Three Easy Ways To Loosen the Grip of OCD !

[OCD Hacks]

OCD is a potentially crippling condition that if left untreated can straightjacket a person's life with immobilizing anxiety and time-wasting, self-defeating, and socially destructive rituals.

The good news is there’s an extremely effective, non-medical treatment that’s been proven to work wonders on OCD: exposure and response/ritual prevention (ERP). But as I’ve written about in previous posts, doing ERP requires real commitment, determination, and grit. For people suffering from OCD who are not quite ready to undertake the rigors of ERP, here are three much easier ways to loosen the straps of the OCD straitjacket: psychological flexibility, ERD, and cognitive correction.

Psychological Flexibility

Most people know the importance of becoming and remaining physically flexible. But surprisingly few people understand the importance of working on their psychological flexibility. Nevertheless, psychological flexibility is very important for staying emotionally fit and mentally nimble. This is especially helpful in prying loose the grip of OCD because many people with OCD strengthen the illness by sticking to rigid patterns of routine behavior and compulsive rituals. Here are some ways to work on your psychological range of motion, and, in so doing, give OCD a serious punch in the eye.

First, try to keep your mind stimulated by learning something new every day, if possible. It needn't be anything complicated or long. Simply trying to commit a new word, historical date, artist's name, or bit of trivia to memory is great mental exercise that activates parts of the brain in novel ways that causes it to stretch, much like a joint or muscle, thus increasing its range of motion.

Second, do something differently, often. That is, consistently introduce some changes in familiar routines and habits that are not necessarily OCD rituals. For example, if you're in the habit of sitting in the same place while watching TV, sit in a different place once in a while. If you always hold your coffee cup with your dominant hand, have a cup while using your other hand. By mixing it up like this you again recruit pathways in the brain that are not as active as the ones used by the default behavior thus providing another flexibility stimulus for your mind.

Third, do different things. Instead of doing the "same old, same old," do something different on a regular basis. For instance, have some tea instead of coffee; wear different clothes than usual; hit the stationary bike instead of the elliptical at the gym; order some different dishes when you get takeout; etc. This, too, activates and stimulates the brain in novel ways which helps keep the mind and psyche more balanced and nimble.

ERD

ERD stands for, “exposure and ritual/response delay.” ERD is very similar to ERP with one notable difference. Unlike ERP that requires people to refrain from doing a ritual completely until their anxiety has significantly subsided, ERD simply asks that people postpone doing the ritual for a specific amount of time. After that, the aim is to gradually extend the time before engaging in the ritual. Eventually, the ritual delay becomes so long that the anxiety compelling the ritual often diminishes to a point where the ritual is no longer “necessary.“

Cognitive Correction

People with OCD usually suffer from intense torrents of anxiety involving extremely exaggerated thoughts of threat, risk, or danger. Indeed, these dramatic thoughts help drive the engine of OCD by compelling sufferers to do rituals. But more compelling than the anxious thoughts are the awful feelings and sensations of high anxiety. This is why “emotional reasoning”—the idea that because one feels strongly about something it must be true—also powers the engine of OCD. Hence, a person with OCD irrationally feels they’ve been contaminated, hurt someone, committed a crime or act of sacrilege, etc. and thus it must be true despite all evidence to the contrary. In other words, OCD suffers confuse their subjective feelings with objective facts. This is partly why a person with germaphobic OCD, for example, will wash far beyond the point of factual cleanliness until they feel they are clean enough.

This is why reminding yourself that a thought or feeling is not a fact is useful. It doesn’t matter what you think, all that counts is how you act. One of the few things we human beings have almost total control of is our voluntary behavior. We can, and do, mostly choose how to move, act and behave.

So, whenever possible, navigating from the compass of objective and agreed-upon facts rather than personal feelings that are often off-base can provide a powerful course correction to the potentially devastating trajectory of OCD.

Another crucial OCD idea states that the anxiety you experience if you don't do a ritual is how it feels when your brain is trying to normalize its balance and function. So the pain (of anxiety) that you feel is your brain trying to heal.

To recap, even without committing to ERP a person can significantly reduce their OCD symptoms by working on psychological flexibility, undertaking progressively challenging ERD, and consistently reminding oneself, “The thought or feeling is not a fact. All that really counts is how I act, “ and, “The pain that I feel is my brain trying to heal,” can put a significant crimp in the fuel line that powers OCD’s engine.

