The best approach?

[Emsie]

Hi everyone, 

I need some advice if that's ok. My obsessions arise from intrusive thoughts and sometimes feelings that then lead to the thoughts. I understand it's my reaction to these intrusive thoughts and feelings that then leads to anxiety/distress and then safety seeking compulsions. My anxiety response however does often kick in immediately after the thought/feeling. 

I've had advice on here in the past that I need to recognise when I'm having intrusive thoughts. When I was having CBT, my therapist said just to notice them. I can recognise them and recently I've been saying to myself 'that's an intrusive thought/feeling' and then getting on with whatever I was doing to prevent the rest of the vicious cycle. But I do say it to myself after the anxiety feelings/internal panic, because that response can kick in so very quickly.

My question is, is saying to myself 'that's an intrusive thought or feeling' a complusion? It is helping me to dismiss them, but of course I don't want to be going down the road of self reassurance by saying that to myself as I am feeling anxiety at the time. 

Any thoughts on this would be gratefully received. X

Edited November 16, 2018 by Emsie

[taurean]

Hi Emsie.

My therapist told me to think "oh that's just my silly obsession" then refocus away. 

The beauty of this was that it took the high ground - rather than the OCD doing so ; and it fits in perfectly with The Four Steps - labelling, re-attributing, refocusing. 

She wasn't telling me to automatically say this after every intrusion - that would be a compulsive ritual - but just initially so I didn't give belief to the intrusion. 

Another, dear, forum friend helped me refocus away before an emotional reaction by using love kindness thinking about myself (remembering I wasn't bad, the OCD was simply targeting my true core character values)  then refocusing into the mindfulness state - purely aware of being in the present in the moment. 

I became able to do this in milliseconds, as quick or quicker than the unwanted emotional behavioural response

 

[gingerbreadgirl]

11 hours ago, Emsie said:

Hi everyone, 

I need some advice if that's ok. My obsessions arise from intrusive thoughts and sometimes feelings that then lead to the thoughts. I understand it's my reaction to these intrusive thoughts and feelings that then leads to anxiety/distress and then safety seeking compulsions. My anxiety response however does often kick in immediately after the thought/feeling. 

I've had advice on here in the past that I need to recognise when I'm having intrusive thoughts. When I was having CBT, my therapist said just to notice them. I can recognise them and recently I've been saying to myself 'that's an intrusive thought/feeling' and then getting on with whatever I was doing to prevent the rest of the vicious cycle. But I do say it to myself after the anxiety feelings/internal panic, because that response can kick in so very quickly.

My question is, is saying to myself 'that's an intrusive thought or feeling' a complusion? It is helping me to dismiss them, but of course I don't want to be going down the road of self reassurance by saying that to myself as I am feeling anxiety at the time. 

Any thoughts on this would be gratefully received. X

Hi Emsie,

I think this is a tricky question and one that can throw a lot of OCD sufferers (myself included).  Personally I think it's OK to say to yourself "this is an intrusive thought" - because you're not engaging with the content.  You're not saying "this is an intrusive thought and it isn't true" or "this is an intrusive thought and it's just OCD".  You're simply acknowledging it for what it is - a thought.  You're not saying anything about the content.  You're just saying I am having a thought.  You're not pushing it away, you're not engaging with it, you're just tipping your hat to it but carrying on.  This I think is the right approach.

If, however, when you say to yourself "I'm having an intrusive thought" what you actually mean is "I am having an intrusive thought and therefore it's nothing to worry about" - that's different, I think it is self-reassurance and therefore a compulsion.  If I am very honest (sorry Roy) I have some reservations about saying "oh that's just my silly obsession" (although I completely respect this has worked for you, Roy).  To me though that seems like a form of self-reassurance, it is reassuring yourself the obsession is silly and not based in fact.  I am personally of the view that we need to accept the doubt that maybe the thought is true, maybe it isn't silly, and accept that uncertainty, welcome it in, embrace it.  For me, the only way to move past my relapse over the last year was to just allow the thought in and not make any judgements on it, not even to say it's OCD/not true/silly or whatever.  I took a blanket approach to all thoughts and didn't try and label them as one thing or another, I just let it all in, let the anxiety in, let it stay for as long as it wanted.  This has helped me a lot and I am in a much better place now. In fact doing this helped me a lot more than anything else I tried. 

