Reaction to exposure

[malina]

I have been in CBT for just over a month now and we've been doing lots of exposure. My main problem has been harm OCD so we've been doing work with knives. I am really finding it difficult, most of the time I leave the session feeling even more anxious than I did going in. Nevertheless, I have been open minded and willing to try all of the exercises that he has asked me to do. I was just wondering how you guys have found this type of therapy? I understand the rationale of it and I'm completely on board, but it's really challenging. My therapist is really nice and supportive so during the sessions I actually feel pretty comfortable trying out this stuff, it's mostly when I leave the session that I start to feel anxious. 

[Gemma7]

Exposures are definitely challenging but well done for giving everything a go

Do you think you might be doing a compulsion afterwards like thinking about the exposure, perhaps making sure everything went ok or something like that? Or perhaps it's because you are reassured everything is ok when you're with your therapist but worry afterwards when you don't have his support? It might be worth bringing it up with him next time you meet

Are you being set homework to do on your own? 

[malina]

9 minutes ago, Gemma7 said:

Exposures are definitely challenging but well done for giving everything a go

Do you think you might be doing a compulsion afterwards like thinking about the exposure, perhaps making sure everything went ok or something like that? Or perhaps it's because you are reassured everything is ok when you're with your therapist but worry afterwards when you don't have his support? It might be worth bringing it up with him next time you meet

Are you being set homework to do on your own? 

 

Hi Gemma,

that's a good question, I haven't actually thought about the compulsions I'm doing afterwards but now that you bring it up I can see what's happening. It's just that the things we are doing feel wrong to me, like holding a knife to my skin, for example. In fact, I'm even finding it hard to write down on here what we've been doing. So I think that after the session, I am reassuring myself that it wasn't wrong, that it was only in the therapy session, that I didn't like doing it etc. I think that I also feel scared that if I'm able to do something like hold a knife against my skin, I could do something to hurt myself. So then I try to reassure myseld that I wouldn't do that. I have mentioned it to him, but this is only the third time we've done it and for some reason it's really had a big impact on me today. And yes, I do have homework, although it's a lot gentler than what we do in the sessions. I am having trouble being alone, so my homework is to stay at home alone for a few hours (no going outside, no texting friends for reassurance) while my partner is out this weekend. I've also had to just use knives and leave them out, which I've been doing for a few weeks now and I've actually found it really helpful (even though that was hard at first too)!

[Gemma7]

It sounds like you're doing well then  

Just try to start noticing when your anxiety goes up if you've been doing any compulsions, stop them, take note and move on. You'll get better at recognising it in yourself it'll just take a bit of time. Keep up the good work

[James Lancs]

It is in your head and it is very difficult good luck

[malina]

Thank you both for the responses. I guess I'm just a bit panicked because I'm worried that the exposure will make things worse. I was starting to feel a bit better and after this exposure I did with the knives, my anxiety went way up. So I'm just scared of what I'm getting myself into here or if I'm strong enough to handle this type of therapy. Has anyone else had these doubts?

[PolarBear]

Things will usually get worse before they get better. After you've done an exposure often enough, it just doesn't have the sting it used to.

 

[malina]

11 minutes ago, PolarBear said:

Things will usually get worse before they get better. After you've done an exposure often enough, it just doesn't have the sting it used to.

 

Thanks PolarBear, that is encouraging to hear. I'm more than willing to stick it out and put in the work, I just want to be sure I'm on the right track. 

[Andrea]

Hi malina,

You are doing a great job in your recovery  

All this anxiety you are feeling is normal when we face our OCD, think that this anxiety is part of the process of healing. This anxiety will decrease the more you face your OCD. Be patient and resist   

Remember that your therapist is there to help you. Tell to your therapist that you feel anxious when you leave the session, he can give you a relaxation tip or some good advice to face that anxiety. 

big hug,  

[Andrea]

At the begining is hard to feel all the anxiety but eventually the anxiety will start to decrease. Be patient. The key is to face our OCD in spite of the anxiety we are feeling. Don´t give up malina you are doing a great job  

[malina]

Thanks a lot for the supportive messages everyone! I think that the OCD is starting to take over - I'm starting to worry that doing this exposure work will make me worse, because if I can do these exercises with knives, I'll then be able to do something bad to myself. Even though people who have been through this all speak wonders about it and say it has helped them immensely. Why would I be any different?