[Ashley]

2 hours ago, OCD Hacks said:

The good news is there’s an extremely effective, non-medical treatment that’s been proven to work wonders on OCD: exposure and response/ritual prevention (ERP). But as I’ve written about in previous posts, doing ERP requires real commitment, determination, and grit. For people suffering from OCD who are not quite ready to undertake the rigors of ERP, here are three much easier ways to loosen the straps of the OCD straitjacket: psychological flexibility, ERD, and cognitive correction.

Psychological Flexibility

First, try to keep your mind stimulated by learning something new every day, if possible. It needn't be anything complicated or long. Simply trying to commit a new word, historical date, artist's name, or bit of trivia to memory is great mental exercise that activates parts of the brain in novel ways that causes it to stretch, much like a joint or muscle, thus increasing its range of motion.

Second, do something differently, often. That is, consistently introduce some changes in familiar routines and habits that are not necessarily OCD rituals. For example, if you're in the habit of sitting in the same place while watching TV, sit in a different place once in a while. If you always hold your coffee cup with your dominant hand, have a cup while using your other hand. By mixing it up like this you again recruit pathways in the brain that are not as active as the ones used by the default behavior thus providing another flexibility stimulus for your mind.

 

I'm sure you are tying to help, but we don't recommend ERP to treat OCD, not on its own at least.  We and the NHS here in the UK recommend Cognitive Behavioural Therapy (CBT), which includes the cognitive aspect and behavioural.

As for the psychological flexibility that you refer to.  This is of course a positive thing so there is no harm in this of course, but the reality is I doubt there is absolutely zero positive impact on helping somebody move forward from OCD.

I understand what you are trying to recommend, but I fear you are off the mark to suggest this is likely to impact somebody's ability to challenge their OCD.

[Caramoole]

9 minutes ago, Ashley said:

 

As for the psychological flexibility that you refer to.  This is of course a positive thing so there is no harm in this of course, but the reality is I doubt there is absolutely zero positive impact on helping somebody move forward from OCD.

I think I have to disagree with you on this one (well I think I do)   Whilst it isn't a specific method, it is something that most therapists would rbe happy to recommend as part of a holistic approach to mental well-being.  Good overall mental health can and does have a positive impact on our ability to tackle OCD, so in the context in which it was written, I think psychological flexibility is a valid tool at least and wouldn't agree it has zero positive impact.  It does fall under the umbrella of ACT Therapy, which although is not the recommended treatment for OCD, is used by many therapists as an adjunct to CBT.

The ERD that the author refers to is no different to the recommendation Jeffery Schwarz makes in Brainlock.

No, none of the above will resolve OCD and CBT is and remains the most important therapy in it's treatment but as a means to aiding good mental health a rounded, positive approach can only help and I "think"  this is what Hack was perhaps trying to demonstrate

[Ashley]

5 minutes ago, Caramoole said:

No, none of the above will resolve OCD and CBT is and remains the most important therapy in it's treatment but as a means to aiding good mental health a rounded

That's fine and I agree it's not a bad thing being suggested.  We just have to be clear about these points when suggesting them as OCD treatments.   If we state XYZ will improve your general mental well-being, which may help you better manage your OCD then I perhaps would not have commented.  But if we state XYZ will play a part in making you able to tackle your OCD then that's subtly different and probably wrong.

[OCD Hacks]

3 hours ago, Caramoole said:

I think I have to disagree with you on this one (well I think I do)   Whilst it isn't a specific method, it is something that most therapists would rbe happy to recommend as part of a holistic approach to mental well-being.  Good overall mental health can and does have a positive impact on our ability to tackle OCD, so in the context in which it was written, I think psychological flexibility is a valid tool at least and wouldn't agree it has zero positive impact.  It does fall under the umbrella of ACT Therapy, which although is not the recommended treatment for OCD, is used by many therapists as an adjunct to CBT.

The ERD that the author refers to is no different to the recommendation Jeffery Schwarz makes in Brainlock.

No, none of the above will resolve OCD and CBT is and remains the most important therapy in it's treatment but as a means to aiding good mental health a rounded, positive approach can only help and I "think"  this is what Hack was perhaps trying to demonstrate

Thank you for this logical answer, madam. Mr. Ashley has not tried the treatment I mentioned, so he doesn't know its importance. This treatment has helped many people recover quickly, without neglecting the importance of CBT of course.
I think his response to my recommendation was a bit authoritarian, rejecting the other types of treatment.
Warmly.

[Ashley]

2 hours ago, OCD Hacks said:

This treatment has helped many people recover quickly, without neglecting the importance of CBT of course.

