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Can someone explain simply CBT


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So I understand that it’s cognitive behavioural therapy, change the thought and behaviour. 
 

but can anyone explain in simple terms particularly the cognitive side in relation to ocd? I understand the behavioural side in terms of exposure response prevention. I have tried searching on here but can’t seem to find a simple explanation. Bonus points if you can explain it in relation to contamination ocd (my particular one happens to be my kids and I getting threadworms)

thanks anyone :)

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In a nutshell, the cognitive side is about changing the way you think about intrusive thoughts. Right now you take them seriously, freaking out, ruminating and doing other compulsions. You can teach yourself to not take the thoughts seriously, to treat them as the lies thry always are.

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A great book is Break Free From OCD. It is very clear and includes things about contamination. If you compare it with Overcoming OCD, Break Free is a clearer account of the same stuff. It has shorter paragraphs, shorter sentences and fewer technical terms. So it’s easier to learn from.

But it is still an accurate account of the theory and practice of OCD therapy written by some of the leading experts in OCD.
 

It is also a self help book.

It was the set book in my therapy. My therapist was one of the writers. She said: she, and her co-writers, aimed to make things as clear as possible.

Edited by Angst
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10 hours ago, Hopingtorecover said:

Bonus points if you can explain it in relation to contamination ocd (my particular one happens to be my kids and I getting threadworms)

How you think now (A):  "Threadworms are completely unacceptable and I must do everything I possibly can to prevent them!"
How you should think (B): "Threadworms are real and not great, but not the end of the world.  I can take reasonable steps to be clean and avoid them, but I do not need to center my life around it."

The cognitive side of CBT helps you get from A to B by changing how you evaluate and respond to situations.

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5 hours ago, dksea said:

How you think now (A):  "Threadworms are completely unacceptable and I must do everything I possibly can to prevent them!"
How you should think (B): "Threadworms are real and not great, but not the end of the world.  I can take reasonable steps to be clean and avoid them, but I do not need to center my life around it."

The cognitive side of CBT helps you get from A to B by changing how you evaluate and respond to situations.

I guess the “reasonable steps” but is where I get stuck. Because what’s reasonable to my ocd mind doesn’t seem reasonable to others...

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5 hours ago, Hopingtorecover said:

I guess the “reasonable steps” but is where I get stuck. Because what’s reasonable to my ocd mind doesn’t seem reasonable to others...

Yes, that’s the challenge, to go from where you are closer to where those people are. CBT helps you do that. 

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23 hours ago, Hopingtorecover said:

So I understand that it’s cognitive behavioural therapy, change the thought and behaviour. 
 

but can anyone explain in simple terms particularly the cognitive side in relation to ocd? I understand the behavioural side in terms of exposure response prevention. I have tried searching on here but can’t seem to find a simple explanation. Bonus points if you can explain it in relation to contamination ocd (my particular one happens to be my kids and I getting threadworms)

thanks anyone :)

I'm not sure you change the thought as such, you just learn that because you've had a thought doesn't mean you have to do anything about it. 

There probably isn't a simple explanation because it isn't that simple to explain, but on the whole the cognitive side is first looking at what maintains OCD, which involves creating a vicious flower diagram. This creates a mutual understanding of what the problem is between sufferer and therapist. You might then look at what makes you act on your worries, like anxiety, distress, assumptions you make and prior beliefs you held like, if I see there is a threat then it is my responsibility to try to do all in my power to prevent it or bad people have bad thoughts. You also look into the role of inflated responsibility in OCD. 

You would then test out your beliefs in behavioural experiments (ERP) to find out if what you believed would happen or didn't happen. You basically collect evidence for why your problem is one of worry not one of risk. You learn that your beliefs feel strong because of compulsions and that not doing compulsions actually reduces how much you care about them. 

7 hours ago, Hopingtorecover said:

I guess the “reasonable steps” but is where I get stuck. Because what’s reasonable to my ocd mind doesn’t seem reasonable to others...

It is highly likely that in therapy with a good therapist, you would learn to drop all safety behaviours involved in preventing getting thread worms. You would prove to yourself that your compulsions had no effect whatsoever on preventing them and that in the unlikely event it did happen, you would cope with it and it wouldn't be as bad as your believed. 

