Jump to content

Recommended Posts

I'm finding CBT quite confusing in some areas mainly due to the way that we are supposed to treat the thoughts as my main issue is HOCD. My therapist says that I should use the term "I could do that to whoever but it's very doubtful I ever would" analogy, while others say just agree with the thoughts and say something along the lines of " Yes OCD I do want to do whatever to whoever" to try and take the sting out of it, that results in a direct approach to the thought and immense anxiety for me and massive guilt even though I know I'm just doing a mental exercise. He says in doing that I'm basically giving in and it's not the best approach but I have seen other therapists reccomending it, I'm confused!

Link to comment

Hmmmm. My take on it would be that there is some truth in both but you’ve not quite got it right. When a thought comes into your head - yes, it’s a thing that *could* happen. So in that sense the second person is right - you shouldn’t deny the thought existed or that it is totally impossible. However, the first person is right too in that while it is a real thought, that doesn’t necessarily make it what you want or likely to happen. Both are true, and I think you the need to let the thought go and not dwell on it. Dwelling on it won’t make you any more certain - in fact it’ll do the opposite. Accept that your initial conclusions are almost certainly correct, yet there is some uncertainty associated with that. That’s the best anyone can do.

Edited by OxCD
Link to comment
2 minutes ago, OxCD said:

Hmmmm. My take on it would be that there is some truth in both but you’ve not quite got it right. When a thought comes into your head - yes, it’s a thing that *could* happen. So in that sense the second person is right - you shouldn’t deny the thought existed or that it is totally impossible. However, the first person is right too in that while it is a real thought, that doesn’t necessarily make it what you want or likely to happen. Both are true, and I think you the need to let the thought go and nor dwell on it. Dwelling on it won’t make you any more certain - in fact it’ll do the opposite. Accept that your initial conclusions are almost certainly correct, yet there is some uncertainty associated with that. That’s the best anyone can do.

Thank you for replying, I actually read that agreeing/ saying "yes I am going to hurt whoever" should bring on massive anxiety and guilt and obviously confirm that you don't really want to commit the particular thought but expose you to the anxiety and fear it gives you. I have done several mental CBT exercises and just said yes to the OCD which has only made me feel massive guilt and made my OCD worse because the disorder says I really meant it even though I am doing it as an exercise. My OCD has a wicked way of even turning the treatment against me.

Link to comment

Not sure I agree with that. Experts have studied this and yes it can cause short term pain, but longer term relief. Your OCD is not that special I’m afraid! ? The same as all of ours most likely.

Link to comment

I have basically been repeating the thought however horrible and trust me they are! and mentally saying yes i will do it hence the massive anxiety but I know deep down I am just doing an exercise in trying to make myself better. I read about a woman who suffered really awful OCD after pregnancy and was advised this was a good way to face the thoughts.and it worked for her..... I just feel awful guilt and its probably justified.

Link to comment

I'm not sure I agree with your therapist's take on CBT. When is it your supposed to use that phrase? 

In therapy you should learn about the prevalence of violent thoughts in the general population, learn that they are common and very ordinary. That someone with OCD places importance on having the thought itself, believing it to either say something about them (which it doesn't) or that they are more likely to act on a thought because it's present (you're not). They usually then look at what behaviours you do that keep making the thought bother you. These may be internal behaviours like arguing with the thought, blocking the thought or external behaviours like checking or avoiding people, places or objects.

You then try out behavioural experiments where you don't do these behaviours and compare what you think will happen with what does happen.

The reason people choose to say to OCD, yes I will do this/that, is usually part of also behaving as if the thought means nothing. You can't do one without the other. It's essential that you act as if the thought has no meaning. And you base that behaviour on the general education about thoughts. 

