its own wasn’t stopping the repetitive thoughts/images.

Medication

Encouraged by a psychiatrist, I tried Fluoxetine, but could not tolerate the side effects. Eventually I managed to settle onto a small dose of Citalopram – this did nothing for the repetitive thoughts but did seem to boost my resilience by easing out mood peaks and troughs. 

Breakthrough in Understanding

I came upon reference to the book “Brainlock” around the same time as I discovered the charity OCD-UK and these forums. The writer Jeffrey Schwartz was the first person I came across who explained why my brain locked onto these thoughts/images and would not let go – like a dog with a bone (there is a revised edition of the book out now, 20 years after the first was published).

I started to use “The Four Steps” treatment plan described in the book and found it helpful. If you put “The Four Steps” into the search field at the top right of your screen you can find out more, and you can refine your search into “in content title only”. The book is freely available, including from the shop on the main OCD-UK website. 

But this wasn’t in in itself enough to help me stop these episodes of continual repetitive thoughts. So, more research followed, with little results other than I learned that such repetitions in OCD can be of three types: occasional, frequent, or continual. In my case, in an episode, they were continual.

More Therapy

About four years ago I elected to seek help again, and thanks to some suggestion here I found a private therapy practice in London (where I then lived) and a young recently-qualified clinical psychologist practising cognitive behavioural therapy in tandem with mindfulness and mindfulness  meditations.

This was helpful, and the mindfulness add-on to the essential CBT helped steer me away from obsessing and carrying out compulsions.

But I was still struggling with the episodes of repetitions.

Refocus and Help from Forum Friends

The final piece in the jigsaw that helped me personally was going back to the “refocus “step of The Four Steps. Here we simply note the intrusion (having previously labelled it as OCD (step 1) and re-attributed it to OCD (step 2) rather than it saying anything about me as a person.

I was to shift my mind away from the intrusion, and into something beneficial – preferably back to what I was doing before the intrusion popped into my mind.

At the same time, I was to apply some self-love and kindness thinking. Believing we are bad, and self-hate, because of the unpleasant OCD  intrusions only strengthens them – so applying self-love and kindness steers away from this.

Once this became the normal default behaviour – rather than falling into a “brainlock” of repetitive thoughts, I had my answer.

The Here and Now 

All that happened 18 months ago now, and except for two very short duration “blips” I am still doing well for the time being. If all continues well, then my doctor and I plan to gradually ween me off the Citalopram medication starting early next year.

In OCD what works for some, may not necessarily work for others – that is a feature of the illness. But it just might, or elements of it might. The more psychological tools we have in our chest, the more options we have.

I sincerely hope that writing this piece may help others.

 

Edited October 29, 2018 by taurean
typo

[Hopingtorecover]

Thanks for this. You mention this book quite often, would it be helpful for any type of OCDdo you think? 

[taurean]

I think it's helpful as an add-on to CBT, especially where a feature of the OCD is repetition like I described. 

If you are looking for something focused on CBT, then "Break Free From OCD"  is great. 

If you want something CBT plus mindfulness, my therapist put me on to "The Mindfulness Workbook For OCD - A Guide To Overcoming Obsessions And Compulsions Using Mindfulness and Cognitive Behavioural Therapy " by Jon Herschfield and Tom Corboy. 

Edited October 29, 2018 by taurean

[Hopingtorecover]

Thanks. I’m having CBT and it’s helping I think, i’m certainly better than I was and understand I need to move towards my fear to overcome it. Some days it’s hard though as the main obsession at the moment is my children getting a fairly common childhood illness and so I often feel overwhelmed trying to prevent something that is probably inevitable at some point. But the issue has become a fear in itself if that makes sense 

[taurean]

I think so. It's necessary to accept that in OCD the illness homes in on some issue, including one which may be central to us such as the welfare of our children, and suggests a threat, creating fear disorder and a compulsive response to try and mitigate the feared threat. 

But the carrying out of compulsions will only worsen, not improve, the obsessional intrusions. 

So we have to learn to uncloak the OCD, accept the threat is false or exaggerated, and change our learned responses to  rational ones - which will also reduce our anxiety response.