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taurean

OCD Core Beliefs And How They Function

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Having picked up leif's comment on struggling to differentiate between core beliefs and triggers, I used the search field to dig out and copy the text of a piece about this I wrote on the forum a couple of years ago. 

Hope this helps leif and others understand why we need to uncover and challenge the underlying core beliefs, as the triggers are purely their means of going about OCD's deadly work. 

It occurred to me to write a short piece about how  important I personally feel it is, based on my experience as a sufferer, to understand this element of the cognitive side of CBT. 

Simplistically our OCD uses a platform of negative bias falsehood lies exaggeration or revulsion to affect our normal daily lives and seek to restrict them. 

It does this by expression through a "core belief" within the particular theme from which we sufferer.We focus in on that core belief via triggers and compulse to try and gain relief from it - but the compulsing only strengthens the connection and prolongs the distress. 

The core belief is the false or exaggerated consequence of the obsessional thought. 

Sufferers worried about forming relationships typically have a core belief of low self-worth and fear rejection. 

In false memory the core belief is that we did something out of line with our core values that, typically, we see will or may have catastrophic consequences. 

Those with harm OCD typically fear lack of control. 

With magical thinking there is typically a fear consequence if they don't carry out a ritual. 

In contamination the core belief is typically fear of causing hurt to self or others through lack of an exaggerated demand for cleanliness or disinfecting, or exaggerated fear that certain things like our own body waste or blood of ourselves or others will cause harm.

Fear of vomit might revolve around a core belief centred on revulsion. 

The core belief can target one or more of our core values. For example in harm OCD we may have a core value of care that the OCD turns on its head to suggest we could act otherwise. 

In treatment we need to know what that OCD core belief means in the suffering that the disorder is causing, so that we can work out how to challenge it - "out"  it to see it for the falsehood or exaggeration it is,  as well as tackle the resultant triggers and compulsions that give it strength. 

A trigger may not reveal the underpinning core belief at the heart of a theme - so we especially need to uncloak it, and challenge it, in order to recover. A number of different triggers over time may intrude to trap us into thinking in terms of that hidden core belief. 

We can all work on this through CBT but for me we need to understand how the OCD operates in this way before we can throw ourselves into addressing it. 

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Makes sense, one of my core values is integrity and being a good person and my ocd themes centre on the ocd core beliefs that maybe I’m living a lie, and pretending to be something I’m not or am a bad person capable of harming others and having intrusive thoughts thoughts certainly gives credibility to those fears when I’m stuck in a loop.

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Great thank you for posting this! :) 

So I feel I can identify my core beliefs beneath the OCD in that mainly I am afraid of causing harm to others with the underlying core belief that I am incompetent and also that the world is a dangerous place. I've had these core beliefs defined a few times while working with CBT. However i just can't seem to work with it to the extent that the core belief is ever let go of. Logically i can see that they are not true, but it remains all the same.

I can also see that i do threat exaggeration.

However, I am struggling with how to work with these core beliefs outside of just doing erp around specific things that trigger me...Are there specific cognitive exercises one uses to work with this? Or is the key just to be aware of the the beliefs that seems to be underlying our issues?

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1 minute ago, leif said:

However, I am struggling with how to work with these core beliefs outside of just doing erp around specific things that trigger me...Are there specific cognitive exercises one uses to work with this? Or is the key just to be aware of the the beliefs that seems to be underlying our issues?

Having uncovered to core belief, you can break it down into its component parts to challenge them. 

Expect to "hear" from the illness in the form of its own weaponry to protect its position. 

It will play the certainty card "but how do you really know that it might be OCD, and so it could be true" and such like. 

One way is to utilise a behavioural experiment. 

If you have the book by Paul Salkovskis and others "Break Free From OCD" how to do this is very well expressed. 

I will again dig into the forum memory bank and see if I can locate something I have written earlier about how this works. 

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OK here is the piece I wrote about behavioural experiments. 

Here is a post I made some while ago that may help people look at the meaning being given by OCD thoughts and find a better way to view it before then working the therapy.

