OCD

[AndyJ73]

Hi Terry,

Thanks for the information.

I've been to see my therapist and she didn't seem too concerned with how I have been feeling. Again she's asking me to try and use my phone as much as possible and shut thoughts down and label them as intrusive when they first hit.

I never watched the video but having been talking about it to my therapist it's set off some anxiety again around the whole issue.

Was the mindfulness a book by Williams and some one else? I saw it today and you get a free cd with it.

[MyNameIsTerry]

Hi Andy,

Yes, the book I have mentioned is the one by Mark Williams. It will have "Frantic World" in the title and has a bluish-green cover with an outline of a blacked out city on the front (like a landscape picture over water).

Your therapist will only likely be very concerned if you display any markers for self harm or acting upon suicidal thoughts. Beyond that, they see a lot of people in various states and they will be concered if you cannot engage with them or progress (I hope).

My advice to your would be to create a hierarchy of exposures with your phone and work through them as would be done in ERP. I think I posted a Moodjuice guide that shows this earlier in this thread somewhere.

In exposure, you need to stay in the situation until your anxiety drops to 50%. If it doesn't, you need to go back a step and introduce a stepping stone between them because otherwise you can be just reinforcing your anxiety by not seeing an improvement.

Talking about it can easily do that. Don't worry about why it set that off, things like counselling & therapy can be intense when you are in a more severe place. This changes as you recover.

[AndyJ73]

Hi Terry,

I guess I'm having a bit of an up and down time at the minute.

I'm back to the topic from the other week. Do you ever feel like stuff is unresolved? As though you need to get some kind of conclusion. I keep having two trains of thought.

1. I should just watch the video and get it over and done with. However I know that if I were to do that I would regret it instantly as it would feel like 'giving in'.
2. I should continue about my normal life and recognise that watching the video would be wrong. However that then leads me to remember the first train of thought, which then makes me feel guilty and question how I could even contemplate watching something which could potentially be wrong.

On top of this, I am still having excess worry about how I feel when seeing people both in the street and on facebook. I also worry that the attraction I used to have to others (before these intrusive thoughts) has now disappeared. I know we have discussed this before, but surely that cant happen. But what does it mean? Is it just depersonalization kicking in?

Sorry for all the questions.

Thanks,

Andy

[MyNameIsTerry]

Hi Andy,

Oh yes, loads of times. Its was incredibly hard at first.

Part of my OCD was the compulsion to ask people to repeat statements. I had heard them, or sometimes only partially so, and I would it doing again so it "felt right".

The same can be said for any of my touching or checking rituals. Trying not to do them brought a strange, what I can nonly describe as an "inner pull". Its a strange feeling and I'm not sure I can fully describe it but I think you will understand what I mean. At times, its like you could almost feel being pulled physical, but not quite, if you see what I mean?

If you watch the video, you don't want to do it as a compulsion. If you did it as a legitimate exercise, like in Behavioural Experiments for instance, you could have a worksheet with you and use it to populate the sections about your thoughts & feelings. If you just do it to be done with it, you have to make sure it is not to reduce fear in some way i.e. a compulsive act.

There is a flaw here. Something you are missing. Where is...

3. I should continue about my normal life and recognise that watching the video would mean nothing.

You have a perception that watching the video would be wrong. But would it? Is it something illegal?

If the subject material is either illegal or a moral problem in anything then you can also consider...

4. I should continue about my normal life and recognise that watching the video would mean nothing. But I accept that this obsession is because the intrusive thought is wrong but its only a though, nothing more and I don't need it or place any value on it.

So, its important to try to think around them otherwise you get the tunnel vision issue. This is one of the reasons why a therapist is very important, we can learn CBT out of a book but how can we apply it when we can't see around our issues? This is where you start out and over time as you learn about thoughts and how these cycles, distortions, NAT's work, etc you start to change how you question them, you think more tactically about it.

Yes, I'm sure we've discussed about prior attraction. You can feel no attraction towards people when you are depressed or any interest in the world at all for that matter (been there!). Some meds can have this as a side effect. So, if these people went through that for years and then recovered and started having these feelings back again, why wouldn't you?

