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I have been referred to a phycologist today and I am now worried that I wont be able to tell them the current thought as they may not understand and report me to someone. I had a private session with a councillor on Monday I was so desperate and I felt ok talking to her but couldn't tell her the new thought, instead skirting around it gaging her reactions to see if it is safe and spent most of the session crying anyway, but I know I need to say it but I cant.

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Hi banthethoughts :)

It can be really scary to share your thoughts, but it's incredibly unlikely that the psychologist will report you and much more likely that they will have heard all the thoughts before. Take a look at this page on the OCD-UK website, hopefully it will reassure you that it's ok to share and will give you the tools to point anyone with any misunderstanding in the right direction :)

https://www.ocduk.org/ocd/risk-assessment-in-ocd/

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1 minute ago, Gemma7 said:

Hi banthethoughts :)

It can be really scary to share your thoughts, but it's incredibly unlikely that the psychologist will report you and much more likely that they will have heard all the thoughts before. Take a look at this page on the OCD-UK website, hopefully it will reassure you that it's ok to share and will give you the tools to point anyone with any misunderstanding in the right direction :)

https://www.ocduk.org/ocd/risk-assessment-in-ocd/

Thank you, I am more concerned about peoples opinions with this thought, I look back and it seems  horrible, but at the time it didn't, but has manifested itself into my sexual orientation that is why I am freaking out. I remember telling someone ages ago I thought I had murdered someone and it shocked me their lack of concern. This one is way more complicated and if they don't understand it  scares me.

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Hello there BTT,

I do have a little working experience of this, and I will try and help you.  The sad fact and reality is that some mental health professionals do get OCD wrong and misunderstand worries about harm thoughts for intent and they fail to consult the NHS recommendations about risk in OCD.  But... these problems are thankfully rare, and these days most mental health professionals understand OCD better. 

So despite what I have written I do think you should tell them your thoughts, after all it is the only way they can help you if the understand your OCD thoughts and worries.  It's hard opening up, I have the same problem for a very different OCD reason at the moment.  But don't worry I will try and help you.

So how do you open up?  I think this is the right place to start.

11 minutes ago, banthethoughts said:

I felt ok talking to her but couldn't tell her the new thought, instead skirting around it gaging her reactions to see if it is safe

Gauge your therapists understanding of OCD by talking generically at first, talking about your other OCD problems (most of us have various OCD issues going on) and you can skirt around it, maybe mention OCD fears of harm without going into detail to both gauge her reaction and importantly see how she responds verbally with the questions she asks. I get this on the phone at least once a day, I can tell instantly that someone is skirting around what they really want to say (I guess that's where having understand of OCD helps).

What I generally do in these situations is demonstrate I understand by giving some examples and asking appropriate questions, i.e...… "is it thoughts of violently or sexually hurting someone.", then "is it harm about a loved one, a child"... then "don't worry, these are not unique thoughts, I hear these a lot".  Usually those three questions are sufficient to demonstrate I understand and the person usually starts to open up. 

You can even ask the psychologist a question during that first session... "I have OCD around harm, do you know much about this manifestation of OCD"?  That question alone may help you gauge.

If you are truly left with no confidence in their ability to understand, if their line of questioning seems off, and you truly don't feel able to talk you could hold back and address it post session by asking for a different therapist (someone with OCD knowledge or a NHS OCD specialist clinic)… that's a hard thing to do in itself, but we can try and help you if it gets to that point. 

Risk Assessment in OCD

An additional set of tools you can attend that first session with is information for the psychologist about 'risk assessment in OCD'. Gemma and myself created some information on this very subject on our website here - https://www.ocduk.org/ocd/risk-assessment-in-ocd/

The three tools I would recommend taking with you.

1 - The quote from the NICE Guidelines for OCD. (You can print the image from the guidelines off the above webpage). What the NICE guidelines state is... 

Consult mental health professional with specific expertise in OCD if uncertain about risks associated with intrusive sexual, aggressive or death-related thoughts. (These themes are common in OCD and are often misinterpreted as indicating risk.)

2 - OCD experts wrote a paper for mental health professionals called 'Risk assessment in OCD'. I don't think you need to print the entire paper, they may have read it, but maybe the title and link (https://www.cambridge.org/core/journals/advances-in-psychiatric-treatment/article/risk-assessment-and-management-in-obsessivecompulsive-disorder/B63116064047CEDFF6EB26E1D40A5638)

Finally

3 - We have an Ice Breaker printout specifically for this problem which explains what you are struggling with and will have both of the above links on it, so actually this perhaps all you need to printout.  Gemma and I have been working on that this last few days, so I will try and get that finished and on the website by tomorrow. When is your appointment for?

