Meta OCD....I'm confused, please help.

[Kranky123]

I've got Meta OCD - in the sense that I now also have an obsession of 'beating' OCD

I sit there and try different treatments for OCD, routinely check-in with myself to see how anxious I'm feeling...I'm literally obsessing about being obsessed.

But I'm confused about what to do.

Ordinarily, we're told to avoid compulsions with OCD.

But if my Meta-OCD compulsions are based upon trying different treatments, that has become a compulsion in itself.

So, should I stop trying treatments?

My therapist said I should treat Meta-OCD as any other OCD and that I should use ERP.

But if I catch myself obsessing about being obsessed - and use ERP to confront this - isn't that then a compulsion?

If it is a compulsion and I shouldn't be doing it - then how would the Meta OCD ever improve?!

Any help would be great.

[Kranky123]

Can anyone help?

If someone has an obsession about OCD - and their compulsions include trying to treat it - then would ERP be a compulsion?

[Kranky123]

Anyone? I'm just so confused by this. 

[NotRock]

6 hours ago, Kranky123 said:

But if I catch myself obsessing about being obsessed - and use ERP to confront this - isn't that then a compulsion?

Dear @Kranky123,  from my point of view ERP is not about confronting, ERP is about doing nothing  , about having the urge to do something (checking for instance) and just be there with that urge, feeling it doing nothing else, until the feeling fades away by itself.

ERP is about acepting your feelings, feeling that you would prefer not to have, feelings that show you that you are not in control, and understand that is normal human experience.

[Kranky123]

14 minutes ago, NotRock said:

Dear @Kranky123,  from my point of view ERP is not about confronting, ERP is about doing nothing  , about having the urge to do something (checking for instance) and just be there with that urge, feeling it doing nothing else, until the feeling fades away by itself.

ERP is about acepting your feelings, feeling that you would prefer not to have, feelings that show you that you are not in control, and understand that is normal human experience.

Maybe confront wasn't the right word... But would it still be a compulsion for Meta OCD? 

[Kranky123]

Anyone? 

[DRS1]

3 hours ago, Kranky123 said:

Maybe confront wasn't the right word... But would it still be a compulsion for Meta OCD? 

 

2 hours ago, Kranky123 said:

Anyone? 

I would ask you to look at whether or not you feel an urgency to find out if it would be a compulsion for Meta OCD? Not that it matters what theme as it is just all OCD anyways but @NotRock pretty much nailed it on the head and to be honest so did your therapist in their suggestion. Don't look at Meta themed OCD as anything different, ERP still treats that. What would be compulsive is if you tried to do perfect ERP every time. In that case you would intentionally try to not do 100% perfect ERP but maybe 85% good ERP and be able to accept that for what it is. For me ERP is almost a game I enjoy, not something I actively worry about having to do in response to OCD. I would recommend sticking with what you have experienced works with ERP and probably look at reducing how often you check how anxious you are. By checking less you are doing ERP but but as @NotRock says you are actually just doing nothing. Doing something would be checking, instead of checking you are doing nothing or maybe a better way of putting it, you are living in accordance with your values, not pre-emptively worrying about OCD.

[Saffron37]

Hi Kranky,

I understand why this is confusing, but if you take a step back and look at the big picture, I think you'll see more clearly what you need to do.

What's vital to remember is that the content of your obsessions and compulsions are completely meaningless--the fact that your current fixation is on getting better from OCD means nothing in terms of how to treat it. Let's walk through what's going on:

1. You have a scary, intrusive thought, probably something like "what if I don't ever recover from OCD?". This idea becomes an obsession, just like in any other type of OCD.

2. You feel really anxious and upset.

3. In order to feel better, you perform compulsions. The one I'm hearing most from you is rumination--you're clearly turning over the question in your mind constantly. It sounds like you're also probably doing things like obsessively googling different OCD treatments, etc. 

4. You mention you "sit there and try different OCD treatments"; please note that therapy-flavored compulsions are not the same as therapy. If you're trying different OCD therapy techniques while compulsively checking in with yourself to see how anxious you are, you're not gonna be able to meaningfully engage with the material. It's just another mask the compulsion is wearing for the moment, not actual therapeutic work. 

5. So what do you do? You carry out ERP, but you do it in a genuinely therapeutic and not compulsive manner. What's the difference? Genuine ERP is all about discipline and resistance and effort. You will not crave genuine ERP, because it will not be something that brings your anxiety down in the short-term, the opposite, in fact.  It sounds like what you are doing is going through the motions of ERP (or other OCD techniques) but really using them as a way to try to soothe yourself, just like with any compulsion. 

6. How do you do this? You create a therapeutic plan with your therapist and you stick to it--no branching off to find alternative techniques, no googling, no checking how anxious you are. When you have the urge to ruminate, you resist it. It doesn't matter if you're ruminating about how to get better from OCD, the type of thinking is the problem. I guarantee that if you really stick to the guidelines of ERP you won't be able to use it as a compulsion.

