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Going back to CBT this Monday - Intense anxiety (Merged Thread)

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Update my stag is now over I managed to forget the door handle issue for the night but sadly not the day I have unscrewed my old handle and I am ordering a new one and getting a joiner to fit it. My reason was my mum touched the wheelie bin and never washed her hands now when I stayed with her she unblocked toilets and dumped the toilet paper in a bag on top of of into the wheelie bin so I fear now if I touch my hands they are dirty and spreading germs. At work I worry I am making everything dirty. I worry my phone is dirty already after trying to touch the door without washing my hands. I bleached the door handle but this gave me no relief only replacing it does.

So anyway the update is I am seeking further CBT this Monday I managed to find funds to do it by making cut backs. I will see how I get on this time as this is my third time in therapy with this therapist. 

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Remember Phil the absolute best therapist in the world is of no help if the patient doesn't believe what they tell them, and doesn't work hard at making the necessary thinking and behavioural changes they tell them to work on. 

At the moment you aren't doing this, from what you previously were told in therapy, and what we have told you, and so the therapy isn't working. 

We told you why there was no need to replace the door handle. 

You haven't believed us and are replacing it. 

So now, with a new session of therapy starting, please enter into it with a new intent to listen to the therapist and not what your OCD is telling you. 

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N. B. Phil your problem might also be one of revulsion. 

I clean my hands after touching the food waste Lucy bin in the kitchen, but my wife doesn't tend to. 

Do I find this revulsive? Yes. Enough to make an issue of it? No. We have been together for approaching 40 years, and it - as with many behavioural differences between us - are just things we became accustomed to. 

Is there a threat there? I don't see one. 

OCD alleges threats that aren't there, or are grossly exaggerated. 

And revulsion becomes a repetitive emotion that creates rules. 

Once you really take that on board, and are prepared to dismantle and stare out those rules, you will start to recover. 

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4 hours ago, Phil19 said:

I have unscrewed my old handle and I am ordering a new one and getting a joiner to fit it. My reason...

The reason is not important, you are simply using it as an excuse to justify your behavior to yourself.  If you want to get better you can take a step now. Put the old handle back, cancel/return the order for the new one, and keep using it.
 

4 hours ago, Phil19 said:

So anyway the update is I am seeking further CBT this Monday

Its good that you are seeking the right kind of help, but it won't matter if you aren't willing to do the work.  If you continue to engage in compulsions you will continue to remain stuck, and the CBT will be a waste of time and money.  You MUST start doing the work.  You MUST stop replacing things.  You MUST start using "contaminated" things.

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Hi Phil, 

I'm new to this forum however I've been suffering for years with OCD (my earliest memories of compulsions being around the age of 6 years old), I'm late 40's, and I was only diagnosed around 4/5 years ago due it going unnoticed as I'm a mental checker, everything that goes on is inside my head only. 

The reason for me replying to this post is that your posts have kind of helped me slightly and hopefully my post may help you. 

It may not sound nice what I'm about to say but hopefully you can see the flipside of it and also realise this is coming from another person who has OCD but on different themes and somebody who is one of the most honest people you are ever likely to find. 

Here goes, apologies if I offend, but it's for the right reasons to try and help you and put some perspective into your OCD.

Your posts above and also the other one I was reading the other day about your site being on the telephone (I believe this was also you?) I find BOTH of your obcessions completely bizarre and unfounded.

I can not honestly see ANY connection with the telephone one, until I spoke to my wife about it, and she pointed out one of the reasons you are most likely making the connection, but even afterwards I found it completely bizarre and I wouldn't have EVER worried about it. 

Therefore why wouldnt I have worried about it? Because it's not one of the themes that my brain would latch on to, just like your brain most likely wouldn't latch onto my obcessions and you would most likely think that mine are completely bizarre also - see what I mean by the flipside and how it has kind of helped me? 

