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Recovery Really Is A Possibility


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1 hour ago, howard said:

So you're saying that CBT worked for you and 'recovery really is a possiblity' for you. Do you know how your OCD started or when?

I am pretty clear that the OCD of myself and my sister is genetic.

My father and his sister displayed signs of it, and in my sister and my case it started in our childhood, which is pretty common.

CBT is all about changing our thinking and behavioural response.  It is used for a range of anxiety disorders including OCD.

If we change our response to intrusions by learning from CBT that they aren't true, learn to ignore, then ease away from them - and also cut down on the compulsions, OCD loses power and we start to regain control.

For me, if the sufferer is not able to work on this then it's the reasons why, and putting those right, not CBT that is the cause.

In addition to the CBT I have found mindfulness extremely helpful, because it redirects our thinking into the present, and just the here and now.

But it won't stop the OCD in itself, it helps refocus.

My own view is that people seeking some magic alternative cure are looking for fool's gold, and might be better served finding help to establish why they aren't accepting that the OCD is false and stopping believing and connecting with it.

And why they aren't able to tackle and stop carrying out compulsions.

 

Edited by taurean
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1 hour ago, taurean said:

i am pretty clear that the OCD of myself and my sister is genetic.

Just a note on this from the OCD_UK website: Overall, genetic studies indicate some tendency towards anxiety that runs in families, although this is probably only slight.

It's under the 'About OCD' tab and 'What causes OCD' section.

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I enjoy these debates, but whenever I enter into them I always imagine folks thinking "oh no, hold to your hats, here comes Wren and her anti-CBT rants" 🤣 (I'm joking, also I'm not anti CBT, just anti CBT being considered as a panacea for all the world's problems). 

Howard, I think what you are mentioning about childhood brain development is something which is analogous to what also gets described as Attachment Disorders and/or Complex PTSD or potentially BPD. It's perfectly possible to have an attachment disorder/cptsd and OCD, in which case the attachment disorder may need treating first (but not always) before the person is able to engage with CBT for OCD. It's probably not possible to fully recover from an attachment disorder, so it's something which needs long term management, but it doesn't necessarily mean a person can't then overcome their OCD as a separate, albeit intertwined, condition. (N.b. the concept of attachment and trauma are quite contentious political issues, and what I've just written is one view point and there are others, but I'm not qualified or knowledgable enough to go into details). 

There's also the issue I've noticed in the terminology in neurodiversity debates, particularly in America, where OCPD and other conditions which result in repetitive behaviours seem to get lumped in together with OCD by some, which confuses matters when these issues about treatment get discussed. Some sources of repetitive behaviour are definitely neurological, such as autism, so thinking of them in terms of identity makes sense but I'm not convinced that OCD (the anxiety disorder) should be seen in that way.

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2 hours ago, taurean said:

I am pretty clear that the OCD of myself and my sister is genetic.

My father and his sister displayed signs of it, and in my sister and my case it started in our childhood, which is pretty common.

CBT is all about changing our thinking and behavioural response.  It is used for a range of anxiety disorders including OCD.

If we change our response to intrusions by learning from CBT that they aren't true, learn to ignore, then ease away from them - and also cut down on the compulsions, OCD loses power and we start to regain control.

For me, if the sufferer is not able to work on this then it's the reasons why, and putting those right, not CBT that is the cause.

In addition to the CBT I have found mindfulness extremely helpful, because it redirects our thinking into the present, and just the here and now.

But it won't stop the OCD in itself, it helps refocus.

My own view is that people seeking some magic alternative cure are looking for fool's gold, and might be better served finding help to establish why they aren't accepting that the OCD is false and stopping believing and connecting with it.

And why they aren't able to tackle and stop carrying out compulsions.

 

How do you know it's genetic? I'm interested because they also believe that depression may have some gentic predisposition but aren't sure how it functions.

Because both your father and sister showed OCD symptoms it could indicate learned behaviour as well. My son was picking up some of my rituals, but I just said he doesn't need to do any of that.

I've done a course of CBT. But I also manage my emotions and rationalise and make my life as stress free as possible. I'm aware that high stress will mean my anxiety needs an outlet like unnecessary compulsions.

I find I can use my obsessive nature to run my life a bit like a business.

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1 hour ago, Wren said:

I enjoy these debates, but whenever I enter into them I always imagine folks thinking "oh no, hold to your hats, here comes Wren and her anti-CBT rants" 🤣 (I'm joking, also I'm not anti CBT, just anti CBT being considered as a panacea for all the world's problems). 

Howard, I think what you are mentioning about childhood brain development is something which is analogous to what also gets described as Attachment Disorders and/or Complex PTSD or potentially BPD. It's perfectly possible to have an attachment disorder/cptsd and OCD, in which case the attachment disorder may need treating first (but not always) before the person is able to engage with CBT for OCD. It's probably not possible to fully recover from an attachment disorder, so it's something which needs long term management, but it doesn't necessarily mean a person can't then overcome their OCD as a separate, albeit intertwined, condition. (N.b. the concept of attachment and trauma are quite contentious political issues, and what I've just written is one view point and there are others, but I'm not qualified or knowledgable enough to go into details). 