So in short I think you will find many different opinions on this, but in my view it is Ok to acknowledge it as a thought but be very careful not to use it as a form of self-reassurance.

GBG x

 

 

[taurean]

But that "oh that's just my silly obsession"  conforms to steps 1 2 of "The Four Steps" - labelling then re-attribution, and is only an initial thing to help acceptance and realisation that the intrusion is nothing to react to emotionally

 We start to adopt a new learned behaviour of not believing, not responding to intrusions. 

This doesn't just take the power away from the intrusion - it also nicely undermines the underlying OCD core belief that leads to the intrusions. 

For me therefore it is great CBT. 

[gingerbreadgirl]

I don't want to disagree with your experience of what your therapist has said Roy, who obviously knows more than I do. Just putting forward a different take on it. To me the idea of seeing ocd as hijacking your core values is reassurance. What if it isn't? There is always doubt and trying to eliminate it is, to me, a compulsion. The only thing which really works for me is allowing the possibly that my obsession is true and I am carrying on anyway. 

Sorry emsie if i am confusing things more!

[taurean]

It's a good debate. 

But, funnily enough, that taking on the belief that your obsession might be true - a common approach by some learned therapists - didn't, and still doesn't, resonate - or work - with me; the knowledge that the OCD was targeting and inverting my true core character values does, and worked. 

One way to perhaps look at this is as two alternative approaches in our OCD treatment toolkit, both having been sanctioned by trained clinical psychologists. 

And interestingly, the therapist who taught me that approach is herself a recoveree from harm OCD so knows all about how it is to be a sufferer. 

And, bless her cotton socks, she elected to train to become a clinical psychologist in order to help others recover

 

[gingerbreadgirl]

It is a good debate  lots of ways to skin a cat, so to speak  

Edited November 17, 2018 by gingerbreadgirl

[lostinme]

Hi Emsie, 

From my personal experiences from issues I've overcome is simply not acknowledging the thought in any way. When I get a thought in things that no longer affect me it's literally seconds that it lasts and so no longer causes anxiety, I think this is where we need to be. I know that the issues I still have problems with is through thought, overthinking that causes more anxiety and this then becomes another problem. I attach fear, dread to the task in hand before I even start and I also say to myself its just a thought, but I'm afraid this can also become a reassurance behaviour so be very careful. At first it's just a thought works well whilst beginning a change in behaviour but after that I think it should become neutral like any other thought that goes through our minds throughout the day. Hope that makes sense, you don't say its just a thought for every single thought you have, so in some way it's still giving these thoughts importance. 

Hope this helps lost xx

[St Mike]

18 hours ago, Emsie said:

My question is, is saying to myself 'that's an intrusive thought or feeling' a complusion?

My view on this action is that it can be utilised as a crutch in the short term to break the intrusive thought - compulsion cycle but it stands a risk of developing into a complusion in the long run. I would rather stick to what your therapist recommended to just notice the thought(s). That is a better option in my opinion.

[Jules46]

8 hours ago, gingerbreadgirl said:

  I am personally of the view that we need to accept the doubt that maybe the thought is true, maybe it isn't silly, and accept that uncertainty, welcome it in, embrace it.  For me, the only way to move past my relapse over the last year was to just allow the thought in and not make any judgements on it, not even to say it's OCD/not true/silly or whatever.  I took a blanket approach to all thoughts and didn't try and label them as one thing or another, I just let it all in, let the anxiety in, let it stay for as long as it wanted.  