And with regard to getting your door handle replaced above? Is this going to cost you money? Because if it is it isn't going to help you will be burning money do you know why?  How do you know the repair man isn't going to cross infect that new handle with any infection that may have been on the old one? Or are you going to instruct one repair man to remove it and another to fit the new one? And there are already loads more possibilities for cross infection that my mind can think of already that is NEVER going to give the type of certainty and reassurance that our OCD NEEDS and this is without me even having your obcessional fears! 

I hope you don't mind me writing the above Phil. But I REALLY want you to know that it IS OCD and you need to take a risk and expose yourself to the obcessions without doing the compulsions and ONLY YOU can do that not the therapist. 

I know it's easier said than done as I also have some really bad worries about things and spend several hours per day doing compulsions - but the last couple of days have been a lot better and I've already noticed that by resisting the compulsions it gets easier almost immediately. Yesterday I hardly did any from around 12 noon to about 8pm which was very good for me. But then I got struck down by some for a couple of hours...... 

Take it easy bud and I will be checking in on ya fella :)

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From seeing your other posts, that seems how you do it,  you replace the item at your expense. 

 You're unable to wait out the anxiety that comes along with it.

Try this  NHS list: 

It is very important to make sure that the therapy you receive is carried out according to best practice. The following are features of quality CBT:

Session length: Sessions should last at least 45 minutes on average with an agenda that is agreed at the start of each session. Some sessions may be longer especially if confronting feared situations.

Who can attend? Depending on your age and circumstances, with your agreement, some sessions might involve your parents or other family members. Sometimes sessions may involve a spouse or other household member. This can be essential to help family members understand the nature of OCD for example how they can best help you by not accommodating your rituals and giving you reassurance.

Content of sessions: The content should stay focused on the OCD problem for most of the time in most of the sessions (although sometimes other issues may be dealt with later in therapy).

The setting of goals: The therapist should help you develop and work towards an agreed set of goals for and after treatment. These should be specific and achievable and described in terms of what you will do (e.g. to hold my baby; to sit on a public toilet seat).

An explanation of how your OCD works: You should be provided with a clear rationale and explanation of how your OCD works, what keeps it going and therefore what you need to do to overcome it. This is usually called “a formulation” and might consist of a diagram.

Therapist aided exposure: The therapist should do at least some exposure or behavioural experiments with you in the sessions to test out your predictions and allow yourself to experience anxiety. Ideally, this should occur at least once in your home or where the OCD is worst. Alternatively, the therapist might demonstrate the exposure task first in front of you. You should feel involved in this process, and not just be told to do it.

Negotiated homework: The therapist should negotiate relevant homework tasks to do between the sessions. This is also likely to consist of exposure tasks or behavioural experiments to test out your predictions and should be relevant towards achieving your goals. The outcome of these tasks should be recorded and reviewed when you next meet.

Encouraged to do exposure: You should be consistently encouraged or requested to perform activities that involve exposing yourself to activities, situations or thoughts that you avoid. Difficulties should be discussed and an agreed plan of action is made co-operatively.
Encouraged to resist your rituals: You should be consistently encouraged and supported to resist rituals (for example the urge to seek reassurance or to “check” or “put things right”).
Keep a record of outcome: The therapist should have some record of outcome (for example by a questionnaire or rating scale) that is specific for your OCD.

Relationship with your therapist: There should be a good enough relationship with your therapist who you can trust and can support you. You should feel your views are sought and you are involved in the process. The therapist should generally have high expectations about your ability to change. The therapist is always encouraging and positive about your ability to make improvements, seeing problems as a way of learning better ways of dealing with the OCD.

Good CBT may also involve;

Listening to recordings of sessions or keeping written summaries of sessions and your homework.
Being recommended or given appropriate reading material.
Being asked by your therapist to summarise what you have learned.

In CBT you would NOT expect to;

Spend most of the sessions talking about your childhood.
Spend most of the sessions with your therapist silent.
Be encouraged to challenge your thoughts or keep thought records.
Be seeking reassurance about your worries or be provided with reassurance by your therapist.
Be encouraged to try and control, stop or block your intrusive thoughts, images or urges.
Be given a mantra or phrase to repeat to yourself or reassure yourself when anxious.
Feel that you are being given tasks that you don’t understand the rationale for.