There's also the issue I've noticed in the terminology in neurodiversity debates, particularly in America, where OCPD and other conditions which result in repetitive behaviours seem to get lumped in together with OCD by some, which confuses matters when these issues about treatment get discussed. Some sources of repetitive behaviour are definitely neurological, such as autism, so thinking of them in terms of identity makes sense but I'm not convinced that OCD (the anxiety disorder) should be seen in that way.

I found the book on how the brain develops during childhood interesting but mostly in a reverse engineering understanding of why I might think the way I do. I can compare what the author says(read the references) about neglected babies and how this affects them on many levels and I make sense.

Social level>My mother was depressed and disliked touching, she also didn't socialise with me(object of shame). Hence my inability to understand some social situations.

But I realised at the age of five, they had nothing to offer except simulations of their own childhoods. 

I see 'obsessive' as part of my identity. I think some work or art suits the obsessive. I did some obsessive sound editing(repeatedly listening to clips over and over), it's niche.

Those other terms you mention, where a particular thought path is linked to OCD, I'm not sure that helps either. I'll have to look into why they do that.

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2 hours ago, howard said:

How do you know it's genetic? I'm interested because they also believe that depression may have some gentic predisposition but aren't sure how it functions

To my sister and I, both pretty clever individuals and now in our 70s, the evidence is sufficient. 

And whilst our expressions of OCD aren't the same  the root elements behind the manifestations are similar.

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8 minutes ago, taurean said:

To my sister and I, both pretty clever individuals and now in our 70s, the evidence is sufficient. 

And whilst our expressions of OCD aren't the same  the root elements behind the manifestations are similar.

Not really evidence though....more supposition and belief.  I suspect anxiety is probably a learned behaviour to some extent as it tends to have a knock on effect

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29 minutes ago, taurean said:

To my sister and I, both pretty clever individuals and now in our 70s, the evidence is sufficient. 

And whilst our expressions of OCD aren't the same  the root elements behind the manifestations are similar.

It's entirely possible according to some research by Prof. Nancy Andreasen, but your mother would have had to have the gene as well.

@Angst you might be interested in her book. She uses psychiatry, human genome structures and the use of neuroimaging to examine the structure and function of the living brain. Brave New Brain: Conquering Mental Illness in the Era of the Genome.

There's so much research going on out there and new tools being developed continually. Maybe one day we will get close to a glimpse of what MIND is.

 

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1 hour ago, howard said:

Those other terms you mention, where a particular thought path is linked to OCD, I'm not sure that helps either. I'll have to look into why they do that.

The neurodiversity movement is an activist movement so you get a lot of debate and fluid use of language, which can get very confusing and hostile. I got the impression it was common to think of OCD as an innate difference to be accommodated rather than an anxiety disorder to be got rid of. 

1 hour ago, howard said:

I see 'obsessive' as part of my identity. I think some work or art suits the obsessive. I did some obsessive sound editing(repeatedly listening to clips over and over), it's niche.

I think it's important to state there is a difference between obsessive behaviour which is enjoyable and potentially useful (even if it gets you ridiculed) and compulsive behaviour which is driven by a distressing obsession - one is personality and the other is a disorder, in my opinion.

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On 11/06/2022 at 17:26, Wren said:

just anti CBT being considered as a panacea for all the world's problems). 

It has its uses though, when there is a need to change our thinking and behavioural response to things.

We can try all sorts of other things as well, and as I well know myself these can be helpful in refocusing and calming down - but unless and until we change those thinking and behavioural response, we are just making the intrusions stronger and reinforcing the problem.

PCD intrusions need engagement and encouragement to flourish - they underpin and strengthen the problem.

When we stop that encouragement, and ease away compulsions, the intrusions tend to diminish, and we start to improve. 

This to me is the essential that every sufferer needs to take on board. If they don't stuck they remain.

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4 hours ago, taurean said:

but unless and until we change those thinking and behavioural response,

Sorry response should be responses

4 hours ago, taurean said:

PCD intrusions

This should be OCD intrusions. 

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4 hours ago, taurean said:

It has its uses though, when there is a need to change our thinking and behavioural response to things.

We can try all sorts of other things as well, and as I well know myself these can be helpful in refocusing and calming down - but unless and until we change those thinking and behavioural response, we are just making the intrusions stronger and reinforcing the problem.

PCD intrusions need engagement and encouragement to flourish - they underpin and strengthen the problem.

When we stop that encouragement, and ease away compulsions, the intrusions tend to diminish, and we start to improve. 

This to me is the essential that every sufferer needs to take on board. If they don't stuck they remain.

The first thing I'd say(I mean as a general statement), is don't obsess about OCD.

And of course CBT is the usual therapy for a number of conditions from OCD to IBS.

Included in this approach; looking at when the anxiety started and if possible in the case of OCD; why the person gives greater priority to certain thoughts(often negative ones), then often exaggerates those thoughts until they get so absorbing that the person gets stuck in a sort of thought loop.

So look at whether the predisposition to greater anxiety is genetic, or both genetic and learned.  Whether the predisposition was triggered by an event or trauma in early life or later.

