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Learning from other people on this forum and a plan of action


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Hey all,

Thanks for taking the time to read this in what may be a lengthy post but that is aimed to come up with a proper plan of action for moving forward. I want to start by saying that I am already doing a pretty good job at the moment, not to blow my own trumpet. But I feel at this present point, there needs to be more done to continue moving in the right direction, as seen by my recent post where I was a bit flustered by the possibility of my leg touching the toilet basin. In my defence, my brother does pee all over the toilet and the bathroom and there is a chance that I could have potentially got urine on me. That being said, I do know that I blow things up out of proportion and my reaction is more down to feelings of disgust as opposed to actual worries about things doing me harm. Anyway I digress.

I've actually been taking a lot in from these forums as of late. I have to thank the recommendation of people like Polar Bear for recommending to read more of the posts. The reason that I have learnt so much from these forums is that, whether people who post realise or not (I'm talking about the ones currently suffering more so than those recovering/advising etc) but most cases if not all follow a near identical construct. Obviously that is why it is OCD after all but it's really simple. You have fears or concerns -> you perform compulsions to relieve that concern -> you tell yourself that the compulsions are essential and that you have to do them or otherwise everything will go to pot. There is obviously a whole lot of denial in there as well where you try to convince yourself that the reason that you're doing this isn't because you have a disorder but because there is something inherently wrong with you or that, in some cases, other people just aren't seeing things clearly enough. I know with me and my contamination aspects, I'm always looking around at other people and thinking to myself "why does that not bother them?" Eventually the realisation does come that the reason it doesn't bother them is because the reality isn't as anxiety provoking as you feel it to be. It's interesting though reading other people's situations and my heart goes out to everyone. I do think though that we can all beat this. In truth, I've found following set programmes of CBT quite hard, partly because I'm currently doing zoom calls with my therapist rather than in person and also because I am not as organised as I would like to be (which is ironic since I am also very particular and organised in other aspects). But anyway...

I do have a lot of issues and I am not going into each of them. I think a really good thing that has developed over time is that I now know clearly when I am performing a compulsion. That isn't to say that I always avoid doing the compulsion, I am not there yet, and yes, sometimes doing it does temporarily make you feel better, but I can nevertheless look back on an action and say "no, you didn't need to do that!".  What's interesting also is that I started this post thinking that I was going to try and work on a schedule with your help to improve things. To list down every compulsion I do would take forever mind you and also, getting you to tell me the answer in a way would not be a good thing because it's reassuring me, right? That being said, I do find myself hitting a few stumbling blocks and I don't really know how to break them. The most common of these stumbling blocks involves the bathroom and bodily fluid "contamination". The main culprits are urine, faeces and semen but sure, it goes beyond that to sweat, blood, spit and anything else that you can excrete from your body. I think the first thing that my therapist has tried to tell me is that "if it comes from you, then it can't harm you" and that is a smart way of looking at things. That being said, I do get discomfort at the thought of any of these excretory products on my person, whether it be hands, clothes or whatever. It's true that whenever I go for a pee, I usually end up changing at the very least my shirt. The reason for that is that I do have bladder issues and I can potentially/if not likely get some urine on me. It might land on my leg or feet or shirt in varying amounts. Tonight, I was too sleepy to care about it landing on my foot, came back to my room, realised what I did and then was like OMG OMG, I need to wipe everything. I haven't wiped everything , although I will admittedly say that I did sniff a couple of things but I did come to the realisation that even if I did get some urine on my property, and it didn't dry on my foot before I even went to my room, then it's not going to do me any harm. That's not an easy conclusion to come to trust me but here I am typing on my computer after sniffing some things and I could potentially have a speck of urine on my hands or presence and i am still using my computer. That's a risk I am just having to take - I risk I might add that deep down know has no consequences besides revulsion at the thought of there being urine on there.

In terms of other stuff, I think SnowBear did an amazing job in trying to calm me down in terms of semen. I guess again, it's one of those things where the revulsion of it being blown out of proportion and why I have no desire to pain my room with it, if I make a concerted effort to keep clean, wash my hands, sure, there might be a speck of it on my clothing or what not but it's not really the end of the world that I feel it is.