I really agree with this GBG, i have a health anxiety ocd that has been absolute torture for myself and family. My GP who has known me for many years and seen different ocd pull me over the rack says that there IS SOME rationale or germ of truth in my concerns its just that my ocd is way too attached in his opinion. If i tell myself it's just rubbish or daft it grinds in all the tighter. I have been caught in such such horrendous rumination that i would genuinely inadvertently put myself in danger when out by myself. Not looking before crossing the road etc so absorbed in thought and fear/worry etc i couldn't see anything around me. HOWEVER by beginning to accept uncertainty and couldn't go as far as welcome, but i allow it to sit with me alongside what else is going on and being mindful where i am walking in spacious countryside or by the coast slowly, slowly i begin to feel more freedom and creativity than the thing trying to totally control and punish me if that makes sense. An analogy i guess would be being aware it's on a shelf of my mind and can't be tipped off yet but letting it be i can be aware of what is on my shelf it begins to diminish. It will still try any new angle it seems to frighten and paralyse me again, i find this especially so when first waking up in the morning. It rushes in and sometimes that feels just such a weight knowing i have to find and dig out some sense of equilibrium again. Does this make sense or connect to you?

8 hours ago, gingerbreadgirl said:

 

 

[Emsie]

Wow! Thank you so much Roy, GBG, Lost and St Mike for all of your input and great advice. Sorry for my late reply, I had family visiting today. Your replies have been so invaluable and the debate was great. It's all made things really clear for me, thank you so much! 

20 hours ago, taurean said:

Hi Emsie.

My therapist told me to think "oh that's just my silly obsession" then refocus away. 

The beauty of this was that it took the high ground - rather than the OCD doing so ; and it fits in perfectly with The Four Steps - labelling, re-attributing, refocusing. 

She wasn't telling me to automatically say this after every intrusion - that would be a compulsive ritual - but just initially so I didn't give belief to the intrusion. 

Another, dear, forum friend helped me refocus away before an emotional reaction by using love kindness thinking about myself (remembering I wasn't bad, the OCD was simply targeting my true core character values)  then refocusing into the mindfulness state - purely aware of being in the present in the moment. 

I became able to do this in milliseconds, as quick or quicker than the unwanted emotional behavioural response

 

Hi Roy, I think that this is a great tool to break the cycle. As ever Roy, thank you so much for your time and support, always so invaluable. X

10 hours ago, gingerbreadgirl said:

Hi Emsie,

I think this is a tricky question and one that can throw a lot of OCD sufferers (myself included).  Personally I think it's OK to say to yourself "this is an intrusive thought" - because you're not engaging with the content.  You're not saying "this is an intrusive thought and it isn't true" or "this is an intrusive thought and it's just OCD".  You're simply acknowledging it for what it is - a thought.  You're not saying anything about the content.  You're just saying I am having a thought.  You're not pushing it away, you're not engaging with it, you're just tipping your hat to it but carrying on.  This I think is the right approach.

If, however, when you say to yourself "I'm having an intrusive thought" what you actually mean is "I am having an intrusive thought and therefore it's nothing to worry about" - that's different, I think it is self-reassurance and therefore a compulsion.  If I am very honest (sorry Roy) I have some reservations about saying "oh that's just my silly obsession" (although I completely respect this has worked for you, Roy).  To me though that seems like a form of self-reassurance, it is reassuring yourself the obsession is silly and not based in fact.  I am personally of the view that we need to accept the doubt that maybe the thought is true, maybe it isn't silly, and accept that uncertainty, welcome it in, embrace it.  For me, the only way to move past my relapse over the last year was to just allow the thought in and not make any judgements on it, not even to say it's OCD/not true/silly or whatever.  I took a blanket approach to all thoughts and didn't try and label them as one thing or another, I just let it all in, let the anxiety in, let it stay for as long as it wanted.  This has helped me a lot and I am in a much better place now. In fact doing this helped me a lot more than anything else I tried. 

So in short I think you will find many different opinions on this, but in my view it is Ok to acknowledge it as a thought but be very careful not to use it as a form of self-reassurance.