Some don't agree with this approach but me and my state-of-the-art therapist and many others do, and it features prominently in "Break Free From OCD" .

From the perceptive I often try and take, which is from the outside looking in from above (and in a detached way) I see so many similarities in the flavour of OCD, if not the content.

And for me it's all about spotting the OCD thought/image, labelling it OCD and not engaging with it, and if rituals are involved becoming convinced they have no real purpose - that's where success in addressing it seems to come from.

So when for example our OCD tells us we should do something, or have done something and we know in our heart of hearts this is actually out of kilter with our true character, then it must be OCD, mustn't it?

This is a key part of modern behavioural therapy, where one of the tools the therapist can use is to introduce to the patient the concept of evaluating theory A - the OCD'd set of circumstances - against theory B - the rational non-OCD version of events.

I have a feeling that this could work well for a lot of people, with most types of OCD. I would be interested in hearing people’s opinions.

Here's a brief example of this in action, applied to the concept of contamination.

Liz is convinced that her office environment is dirty,and she will get contaminated with germs, become ill and could die.
.
She spends a large amount of time every morning cleaning and decontaminating her workspace and environs before she can do any work.

For Liz, the theories might be explained as:

Theory A Theory B

My workspace environment is contaminated Our workspaces are simply
With dirt and germs cleaned overnight by the cleaners

If I don’t clean and decontaminate My colleagues are perfectly healthy
With powerful chemicals I will catch a disease 
And I might die

Who will bring up my young son No-one in the firm has been taken ill
If I die – I am a widow? From contamination at their desks.

Theory A shows the OCD at work , seeding the thought and magnify and catastrophizing it.

Theory B shows the pragmatic rational approach.

When Liz is shown theory B with the conclusive evidence that no-one has been taken ill from contamination, she can see that theory A is what it is – OCD and consequent compulsive rituals she is feeling obliged by the OCD to undertake to make her “safe”.

So theory B is used to undermine the power of the OCD , and aid the sufferer to then enter into a hierarchic gradual exposure to theory B via exposure and response prevention.

Edited February 26, 2015 by taurean

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Thanks for searching that out and reposting Taurean.

The theory A and B part seems to have gotten mixed in together but i get the idea. I've used approaches like that to work with specific triggers just like in the example, and I find it very useful. I don't see how one would apply it to a core belief though. Specific triggers seem easier to work with, whereas the core belief, the deeper set beliefs I hold, seem harder for me to shake, even when i can see logically they're not true, or when i prove it to be an exaggerated focus on the negative.

For instance if I am working with the core belief that the world is a dangerous place, I can come up with several examples to both support and not support this belief. Bad/scary things happen all the time, but so do the opposite.

I can also see evidence that while we can do some things to protect ourselves, things are pretty random.

So logically I can see that I am overemphasizing the negative, or the threat. However I'm not sure how to re-balance that thought, except for trigger by trigger using ERP.

So recognizing that yes, there is a threat in being exposed to other people's blood, for instance, I can see I overemphasize the threat, and then need to re-balance the approach I take to encounters with it. And maybe over time that will shift my core belief? But I just find I seem to have held these core beliefs for practically my whole life and they don't seem to shift, even if I can move on from a particular trigger. So while I might be able to move on from a particular trigger, the core belief just creates another focus for me. So then it might be that I might start a fire and end up checking the apartment for an hour before I can leave. So then I deal with that trigger...is that the only approach we can take? Trigger by trigger, or is there another way to work with our core beliefs that create the triggers?

I think a lot of this just has to do with the very real uncertainty of life, and my lack of ability to know how to live with that. 

 

 

Edited by leif

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I  believe the first step is triage. This is where I decide which thoughts to keep.

However. very few people just have OCD & when they do it's easy to treat. Most have a  load of mental conditions battling with each other. Otherwise just doing cbt would 'cure' everyone & it does not.

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You are exasperating.

OCD is anything but 'easy' to treat. OCD recovery is fairly simple and straightforward, but it is not easy!

And I don't know where you get the idea thst OCD sufferers have 'loads' of mental conditions.

Edited by PolarBear

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