In terms of faeces, it's a bit more of a complicated situation. The thought of having that on my presence really disturbs me and is something that I actually really struggle with. Actually, going to the toilet for that purpose is probably one of the most challenging things I do every day. Part of the reason for that is that my brother pees all over the floor (he's autistic) and I have to mop the floor usually before I can sit on the toilet but putting my shorts near or on the floor isn't really something that I am particularly thrilled about when I'm going. And then there is the whole wiping stuff which in itself is really distressing. Without the intention of distressing or upsetting anyone, I do kind of figure that I can't be the only one to occasionally get my hands slightly unclean in the process of wiping myself down, at least I hope not. I feel like it's just one of those things, especially if you happen to be using poor/cheap loo paper. The problem for me is that, if I do find myself in that situation and I know that my hand isn't clean, trying to get my trousers and boxers up without contaminating my clothes is a real problem. Again, I have spoken with my therapist about this sort of thing and he will tell me that it's something that people have been doing for years and years and people just don't think about it. That being said, if someone is consciously aware that they have poo on their hands, I don't know how they just go "OK, I am going to pull my pants up anyway" knowing full well that they could be getting that very stuff on their clothes. I am also very conscious about which hand I use to turn the tap on, which hand I flush the toilet and so on. I don't think though in these cases, that is particularly a weird thing to do. Changing your clothes after you've been is probably overkill but I think to myself, OK, I have my brother's urine on my shorts from the toilet floor or my shorts aren't clean because i've pulled my pants up and I think it's the safest option. In reality, again, there is probably no harm that is going to come from it if I did have some on me but that doesn't really comfort me. 

Probably the most distressing thing though about the contamination side of my OCD does involve my brother though. Like I said, he is autistic and has zero concept of hygiene. He will go to the bathroom without washing his hands for starters. He'll use the food bin which is notoriously a bit rank and not have a second thought about then touching the fridge or a cupboard afterwards without washing his hands. There are a lot of other things too. The reason I mention this is not to slag off my brother at all but to really try and work through these issues. My therapist will say things such as "well, your parents deal with it and they're still alive and well", which is a fair point. I do think however that I obviously have a very very high standard when it comes to cleanliness and, in essence to adapt to the fact that my brother is how he is, have accepted that they have to lower their standards somewhat. And gosh, that's fair enough I guess. At the end of the day, they want to provide my brother with love and affection and allow him to have as normal a life as possible, so of course they'd let some things slide. The problem is for me that I find it very difficult to do. It's bad enough me worrying about getting my OWN bodily fluids on stuff, never mind other peoples. AGAIN, I want to be clear that I am well aware that we don't live in a perfect or perfectly clean world. Everything we touch is probably contaminated to some degree. Even the money that we use probably has lots of contaminants on it. It's just, very hard to swallow when you think about that sort of stuff being brought over to the bed that you sleep or your computer or television remote or whatever. And yeah, I know I don't put any of that stuff in my mouth or whatever but it's just a horrible thought.

My OCD is by far solely related to these contamination thoughts but I figure this is as good a start as anything to be working on. I figure if I can break the camels back on one of these things, then everything else will follow suit. It's just a matter of trying to get my head around everything. I would REALLY appreciate your thoughts on this. True enough, probably the easiest way of dealing with is to just succumb and say YES, there might be some poo on my shirt or urine on my shirt and or semen and it might get on my computer or remote or whatever. But so what. I might even push that sentiment to my brother too and say, yep, there is a good chance I'm going to have all that stuff on my presence and on my stuff which I love but it's all really inconsequential. Obviously, I'm not advocating having lumps of stuff on me or a t-shirt drenched in urine but if it is small proportions, then really maybe I should be letting this go? I ask that as a question but I am pretty sure I know the answer. I guess what I am doing right now is trying to convince myself. It's not the easiest.

Anyway, I just want to say thank you to everyone who shares their thoughts on here. It really helps you in more ways than one to kind of process your own situations. I really hope that people can find the peace they deserve with this rubbish illness because it's not fair. I know you guys can pull through however - it's what I intend to do myself.

 

 

 

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8 hours ago, BigDave said:

most cases if not all follow a near identical construct. Obviously that is why it is OCD after all but it's really simple. You have fears or concerns -> you perform compulsions to relieve that concern -> you tell yourself that the compulsions are essential and that you have to do them or otherwise everything will go to pot. There is obviously a whole lot of denial in there as well where you try to convince yourself that the reason that you're doing this isn't because you have a disorder but because there is something inherently wrong with you or that, in some cases, other people just aren't seeing things clearly enough.