GBG x

 

 

Hi GBG, this REALLY helped, to see the two ways you can say these things to yourself and how one is helpful and one not. If I'm being honest I am guilty of this:

10 hours ago, gingerbreadgirl said:

If, however, when you say to yourself "I'm having an intrusive thought" what you actually mean is "I am having an intrusive thought and therefore it's nothing to worry about" - that's different, I think it is self-reassurance and therefore a compulsion

Sometimes I'm not, but often I'm saying it to reassure myself it's not real, it's my OCD, it's irrational, it's nothing to worry about etc. Invaluable advice GBG, thank you so much! X

 

8 hours ago, gingerbreadgirl said:

Sorry emsie if i am confusing things more!

Not at all GBG, loved the debate and I'm sure many others will find it very helpful. X

4 hours ago, lostinme said:

Hi Emsie, 

From my personal experiences from issues I've overcome is simply not acknowledging the thought in any way. When I get a thought in things that no longer affect me it's literally seconds that it lasts and so no longer causes anxiety, I think this is where we need to be. I know that the issues I still have problems with is through thought, overthinking that causes more anxiety and this then becomes another problem. I attach fear, dread to the task in hand before I even start and I also say to myself its just a thought, but I'm afraid this can also become a reassurance behaviour so be very careful. At first it's just a thought works well whilst beginning a change in behaviour but after that I think it should become neutral like any other thought that goes through our minds throughout the day. Hope that makes sense, you don't say its just a thought for every single thought you have, so in some way it's still giving these thoughts importance. 

Hope this helps lost xx

Hi Lost, this helped so much, Lost, thank you so much. You're so right, we need to be very careful for it not to become reassurance. I agree, it can work well at the beginning, but after a bit, we just need to notice the thoughts. I love your last sentence, how true is that! X

 

2 hours ago, St Mike said:

My view on this action is that it can be utilised as a crutch in the short term to break the intrusive thought - compulsion cycle but it stands a risk of developing into a complusion in the long run. I would rather stick to what your therapist recommended to just notice the thought(s). That is a better option in my opinion.

Hi St Mike, thank you so much for your advice. I completely agree. I think I will need to use it short term to break the cycle. I want to stick with what my therapist recommended to just notice the thoughts and it's something I want to move swiftly on to, but I'm not sure how to. I don't just have intrusive thoughts, they can be feelings/fear and my anxiety response is so quick and I feel so panicky I don't know how to just notice them. The ruminating, analysing, checking, reassurance seeking etc can come so automatically. My current predominant theme is my health and the health of others such as my little girl, so I find it very hard to deal with because to ignore it would be irresponsible. I will keep persevering. Thank you. X

 

1 hour ago, Jules46 said:

It will still try any new angle it seems to frighten and paralyse me again, i find this especially so when first waking up in the morning. It rushes in and sometimes that feels just such a weight knowing i have to find and dig out some sense of equilibrium again. 

Hi Jules, I have this too. Often fears I think have gone, return full blast in the morning, it's my most dangerous time. X

Thank you so much everyone X 

[Emsie]

Hi again everyone,

I’m not in an OCD episode at the moment, but triggers can make the trap door open for me at anytime. So I thought this would be a good time to get some further advice. 

I’d like to move on from labelling my thoughts/fears when they arise, such as saying something to myself like ‘that’s just my obsession’ ‘that’s an intrusive thought’. This might sound like a stupid question, but how do you just notice the thoughts/feelings when there is a rapid, huge surge of anxiety and you’ve instantly started to ruminate on it/check things etc, etc? Obviously I know what ‘notice’ means but I don’t know how to notice a thought/feeling.

Thank you for any help you can give me. X

[taurean]

This happened to me over the weekend. A trailer appeared on TV and the title of the programme was something onto which my OCD would previously have focused (harm theme).

