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How Do We Stop Intrusive Thoughts?


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I was able to locate my previous post - here it is :

When a core belief isn't obvious clinical psychologists use the "downward arrow"  principle to look to find it. 

You can yourself try the downward arrow principle to find out what the core belief is that is causing you a problem .

On a piece of paper write down a statement as to what you think is your OCD issue. 

 Then underneath it, draw a downward arrow and then write in the answer to this question. If this were true, why would it be so bad?

 After writing in the answer,  put in another downward arrow underneath, and ask the same question again.

 Keep going until no further answer is possible – your last answer should reveal the core belief 

There is no need to understand where the core belief came from - but a traumatic event is one possibility. The source may become clear once the core belief is revealed - but whatever, you go about challenging the truth of the core belief when you have uncovered it. 

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36 minutes ago, taurean said:

Maybe you need to look deeper down to understand if there was a "seeding event" that caused the health anxiety. 

In the case of a team secretary at my work some years ago, the seeding event was her husband suddenly dying, leaving her to bring up their son on her own. 

Her fear was that she would get a life-threatening illness that prevented her from doing this, and any health problem she had was awfulised into such, with reassurance-seeking visits to the doctor. 

We told her this seemed to be obsessional and what we saw as why the OCD had latched onto it. 

Understanding why she was reacting in this way - the cognitive side of CBT - coupled with facing up to the intrusions such as "what if its xyz? (a terminal illness)" by being mindful of what the OCD's game was - to plant the suggestion of a catastrophic diagnosis - helped her to tough the thoughts out and resist the urge to compulse. She appeared to recovered well from this. 

So maybe dig down to find out what the actual OCD core belief is in your case and whether it was trauma induced as hers was. 

If you can't identify exactly what the OCD core belief may be (which could then lead to discovering any underlying trauma if there is one ), try using the "downward arrow" technique. I will look for a previous explanation of this from the search field, and hopefully add it to the thread. 

Remember, at any time, in a safe place you can bring into your consciousness a trigger thought to tackle in a structured ERP session - we don't have to be actually in the situation to do this. 

Thank you so much Roy, that’s all brilliant and so helpful. 

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31 minutes ago, taurean said:

I was able to locate my previous post - here it is :

When a core belief isn't obvious clinical psychologists use the "downward arrow"  principle to look to find it. 

You can yourself try the downward arrow principle to find out what the core belief is that is causing you a problem .

On a piece of paper write down a statement as to what you think is your OCD issue. 

 Then underneath it, draw a downward arrow and then write in the answer to this question. If this were true, why would it be so bad?

 After writing in the answer,  put in another downward arrow underneath, and ask the same question again.

 Keep going until no further answer is possible – your last answer should reveal the core belief 

There is no need to understand where the core belief came from - but a traumatic event is one possibility. The source may become clear once the core belief is revealed - but whatever, you go about challenging the truth of the core belief when you have uncovered it. 

Bless you Roy for finding your previous post to share with me. Thank you, again so helpful. I have tried to work out my core belief on this one and I’ve found it confusing as it appears I have more than one surrounding health, actually quite a few core beliefs if that’s possible??  I can’t get down to one. 

I worked out my other core beliefs surrounding my other themes and they were clear cut, but the health one seems complex in terms of core beliefs so maybe that’s why it’s harder to crack?? Incidentally I have pretty much cracked a lot of my other obsessions/themes where it was straightforward working out my core belief. 

Thank you so much for your support and great advice. 

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48 minutes ago, taurean said:

Remember, at any time, in a safe place you can bring into your consciousness a trigger thought to tackle in a structured ERP session - we don't have to be actually in the situation to do this. 

I’ll look at how I can approach this and give it a go. Thank you. 

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16 hours ago, dksea said:

I'm with Taurean on this one.
For example if I'm having the intrusive thought "maybe I'm having a heart attack", the prudent thing to do if I'm supposed to "believe" the thought would be to call an ambulance right?
Instead I find that recognizing the thought is probably OCD, that I don't need to give it time, and that I'm probably NOT having a heart attack and should just get on with my day is the more beneficial approach.  The key, is to recognize the "probably" part.  Recognizing that OCD is causing me to seek certainty, that certainty is an impossible goal, and I need to accept doubt.

Spot on, 'probably OCD' and 'possibly not' - OCD hates them. 

Edited by paradoxer
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14 hours ago, worriedjohn said:

I think relabeling doesn't give you chance to desensitize of your fear. When you are relabeling, you are not feeling the anxiety that is caused by OCD. But ultimately OCD fear (obsessions) are caused by OCD and they are not genuine danger.

I'm not sure I agree with this based on my own experience at least.  I almost always recognized that my fears were irrational, I could logically explain them away.  The difficulty for me is that no matter how much "logic" I was applying to the situation, I was still feeling anxiety, which allowed the doubt to creep in "well you THINK that it can't be XYZ because of A, B, C, but you still feel anxious so are you SUUUUURE about that??".  Where relabeling helped was to serve as a reminder for me, a guidepost in a way, that  I didn't NEED to solve the problem, that there was a reason that I kept feeling anxiety and that reason wasn't based on the actual problem.  Relabeling gave me the permission to treat the problem as OCD and to stop fighting it.  It didn't make the anxiety suddenly stop, but it made riding out the anxiety wave easier because I didn't need to keep fighting it.

Relabeling also helped me with my exposures.  One of my early intrusive thoughts made riding public transit difficult, but I had to do it in order to visit my girlfriend at the time during University as she lived across town.  Since riding on the bus was a period of intense anxiety for me, those were significant in situ (real life) exposures.  One way I was able to endure them was to remind myself that the anxiety I was feeling was from OCD, not a real threat, and that I needed to just let it happen.  Without relabeling I doubt I would have been able to ride the bus so far.  I might have made progress in a different way, taking short bus rides at first and progressively longer ones, but honestly that would have meant I was unable to spend time with my girlfriend and would have severely impacted my life negatively.  Relabeling helped me endure much longer periods of anxiety and helped me get over the bus anxiety much quicker than I otherwise would have I believe.  To be clear I wasn't sitting on the bus, eyes closed, constantly chanting "its just OCD, its just OCD" to myself the whole way, I'm not sure that would have actually helped.  But when I felt the anxiety intruding a little too much and I was struggling to avoid ruminating or panicking, the gentle reminder of relabeling helped me get back to focusing on other things, at least for awhile.

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I think Dksea's experience shows that attempts to make hard and fast rules aren't helpful. Someone may be benefiting. 

I would like to see a little more flexibility in approach from therapists as people respond to different approaches - one size does not fit all. 

 

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I have had 6 privately-funded courses of CBT with four therapists, of which two therapists I felt were excellent. 

But they both brought different strategies to the party. The first of the best was a Paul Salkovskis afficionado, the second had been trained in mindful ness-based CBT for OCD. 

I was able to marry up the best of those with The Four Steps from the book "Brainlock" and with meditation and relaxation skills and love kindness meditation to create a package which works for me. And 20 mg Citalopram seems to have balanced mood swings and boosted my resilience. 

So why would not a more bespoke solution rather than a rolled out en masse solution also be best for others? 

 

 

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