I can remember having periods where I didn't really care if I died in my sleep. I had periods where I didn't feel attracted to anyone. I don't have that now, it was just a lack of emotion at the time that passed. Sometimes it was longer periods, sometimes short.

What you are probably thinking is "have my tastes change because I spend so much time with these intrusive thoughts and not with my previous thoughts of attraction?" But we know OCD doesn't turn people into paedophiles. POCD is not commonly known of in general but if you search on Google for things like this you will get a lot of hits. Its well known, just to the profession and online, charities, etc. They don't say tastes change so that you develop into what your intrusive thoughts are leading you to believe. I used to have harm based ones mostly, am I an axe murderer? No. My intrusive thoughts don't define me and you will see this quoted in OCD quarters as its very important for us to get into this mindset.

Sometimes I think of intrusive thoughts in the same way as dreams/nightmares. Do we all wake up and say 'I had a dream about killing someone, I must be a murderer?' Or do we wake up and say 'god, what a weird dream?'. The anxious person is often disturbed by their dreams (and the physical feelings that nightmares naturally bring) but the non anxious person just shruggs it off. I used to do that for 30 years until my anxiety started!

Now, I don't understand the science of dreams so there are going to be reasins for why we dream what we do but thats not my point. My point is, we don't focus on our dreams like we do our intrusive thoughts in real life EXCEPT when we are anxiety sufferers as we are reading into everything. Again, our reaction to the event is the reason for the cycle remaining.

Rationalise it. OCD is very common across the world. POCD is also pretty common. Can you find a expert anywhere telling people someone with POCD has committed an offence? Have you ever seen a news report anywhere saying this? No.

It may be a bit of DP kicking in. I don't really know much about DP but I've been wondering whether I get a fair bit of it as a low level symptom. Maybe it is common in OCD?

So, I don't think it means anything really. You are so absorbed by the obsession that there is little time for anything else. I've been there. I've probably talked about my obsessive management of my days? I know I've spoken about the hundreds of rituals. My day was the same everyday for well over a year at first. The only time it changed is if an external factor caused it e.g. a shop closing early. When this change happened, my anxiety rocketed. I had no time for anything else. I could go months before reading a letter I put next to my bed. Nothing mattered but the routine. I had no interest in hobbies, fun, my GF, nothing because there was no time to fit it in. As I started to break out of this cycle it felt so strange to be involved with these other things and scary. It was, and still is, like learning how to live again.

Does that sound familiar? Could you relate to that some how?

[AndyJ73]

Hi Terry.

Thanks very much. I guess the fear is this video could have been from a year or so ago and then could be deemed illegal. That then makes me question, 'well how would that make you feel?' and because I'm not getting the repulsion I'm after, that makes me worry more.

Clearly I have anxiety and I should know that I didn't have these thoughts before. In fact it was a year on Friday since 'that' first intrusive thought kicked in. That's been pretty hard to come to terms with. I'm at the stage where my motivation and ambitions have pretty much fallen to zero and whenever I seem to enjoy things I always have this thought of 'well you can't enjoy that because of the intrusive thoughts.'

I need to change something, be it what I do between sessions or when I'm at sessions. It's hard to understand why the repulsion no longer comes.

Thanks again

[MyNameIsTerry]

Hi Andy,

If it were from a year ago, hence making her 15, it would make you think you are crossing a line so I get that. Thats a "what if" situation and its just another one of anxiety worms in our heads.

The thing is, you may not be getting the revulsion but you have missed the fact that you still view it as wrong. A paedophile wouldn't view it as wrong. You expect your more extreme reactions each time but that isn't always going to be the case and I've found that the more you live with OCD, the more you seem to adapt to it and these things can happen. That doesn't mean by "adapt" that you change though because you have a higher moral code preventing that. Its just how patterns can change.

Also, have you thought that a part of you knows that this is a nothing issue because it is a 16 year old? If we were talking a 6 year old, maybe your revulsion would be there? But one part of your mind is saying its wrong because she could have been under 16 at the time but another part of you knows she wasn't. So, you don't get a full reaction on that basis.

