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Forcing the trigger or refocusing?


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So I’ve pushed myself a little too hard today with exposure and now I’m struggling with a phrase I read earlier that triggered me. This phrase now keeps popping into my head intrusively and spiking my anxiety. How best do I approach this? 

a. Do I repeat the phrase purposefully and make it come into my head under my control rather than the ocd’s?

OR  

b. Because I have been attempting ERP already today and my ocd resilience is super low right now, should I passively allow the thoughts to come and practice refocusing instead? 

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On ‎03‎/‎05‎/‎2019 at 14:21, HadenoughofOCD said:

So I’ve pushed myself a little too hard today with exposure and now I’m struggling with a phrase I read earlier that triggered me. This phrase now keeps popping into my head intrusively and spiking my anxiety. How best do I approach this? 

a. Do I repeat the phrase purposefully and make it come into my head under my control rather than the ocd’s?

OR  

b. Because I have been attempting ERP already today and my ocd resilience is super low right now, should I passively allow the thoughts to come and practice refocusing instead? 

Just wondering how this went for you Hadenough...

I think I would have chosen option b.

Are you working through a book or with a therapist, or both? I find it best to pace oneself with the exposure work, working methodically through an exposure hierarchy (with the support of cognitive work) so that the triggers don't cause too much anxiety (maybe around 3/10) I know sometimes one can just get exposed and get triggered beyond that and that's when I try to just do more distraction techniques, but then I try to continue to work with the hierarchy in a methodical way.

Sounds like you are doing great work to help yourself get better--that's great!

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6 hours ago, leif said:

Just wondering how this went for you Hadenough...

I think I would have chosen option b.

Are you working through a book or with a therapist, or both? I find it best to pace oneself with the exposure work, working methodically through an exposure hierarchy (with the support of cognitive work) so that the triggers don't cause too much anxiety (maybe around 3/10) I know sometimes one can just get exposed and get triggered beyond that and that's when I try to just do more distraction techniques, but then I try to continue to work with the hierarchy in a methodical way.

Sounds like you are doing great work to help yourself get better--that's great!

Hey Leif :)  I decided on option B in the end - I agree that triggers seem much easier to handle when you go into them intentionally rather than try to fight fire with fire when they intrusively pop in. 

The purposeful exposure I did the other day has however, left me with an ongoing surge of intrusive thoughts and a general feeling of foreboding (that had left me alone for a little while) which I will have to try to handle with distraction until they abate. So in that regard, it’s interesting how best to handle the aftermath of exposures. I wonder do these “exposure hangovers” get shorter as time goes on? Your approach sounds like a good one which I will definitely be trying - intentional exposures using the heirarchy, with refocusing and other cognitive tools for when they try to intrude and take control of my brain. 

I’m currently waiting for CBT so have been reading as much as I possibly can about overcoming this horrible thing. I’ve read Overcoming OCD by Veale and Willson, Acceptance and Commitment Therapy by Hayes and I’m just now in the middle of Brain Lock by Schwartz. They have all taught me a lot and have at the very least introduced me to many of the techniques I can put more forcefully into practice when I get to CBT.

Its really interesting as some days I feel like I am not making any progress and that the light at the end of the tunnel is so small that it’ll take me a lifetime to get there. But then I have to remind myself that even though it doesn’t seem like it, I have made enormous steps - I didn’t even know what was happening to me until quite recently! Now I am able to look at what’s happening at least with a perspective I never had before. 

Whenever I have these worst fears hit my mind, I try to remind myself that it’s most likely just my ocd, and that thought alone (that the things I am afraid of may actually just be a load of rubbish, and that there is hope to live a normal life) is enough to distract me for a little while at least! 

 

 

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17 hours ago, HadenoughofOCD said:

I’m currently waiting for CBT so have been reading as much as I possibly can about overcoming this horrible thing. I’ve read Overcoming OCD by Veale and Willson, Acceptance and Commitment Therapy by Hayes and I’m just now in the middle of Brain Lock by Schwartz. They have all taught me a lot and have at the very least introduced me to many of the techniques I can put more forcefully into practice when I get to CBT.

