"Ego" OCD?!

[FJ5]

First post here, hello all. I have suffered mild to moderate anxiety issues since my teens, but since my daughter was conceived 2 yrs ago everything's got a lot worse and come to a head. I wanted to share my specific experience of OCD as I can't find anything else that quite describes it anywhere and even my therapist is starting to get a little confused!

Basically I have this very fixed personality profile of myself in my head; it encompasses who I am, how I want people to see me, the person I feel I need to be, where I must fit into the world, my characteristics, passions and personality. And it becomes this benchmark that feeds my obsessive ruminations. Basically, I'll have a conversation with someone or perform some every day action that is in reality insignificant but then this burst of extreme anxiety steam rollers my thoughts and I feel very intensely that I was unforgivably "weird". I then have to match my actual behaviour to this profile in my head, often mentally reviewing from several different angles and endlessly ruminating until I feel satisfied that they adequately match up and I get that "OK" feeling. This can take anything from a few seconds to a few hours, but at it's worse it's completely exhausting, maddeningly stressful, just one obsession after another looping round my head. Even though I know it's illogical and just a chemical reaction, the fear is too intense to avoid the mental reenactments. It feels like my confidence is entirely dependant on the temporary assurance the ritual gives me; like if I deny the ritual my confidence will be irreparably damaged and my future ruined, perhaps I'll go mad, perhaps loved ones will abandon me, perhaps my daughter will be affected - all crazy projections of stuff that's never going to happen but the fear just tramples my logic into the ground.

I've now done ten sessions of CBT and at first it seemed to be helping just sharing with someone, but the further we go into it the less helpful it seems as she constantly struggles to understand what I am describing and how her usual methods can help me - she seems more geared towards helping people with outward compulsions via exposure, where as my OCD is 95% abstract, internal obsessions.

Can anyone else relate to this type of intrusive thinking? I can find vaguely similar things online but nothing that quite describes my experience. It seems to be part Pure O, part magical thinking, part perfectionism, part social anxiety, maybe none or all of the above. I'd love to share coping strategies with anyone who suffers similar maddeningly abstract obsessions as it's driving me crazy and making me very unhappy!

[leavesonastream]

FJ5, you might as well have just described me! Are you male or female, I can't tell? I have apparently had OCD tendencies my whole life and they emerge when I am under stress, and first became properly disabling when I was first pregnant with my oldest son 3 years ago. During my second pregnancy, I had to become involved with secondary care as I was really all over the place. My younger son is now ten months and things are much, much better. I have had 25 sessions of CBT on the NHS but Acceptance and Commitment Therapy and Mindfulness have been more useful to me than traditional exposure therapy. At this point, I am beginning to be able to do "internal exposure" e.g. preventing internal compulsions like you describe, but that is only VERY recent.

I actually "manufactured" outward compulsions in my early stages of therapy because I felt that the fact that I didn't have cleaning/checking etc type of obsessions meant that I was "making it up". All my obsessions and compulsions are internal really but I have learned over time that I have a lot more of these than I initiailly thought, in the early stages I didn't realised how much I did "typical" OCD things like calculating/repeating phrases/spending huge amounts of time editing emails and posts online etc, I would have said that I never did these things but as the mental review dissipated I realised that these were there.

A huge amount of mine is explaining myself internally to other people. I have ongoing conversations about the same thing again and again and again explaining myself in the way I want to appear.

I have learned how to hold the fear and to accept it, let it arise, peak and fade away. It took a lot of hard work! You have to learn how to watch your thought without needing to do anything with it - Mindfulness is great for this, as is ACT.

I think when you describe this to people they assume that as everyone does this it can't be an obsession but at the height of my illness I was both reviewing and planning conversations with three or four people at once and the noise in my head was extreme, I couldn't focus on anything else. I don't think that is typical behaviour!