Think back to trying to do this in therapy. You couldn't get the true reaction you experience what it happens in real life, what would be called in vivo. Your therapist tried to get you to see it in therapy but the image just wasn't strong enough. But what if she got out her laptop and pulled it up? That would be more real to you and your reaction could be the one you expect to be having.

Think of it another way. If you have panic attacks in shops, would someone describing that shop to you necessarily mean you have another panic attack? No, it wouldn't and the reason for this as that your mind knows its not really a shop. The therapist has to make the image rich enough for you to believe it to experience the reaction.

I've spoken to people in charity walk-in sessions about this alien feeling or sense of wrongness or even guilt for enjoying yourself or even having a better or more normal day. People on here have talked about it. Its pretty common and its something that does change over time so don't read into that one because it will pass as you start to experience more better days. You are used to being in this current state and anxiety is very resistant to change or uncertainty - its the point of fight or flight. So, it will resist better days and because over a long period of time you can condition yourself to being an anxious person, it feels every bit as weird to have a good day as it can be to have a bad day when you first start experiencing anxiety.

Have you ever seen The Shawshank Redemption? Great film. There is a scene in it where Brooks takes his life and they are gathering reading his letter and Red says:

'These walls are funny. First you hate 'em, then you get used to 'em. Enough time passes, you get so you depend on them. That's institutionalized.'

Does that sound familiar? It sounds like anxiety doesn't it?

The truth is though that things do get better and how you are feeling right now won't last but it takes work & time. If you can't improve, how did I get much better because I was a massive mess?

It is good that you recognise you need to make changes. Inertia is bad with these disorders, they can sneak up on you again. Realising it is time to change is an early step, part of accepting your disorder and that its just a transient state - its a positive thought.

---------- Post added at 09:30 ---------- Previous post was at 06:46 ----------

Hi Andy,

Something relevant to you here that can be found on OCD Action's forum from Wiki:

Sexual ideation[edit]
It cannot be overemphasized that the sexual obsessions in OCD are the opposite of the usual sexual daydream or fantasy. The thoughts are not really part of the person's identity, but they are the sort of thoughts or impulses the person with OCD fears that he/she may have.[10] The sexual ideation in OCD is unpleasant and distressing for the person with OCD. The individual with OCD does not want the thought to become real. The idea of acting out the obsession fills the OCD victim with dread.[11] The sexual ideation in such situations is termed ego-dystonic or ego-alien, meaning that the behavior and/or attitudes are seen by the individual as inconsistent with his or her fundamental beliefs and personality. Therefore, OCD can decrease sex drive.

The OCD sufferer may have a constant focus on not becoming aroused or checking that they do not become aroused, and this may lead to 'groinal response'. Many OCD sufferers take this groinal response as actual arousal, when in reality it is not. OCD sexual obsessions often result in guilt, shame, depression and may interfere with social functioning or work. Approximately 40% of sufferers (number could be higher due to the embarrassment associated) also report some accompanying physiological arousal. Reactions can include increased heart rate, a feeling of being turned on, and even erections, increased lubrication (in women), and orgasm. This response typically generates more confusion and uncertainty. However, this is a conditioned physiological response in the primitive thalamus of a brain which does not identify the thought as sex with a particular person, just sex. This is generally not indicative of one's own personal desires. (Osgood-Hynes)

So, if you ever did even have a physical response - its explained there as to why its meaningless. But I thought it also useful because of the statement of how these thoughts do not part of the individuals identity and how OCD can be ego-dystonic or ego-alien.

[AndyJ73]

Hi Terry.

Thanks for your response and the link to the Wiki page. It's hard to deal with it as it's something which keeps coming up in my mind. I thought I had overcome the thoughts around it but I don't know how to handle them. What do I say to myself? 'These are just intrusive thoughts?'. It feels real and for some reason there seems to be a part of me that wants to watch this video. It isn't normal to be this obsessive about something so innocuous yet it continues to play on my mind.

It just feels like I have to deal with it and move on. The uncertainty and not knowing isn't helping me.

I just feel like I'm one wrong move away from it being the final straw. I genuinely don't want to live like this for another month let alone another year. I'm amazed I'm still going and living my life. I just feel so lost and everything I try seems to come back and bite me on the backside. I just can't feel any progress.