That's great that you are doing lots of reading and familiarizing yourself with the different techniques Hadenough. I really found the books so helpful in understanding how it all works.

17 hours ago, HadenoughofOCD said:

The purposeful exposure I did the other day has however, left me with an ongoing surge of intrusive thoughts and a general feeling of foreboding (that had left me alone for a little while) which I will have to try to handle with distraction until they abate. So in that regard, it’s interesting how best to handle the aftermath of exposures. I wonder do these “exposure hangovers” get shorter as time goes on? Your approach sounds like a good one which I will definitely be trying - intentional exposures using the heirarchy, with refocusing and other cognitive tools for when they try to intrude and take control of my brain. 

Yes many areas remain a little grey for me. Like, as you say, when an intrusive thought continues to hang around after an exposure that feels like maybe too much.

I find for me if I'm in control of what I'm exposing myself to, then I can usually handle the anxiety and uncertain feeling that continues to hang around afterward. My theme being mainly contamination lately, I've walked around for days in clothes that have a feeling of contamination for me, but its at a level I can handle. However if I'm facing an exposure I wasn't ready for and the exposure is too high and  I feel I can't handle that level of anxiety, I usually resort to washing/cleaning riituals but stay consistent with trying to expose myself to contamination at a level I can handle.

17 hours ago, HadenoughofOCD said:

But then I have to remind myself that even though it doesn’t seem like it, I have made enormous steps - I didn’t even know what was happening to me until quite recently! Now I am able to look at what’s happening at least with a perspective I never had before. 

You sound like you are on a really good track to recovery. And its so great that you are getting a head start on things while you wait for therapy--all this reading and practice will help so much once you get to a therapist. I did most of my work just with books and found them so helpful!

Keep us posted as to how you continue with your work and keep your eye on that light at the end of the tunnel :) 

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On 06/05/2019 at 15:48, leif said:

I find for me if I'm in control of what I'm exposing myself to, then I can usually handle the anxiety and uncertain feeling that continues to hang around afterward. My theme being mainly contamination lately, I've walked around for days in clothes that have a feeling of contamination for me, but its at a level I can handle. However if I'm facing an exposure I wasn't ready for and the exposure is too high and  I feel I can't handle that level of anxiety, I usually resort to washing/cleaning riituals but stay consistent with trying to expose myself to contamination at a level I can handle.

I can definitely relate to this way of handling triggers, but I do struggle a little with ranking my levels of anxiety, as when I am triggered, everything seems just as anxiety inducing as everything else related to the topic lol! But thinking about it, I may have made progress and not realised it, as when this new manifestation of my theme (legal/fault ocd) first reared it’s head, I couldn’t bear having anything at all to do with any of it. Now I am able to go on my computer and check emails etc. Which I couldn’t have done before. 

For me, I have to be really careful not to ruminate and “what if” my way down the rabbit hole when I’m involving myself in theme-related actions. I’ve noticed it’s so easy for me to be handling checking my emails quite well, but as soon as a “what if” thought enters my head, I have to work really hard not to follow the thought with checking and ruminating. 

A perfect example happened just now. I am forever getting calls from nuisance numbers and I will block those numbers if they call. I just had a call from another number, but then made the mistake of going through all the numbers I had blocked previously and checking to make sure they were in fact only nuisance callers and not important calls I have somehow blocked. 

Numbers I don’t recognise make me extremely anxious as I fear that it could be someone calling me to say I’ve done something wrong or I’m going to get into some legal trouble somehow, so avoiding answering and blocking these numbers are actually avoidance tactics (which I have only just now realised).  But, they are trapping me and keeping my OCD going as I follow the same ritual each time: 

1. Anxiety spikes when the phone rings and I don’t know the number, so I ignore the call 

2. I then search the number on the internet to see if it’s listed as nuisance (which is what I am always hoping for) 

3. If not a nuisance number, I then go into further panic and then check all the potential areas of my life that the number could have called me from and the reasons why (e.g. a call to say I’m being sued etc). 