If you have any concerns about the CBT that you are receiving it is important that you address this with your therapist.

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5 hours ago, MentalChecker said:

Hi Phil, 

I'm new to this forum however I've been suffering for years with OCD (my earliest memories of compulsions being around the age of 6 years old), I'm late 40's, and I was only diagnosed around 4/5 years ago due it going unnoticed as I'm a mental checker, everything that goes on is inside my head only. 

The reason for me replying to this post is that your posts have kind of helped me slightly and hopefully my post may help you. 

It may not sound nice what I'm about to say but hopefully you can see the flipside of it and also realise this is coming from another person who has OCD but on different themes and somebody who is one of the most honest people you are ever likely to find. 

Here goes, apologies if I offend, but it's for the right reasons to try and help you and put some perspective into your OCD.

Your posts above and also the other one I was reading the other day about your site being on the telephone (I believe this was also you?) I find BOTH of your obcessions completely bizarre and unfounded.

I can not honestly see ANY connection with the telephone one, until I spoke to my wife about it, and she pointed out one of the reasons you are most likely making the connection, but even afterwards I found it completely bizarre and I wouldn't have EVER worried about it. 

Therefore why wouldnt I have worried about it? Because it's not one of the themes that my brain would latch on to, just like your brain most likely wouldn't latch onto my obcessions and you would most likely think that mine are completely bizarre also - see what I mean by the flipside and how it has kind of helped me? 

And with regard to getting your door handle replaced above? Is this going to cost you money? Because if it is it isn't going to help you will be burning money do you know why?  How do you know the repair man isn't going to cross infect that new handle with any infection that may have been on the old one? Or are you going to instruct one repair man to remove it and another to fit the new one? And there are already loads more possibilities for cross infection that my mind can think of already that is NEVER going to give the type of certainty and reassurance that our OCD NEEDS and this is without me even having your obcessional fears! 

I hope you don't mind me writing the above Phil. But I REALLY want you to know that it IS OCD and you need to take a risk and expose yourself to the obcessions without doing the compulsions and ONLY YOU can do that not the therapist. 

I know it's easier said than done as I also have some really bad worries about things and spend several hours per day doing compulsions - but the last couple of days have been a lot better and I've already noticed that by resisting the compulsions it gets easier almost immediately. Yesterday I hardly did any from around 12 noon to about 8pm which was very good for me. But then I got struck down by some for a couple of hours...... 

Take it easy bud and I will be checking in on ya fella :)

I don’t think the telephone one was me but the door handle one is. 

And I don’t mind what the repair guy has touched isn’t door handles the most common ocd thing? It’s only when I witness something with toilet germs or dirty laundry germs I need to replace.

I Duno what I can take from therapy I will talk about these issues but I think some of these issues I prefer to be extra clean so I might never be able to let go of these worries. 

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18 hours ago, dksea said:

The reason is not important, you are simply using it as an excuse to justify your behavior to yourself.  If you want to get better you can take a step now. Put the old handle back, cancel/return the order for the new one, and keep using it.
 

Its good that you are seeking the right kind of help, but it won't matter if you aren't willing to do the work.  If you continue to engage in compulsions you will continue to remain stuck, and the CBT will be a waste of time and money.  You MUST start doing the work.  You MUST stop replacing things.  You MUST start using "contaminated" things.

This post is why we need a Like button.

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5 minutes ago, Phil19 said:

I don’t think the telephone one was me but the door handle one is. 

And I don’t mind what the repair guy has touched isn’t door handles the most common ocd thing? It’s only when I witness something with toilet germs or dirty laundry germs I need to replace.

I Duno what I can take from therapy I will talk about these issues but I think some of these issues I prefer to be extra clean so I might never be able to let go of these worries. 

Then you will remain trapped. It's as simple as that. We've been telling you that for a long time.