Don't worry, most therapists are great and will help you relax and demonstrate you can trust them :)

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3 minutes ago, banthethoughts said:

Thank you, I am more concerned about peoples opinions with this thought, I look back and it seems  horrible, but at the time it didn't, but has manifested itself into my sexual orientation that is why I am freaking out. I remember telling someone ages ago I thought I had murdered someone and it shocked me their lack of concern. This one is way more complicated and if they don't understand it  scares me.

What about them not understanding scares you, what do you worry will happen? 

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22 hours ago, Ashley said:

Hello there BTT,

I do have a little working experience of this, and I will try and help you.  The sad fact and reality is that some mental health professionals do get OCD wrong and misunderstand worries about harm thoughts for intent and they fail to consult the NHS recommendations about risk in OCD.  But... these problems are thankfully rare, and these days most mental health professionals understand OCD better. 

So despite what I have written I do think you should tell them your thoughts, after all it is the only way they can help you if the understand your OCD thoughts and worries.  It's hard opening up, I have the same problem for a very different OCD reason at the moment.  But don't worry I will try and help you.

So how do you open up?  I think this is the right place to start.

Gauge your therapists understanding of OCD by talking generically at first, talking about your other OCD problems (most of us have various OCD issues going on) and you can skirt around it, maybe mention OCD fears of harm without going into detail to both gauge her reaction and importantly see how she responds verbally with the questions she asks. I get this on the phone at least once a day, I can tell instantly that someone is skirting around what they really want to say (I guess that's where having understand of OCD helps).

What I generally do in these situations is demonstrate I understand by giving some examples and asking appropriate questions, i.e...… "is it thoughts of violently or sexually hurting someone.", then "is it harm about a loved one, a child"... then "don't worry, these are not unique thoughts, I hear these a lot".  Usually those three questions are sufficient to demonstrate I understand and the person usually starts to open up. 

You can even ask the psychologist a question during that first session... "I have OCD around harm, do you know much about this manifestation of OCD"?  That question alone may help you gauge.

If you are truly left with no confidence in their ability to understand, if their line of questioning seems off, and you truly don't feel able to talk you could hold back and address it post session by asking for a different therapist (someone with OCD knowledge or a NHS OCD specialist clinic)… that's a hard thing to do in itself, but we can try and help you if it gets to that point. 

Risk Assessment in OCD

An additional set of tools you can attend that first session with is information for the psychologist about 'risk assessment in OCD'. Gemma and myself created some information on this very subject on our website here - https://www.ocduk.org/ocd/risk-assessment-in-ocd/

The three tools I would recommend taking with you.

1 - The quote from the NICE Guidelines for OCD. (You can print the image from the guidelines off the above webpage). What the NICE guidelines state is... 

Consult mental health professional with specific expertise in OCD if uncertain about risks associated with intrusive sexual, aggressive or death-related thoughts. (These themes are common in OCD and are often misinterpreted as indicating risk.)

2 - OCD experts wrote a paper for mental health professionals called 'Risk assessment in OCD'. I don't think you need to print the entire paper, they may have read it, but maybe the title and link (https://www.cambridge.org/core/journals/advances-in-psychiatric-treatment/article/risk-assessment-and-management-in-obsessivecompulsive-disorder/B63116064047CEDFF6EB26E1D40A5638)

Finally

3 - We have an Ice Breaker printout specifically for this problem which explains what you are struggling with and will have both of the above links on it, so actually this perhaps all you need to printout.  Gemma and I have been working on that this last few days, so I will try and get that finished and on the website by tomorrow. When is your appointment for?

Don't worry, most therapists are great and will help you relax and demonstrate you can trust them :)

Thank you, I have been in and out of therapy and only had 2 people who didn't understand so I have been lucky but this thought makes me worry they will panic and call the police. I have counselling every Monday private as I was so desperate and am waiting for my psychology appointment. I will have a read through.

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3 hours ago, banthethoughts said:

that they will take my children away

I understand, it's very common for parents to feel that way, but it is incredibly unlikely that this will happen. Hopefully some of what Ashley shared will help you feel more confident. Let us know how you get on with the psychologist :)

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