Okay, I hope that helps! Best wishes! 

 

Edited August 13, 2022 by Saffron37

[Kranky123]

6 hours ago, Saffron37 said:

Hi Kranky,

I understand why this is confusing, but if you take a step back and look at the big picture, I think you'll see more clearly what you need to do.

What's vital to remember is that the content of your obsessions and compulsions are completely meaningless--the fact that your current fixation is on getting better from OCD means nothing in terms of how to treat it. Let's walk through what's going on:

1. You have a scary, intrusive thought, probably something like "what if I don't ever recover from OCD?". This idea becomes an obsession, just like in any other type of OCD.

2. You feel really anxious and upset.

3. In order to feel better, you perform compulsions. The one I'm hearing most from you is rumination--you're clearly turning over the question in your mind constantly. It sounds like you're also probably doing things like obsessively googling different OCD treatments, etc. 

4. You mention you "sit there and try different OCD treatments"; please note that therapy-flavored compulsions are not the same as therapy. If you're trying different OCD therapy techniques while compulsively checking in with yourself to see how anxious you are, you're not gonna be able to meaningfully engage with the material. It's just another mask the compulsion is wearing for the moment, not actual therapeutic work. 

5. So what do you do? You carry out ERP, but you do it in a genuinely therapeutic and not compulsive manner. What's the difference? Genuine ERP is all about discipline and resistance and effort. You will not crave genuine ERP, because it will not be something that brings your anxiety down in the short-term, the opposite, in fact.  It sounds like what you are doing is going through the motions of ERP (or other OCD techniques) but really using them as a way to try to soothe yourself, just like with any compulsion. 

6. How do you do this? You create a therapeutic plan with your therapist and you stick to it--no branching off to find alternative techniques, no googling, no checking how anxious you are. When you have the urge to ruminate, you resist it. It doesn't matter if you're ruminating about how to get better from OCD, the type of thinking is the problem. I guarantee that if you really stick to the guidelines of ERP you won't be able to use it as a compulsion.

Okay, I hope that helps! Best wishes! 

 

What if I have a compulsion of checking how worried I am? Surely then, knowing how worried I am during ERP would be q compulsion too? How would I avoid checking how worried I was during ERP if the goal is to recognise that your anxiety decreases? 

[Saffron37]

3 hours ago, Kranky123 said:

What if I have a compulsion of checking how worried I am? Surely then, knowing how worried I am during ERP would be q compulsion too? How would I avoid checking how worried I was during ERP if the goal is to recognise that your anxiety decreases? 

The initial goal in ERP is not to recognize that your anxiety decreases. In fact, if you're doing ERP correctly, your anxiety will actually increase in the short-term, and you will see the benefits of decreased anxiety over time--and by over time, I mean days to weeks to months, not minutes or hours. One way to distinguish between treatment and compulsions is to recognize that compulsions are always about immediate relief, so if you're engaging in a behavior with the goal to bring the anxiety down now, there's a good chance it's a compulsion.

I'd advise you to explain your confusion to your therapist and ask them to help you create a plan. 

[Kranky123]

34 minutes ago, Saffron37 said:

The initial goal in ERP is not to recognize that your anxiety decreases. In fact, if you're doing ERP correctly, your anxiety will actually increase in the short-term, and you will see the benefits of decreased anxiety over time--and by over time, I mean days to weeks to months, not minutes or hours. One way to distinguish between treatment and compulsions is to recognize that compulsions are always about immediate relief, so if you're engaging in a behavior with the goal to bring the anxiety down now, there's a good chance it's a compulsion.

I'd advise you to explain your confusion to your therapist and ask them to help you create a plan. 

But in any case, if I had a compulsion of constantly checking how worried I am... I can still use ERP?

What happens if I think about how worried I am during ERP (if this was a compulsion) 

[Saffron37]

1 hour ago, Kranky123 said:

But in any case, if I had a compulsion of constantly checking how worried I am... I can still use ERP?

What happens if I think about how worried I am during ERP (if this was a compulsion) 

Yes, you can still use ERP. Don't worry, you can never ruin ERP for yourself. 

If you find yourself thinking about how worried you are during ERP, you treat it exactly the same as you would any other intrusive thought: you do not engage with it, you do not ruminate, you label the thoughts as intrusive and distract yourself with an enjoyable activity. The obsessions and compulsions here are identical to any other case of OCD. If you find yourself wanting to stop and test and see how anxious you are, you treat it like any other compulsive urge: you just don't do it. You sit with the discomfort of resisting the impulse, which is when the work of ERP actually happens.

[Kranky123]

44 minutes ago, Saffron37 said:

Yes, you can still use ERP. Don't worry, you can never ruin ERP for yourself. 