Who? Where?     Are you saying sitting in a different place to watch TV or holding your coffee in a different hand than normal can help people recover from OCD?  If so then yes, I will reject that and absolutely call that out to be ludicrous.

I am open to other treatment approaches where the evidence shows it could help, EMDR one such example.  But where people post theories I will always challenge for what they are, and then other users can make their own informed choice.

[snowbear]

11 hours ago, OCD Hacks said:

Psychological Flexibility

Most people know the importance of becoming and remaining physically flexible. But surprisingly few people understand the importance of working on their psychological flexibility. Nevertheless, psychological flexibility is very important for staying emotionally fit and mentally nimble. This is especially helpful in prying loose the grip of OCD because many people with OCD strengthen the illness by sticking to rigid patterns of routine behavior and compulsive rituals. Here are some ways to work on your psychological range of motion, and, in so doing, give OCD a serious punch in the eye.

First, try to keep your mind stimulated by learning something new every day, if possible. It needn't be anything complicated or long. Simply trying to commit a new word, historical date, artist's name, or bit of trivia to memory is great mental exercise that activates parts of the brain in novel ways that causes it to stretch, much like a joint or muscle, thus increasing its range of motion.

Second, do something differently, often. That is, consistently introduce some changes in familiar routines and habits that are not necessarily OCD rituals. For example, if you're in the habit of sitting in the same place while watching TV, sit in a different place once in a while. If you always hold your coffee cup with your dominant hand, have a cup while using your other hand. By mixing it up like this you again recruit pathways in the brain that are not as active as the ones used by the default behavior thus providing another flexibility stimulus for your mind.

Third, do different things. Instead of doing the "same old, same old," do something different on a regular basis. For instance, have some tea instead of coffee; wear different clothes than usual; hit the stationary bike instead of the elliptical at the gym; order some different dishes when you get takeout; etc. This, too, activates and stimulates the brain in novel ways which helps keep the mind and psyche more balanced and nimble.

I've been advocating this as a method to improve brain plasticity for years. I'm convinced of the science behind it and that it's a simple way to begin to break free of the rigidity of thinking which often accompanies OCD.

BUT I'm 100% with Ashley on the fact this is NOT a therapy for OCD. 

At best it's an adjunct to CBT, as Caramoole says akin to ACT, or my favourite adjunctive - mindfulness.

12 hours ago, OCD Hacks said:

Cognitive Correction

@OCD Hacks  Everything you wrote in this section is true.

BUT it completely omitted the most important aspect of cognitive correction, which is to change the meaning you attach to the thoughts.

Everybody's experience is welcome, and I'm glad the above 3 'hacks' worked for you.

At OCD-UK we advocate CBT for OCD. Cognitive and behavioural therapy. Everything else is either an adjunct to CBT or unproven as a single approach therapy. (Actually almost all are proven NOT to work on OCD when used alone in the absence of CBT.)

Properly administered CBT (ie. by a qualified therapist or someone who understands how to administer CBT and isn't just drawing on personal experience) is the only therapy proven to work for OCD.

[MarieJo]

Thank you for those tips. I do not believe CBT is the only or best treatment for OCD, well not for everyone anyway. I have had this treatment twice and personally it did not help me, not surewhy as I was open minded and really wanted/want to break free of my cripplinganxiety. I think we should all be open to other approaches in treatment.

Edited August 1, 2021 by MarieJo

[PolarBear]

MarieJo, some of us have bern around for a while. We've seen treatments come and go. None of them stand up to CBT.

In order to recover from OCD, teo things must happen: you must change the way you think about the thoughts and you must change the way your behavior as a result of the thoughts. CBT fits that bill.

The ideas here more or less fit in with that.

Changing your behavior means stopping compulsions.

If you have been through CBT twice and not seen an improvement, there are three reasons why:

1. You were not guided properly by your therapist,

2. You did not do the work required.

3. You were not in therapy for long enough.

 

 

[MarieJo]

Well then maybe not enough therapists apparently trained to carry out CBT are up to it then. I did all the homework set. I am 48 years old and have suffered for over 40 years with this vile disorder. Some aspects of my ocd are better after self education and learning more about the disorder and myself but some obsessions I just cannot break free from as my logic tells me that my fears are real and very well may come true.