There are all sorts of factors. Also diet is important, we know about the benefits of say Omega 3 Supplements for depression and other disorders. The amino acids are converted to neurotransmitters. Addressing physiological aspects. NHS hospitals have nutitionist teams and it should be possible to find out if your body and brain are deficient in any required nutrients.

And there are a number of supplements that boost seratonin and plants like St John's wort that help with mental disorders including OCD.

Also of course being aware of what makes you stressed and making sure it doesn't reach a harmful level both physically and mentally. Maybe a change of lifestyle. Exercise, Yoga, etc all help.

I also wonder if the OCD can be treated like this, but some of the obsessions where someone else is drawn into the obsession would require a psychiatrist's insight.

 

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On 11/06/2022 at 17:26, Wren said:

I enjoy these debates, but whenever I enter into them I always imagine folks thinking "oh no, hold to your hats, here comes Wren and her anti-CBT rants" 🤣 (I'm joking, also I'm not anti CBT, just anti CBT being considered as a panacea for all the world's problems). 

Howard, I think what you are mentioning about childhood brain development is something which is analogous to what also gets described as Attachment Disorders and/or Complex PTSD or potentially BPD. It's perfectly possible to have an attachment disorder/cptsd and OCD, in which case the attachment disorder may need treating first (but not always) before the person is able to engage with CBT for OCD. It's probably not possible to fully recover from an attachment disorder, so it's something which needs long term management, but it doesn't necessarily mean a person can't then overcome their OCD as a separate, albeit intertwined, condition. (N.b. the concept of attachment and trauma are quite contentious political issues, and what I've just written is one view point and there are others, but I'm not qualified or knowledgable enough to go into details). 

There's also the issue I've noticed in the terminology in neurodiversity debates, particularly in America, where OCPD and other conditions which result in repetitive behaviours seem to get lumped in together with OCD by some, which confuses matters when these issues about treatment get discussed. Some sources of repetitive behaviour are definitely neurological, such as autism, so thinking of them in terms of identity makes sense but I'm not convinced that OCD (the anxiety disorder) should be seen in that way.

Hi Wren

I believe that a variety of approaches can help mental distress. I have know people who have benefitted from CBT for psychosis and then go on to attachment therapy for psychosis. (These people developed psychosis in the early years of their professional careers so a biased sample for general theories.) A treatment recommended by many in the Hearing Voices Network. These people suffered from abuse in their early years. And read about a psychiatrist who had both CBT for depression and psychodynamics for depression. Both were helpful. It could be that people with a diagnosis of psychosis and OCD. Could benefit for a variety of therapeutic regimes. I think the general opinion is managing the psychosis should be dealt with before treating the OCD. I think the general opinion of BPS division of clinical psychologists is that most approaches have benefits. Generally CBT for OCD seems the best approach for OCD but how you get there may have different routes.

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8 hours ago, taurean said:

It has its uses though, when there is a need to change our thinking and behavioural response to things.

We can try all sorts of other things as well, and as I well know myself these can be helpful in refocusing and calming down - but unless and until we change those thinking and behavioural response, we are just making the intrusions stronger and reinforcing the problem.

PCD intrusions need engagement and encouragement to flourish - they underpin and strengthen the problem.

When we stop that encouragement, and ease away compulsions, the intrusions tend to diminish, and we start to improve. 

This to me is the essential that every sufferer needs to take on board. If they don't stuck they remain.

I was just joking because I suspect I'm gaining a reputation for being difficult because I often defend the use of psychotherapy as an adjunct to CBT for people with complex problems. I've always said that the primary and central treatment of OCD should be CBT.

Thanks Angst, that's exactly what I mean. I only speak out if I worry that someone who may have complex problems is being pushed into believing that the only reason CBT isn't working for them is because they are failing to engage with the therapy. The problem is though, that I suspect that in the vast majority of cases, the reason that CBT is failing is because the sufferer is not engaging or being persistent enough, and there is a very real danger of someone fruitlessly pursuing alternative therapies because they want a magic cure, so I do try to be careful in what I say. 

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25 minutes ago, Wren said:

I only speak out if I worry that someone who may have complex problems is being pushed into believing that the only reason CBT isn't working for them is because they are failing to engage with the therapy.

This is a key point.  When you say that 'just anti CBT being considered as a panacea for all the world's problems'  is an important thing to remember.  I have seen on many occasions people from sedentary positions advocate CBT when it appears that there are more complex issues going on in a particular case.

No matter how many times someone undertakes CBT they are unlikely to see much significant progress unless the underlying mental health issue is addressed first.

Personally, any benefit I have had from CBT has only been evident after (and also along side) the treatment of the underlying and enduring problem.

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6 hours ago, Wren said:

Northpaul, can I ask you how you dealt with your depression? No pressure, if it's not something you want to talk about. W 

Hi Wren, I will start a new thread on that one.  From the original poster, this thread has seen some interesting and varied points and some of my points may take it in a different direction.

I will post something in due course - my co-ordination problem dictates that everything these days takes alot of time.

But always happy to talk, it keeps me busy and that is good for therapy!  And gives me a porpoise as well!  🐬

 

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