If you find yourself thinking about how worried you are during ERP, you treat it exactly the same as you would any other intrusive thought: you do not engage with it, you do not ruminate, you label the thoughts as intrusive and distract yourself with an enjoyable activity. The obsessions and compulsions here are identical to any other case of OCD. If you find yourself wanting to stop and test and see how anxious you are, you treat it like any other compulsive urge: you just don't do it. You sit with the discomfort of resisting the impulse, which is when the work of ERP actually happens.

But to sit with the discomfort you must have an awareness of how anxious you are feeling, correct? 

To be aware that I am anxious but to doing nothing to reduce it would be okay? 

But then, surely even attempting to treat OCD is an attempt to reduce anxiety and would therefore be a compulsion? 

 

Edited August 13, 2022 by Kranky123

[Saffron37]

Just now, Kranky123 said:

But to sit with the discomfort you must have an awareness of how anxious you are feeling, correct? 

 

Kranky, you're getting caught up in irrelevant details. It's like you're zoomed in so close to your obsession that you've lost sight of what's actually there. This is a lot simpler than your brain is making it out to be. 

Sure, to sit with discomfort you will have some awareness of how anxious you're feeling. But that's okay--it's not a bad or unhealthy thing to have that awareness. What would be unhealthy would be then ruminating on how anxious you are, and thereby performing compulsions. If you found yourself doing that, you would need to distract yourself from the rumination, just like you would with any type of OCD thought. But please be aware that the compulsion, the rumination is what would be the problem, not some awareness of how anxious you are or aren't feeling. You can't turn off your ability to sense your own emotions, after all!

[Kranky123]

But then, surely even attempting to treat OCD is an attempt to reduce anxiety and would therefore be a compulsion? 

[Kranky123]

3 minutes ago, Saffron37 said:

Kranky, you're getting caught up in irrelevant details. It's like you're zoomed in so close to your obsession that you've lost sight of what's actually there. This is a lot simpler than your brain is making it out to be. 

Sure, to sit with discomfort you will have some awareness of how anxious you're feeling. But that's okay--it's not a bad or unhealthy thing to have that awareness. What would be unhealthy would be then ruminating on how anxious you are, and thereby performing compulsions. If you found yourself doing that, you would need to distract yourself from the rumination, just like you would with any type of OCD thought. But please be aware that the compulsion, the rumination is what would be the problem, not some awareness of how anxious you are or aren't feeling. You can't turn off your ability to sense your own emotions, after all!

But then, surely even attempting to treat OCD is an attempt to reduce anxiety and would therefore be a compulsion? 

[Kranky123]

25 minutes ago, Saffron37 said:

Kranky, you're getting caught up in irrelevant details. It's like you're zoomed in so close to your obsession that you've lost sight of what's actually there. This is a lot simpler than your brain is making it out to be. 

Sure, to sit with discomfort you will have some awareness of how anxious you're feeling. But that's okay--it's not a bad or unhealthy thing to have that awareness. What would be unhealthy would be then ruminating on how anxious you are, and thereby performing compulsions. If you found yourself doing that, you would need to distract yourself from the rumination, just like you would with any type of OCD thought. But please be aware that the compulsion, the rumination is what would be the problem, not some awareness of how anxious you are or aren't feeling. You can't turn off your ability to sense your own emotions, after all!

Also, what's the difference between ruminating about OCD and educating yourself about what to do? 

 

[NotRock]

@Kranky123: @Saffron37 explained it perfectly, read her again looking for understanding, not refusing, because its OCD who is fighting.

You now have a doubt about if your OCD can twist EPR into a compulsion, and how avoid that from happening etc.  Its clear you have that doubt (see your last posts, all them starts with "but...." ).

So thats the compulsion now (asking and never be enough sure about it), so acept the doubt, acept the feeling that maybe ERP will not gonna work, acept all the stuff and doubts and do the things that are important for you today (call that friend, clean the home, do that job...).

You have a life to live apart this doubt. I really hope to help you.

[NotRock]

2 minutes ago, Kranky123 said:

what's the difference between ruminating about OCD and educating yourself about what to do? 

 

educating --> you starts this when you are calm, it does not come from an urge, and you can stop whenever you want

ruminating --> you starts because you feel insecure or nervious and once you start is hard to stop

[Kranky123]

5 minutes ago, NotRock said:

educating --> you starts this when you are calm, it does not come from an urge, and you can stop whenever you want

ruminating --> you starts because you feel insecure or nervious and once you start is hard to stop

So if someone seeks treatment for OCD because they are ruminating, would that be a compulsion? 

[Saffron37]

Kranky, I don't know if you're aware of this, but you're asking a lot of near-identical questions. You can apply the same answer to all of them.

I think it might be really helpful to show this thread to your therapist--would give them a really good picture of your mindset and perspective.