Is that any clearer, I know I've written a lot? Is your therapist an NHS therapist or a private therapist? :)

Edited by Gemma7
Link to comment

@Gemma7 I almost agree with you but not quite. So I used to be worried that I could catch HIV from kissing. And sometimes I’d have that thought and it would cause me loads of distress. However eventually, I would conclude its ridiculously unlikely (though in fact scientifically possible) and therefore let the thought go.
Sometimes there is a slither of possibility in thoughts, yet it’s about putting them in perspective. Theoretically a random thought about something *could* mean something.... It’s just very unlikely given the high prevalence of random thoughts like these in the population. Part of getting better is accepting this uncertainty. Another example: Did I brush against the dirty thing? It *may* have happened - it’s just very unlikely given that I was 5 metres away from it. You can’t just label everything nonsense. It’s just extremely unlikely and we have to embrace the lack of absolute certainty.

Edited by OxCD
Link to comment

I argue and engage with the thoughts at every opportunity constantly dismissing them and saying no, no, no I am not that kind of person and I would never harm anyone and that has got me stuck in my current position. I probably like most sufferers have a very active mind and having read various blogs on the issue decided to mentally say the thoughts back to myself as if I was/am capable to carry them out and I am now regretting it due to a massive sense of guilt.

Link to comment

@Gemma7 My point is simply that the solution is not to say everyone has random thoughts - my current thought must just be one of these nonsense ones. Rather - everyone has random thoughts, my current thought is almost certainly one of these (but acknowledging there is ambiguity there).
In my example about HIV and kissing I can’t just say everyone kisses and no one catches HIV by that route. Rather I must acknowledge it’s very very unlikely but there is some uncertainty there. As ultimately, it’s the certainty and reassurance things are going to be ok that we crave, and learning to accept this uncertainty is part of getting better.

Edited by OxCD
Link to comment

@phillev I agree with @Gemma7 that this does in fact seem a bit odd. I originally thought you meant you acknowledge the thought may be true but it’s just very unlikely - but now you elaborate, it sounds weird for CBT. You are fuelling the fire by ruminating. You need to let it go. Maybe the person is wrong, or maybe you’ve understood it wrong? It certainly seems to go against what my therapist and psychiatrist say.

Edited by OxCD
Link to comment
18 minutes ago, OxCD said:

Rather I must acknowledge it’s very very unlikely but there is some uncertainty there. As ultimately, it’s the certainty and reassurance things are going to be ok that we crave, and learning to accept this uncertainty is part of getting better.

I agree, I wasn't suggesting that you base your actions on being sure that there is no threat. Indeed, you have to take a leap of faith that what you fear won't happen. Sorry if there was some confusion there :)

Link to comment

@phillev Seems he mentions the conventional stuff we discussed first - and then this odd approach that flies in the face of all CBT I know about. Looking at his page - he’s not actually a psychiatrist, certainly not a recognised world leading OCD psychiatrist. I’d be careful what you read - there’s a lot of **** on every subject on the internet.

Link to comment

@phillev Nah. I get confused by people online all the time. That’s normal. And don’t dwell on this.... You had a thought you’re a bad person. Not the same thing as being a bad person. Be strong and let the thought go.

Link to comment
3 hours ago, phillev said:

I argue and engage with the thoughts at every opportunity constantly dismissing them and saying no, no, no I am not that kind of person and I would never harm anyone and that has got me stuck in my current position. I probably like most sufferers have a very active mind and having read various blogs on the issue decided to mentally say the thoughts back to myself as if I was/am capable to carry them out and I am now regretting it due to a massive sense of guilt.

Arguing and engaging with the thoughts is absolutely the WORST thing you can do. They are compulsions and they only prolong your anxiety. 

Link to comment

There is a lady called Diane Wilson who has suffered with OCD and PND and she was actually instructed by her CBT therapist to mentally repeat the thoughts as exposure to the anxiety and telling the OCD she would do whatever to her newborn baby and not responding to it with the usual negative response. I had an OCD flare up last year over a certain word I used in describing my symptoms and a board member said I should say out loud "I'm TEMPTED to kill everyone" which is kind of the same thing. I'm totally confused.......

Edited by phillev
Link to comment

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
×
×
  • Create New...