 

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1 minute ago, PolarBear said:

Then you will remain trapped. It's as simple as that. We've been telling you that for a long time.

 

"Like".... :)

 

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The risk is I am replacing the handle I ordered it today but the issue is the germs have spread to the blind chord the phone the furniture everything touched after that door handle so I fear I may never feel clean again which is awful to feel that way.

But why did I replace the door handle? I am using elbows to open it at the moment so atleast I will once again use my hands.

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55 minutes ago, Phil19 said:

The risk is I am replacing the handle I ordered it today but the issue is the germs have spread to the blind chord the phone the furniture everything touched after that door handle so I fear I may never feel clean again which is awful to feel that way.

But why did I replace the door handle? I am using elbows to open it at the moment so atleast I will once again use my hands.

But only you see this as a threatening risk. 

Your behavioural response is a learned behaviour - it can be unlearned through CBT. BUT you must be prepared to undergo some short term pain for long-term gains. 

Don't waste the time and money you will have paid for the CBT. Rather, be ready to believe and engage with that, and look to handle it professionally and well. 

  

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Phil, replacing the door handle is a big mistake. You know that after being told such a hundred times here. 

The fact is, there are no germs on the door handle or anything else you touched. The germs exist only in your head. If you replace that door handle, you will make things worse for next time. And there will be a next time. And another and another.

What do you hope to accomplish with CBT? Because if your therapist is any good, s/he will tell you the same things we have. You haven't listened to us or done any of the hard work we've advised you do, so what's going to be different going to a therapist? 

Edited by PolarBear

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37 minutes ago, PolarBear said:

Phil, replacing the door handle is a big mistake. You know that after being told such a hundred times here. 

The fact is, there are no germs on the door handle or anything else you touched. The germs exist only in your head. If you replace that door handle, you will make things worse for next time. And there will be a next time. And another and another.

What do you hope to accomplish with CBT? Because if your therapist is any good, s/he will tell you the same things we have. You haven't listened to us or done any of the hard work we've advised you do, so what's going to be different going to a therapist? 

My therapist talked me out of buying a new door after the letter box issue so maybe it can help? 

The replacing doesn’t stop there it was a spike to more I need a new measuring tape that I measured the handle with I have quarantined the screw drivers. I needn’t a new rucksack as someone left a badge at my stag night I worry it was my dads and bin germs got on the bag. It’s hard to keep up with the ocd.

That said I have been able to resist replacing many stuff over the months. I like to wash my hands and stay extra clean so I hope to continue some mild ocd to keep me clean but I hope to cut back on the severe ocd and belief something is forever contaminated. The door handle I mean they say don’t clean it but the fact is those germs or whatever it is got on my front handle as she never washed her hands. Im not sure much can change my mind on that. It was like when I binned my shoes after dirty laundry fell on them. I admit yes if I don’t replace something perhaps I don’t think about it all the time but sometimes I do and I can’t cope with the anxiety. I replace as I can’t handle the anxiety I get I don’t fear the germs in any way 

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Phil, I know you have high anxiety and I know in your panicked mind, all you can think of is getting rid of the anxiety. That's what drives you. What you need to understand is that YOU have caused your anxiety to be so high. Every time you do a compulsion, you reinforce in your mind that the thoughts were true. That guarantees more thoughts in the future and higher anxiety. It slowly gets worse and worse.

You don't want to return to a mild form of OCD, Phil. You want it gone, obliterated. Your gosl needs to be to kill OCD once and for all. Kill it!

And how do you do that? Mainly by abstaining from compulsions and exposing yourself to that which you fear.

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5 hours ago, Phil19 said:

I think some of these issues I prefer to be extra clean so I might never be able to let go of these worries. 

What you are doing is not being "extra clean" since you, yourself, admit its only an issue if you witness the supposed "contamination".

This is just another excuse to avoid doing the hard and unpleasant work to get better.  You might never be able to let go of these worries? Sure, maybe, who knows.  But you definitely will remain stuck this way if you don't change what we have told you you need to change.

