Designing a catalogue of compulsions and working through them

[BigDave]

Hey ladies and gents,

Hope you are well. I myself have been having a really rough time of it as of late with regards to my OCD and I have had enough of wallowing in my own self pity so I thought I'd do something productive and begin with a hierarchy of compulsions in order to try and tackle this bar-steward. 

So the thing is, there are some compulsions that I know I probably can tackle with relative ease; I don't even know if it is worth even listing them. For example, not washing my hands if I've accidentally touched my lap while I am working on my work computer. But then there is stuff that seems like it is completely out of the realms of implausibility in terms of me actually being able to achieve. So I don't really have any middle ground. Now the thing is I was told that the best way to do it is by rating things by difficulty. The issue is is that I probably have a bunch of things that are rated like 20/100 which I know I can do easy. And then the rest seem like 100s. So there is a big gap in the jump. So some examples of each

 

100s

Something touching my wet lap after I've been for a wee and then carrying on like nothing has happened (yes, I know urine is sterile but the thought of transferring urine everywhere is horrific).

Walking past the bin (close to it) and not changing my clothes.

Putting stuff in the food waste bin.

Stepping in urine on floor that my brother has peed on and then not going for a full shower (some would say it is just urine, it's not a big deal, mop up and move on, others might say, wipe your foot, no big - these ones I find quite difficult because there seem to be a number of possible solutions so deciding which is the right one turns to be a bit of a tricky situation)

Going to the toilet generally and not changing clothes (especially #2)

Spraying a bit of urine on my legs while I go for a pee and not immediately wiping it off like I have anthrax on me (some people again would say, it's just urine, move on through - others would say wipe it - again, in these situations, my gut is saying wipe but I understand with ERP that sometimes you have to expose yourself further to stuff than you would normally...I think?)

- there are other things I've mentioned in the past: the whole "self love" thing is a particularly tricky situation as is pretty much touching my brother in any way (hugs, whatever or anything he's touched, especially after he's been to the bathroom, without wanting to have a full blown shower). I also cannot enter my bedroom with ease unless I am completely confident that I am clean. 

- I also have some childhood keepsakes that if I get urine on me, I am confident I end up spreading onto them (if I step on them by accident for example or if I walk past them after I've peed or stood in pee) and I quite frequently ask my mum to wipe them down because I am freaked out by that. Again urine, both mine and my brothers really freak me out.

- I also can't walk barefoot around the house because of urine/cat litter

- if the cat rubs up against me after I've been for a wee and I think i've got urine on me, I'll end up having to wash the cat (which he doesn't love).

 

And then there are the 20s

Play with the cat then go back to working at my computer 

resisting to check my tv screen after I walk back into my room with wet hands

moving my bedroom bin so I can get to my computer.

 

As you can tell, a lot more 100s than 20s. - I need to figure out how to really approach the big ones. I know people will say, go for the 20s first and then try the big ones but the 20s seem l ike easy gestures and then I'll freeze on the big ones.

 

What do you guys think?

[dksea]

55 minutes ago, BigDave said:

As you can tell, a lot more 100s than 20s. - I need to figure out how to really approach the big ones. I know people will say, go for the 20s first and then try the big ones but the 20s seem l ike easy gestures and then I'll freeze on the big ones.

 

What do you guys think?

A couple thoughts.

First, good on ya for putting down a list, thats a great step to take.

As for lots of 100s, it might be helpful to break that logjam down by comparing those.  Take any two, see which one you think would be worse, try not to think to hard about it it dosn't have to be perfect, and put them in order.  Keep doing that with pairs of items until you've got them all in order.

As for tackling the 100s, it can seem a lot so try and break those down into either smaller pieces, or gradual steps.  

For example: "Going to the toilet generally and not changing clothes (especially #2)"  Ok, with this one, at first see if you can wait 10 minutes before you change.  Then wait another 10 minutes etc.  If at some point you feel you just have to do it, ok, early on you change.  But now you try to keep to at least that same amount of time.  Say its 20 minutes.  Once you get to the point where waiting 20 minutes is no problem, bump it up to 30 minutes, or 40, etc.  Rather than trying to cut out the behavior completely, gradually improve.
 

1 hour ago, BigDave said:

Stepping in urine on floor that my brother has peed on and then not going for a full shower (some would say it is just urine, it's not a big deal, mop up and move on, others might say, wipe your foot, no big - these ones I find quite difficult because there seem to be a number of possible solutions so deciding which is the right one turns to be a bit of a tricky situation)

Again here you don't have to solve everything at once, try and improve from the current situation.  And when it comes to multiple solutions, don't focus on trying to find the "right" or "best" one, pick one and go with it.  Washing off your feet if you step in urine seems like a reasonable compromise at this point for example.  Then once you have shifted completely from full shower to just washing your feet, next you could try just wiping off your feet with a wet wipe, etc.  
 

1 hour ago, BigDave said:

I also can't walk barefoot around the house because of urine/cat litter

For this one, no problem, don't walk around with barefeet if you don't want to.  Lots of people wear slippers or shoes inside the house.  In Japan its not only common, but people provide guest slippers for when people visit their house (since shoes inside is a complete no no).  They even often have slippers just for using the bathroom/toilet.  If wearing slippers for when you walk around the house makes your life easier, that seems totally reasonable to me.