But, because during my CBT homework I have learned not to focus in on such things, but rather to observe then let it pass, like any other thought, there was no emotional response, no anxiety surge, no start-up of an anxiety spiral. 

So that is the goal. Moving on from the initial paraphernalia to just an awareness, not focusing in and not emotionally reacting. 

[Gemma7]

I'm not sure I know how to either

For me it's like OCD turns on a tap and you just have to shut it off as soon as you notice. You can't really notice something before it happens, you just have to react as soon as you think your problem is OCD. But don’t check it's OCD, you can't know for sure, you have to take a leap of faith when it seems like it is. 

[Emsie]

Thank you Roy. So good that all your hard work has paid off. You are an inspiration to us all. 

So would a good idea be to continue as I am for a while, as in labelling the thoughts in order to dismiss them, because I am reacting emotionally very quickly with huge surges of anxiety. At present that’s automatic.  And then when I feel I have broken the cycle of thought/feeling>anxiety>compulsions, try to move on to not focussing in on triggers?

How do you not focus in on such things? Certain aspects surrounding my health and the health of others are simply on my radar. X

Edited November 19, 2018 by Emsie

[Emsie]

2 minutes ago, Gemma7 said:

I'm not sure I know how to either

For me it's like OCD turns on a tap and you just have to shut it off as soon as you notice. You can't really notice something before it happens, you just have to react as soon as you think your problem is OCD. But don’t check it's OCD, you can't know for sure, you have to take a leap of faith when it seems like it is. 

Bless you Gemma 

Thank you for your reply, I love the tap analogy. What you have said is great advice. I will aim to take that leap of faith it’s OCD when I think it is and turn off the tap. Thank you so much. Love your take on things. X

[gingerbreadgirl]

I struggle with this (as I think we all do!) but the thing I try to do is slightly different. Sorry if I am confusing things yet again. But when that thought hits I try to welcome it in. I use visualisation a lot for this. I imagine the thought kind of floating into my brain, and I let it in, for as long as it wants to stay. I let the anxiety in too, for as long as it wants to stay. I imagine holding it in my mind, and sometimes I even try to ramp it up. I don't try and block it out or shut it out or do anything with it whatsoever. I try to treat it the same way as I would any other thought  - I try not to give it a label or treat it differently  or figure out whether it really is ocd or not. I just let it in whatever it may be, and all the accompanying feelings. I find this works better for me than the idea of shutting  it off - I find it I try and shut it off it  teaches my brain that it is something to fear and makes my ocd worse. I'm not sure if that makes any sense! X

[Gemma7]

When i said shut it off, i mean any compulsions you do, as in do not buy in as soon as you can. I did not mean shutting down any anxiety or thoughts. Just want to clarify since you raise a valid point GBG

Also, ramping up your anxiety will definitely be better than simply tolerating it I agree. 

[taurean]

1 hour ago, Emsie said:

How do you not focus in on such things? Certain aspects surrounding my health and the health of others are simply on my radar. X

I call the radar the "scanner" and a feature of OCD is that scanner inside our head searches for the thing we fear. 

So I spent a long long time, wasted, searching for a mechanism to switch off the scanner. 

I eventually learned that this was the wrong way. By tackling the underlying OCD core belief - in your case seemingly around getting ill yourself, or others, or specifically whatever - then when I had the CBT working including the ERP disarming the triggers, the scanner had no reason to be, and switched itself off

 

[gingerbreadgirl]

11 minutes ago, Gemma7 said:

When i said shut it off, i mean any compulsions you do, as in do not buy in as soon as you can. I did not mean shutting down any anxiety or thoughts. Just want to clarify since you raise a valid point GBG

Also, ramping up your anxiety will definitely be better than simply tolerating it I agree. 