This has just happened to me with a couple of the numbers I had blocked, as they weren’t listed as nuisance, and I had the overwhelming urge to go and check all the usual areas. I very nearly did until I realised what was happening! 

So im guessing in this particular scenario, full exposure would just be to answer the calls, and refocusing would be what I have just done, by resisting the compulsion to go and check phone numbers of those “potential” callers, and focus on something else until the anxiety abates. My anxiety is lower now, but I still have a background hum that’s making me feel uneasy. I wonder how long that will take to pass.

I have also been having the OCD doubt, that perhaps this isn’t OCD and I have a genuine need to fear, but even looking at this scenario, my logic and reasoning in relation to the unfamiliar numbers reassures me that it must be ocd as the fears don’t make sense. For example, if it was indeed a feared phonecall from such an organisation as a solicitors etc. they wouldn’t be calling me from a mobile number for one. This realisation is not helpful for overcoming the trigger itself, but is a good way to remind myself that it is indeed OCD. 

I am learning now that if for any reason I get that awful stomach twisting sensation when something happens, I need to take a step back and examine what’s happening there further, rather than just automatically trying to get rid of the feeling. It’s amazing the ways your theme sneaks into your life without you noticing! 

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On ‎07‎/‎05‎/‎2019 at 11:20, HadenoughofOCD said:

But thinking about it, I may have made progress and not realised it, as when this new manifestation of my theme (legal/fault ocd) first reared it’s head, I couldn’t bear having anything at all to do with any of it. Now I am able to go on my computer and check emails etc. Which I couldn’t have done before. 

Yes that sounds like really great progress!

On ‎07‎/‎05‎/‎2019 at 11:20, HadenoughofOCD said:

but as soon as a “what if” thought enters my head, I have to work really hard not to follow the thought with checking and ruminating. 

Yes I am the same way! As soon as one starts down there it is hard to get out! One thing I like is when I can acknowledge the 'what if' thoughts with "Right I guess that's a possibility but not very likely!" That's when I feel like I'm making some progress. Or I purposefully allow the 'what if' thoughts to 'speak' and not allow the compulsions. That is another one of my good signs of progress and helps the thoughts lose power.

On ‎07‎/‎05‎/‎2019 at 11:20, HadenoughofOCD said:

I am learning now that if for any reason I get that awful stomach twisting sensation when something happens, I need to take a step back and examine what’s happening there further, rather than just automatically trying to get rid of the feeling.

Yes exactly! And that is a hard lesson to learn as most of us want to feel better right away. I think it sounds like you are doing a wonderful job on working on this with just your books. With this kind of motivation and hard work I'm sure you will be seeing lots of good progress. It'll be that much better too when you see a therapist as you'll understand the process yourself and that is so helpful!

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@HadenoughofOCD  Sounds like you are handling this pretty well, you should be proud of yourself for making some good use of CBT techniques and applying them to your life and your OCD.  I see a lot of good insight in these posts, good for you!

Regarding the choice you mention:
 

On 04/05/2019 at 06:21, HadenoughofOCD said:

a. Do I repeat the phrase purposefully and make it come into my head under my control rather than the ocd’s?

OR  

b. Because I have been attempting ERP already today and my ocd resilience is super low right now, should I passively allow the thoughts to come and practice refocusing instead? 

Both ERP and refocusing are, IMO, valid approaches to OCD.  The overall goal of both approaches is to train the mind to treat the intrusive thought as not a big deal.  Sometimes one may work better for a particular trigger or situation, but I think its one of those things where you can spend a little time considering which best fits your situation in the moment, but ultimately just picking one and going with it will be fine.  Your approach of applying ERP in controlled situations but using refocusing when dealing with unexpected anxiety very much mirrors my own general approach.  In the end its about what helps you the most and what you can handle at the time.  The more often and more intense you can do ERP will probably lead to faster results BUT if you overdo it you can set things back too.  Finding a balance is, like most times in life, probably the wiser path.  Like I said in the beginning, sounds like you are handling things pretty well and making smart choices.  Keep up the work and I hope you continue to see good results!


 

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