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Ashley

Finding Normal - Why we have to go to extremes

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Something that came up in my OCD support group this week, was the question of why we need to do extreme exercises (i.e. normal people without OCD would not do that).. I don't like the term normal people, but I get the point of the question.

I use this very simplistic image to explain why we have to do the extreme to achieve 'normal response',

Anti OCD.jpg

 

As I found out after decades of OCD showering, when I asked the question what do people without contamination OCD do when showering, there is actually no normal point, there will always be a range of ways to respond to thoughts (for people without OCD) and those responses will differ for everybody, but generally a non-OCD response would be somewhere within that central range, some more than others but non will be overly extreme.

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That's very nicely explained. And a great visual way to help sufferers. 

It is a difficult word, normal. You could argue that listening to rap music is normal, since so many people do so and like it. 

But to someone who spent some of his years from junior to around 32 singing in church, school, choral and operatic society choirs, I neither consider it singing, musical or nice - so, to me, it's not normal. But it is widespread and popular. So it's normal I suppose sigh :sadwalk:

 

 

Edited by taurean

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Very nice post Ashley. I think this is something I struggled with a lot when I started ERP a few months ago. I kept wondering why my therapist was asking me to do such extreme things that I didn’t need to be able to do to live normally. Yet it was on doing those things that I was able to see that no harm would come and I could continue without going to extremes. 

I’m not sure that anyone is really ‘normal’. I am sometimes completely flabbergasted by how some people think. These are people who don’t have a mental health condition (that I’m aware of at least) an yet can be so irrational and create problems for themselves and others. Now I have a mental health condition but I can manage certain aspects of my life better than some other people can. We all have strengths and weaknesses.

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Some sufferers here express shock when we tell them how far they eventually need to go with their exposures. It needs to be done. Sufferers are so off the normal scale in one direction with their compulsions that only a sustained visit to the other side of the spectrum will suffice.

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It's a case of bending that coat hanger back a bit further to reach equilibrium. 

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It is right of course that if we have extreme, exaggerated, obsessions we will likely need extreme exposure. 

We can build up the exposure from a lesser level upwards, but we won't overcome the fear and dread without the extreme stuff. 

 

 

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Coming back to showering, normality for me is a couple of times a week, usually Wednesday and Sunday. 

This will probably horrify those with high desires for cleanliness standards, and won't meet the expectations of a contamination OCD sufferer - but it works fine for me. 

The normal area of the graphic does seem therefore to need to stretch to suit the issue. 

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Effectively I guess what I was saying is that if we are comfortable living in the anti-OCD zone, that then accepting that normal range becomes an easy walk in the park. That's why we have to go from one extreme to another.

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Not sure what is meant by what do ‘people without contamination do when showering’. Taurean operationalises this notion by giving an example of his frequency of showering. In this example, I suppose the cessation of showering all together might  be an example of anti OCD work.

Two or three generations ago the weekly bath was common if you needed it or not. Bathing has increased in certain societies. But by no means all.

People have been know to use bleach when showering. In my book this should cease immediately. 

In some cases in the context of contamination an extreme strategy might be useful.

But whether it applies to all themes? For example if a person with pedophilia OCD who avoids children to the extent that he or she had ceased going out. There have been examples on the forum. Should he or she deliberately go to areas where there are many children?  Or simply go out? can see arguments on both sides.

I think it might work with some forms of checking OCD.

The devil is in the detail. I think the strategy is best worked out with a professional therapist. 

Edited by Angst

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3 hours ago, Angst said:

People have been know to use bleach when showering. In my book this should cease immediately. 

Those people will end up with environmental induced asthma or worse an anaphylaxis event! 

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6 hours ago, Angst said:

Not sure what is meant by what do ‘people without contamination do when showering’. Taurean operationalises this notion by giving an example of his frequency of showering. In this example, I suppose the cessation of showering all together might  be an example of anti OCD work.

Two or three generations ago the weekly bath was common if you needed it or not. Bathing has increased in certain societies. But by no means all.

People have been know to use bleach when showering. In my book this should cease immediately. 

In some cases in the context of contamination an extreme strategy might be useful.

But whether it applies to all themes? For example if a person with pedophilia OCD who avoids children to the extent that he or she had ceased going out. There have been examples on the forum. Should he or she deliberately go to areas where there are many children?  Or simply go out? can see arguments on both sides.

I think it might work with some forms of checking OCD.

The devil is in the detail. I think the strategy is best worked out with a professional therapist. 

Yes, someone with pedophile thoughts would eventually have to be around kids. Absolutely.

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Which proves the necessity of exposure and response prevention. Without working through that, such a sufferer will be consigned to the imposition of an OCD rule of avoidance and an ongoing belief that their obsessive fears are true. 

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I completely understand the need to do extreme exercises and I can see how it can be applied to many themes.

However, I don’t understand how I can apply it to one of my themes, which is health, either my own or others. 

