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Hello I just wanted to get some advice on ERP 

I have been completing some exercises inbetween therapy sessions 

Its obviously very anxiety provoking but I've been trying my best im not formally diagnosed but she said I had obsessive and intrusive thoughts 

I am emailing as I have had what I can describe as an emotional breakdown this morning just because I lost my bag (it was then found in a obvious place) 

Is it possible this is a result of engaging in erp? And my anxiety levels being high? And will it get worse before it gets better as now it feels pretty tough, tougher than before therapy 

 

Thanks 

Lauren

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Hiya Loz,

Welcome to the forums :)  I am sorry you had problems this morning, try and stay strong, bad days do pass :)

2 hours ago, Lozxm said:

im not formally diagnosed but she said I had obsessive and intrusive thoughts 

The first thing I would say about that is to question the therapists comments, did she actually say you have OCD or just above that you have intrusive thoughts?   Whilst most of us tend to self-diagnose our OCD, I am always wary of therapists that fail to actually be clear that a person is suffering from Obsessive-Compulsive Disorder.  So next time you see her, ask her if you do suffer with OCD. If she's not prepared to say that formally, I would question if she is the right person to treat you.

 

2 hours ago, Lozxm said:

Is it possible this is a result of engaging in erp? And my anxiety levels being high? And will it get worse before it gets better as now it feels pretty tough, tougher than before therapy 

Obviously I can't say if today's setback was because of ERP, but yes badly done therapy (by the therapist, not you) can make things worse.  However, good therapy should prepare a person for any behavioural exercises and in my experience when done right any exposure work the anxiety is fleeting (few minutes), partly because we have chosen to do the exercise and prepared for it.

In terms of OCD therapy we don't actually recommend ERP alone, we do suggest CBT (including ERP) which is a more thorough treatment approach. 

Is your therapist through the NHS or private?

Ashley.

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Thanks for your reply 

My therapist is through NHS and I was stepped up for face to face therapy from telephone. 

She has said that she thinks I have obsessive thoughts and seemed to think these stem from issues with self esteem and general anxiety. She said that she wasn't sure if it was full blown ocd.  And that in the past it may have been ocd but not sure now. 

As we went into more of the content of the thoughts she has told me to have a week where I face these head on. Through exposure to feared situations amd saying phrases to myself  that make me anxious etc

I was happy in the fact that she has talked through obsessive doubts that are common and sounds like she has had personal experience 

It was only my second session so not sure if she was aware how much the thoughts were bothering me until. The end

Maybe see what next week brings? Any advice will be appreciated

 

Thanks 

Lauren

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Hi Lauren, of course give it a couple more weeks if you feel more comfortable to do that.  I can't tell you what to do of course but I can tell you what I would do (I did actually do something similar last year).

5 minutes ago, Lozxm said:

She has said that she thinks I have obsessive thoughts and seemed to think these stem from issues with self esteem and general anxiety. She said that she wasn't sure if it was full blown ocd.  And that in the past it may have been ocd but not sure now. 

This immediately strikes me as someone with insufficient understanding or knowledge of OCD, so I would certainly think about changing if this was my therapist.  I assume this is through a local IAPT service?  If so, asking for another therapist is easy enough, although a tad awkward. They should be able to assign you a new therapist, although you may have to wait until one becomes available.. feel free to blame me if you like "Ashley from OCD-UK suggesting I ask for a therapist with knowledge of treating OCD".

Where in the country are you, are you near one of the specialist NHS clinics?

Happy to advise further if you need me to.

 

 

 

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Thanks Ashley appreciate it

I was just relieved at first to have someone confirm that they were intrusive thoughts and not necessarily me but I've felt so anxious facing them this week. She has basically told me to have a 'lesbian week' and face situations that make me anxious. I have had thoughts about relationships, smells and children in the past the theme can change 

I am near greater manchester and getting it through healthy minds at primary care trust

I have been waiting for a year nearly in total to get this help so I really want it to work 

I am planning on moving in the summer overseas (if i feel better) so I am reluctant to wait this long again it needs to be sorted 

 

Thanks 

Lauren

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3 hours ago, Lozxm said:

Thanks Ashley appreciate it

I was just relieved at first to have someone confirm that they were intrusive thoughts and not necessarily me but I've felt so anxious facing them this week. She has basically told me to have a 'lesbian week' and face situations that make me anxious. I have had thoughts about relationships, smells and children in the past the theme can change 

I am near greater manchester and getting it through healthy minds at primary care trust

I have been waiting for a year nearly in total to get this help so I really want it to work 

I am planning on moving in the summer overseas (if i feel better) so I am reluctant to wait this long again it needs to be sorted 

 

Thanks 

Lauren

Hi Lozxm

sorry to hear you're struggling at the moment.

I agree with Ashley i would be a little sceptical about how much your therapist knows about OCD. 

Have you read any self-help books on OCD such as "break free from OCD"? :) 

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Thanks I'll have a look at that

Possibly, I feel I was told to face my fears but I wasn't given any strategies or understanding on what I need to do with accompanying racing thoughts and anxiety that arise as a result of facing things

I have been a bit disheartened when my anxiety levels haven't gone down 

 

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14 hours ago, Lozxm said:

Possibly, I feel I was told to face my fears but I wasn't given any strategies or understanding on what I need to do with accompanying racing thoughts and anxiety that arise as a result of facing things

I have been a bit disheartened when my anxiety levels haven't gone down 

I think this is the beauty of the C part of CBT, whilst it doesn't make facing our fears any less easy, it does ensure we understand the beliefs behind our thoughts and why we need to do the exercise and in theory should help with the anxiety post exercise.

I also would argue nobody with OCD should ever be 'told' to face their fears. Good therapy is a collaborative effort between patient and therapist who agree therapy exercises together at the right time and at the right level of exposure for that person at that time.

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She did talk about cbt. The beliefs that were suggested were about my self esteem and self worth not specifically related to the individual intrusive thoughts... 

She said I have these obsessional thoughts as a result of triggers that relate to my low self esteem and belief of not being good enough. Then in turn she said to face my fears. 

It kind of made sense I supoose I'm just a bit confused of how to go forward and don't fully understand everything yet. Early days eh ?

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Hi Lauren,

I do understand and hopefully we're not confusing things for you.  My gut feeling from what you describe is the therapists understanding of OCD is not there, OCD saps peoples confidence and self-esteem, but it's the actual OCD that is the problem.  

You could give her a couple more sessions as you suggested to see if things get better, but my thought is it may be time to ask for someone with more experience of treating OCD (seeing she's not labelled OCD).

Good luck whatever you decide to do :)

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Thanks Ashley

I can confuse myself in an empty room so don't worry about that haha 

Yeah the main thing that bothers me in my life is the thoughts and it has done for years... that's why I came to therapy in the first place. 

I'm gonna stick it out and see what comes of it first, possibly go private if I'm not happy. 

Thanks again for your help?

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1 minute ago, Lozxm said:

Thanks Ashley

I can confuse myself in an empty room so don't worry about that haha 

Yeah the main thing that bothers me in my life is the thoughts and it has done for years... that's why I came to therapy in the first place. 

I'm gonna stick it out and see what comes of it first, possibly go private if I'm not happy. 

Thanks again for your help?

hope you manage to make progress Lozxm :)

I'd really recommend checking out that book if you get chance (break free from ocd by paul salkovskis).  x

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