[taurean]

Because you are still listening to, and believing, the OCD. 

1 hour ago, malina said:

Why would I be any different?

You aren't. Whatever the theme of OCD it will often hit back when threatened. 

But we learn that is what it tries to do, and we learn to simply note it and not believe, or connect with, it. Gradually it then loses power and frequency. It will take time, be patient. 

Edited January 20, 2019 by taurean

[malina]

55 minutes ago, taurean said:

Because you are still listening to, and believing, the OCD. 

You aren't. Whatever the theme of OCD it will often hit back when threatened. 

But we learn that is what it tries to do, and we learn to simply note it and not believe, or connect with, it. Gradually it then loses power and frequency. It will take time, be patient. 

 

Thank you Roy...and everyone else! I am not giving up on this! I have been dealing with OCD for such a long time, but have always been willing to take the middle ground where I'm not really anxious, but don't challenge myself to face the anxiety. I think that has helped me get through life and feel happy, but has also left me feeling detached and always looking over my shoulder, waiting for the anxiety to strike. Now that I'm older and a little wiser, perhaps it's time to start actually fighting this. I think that I just didn't fully realise how hard it was going to be...but it's a process. I really appreciate all the support. 

[taurean]

We all go on the recovery journey, and it can be tough at first. 

My OCD only tended to affect me for several weeks a year and often when I took a break from work. 

But it began to worsen, I got diagnosed with OCD, started out on therapy and added knowledge on the journey. 

Be careful not to fight it directly, such as trying to neutralise an intrusion with an opposite thought, or trying to push thoughts away. This is still connecting with them, and makes them stronger. 

Not believing  or connecting, with the intrusive thoughts - just noting then easing mental focus away elsewhere - is the way forward.

Make sure you tell your therapist what you told us, he or she needs to be aware that the OCD is trying to fight back. 

[malina]

4 hours ago, taurean said:

My OCD only tended to affect me for several weeks a year and often when I took a break from work. 

But it began to worsen, I got diagnosed with OCD, started out on therapy and added knowledge on the journey. 

 

This sounds a lot like me, I think that I'm going through a relapse at the moment because my life has finally calmed down and I have time to think. For the last few years, I've been working so much and doing so many things that, whenever I started to gte anxious, I'd get distracted and forget about it. I was diagnosed with OCD 11 years ago now and sometimes I feel disappointed in myself that I'm going through a relapse because I wonder what happened to all the knowledge I gained at the time. However, this time round it is nowhere near as bad as it was then, so perhaps I have learned a lot. Thanks a lot for your advice, I really appreciate it and all of your posts about your journey.  

[malina]

Thanks so much to everyone for your advice! I spoke to my therapist today about how I was feeling and we decided to take things a little slower with the exposure. Still doing it and still have homework etc, but just taking a slightly more gentle approach until I'm ready to try the more difficult stuff again. :) 

[Andrea]

What a great news malina   I am so happy for you, you are doing an amazing work in your recovery  keep going!

big hug

Edited January 25, 2019 by Andrea

[taurean]

9 hours ago, malina said:

Thanks so much to everyone for your advice! I spoke to my therapist today about how I was feeling and we decided to take things a little slower with the exposure. Still doing it and still have homework etc, but just taking a slightly more gentle approach until I'm ready to try the more difficult stuff again.

This seems a good plan - recovery is a marathon not a sprint.

From my experience personally, and listening to others, trying to rush ERP isn't right - it takes whatever time it takes. 

I think some therapists may have a "gung ho"  approach, as if the sufferer is on a production line and ERP is just one - sequential - element until the finished product comes off the end of the production line, and the patient is recovered. 

But it isn't like that. Any part of the OCD recovery process may prove sticky and require ongoing homework and dedication after CBT teaching has ended. The therapy course is the learning process not the end product. 

All the best 

Roy