There is a difference between can't and won't, and you are firmly in the won't camp.  You would rather keep suffering the anxiety you know rather than face the different (but temporary) anxiety you don't.  Thats your choice, of course, but things won't change if you continue to make that choice.

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Phil there is nothing going on around you that isn't going on in miriads of other homes. 

It's YOU that has to change. 

Change your interpretation of what OCD is telling you to do. Understand it lies and grossly exaggerates. 

Change your demand for absolute cleanliness. 

Learn to cast off revulsion, as I and others do. 

There will be anxiety as you go through this process, but then it will ease away - as it has done in my case. 

Only YOU can make this happen. 

Edited by taurean

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24 minutes ago, taurean said:

Phil there is nothing going on around you that isn't going on in miriads of other homes. 

It's YOU that has to change. 

Change your interpretation of what OCD is telling you to do. Understand it lies and grossly exaggerates. 

Change your demand for absolute cleanliness. 

Learn to cast off revulsion, as I and others do. 

There will be anxiety as you go through this process, but then it will ease away - as it has done in my case. 

Only YOU can make this happen. 

Yes that’s true I mean I have stayed myself for almost 4 years now but I have realised when you need repair men out or stuff that happens the house gets dirty. I spoke to my therapist and she explained how someone she knew had a toilet leak. They wanted to move but in the end never. Again the problem is when I witness it? I mean I would be horrified to go into another house where they don’t wash there’s hands after the toilet, bins and dirty laundry..I admit it most happen but right now my urge would be to get a new house each time but I know that’s not practical. I went through a house move it was stressful but it costs thousands of pounds. The only contamination I can think of is my sister had a dog and it pooped everywhere when it was a puppy. My brother had a sofa that was at my mums “contaminated house” so I can see other people’s houses may have germ risks. I use avoidance behaviour like I won’t take a bag of shopping to these houses 

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There is a guilt from me about replacing the door handle as it’s original and been in the house a while. That said it’s going green and a bit rusty and the replacement is similar but it’s new and clean so perhaps if I do replace it then its only going to improve the house but I feel the guilt of replacing something that’s been there for years. I admit there is some other handles in my street been replaced though.

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I had forgot about the letter box issue for a while but it’s come back to my head if that envelope came from the bin my bank card and all my mail is dirty but I cant prove it came from the bin thats the annoying thing. 

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1 hour ago, Phil19 said:

I use avoidance behaviour like I won’t take a bag of shopping to these houses 

As long as you keep doing that behavior you will keep suffering, its that simple.
 

1 hour ago, Phil19 said:

but it’s new and clean

New yes? Clean no.  The "clean" you think is there (or not there) is something you have made up, its not real.
 

1 hour ago, Phil19 said:

but I cant prove it came from the bin thats the annoying thing. 

It doesn't matter which bin it came from, its not "contaminated" either way, thats all in your head.

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‘New’ and clean do not equate. You could have had a factory or packing operative that had gone to the loo (no.2) and didn’t wash his hands and went straight back to packing/assembling. You’re just wasting your money buying new stuff. You need to accept that everything will have an element of ‘contamination’ but the contamination itself isn’t harmful and should not be focused on, investigated, or stopped.

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We can't obey a rule that everything has to be free of everything else at all times. 

And if we "see" something, it doesn't then - magically - become a problem, where none was perceived before. 

If I hadn't faced up to the attempted rules of my OCD I would never have been able to leave my house, never been able to go to work. 

OCD's rules are fabrications and exaggerations :thumbdown:

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So being honest how often do situations I would find as “forever contaminated” come up in daily life with others? For example dog poo, toilet germs, blocked toilets, dirty laundry without washing hands. How common is this? 

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Except with a subset of those with Contamination OCD, basically not at all. Dog poop is a common occurence. So is dirty laundry. But people generally don't wash their hands after touching dirty laundry. Dog poop gets cleaned up. In all cases, there is no such thing as forever contaminated. That is an irrational concept your mind invented with no basis in reality.

Edited by PolarBear

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