[PolarBear]

One thing I notice is that many of your high anxiety situations assume you have urine on you. Is it possible to get a drop on you when you pee? Sure. But your mind appears to be telling you that it often or always happens. That's ridiculous and an OCD lie.

This is where the cognitive side of CBT comes in. You have to start challenging these thoughts. They are lies. Chances are you rarely have urine on you. And that means most of the compulsions you do are pointless.

[BigDave]

I actually probably do have urine on me more often because I do have kidney issues to be honest, which I think has only exacerbated my OCD. 
 

I do think there are certain things I shouldn’t have problems with. For example, I struggle to touch my shorts or trousers after I’ve used the bathroom. I really struggle to pull my trousers up if falling down without immediately rushing to wash my hands. Again, I know everyone has urine and stuff on them and saying that everything is perfectly clean always is an absolute lie. But I still struggle. I feel like I need to figure out a way to overcome that. Things like bumping into DVDs with my bum and then feeling the urge to wipe them. I shouldn’t need to do that. Nobody else would do that. It’s OCD!

[PolarBear]

Exactly. And the way you overcome it is by challenging your OCD head on. You have to start doing the things you fear, often and repeatedly.

[Nikki79]

@PolarBear can I ask you how does that work for other things that cause compulsions for people? For example if someone is worrying about something they think they might have did or that kind of thing. How do you face those type of fears? 

[paradoxer]

1 hour ago, Nikki79 said:

@PolarBear can I ask you how does that work for other things that cause compulsions for people? For example if someone is worrying about something they think they might have did or that kind of thing. How do you face those type of fears? 

The basic rule for tackling OCD remains the same. The thought/dilemma presents itself, and instead of responding with an attempt to neutralize the 'threat', you accept it - or embrace it, and then pay it no more mind. 

[PolarBear]

Easy. You get intrusive thoughts when you change your child's diaper. It's something you are already exposed to multiple times a day.

What's missing is doing no compuldions, which is the response prevention part of OCD. You refuse to do your usual compulsions.

[leif]

@BigDave

That is a really good start. i agree with Dksea that a further breakdown would be helpful. I found it very helpful once I was able to draw up a hierarchy that went up in increments of 10 so there's not such a big leap.

 

10 hours ago, BigDave said:

there are some compulsions that I know I probably can tackle with relative ease; I don't even know if it is worth even listing them. For example, not washing my hands if I've accidentally touched my lap while I am working on my work computer.

I wouldn't write those off necessarily. Might be a good place to start and see if it easy for you.

[Nikki79]

9 hours ago, PolarBear said:

Easy. You get intrusive thoughts when you change your child's diaper. It's something you are already exposed to multiple times a day.

What's missing is doing no compuldions, which is the response prevention part of OCD. You refuse to do your usual compulsions.

That is true. Everyday has been a huge exposure since 14 months passed so that is why I’m so disappointed I’m not well over this. However when I have an incident like the other day and I panic and act weird then it sets me right back

[BigDave]

Ok so just to get this crystal clear in my head, I currently have a wet patch on my boxers. I can feel it. My underwear is touching my shorts that obviously wetness will spread to. I try to avoid my lap touching anything but that’s pretty hard and the urge is to wipe everything that touches it. I’m supposed to just IGNORE all of this right? Let stuff touch my lap etc. It’s not a big deal. That’s the right thing right? Why is it so hard?

[PolarBear]

Yes that's right. It's hard because you made it hard. Sorry to lay the blame on you but back then you didn't know better.

The more you did compulsions, the deeper seated the fear became. What was at first a minor annoyance, over time, became a huge issue.

[Closed for repairs]

Don't write off the "easy" ones

For one thing you have to see your self making progress, and every one needs a win.

For another they are some times not as easy as you think!

I got a bit stuck like this, the "easy" ones seemed daft, and the hard ones were "no bloody way is that happening!".

So I wasn't doing anything really and the OCD crept back in.

So I went back to the  beginning and am doing the "easy" stuff its all part of getting used to the anxiety.

And it turns out that forcing your self not to do the compulsions, (you know the ones where you think it's easier just to do them), is harder than it looks!

[BigDave]

Man. I’m struggling tonight. My butt touched my DVDs and the cupboard and I put my hand in the paper and wipe bin to press stuff down when it was full and now I feel like I have to wash my hands and wipe my DVDs. I’m doing neither but it is hell. 

[PolarBear]

Yeah, it is hell. But it gets easier after a while.

[BigDave]

30 minutes ago, PolarBear said:

Yeah, it is hell. But it gets easier after a while.

Genuinely mate, I know that I probably don't have any poo or whatever on my DVDs from my bottom touching them but I can't help but think what if. I mean, there is no way of being certain and I know certainty in OCOD is a lie, I understand. I am just pulling my hair out. I realise there is nothing that I can ask of you that will make that better and I won't be able to tell for sure unless I use a black light or something like that. I guess it doesn't matter, I just have this idea of me smearing it all over the place.