If I can give an example, I find a ‘lump’ in my neck, next comes rush of anxiety, I panic it’s abnormal, I keep checking it and comparing it with the opposite side of my body, I ruminate, I google and end up seeing a doctor to get it checked to then find out it’s perfectly normal. That’s a very brief description of my intrusive thoughts and feelings and compulsions. Lumps are a big thing for me and I fear seeing and feeling them on myself, daughter, husband and even my cats. 

I can work on stopping the compulsions, that I understand, but what would my anti OCD exposure exercises be? 

Thank you for any help that you can give me on this. 

Edited by Emsie

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Simply going out would mean in the course of things being around children. But I imagine the extreme position would be hanging around schools and playgrounds. Making journeys to shops at school closing times. Would these be examples of the extreme approach?

Edited by Angst

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2 hours ago, Angst said:

Simply going out would mean in the course of things being around children. But I imagine the extreme position would be hanging around schools and playgrounds. Making journeys to shops at school closing times. Would these be examples of the extreme approach?

I can see the need to go to extremes to finally rid yourself of a specific OCD theme altogether, but think you need to really build up to it in a graduated way, otherwise it would be akin to flooding, and ERP to what is "normal" will ease things, but most likely keep a small element running in the background.

Having said that, even I, a non sufferer of any kid related OCD theme would feel slightly awkward hovering when alone near schools or playgrounds. So much so, that I even borrowed a nephew to accompany me to a local firework event at a nearby school that I wanted to go to!:lol:    I joke of course, because an element of going was thinking my nephew might enjoy it, but I certainly would not have gone alone, so I too can see two sides to these things.

 

 

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9 hours ago, Emsie said:

I completely understand the need to do extreme exercises and I can see how it can be applied to many themes.

However, I don’t understand how I can apply it to one of my themes, which is health, either my own or others. 

If I can give an example, I find a ‘lump’ in my neck, next comes rush of anxiety, I panic it’s abnormal, I keep checking it and comparing it with the opposite side of my body, I ruminate, I google and end up seeing a doctor to get it checked to then find out it’s perfectly normal. That’s a very brief description of my intrusive thoughts and feelings and compulsions. Lumps are a big thing for me and I fear seeing and feeling them on myself, daughter, husband and even my cats. 

I can work on stopping the compulsions, that I understand, but what would my anti OCD exposure exercises be? 

Thank you for any help that you can give me on this. 

Simple. First, you have identified your usual compulsions you do when you find a lump or bump.

Clearky we don't want you to somehow make a bump, but I suspect since you fixate on them, you likely find them all the time. So...

Next time you find a lump, say to yourself, "This is a cancerous tumor. It's growing and soon I'll die from it." Say it several times. Then, and this is the crucial part, DO NOT allow yourself to do any of your usual compulsions. Let the anxiety come and, as you continue on with your day, notice that it slowly lessens.

Do that repeatedly.

This would constitute an extreme exposure for someone like you.

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19 hours ago, PolarBear said:

Simple. First, you have identified your usual compulsions you do when you find a lump or bump.

Clearky we don't want you to somehow make a bump, but I suspect since you fixate on them, you likely find them all the time. So...

Next time you find a lump, say to yourself, "This is a cancerous tumor. It's growing and soon I'll die from it." Say it several times. Then, and this is the crucial part, DO NOT allow yourself to do any of your usual compulsions. Let the anxiety come and, as you continue on with your day, notice that it slowly lessens.

Do that repeatedly.

This would constitute an extreme exposure for someone like you.

Thank you so much, PolarBear! That makes perfect sense, but I do find it pretty scary! 

I find ‘lumps’ from time to time so it would be sporadic and unplanned ERP...do you think that’s ok/enough? 

I couldn’t employ this technique with my daughter (she’s 3), I find that too risky. At the moment, I would tell my rational husband and let him make a decision. I don’t know what the way forward with her would be as I cannot take risks with her and ‘experiment’ therapy with her. 

Also, and I know this is a predictable avenue, but one day by employing this ERP on myself, I could miss a genuine problem/health issue, so how do I deal with that? Or do you think a genuine health issue/lump etc would be obvious and therefore I would naturally take sensible action by seeing the doctor? 

A big thank you! 

Edited by Emsie

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We're talking about extremes here. What I duggested eould be at the top of your hierarchy. I'm not sure what could come before.

As I said, you can't very well create bumps to then ignore so you'd have to wait until you found one to practice ERP. I suspect you find them often enough to be able to practice.

After a good chunk of time you may gain insight into what's real or not. A good yearly checkup would solve most problems. There are so many possible issues but you focus on one, lumps. 

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Thank you PolarBear! 

23 minutes ago, PolarBear said:

What I duggested eould be at the top of your hierarchy. I'm not sure what could come before.

No, me neither. At the moment if I find an ‘issue’ I just try to not engage/not do compulsions as my CBT techniques. When I fail it’s a catastrophic fail. 

 

24 minutes ago, PolarBear said:

. There are so many possible issues but you focus on one, lumps. 

I do have a thing about lumps and they are a big obsession, but it is not the only thing, it could be anything about my health...skin cancer, mouth cancer, bowel cancer, my heart, diabetes, my teeth, MS etc etc to name a few that I have feared. 

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