[PolarBear]

10 minutes ago, MarieJo said:

Well then maybe not enough therapists apparently trained to carry out CBT are up to it then. I did all the homework set. I am 48 years old and have suffered for over 40 years with this vile disorder. Some aspects of my ocd are better after self education and learning more about the disorder and myself but some obsessions I just cannot break free from as my logic tells me that my fears are real and very well may come true.

That's where the cognitive side comes in, learning that your obsessions are all fake.  More to it than that, but, yeah, the cognitive side of CBT.

[OCD Hacks]

58 minutes ago, MarieJo said:

Thank you for those tips. I do not believe CBT is the only or best treatment for OCD, well not for everyone anyway. I have had this treatment twice and personally it did not help me, not surewhy as I was open minded and really wanted/want to break free of my cripplinganxiety. I think we should all be open to other approaches in treatment.

yeaaah !!! you are a smart girl.

[snowbear]

29 minutes ago, MarieJo said:

Well then maybe not enough therapists apparently trained to carry out CBT are up to it then. I did all the homework set. I am 48 years old and have suffered for over 40 years with this vile disorder.

I second everything Polar bear said. I've had OCD for over 50 years and been around the block a bit too. I quite often hear people say CBT hasn't worked for them. It can be because the therapy wasn't properly explained, or because there was too much emphasis on the behavioural side and not enough work done on the cognitive side.

It's easy to blame therapists for this, though I've come to realise that so much of the cognitive side is 'obvious common sense' (to anyone without OCD skewing their thinking) that many therapists probably think it goes without saying!

Quote

Some aspects of my ocd are better after self education and learning more about the disorder and myself

I'm all for self-learning. The better you understand OCD the more able you are to overcome it.

How OCD works, and how to recover, is the same across the board. But as we're all individuals it doesn't hurt to gain a few insights into yourself, why you think as you do and why you react (behave) as you do. All good stuff on the recovery journey!

Quote

but some obsessions I just cannot break free from as my logic tells me that my fears are real and very well may come true.

That's why you need the cognitive therapy. You need to learn how your logic is failing you, that what seems logical when suffering from OCD is actually illogical and untrue. You need to accept that feelings are not fact and you can go against them without detriment.

Are you currently getting more CBT or waiting for it to start? If not, that's definitely the path to go from here, with a bit more work on the cognitive side to help you progress.

 

[OCD Hacks]

2 hours ago, snowbear said:

BUT it completely omitted the most important aspect of cognitive correction, which is to change the meaning you attach to the thoughts.

Everybody's experience is welcome, and I'm glad the above 3 'hacks' worked for you.

At OCD-UK we advocate CBT for OCD. Cognitive and behavioural therapy. Everything else is either an adjunct to CBT or unproven as a single approach therapy. (Actually almost all are proven NOT to work on OCD when used alone in the absence of CBT.)

Properly administered CBT (ie. by a qualified therapist or someone who understands how to administer CBT and isn't just drawing on personal experience) is the only therapy proven to work for OCD.

Yes, I did not talk about it as a single treatment.
Cognitive and dialectical behavioral therapy remain useful.

[OCD Hacks]

5 hours ago, Ashley said:

Who? Where?     Are you saying sitting in a different place to watch TV or holding your coffee in a different hand than normal can help people recover from OCD?  If so then yes, I will reject that and absolutely call that out to be ludicrous.

I am open to other treatment approaches where the evidence shows it could help, EMDR one such example.  But where people post theories I will always challenge for what they are, and then other users can make their own informed choice.

just do ur research.
i respect your opinion.
regards.

[felix4]

26 minutes ago, MarieJo said:

Well then maybe not enough therapists apparently trained to carry out CBT are up to it then. I did all the homework set. I am 48 years old and have suffered for over 40 years with this vile disorder. Some aspects of my ocd are better after self education and learning more about the disorder and myself but some obsessions I just cannot break free from as my logic tells me that my fears are real and very well may come true.

I had a few lots of CBT, as in 5 x 12 sessions with various psychologists & therapists, both group & one to on, & no two sets of CBT were the same! You'd think they would be, but no, luckily a OCD clinic opened up in my town with people who know OCD inside out, which was got me back to some normality! 

[snowbear]

56 minutes ago, PolarBear said:

If you have been through CBT twice and not seen an improvement, there are three reasons why:

1. You were not guided properly by your therapist,

2. You did not do the work required.

3. You were not in therapy for long enough.

I'd add another very common reason to that...

4. You diligently did all that was asked of you, but through gritted teeth and without changing your thinking.

If you hold onto the old beliefs and ways of thinking then you can't expect anything to change significantly just from doing a few exposure exercises.