Ah ok I see what you mean gemma - that'll teach me to read things too quickly  

[Gemma7]

10 minutes ago, gingerbreadgirl said:

Ah ok I see what you mean gemma - that'll teach me to read things too quickly  

No it was my lack of clarity which I'm glad you pointed out

[Emsie]

1 hour ago, gingerbreadgirl said:

I struggle with this (as I think we all do!) but the thing I try to do is slightly different. Sorry if I am confusing things yet again. But when that thought hits I try to welcome it in. I use visualisation a lot for this. I imagine the thought kind of floating into my brain, and I let it in, for as long as it wants to stay. I let the anxiety in too, for as long as it wants to stay. I imagine holding it in my mind, and sometimes I even try to ramp it up. I don't try and block it out or shut it out or do anything with it whatsoever. I try to treat it the same way as I would any other thought  - I try not to give it a label or treat it differently  or figure out whether it really is ocd or not. I just let it in whatever it may be, and all the accompanying feelings. I find this works better for me than the idea of shutting  it off - I find it I try and shut it off it  teaches my brain that it is something to fear and makes my ocd worse. I'm not sure if that makes any sense! X

Thank you for your reply GBG, you’re not confusing things at all. It’s great to hear what works for you and it is something that I’d definitely like to work towards. I completely agree, shutting it off will only make it come back with more force. It makes perfect sense. X

 

15 minutes ago, Gemma7 said:

When i said shut it off, i mean any compulsions you do, as in do not buy in as soon as you can. I did not mean shutting down any anxiety or thoughts. Just want to clarify since you raise a valid point GBG

Also, ramping up your anxiety will definitely be better than simply tolerating it I agree. 

Thank you Gemma, I knew that’s what you meant. I do buy in and that’s what I need to shut off.  

I think ramping up the anxiety is something I can work towards. 

15 minutes ago, taurean said:

I call the radar the "scanner" and a feature of OCD is that scanner inside our head searches for the thing we fear. 

So I spent a long long time, wasted, searching for a mechanism to switch off the scanner. 

I eventually learned that this was the wrong way. By tackling the underlying OCD core belief - in your case seemingly around getting ill yourself, or others, or specifically whatever - then when I had the CBT working including the ERP disarming the triggers, the scanner had no reason to be, and switched itself off

 

Thank you Roy, I completely agree with this. During my CBT, which has now finished, I feel my scanner has been switched off for some of my other themes and we looked at my core beliefs surrounding those. I know this to be the case because the triggers don’t exist for me now even though they are still there. They are not on my radar now. I’m just finding the health theme particularly difficult, especially when it’s not my own and my daughters. It doesn’t have to be really serious things either. It’s been about her teeth and seeing cavities that aren’t there for example and it’s just normal tooth structure. 

Thank you so much Roy, Gemma and GBG. This has been such a helpful discussion and I now feel I can put a plan together to work on this.  X

[PolarBear]

3 hours ago, Emsie said:

Thank you Roy. So good that all your hard work has paid off. You are an inspiration to us all. 

So would a good idea be to continue as I am for a while, as in labelling the thoughts in order to dismiss them, because I am reacting emotionally very quickly with huge surges of anxiety. At present that’s automatic.  And then when I feel I have broken the cycle of thought/feeling>anxiety>compulsions, try to move on to not focussing in on triggers?

How do you not focus in on such things? Certain aspects surrounding my health and the health of others are simply on my radar. X

You have to get them off your radar. You do do by dismissing the thoughts and getting on with your day. You do that consistently, time and time again.

[Emsie]

1 hour ago, PolarBear said:

You have to get them off your radar. You do do by dismissing the thoughts and getting on with your day. You do that consistently, time and time again.

Hi PB,

Thank you for your advice and support. Yes, consistency is the key.

Can I please ask you, what method do you think is best for dismissing the thoughts? X

[Guest OCDhavenobrain]

I saw Gingerbread ask the same question today. There is no fancy way, it will only make you ruminate about how you should recover. Do other things which change your focus away from involving in the thoughts

Atleast that is the idea, I think it is pretty hard lol.  Hope you find some luck in trying to dismiss them. 

Edited November 19, 2018 by OCDhavenobrain