I really appreciate all the advice you've given me though.

[MyNameIsTerry]

Hi Andy,

I know what you mean, it's like another day of this is just too much but you look back and see hundreds of days just like it. It can be tormenting just getting through each day at a time at first.

Even if you did watch that video, its not a final straw at all, it's just an event and whilst you will feel guilty and analyse it & what it means, recovery is still the same journey. We make mistakes and cause ourselves more anxiety at times in this.

Yes, subconscious thoughts feel real like they have more power because they are thoughts that are produced with feelings, sensations, emotions and even memories for some. That's a lot more than a Cognitive thought BUT Cognitive thoughts have decision making power whereas subconscious thoughts don't. Subconscious thoughts are being sent to the conscious mind for a decision because it doesn't know what to do with them.

They can be a torment but in all cases they cannot make anything ever happen because that comes from the conscious mind and you have full control of that.

Getting your mind to accept this can be tough, I found this very hard for a while. Some people find it easy to write if down because then it feels like it's out of your head and in the physical world which can help with racing thoughts and analysing. Thought Records are a good way to do this so you have to fill in the counter arguments. Some people find journalling helps. Obviously, given some of the sensitive subjects, we have to be careful how we do it because not everyone understands OCD.

Have you tried anything like that? It does mean telling yourself they are just meaningless thoughts or whatever I don't care. Trying to learn not to judge, interact, analyse and react are key to beating it. With Thought Records you write down more than this because you provide evidence as to why the thought is not real or that something may or won't happen.

[AndyJ73]

Hi Terry,

Thanks again.

So what do I do? Do I just move on and try and forget about it? As soon as I read anything do I just shut it down and say 'this is causing anxiety'. I've read so much anboujt trying to allow anxiety to be there, but with the subject of mine, it's hard not to try and talk myself out of it and reason with it.

I think it makes it worse because I am torn between what to do. And the fact I'm torn makes it even worse. Because that then means I have allowed myself to 'almost' do something I shouldn't have. And because I have contemplated it, then that surely is a bad thing?

I have tried to live my life as normally as possible today. I used to love distance running, ironically it helped clear my head. I went for a five mile run tonight and it was like torture. Being alone with only my thoughts and the harder I attempted to let them be, the harder it seemed to distract myself.

Thanks again mate, I don't know where I'd be without you.

[MyNameIsTerry]

Hi Andy,

Sorry, I was typing up this and my connection died on my last night.

Contemplation is different to actually doing something. You could argue that this was a way of analysing a problem with the cognitive mind but because the outcome was not to watch it, then it was purely an option that was being assessed - should I watch it or not + reasons for & against. If that meant that process was negative, hence feeds the obsession, then CBT would be completely flawed because part of its Cognitive Restructuring phase is to do that very thing. So, I think you need to view this as analysing a problem, weighing up the options, etc and only the outcome matters which is not to watch it because you see it as wrong.

With the running, would a practical solution help with this e.g. music or podcast? Something to remove the issue of silence that gets filled with thinking? Mindfulness includes a walking form where you concentrate on the feelings in your legs and attempt to feel every step. This might be useful here as you could then spend your time focussing on the sensations in your feet & legs. You would need to learn to feel it walking though first.

This feels like your obsession has shifted away from a general POCD to a specific issue over this person & video. Shifting this obsession could see a return to the general state and then something like this could happen again if it affected you strongly enough.

Trying to forget can be a problem and there are studies that show this doesn't work for some people because by actively trying to forget your mind concentrates on the subject more knowing it has a job to do. So, it’s like trying too hard at something. Maybe this works for some people but it’s something you would have to try. I think you would need to couple this with things that distract you though and things that take up a lot of your day so you don't have time to sit down and allow those thoughts to come back. You could try it, but I don't know how effective it can be as these methods work for some & not for others.

How do you feel about trying something like Mindfulness? Does sitting and allowing your thoughts to come & go provoke fear because you don't want them anymore? In meditation you can revert to a breathing anchor to give you a physical sensation to focus on which helps break the thoughts for perhaps 30 seconds and then you return to monitoring. It could help you although it’s not always quick.