Yes! This is such a great summary of the problem. When you come up with something that, to you, is very new and people say "it's all the same", this is exactly what they mean. I think this is how the forum helped me when I was really struggling, at some point I realised that everyone is essentially following the same pattern. Sure, the nature of the worry can vary dramatically, but the underlying pattern is always the same. I'd just like to add that there is another element, we all go to great lengths to "keep ourselves safe" from whatever threat we perceive, which can range to seeking reassurance that you're not a pedophile to cleaning surfaces to avoid contamination. Yet, our efforts to keep ourselves safe usually lead to everything else in our lives falling apart.

8 hours ago, BigDave said:

My therapist will say things such as "well, your parents deal with it and they're still alive and well"

I think your therapist is right and I think this mentality is something you could apply to almost everything you have written. Yes, your brother may touch the big and then the fridge and some of the dirt will get to you. Sure, that is unpleasant but it is very unlikely to kill you. Now, what is worse, facing some disgust or spending the rest of your life suffering because of it?

Okay maybe your brother isn't the most hygine conscious person so you don't live in the cleanest home. In reality, your living conditions aren't extreme (even if they may seem so to you?). We all have to deal with dirt, contamination, poo, urine etc. I am pretty clean but the other day I noticed that there was a big circle of mould building up under the holder of my plunger, I have no idea how long it has been there. I cleaned it up and forgot about it until now, still very much healthy and alive. 

Anyway, it sounds like you've got the right idea. You just have to make yourself actually do it and start implementing some changes. Good luck!

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I agree, facing the disgust is always the best course of action. I’m trying hard, albeit I had a little slip in the bathroom this morning where I wasn’t sure if I touched my knee after going to the toilet. In essence, I’m pretty sure I did but at worst, if I’m really unlucky, I may have tiny amounts of poo on me, not radioactive waste. That’s how I need to start looking at it anyway I believe. 
 

You’re awesome @malina thank you!

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18 minutes ago, BigDave said:

You’re awesome @malina thank you!

Thanks @BigDave, this is always a great thing to hear on a Saturday morning ?

19 minutes ago, BigDave said:

I agree, facing the disgust is always the best course of action. I’m trying hard, albeit I had a little slip in the bathroom this morning where I wasn’t sure if I touched my knee after going to the toilet. In essence, I’m pretty sure I did but at worst, if I’m really unlucky, I may have tiny amounts of poo on me, not radioactive waste. That’s how I need to start looking at it anyway I believe.

I think you've got the right idea. It'll be really hard at first but just keep at it and you'll build some momentum. Good luck!

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Hi 'BigDave'!

'BigDave' wrote on 24 April 2021: "What's interesting also is that I started this post thinking that I was going to try and work on a schedule with your help to improve things. To list down every compulsion I do would take forever mind you and also, getting you to tell me the answer in a way would not be a good thing because it's reassuring me, right?"

Well, I read your lengthy post and see it didn't go as planned, BigDave, but trying is important! It's really hard to _not_ talk about the details, isn't it?

Yet, you are right about listing everything. I have wondered if I could draw a 'map' (like a flowchart) of my OCD to show non-sufferers how mad it gets, but in the end, the list is just a reflection of "what might happen today?". It's too much. I used to remark that it is quicker to list the themes of OCD I _don't_ have as opposed to the themes I _do_ have.

My OCD also includes toilet problems, and my contamination issues are disgust-based, not fear-based. (I mean, I do not fear germs, viruses, parasites, etc., but I have strong disgust of certain substances or features, usually if they are from or caused by other people.)

I did not read you last toilet & leg thread, but I know the problem(s) well. A long time ago, I modified my behaviour: I always sat down for a number one. Now, I'm back to standing again, because I have to use a shared toilet that is absolutely disgusting (not OCD disgusting, I mean "How clean is you house?" disgusting). I tear and lay Blitz kitchen roll on the seat, and use more of that to wipe. Any toilet I use has to have a sink right next to it, so that I can wash my hands before I pull my clothes right again. Etc.

Contact is a trigger, yes I know that one. So, I have to move and position myself very precisely. I can only change my clothes at bathtime, which is currently once a month for me, and I have to sleep in them (a strange claim, but I'll skip explaining why here). Washing sin is relatively easy, but cloth, not so easy. If I have a contact, I'll be needing hot water, washing up liquid, bleach ands a dampened cloth. That may seem bad, but I can get satisfaction with one or two goes of wiping, whereas formerly it would be complete soaking and, ah ...