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1 hour ago, dksea said:

Yes, that’s the challenge, to go from where you are closer to where those people are. CBT helps you do that. 

So today, for example, I’m at a toddler group in a building that my family go to a Couple of times a week for different things. And there’s a kid there with his hand down the back of his underwear touching his bottom. I ended up leaving cos I couldn’t cope but now obviously I don’t know where he’s touched and then who’s touching that and then coming into my house. Also my kids will go there later this week and so my thoughts start to spiral and I don’t know what’s reasonable and what’s not!!

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24 minutes ago, Gemma7 said:

 

It is highly likely that in therapy with a good therapist, you would learn to drop all safety behaviours involved in preventing getting thread worms. You would prove to yourself that your compulsions had no effect whatsoever on preventing them and that in the unlikely event it did happen, you would cope with it and it wouldn't be as bad as your believed. 

That’s helpful because my understanding is that ocd can take a relatively “normal” and common childhood illness and make the thought catastrophic. Like I really believe if it happened I wouldn’t cope and we would never get rid of them but I know it’s common and people deal with it all the time. 

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46 minutes ago, Hopingtorecover said:

and so my thoughts start to spiral and I don’t know what’s reasonable and what’s not!!

When it comes to day to day situations the wisdom of the crowd, i.e. the behavior most other people are doing is a good guide.  If you don’t see other people panicking or running out in those situations it’s a good sign you don’t have to either. Doesn’t mean you won’t feel anxiety. Doesn’t mean you won’t want to run. But it will at least give you an idea whether your behavior is reasonable or not. 

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Nature of the beast. There is, in everyone, an ancient part of the brain, rather dumb, that is supposed to raise an alarm in times of trouble or danger.

That part of the brain triggers the fight or flight response. Came in real handy when our ancestors came across a sabre toothed tiger. You either had to fight it or run like all get out.

In sufferers, that part of the brain acts up. Instead of firing just when there's danger, like fire, it can go off with just a thought. This makes you sit up and pay attention. You become alarmed and anxious, as if that thought is really important. And that's where the trouble starts.

A non-sufferer can have the same thought but the slarm doesn't go off. They can easily dismiss the thoughs irrelevant.

However, sufferers can learn to not give the thoughts attention. Eventually that dumb part of the brain calms down and stops raising the alarm for such thoughts.

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Keep going. You are doing great! Hope you get some sleep tonight and tomorrow is another day. 

I really appreciated the advice about what do you see other people doing, I will remember that one. I tell myself I'm highly observant and no-one else has noticed but whose to say this is true! 

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10 hours ago, Hopingtorecover said:

Why does ocd do this?? Take a minor ailment and blow it out of proportion? 

Because you reacted to it as such therefore changing your brain neuroplasticity. 

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For me a few key elements for the cognitive side of therapy (mostly self-directed from books) has been

  • understanding OCD and how it works 
  • working up the motivation to do the work to get better (various exercises included writing out how OCD interferes with my life, how it impacts others around me, how much freer my life would be without it etc)
  • understanding my own personal beliefs and attitudes that contribute to my OCD (for me threat exaggeration and responsibility exaggeration are key)
  • understanding the process of erp so that when the anxiety goes up i am ready with my new approach to it.

the main book i used had quite a few writing exercises to approach this. I found it very helpful to help me stay on track

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18 hours ago, Hopingtorecover said:

So stop reacting and change the brain back? 

Absolutely!  It takes time to get used to the anxiety feeling. It’s uncomfortable but can’t harm you. 
 

Btw, I notice you have more than one topic.  It’s easier for us to follow you if you just add to a previous topic. 

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  • 2 months later...

I have never posted on anything like this before but I just wanted to say I have exactly the same fears as you. That me and my daughters will get threadworms and never get rid of them. I think about it day and night and it is ruining my life. I had a course of CBT but it didn't help. I am goingback to my GP next week as I feel unbearable. Sorry im not being helpful in the slightest but I just wanted to say hello and I hope you are ok. I don't know anyone with this specific fear. The therapist told me he didn'tknow how to help me as he'd never heard of it eirher. Reading your posts has made me feel a glimmer of hope. 

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