When CBT doesn't work it's nobody's fault. It simply means you need to look at why it didn't help and address those reasons the next time around.

 

[MarieJo]

The problem I have is this. I see ocd is often just irrational fears. I used to get harm ocd. When my kids were young I would have intrusive thoughts of hurting them in some way, I now understand that it was just anxiety as hurting them was my biggest fear as I love them so much and that I would never do anything to hurt them.  However, the obsessions I cannot get over are of other people harming them or them coming to harm. I fear every time my son goes out that he will get beaten up, or someone will drug his drink, he will get mugged, run over, stabbed etc..now as I live in London and it's become increasingly violent and young boys get stabbed to death almost daily, I do not see this as an irrational fear so I cannot stop feeling afraid. Does this make any sense? I also fear them getting ill and dying. Every where I look a young person seems to be battling some terrible illness. Maybe it's just more known now because of social media and I know I am catastrophising but these fears are not completely irrational in my view. I just always seem to be obsessing about something and just want some peace.

Edited August 1, 2021 by MarieJo

[PolarBear]

No difference. It's still an obsession. The thing is, it's your current obsession, which always seems worse and harder to deal with, only because it's what you are desling with right now.

You still apply the same techniques. You do cognitive work. You figure out what your compilsions are. You work on stopping those compulsions. You do some ERP.

[MarieJo]

I know what my compulsions are. I text or phone him. I have tried very hard to stop but I get so afraid that I can't seem to do it. I know the compulsions feed the obsessions but when I am so scared and need to know he's safe u seem to have no control. I delay the compulsions now but cannot seem to be able stop them completely as my logic tells me he may well be hurt or in danger.

[MarieJo]

I have stopped my Google group compulsion when the kids are ill which has helped. I now dread the weekends as my son goes out. I have 3 kids and so have years ahead of this unless I can get the right help. Sometimes I wish I would just die so I get some peace bit then I wouldn't want to leave them or cause them pain so I have just resigned myself to this suffering after two attempts at treatment failed to heal me

[snowbear]

20 minutes ago, MarieJo said:

I have just resigned myself to this suffering

That's a shame, Marie Jo, because you won't be the only one suffering. What you see as caring and protective your kids may see differently. Even if they know you're just trying to look out for them it can be hard for a teenager on the receiving end of this behaviour not to feel controlled or even rebellious, maybe taking unnecessary risks just to get away from parental scrutiny. It could potentially also make them overanxious, or prevent them from developing confidence as they navigate the normal self-reliance phase that all teenagers need to go through to become healthy young adults in their own right.

I do hope you'll consider further CBT and stay determined to overcome your OCD.

[MarieJo]

It is a shame and you're  completely right. It's not just me who suffers. My kids are the reason I sought help after decades of suffering. I got the help because I knew I was impacting negatively on their lives and didn't want that as it's not fair. I am in this mess because of my own upbringing. However, as I explained it didn't work for me unfortunately. In the NHS here in the UK we get therapy free but there is a long waiting list and because of covid it's even longer now, also the therapyis a bit hit andmiss I think. Private therapy is expensive and I have been made redundant from my job so I really see no way out of this soon unfortunately which is a bit depressing tbh 

[Ashley]

3 hours ago, Doubt_It said:

totally understand your point about nhs therapy. I’ve been on the waiting list now for over 18 months. They keep offering me group therapy quicker, but I’ve tried that before but the nature of my obsessions are difficult to discuss in group sessions.

Is that for a secondary care service or a primary (IAPT) service?   Certainly if somebody is uncomfortable talking about the nature of their OCD then you can of course request individual therapy.  18 months seems a long time for IAPT level.

Brain Lock is ok, and I used the refocus step with my own therapy but I used that step within the CBT process, which I found was right for me and the best of both worlds.  Two books I would recommend are:

• Break free from OCD - Written by three of the best NHS experts for OCD.
• OCD, Anxiety and Related Depression.  - Written by a guy with OCD and his therapist. CBT based but uses common sense English language rather than clinical language.

 

 

 

[Ashley]

I know some services are not quite back to offering face-to-face, but all services should be offering individual therapy (remotely online) and in a much less time than 18 months.   I do sit on the national IAPT stakeholders group and that wait time seems excessive from what they are reporting.

You don't have to at all, but if you want to post or email me the name of the IAPT or your postcode town I can make generic queries to find out about the wait times and I can review if there are alternative options for you.