I know the "did I, didn't?" contact problem. I have a workaround for that (N.B., not a cure!). If I 'feel' a contact, I freeze and sway slightly looking back at where I think the contact was and how I think I moved. Often, I would see that I was too far from the foriegn object to be able to make contact without having to reposition myself too much. I later found out that sometimes wrinkles in my clothing could 'snap' flat as I flexed and give the sensation that something touched me. I had discovered that my subconscious mind could trick me with doubts about clearing a foriegn object. I still dread contacts (so, not cured of OCD), but I'm now able to dispell 'false alarm' contacts.

At an assessment for CBT, I was told that disgust-based contamination OCD (like ours) would take longer to treat than fear-based contamination OCD (like disease). I didn't get to find out why (the CBT never happened as I was refused admission for being homeless). I currently suppose it's because disgust-based contamination OCD is more 'hardwired' than fear-based contamination OCD, because the latter requires an abstract element of relating disease to germs, whereas the former directly objects tho the subtances we directly see/smell/feel.

Hello, 'malina'!

'malina' wrote on 24 Apr 2021:"Yes! This is such a great summary of the problem. When you come up with something that, to you, is very new and people say "it's all the same", this is exactly what they mean."

Indeed. It's the same brain processes that we inherit, which have gone and got too big for their boots. That there amygdala being at the centre of it, picking specifics from the rest of our brains to throw at us. It's half the story though, because although you and 'BigDave' now see the general priinciple, I think there's another half where the general principle has to be applied to the specifics. My understanding of CBT is that the cognition model is where that happens. So for example, on 'BigDave's 'block', I'll try this:

'BigDave' wrote on 24 April 2021: "That being said, I do find myself hitting a few stumbling blocks and I don't really know how to break them. The most common of these stumbling blocks involves the bathroom and bodily fluid "contamination". The main culprits are urine, faeces and semen but sure, it goes beyond that to sweat, blood, spit and anything else that you can excrete from your body."

Your brother will always be your challenger (for free!). Yet, what I'm amazed by about these bodily fluids is how soluble they are! If you look at it in reverse, how long to do think you could keep such fluids on you if they kept getting water on them? Urine, faeces, snot, saliva, sweat, blood, semen, all soluble. For the last two, there's a washing trick (this is _not_ OCD, so nobody stamp on this!): use cold water, at least not about body temperature. The reason is that they are heavily protein based, and hot water 'cooks' the proteins. Blood will stain, and semen will coagulate (which is terrible on hairy skin!).

So, I gather this is an actual problem of applying the general principles of CBT and ERT. As far as I know, regular therapy (CMHT locality) has a 60%-ish success rate, and intensive/residential therapy has a 90%-ish success rate. Why are there failures? I suppose it's largely because somehow the patient wasn't able to translate the principles to the specifics. I wonder what can be done to improve this?

(As an aside, I'm sure some here will say: "it's always the same! End of!" but I'm minded of a conversation I had with a teacher, who pointed out the (unacknowledged) skill of her profession was that when teaching 20 schoolchildrem one maths lesson, the teacher might have to teach that lesson in up to 20 different ways.)

Anyway, 'BigDave', what is normality? We're told to wash our hands after using the toilet (most don't, urgh!). So the aim should not be to leave the fluids there. It's one hand wash of 20 seconds. I'm not there, but I think I have declined in thouroughness over the years, as this place is challenging too. You want to go faster though, right?


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Well the week has been going OK but I still feel frustrated because I don’t feel like I’m breaking through the wall that I want to. I know what @PolarBearwould say. He’d say “stop the compulsions”. The problem is the huge fear of not doing them. For example, I have recently been to the toilet and I can feel a wet patch on my crotch. If my hand as much as glances that area or is perceived to, then I have to wash my hands. Well, no, I don’t have to wash my hands technically but I also don’t want urine on everything. Anyway, the same applies to all my issues I guess. The problem is that I know that to just give in and not do any of the compulsions would be liberating but my life would be definitely more unsanitary. I can’t convince myself that that is a worthwhile compromise. I mean, logically it is but I also don’t want my brother’s pee on my foot or whatever else on my hands and then In my bed or on my computer. It’s so frustrating!!

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Dave, how do you think the rest of the world manages to survive without doing compulsions like you do?

You have to break the cycle, both cognitively and behaviorally. 

The thought you get that having a dpeck of urine on your things is the worst possible thing is an outright lie. Start telling yourself that.

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I used to have very severe contamination ocd. I then felt it appropriate to go the other way and not wash my hands at all accept after I went for a  poo.

I would shower once daily. I went to the other extreme because anything in between led to lots of overanalysis. That seemed  to work well for me.

 

Anybody had similar experience?

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