OCD relapse

[Paul7]

Been a year or so that I have been on the forum but desperate for some help.😞i have had a relapse with OCD which has hit me so hard after being in control of the symptoms and compulsions for so long..my intrusive thoughts and pure o over harm have been conquered somewhat but ocd seems to have taken a different theme..looking at a few threads it seems this might be common but my thoughts have turned to me having a fear of developing schizophrenia. I have similar thoughts before but seem to have done the fatal error on reading symptoms and seem to have brought them on and have intense paranioa. Even to the extreme of reading that sufferers of the disease imagine they are being bring followed so I have imagined it myself when driving. It's created extreme anxiety..and had a massive effect on my day to day life., the cbt techniques I used with harm ocd don't seem to be working with these thoughts and am desperate for reassurance which looks like more ocd traits..am desperate to get Back on track can anyone help 🙏

[MyNameIsTerry]

Hi Paul,

If you look on the GAD board you find threads about this as well as those where people fear going crazy or that they will develop a more serious psychological illness. Everytime someone raises this, there are some that will reassure people that it doesn't work like that and that those who truly do experience that, do not know it until someone points it out to them, or some never understand it because its normal to them.

I wouldn't worry about CBT techniques not working for a different form of anxiety, this can often be the case and you have to just look for more CBT techniques or other forms of technique from other treatments/therapies. This is something I've seen often on here as well, not just this board but the HA one too. If the techniques were created to tackle the problem at the time, they may not translate to this one or they may need some alteration for them to work for you.

What techniques do you use?

I have OCD and I have found that I have obsessional tendencies in general now, not those which require rituals, but ones that can make my life rigid due to living inside a structured routine that I find hard to break. So, I get what you mean by how you have found a new form of anxiety and the obsessional side of you has looked it at and decided it must occupy your thoughts in such extreme ways.

Before this happened, were you finding yourself becoming more anxious? I ask this because I know for me, I literally could not get anywhere hardly with CBT on my OCD and I learned that I needed to stop working on the OCD and reduce my GAD which was more severe (even though the OCD was driving me nuts all day!) and was keeping my OCD going. Once I did this, a lot of the OCD quickly vanished, reduced or I found I could work on it more. Could this be the same for you? Could you gear your CBT towards an underlying anxiety that was coming along and caused all this to start up again?

Paranoia is common with more extreme anxiety, when we are the worst stages of it that is, and CBT is also used to combat this but given its not as much an inward focus, maybe they apply it differently? Or maybe they use different tools because I know I only used a small number of the tools in my therapy.

I think OCD has a big link to a lack of self trust and self belief, hence all the checking we can be doing. Its like we don't trust ourselves and I remember mine starting with double checking and it got far worse from there. I couldn't get past roadsigns on my walks without rituals of checking, it was killing me at that stage.

You got better last time, so keep that in mind because I bet before then you didn't think you could achieve this...and you did. Its hard work with the techniques, but they pay off.

I also found Mindfulness helped me more than anything. Have you tried this? It would really help you with OCD and it is also geared towards compassion to yoursellf which could help you detach from the paranoia by getting you into more productive thought patterns. It can be subtle, I remember changes popping up from nowhere and I felty different about things but it is really good at training you to be non judgemental to your thoughts, sensations, feelings & emotions and this could really help you.

[Paul7]

Thanks for the response i have never had such a helpful reply from
Any forum.. It really means a lot.
You are spot on regarding the anxiety which was defiantly and still is the main problem at the moment but as you well know once the anxiety or stress reaches boiling point the ocd seems to kick in. Without going too much into the previous period of ocd in which I recovered well and gained control of the ocd this one seems to be a lot worse as previously stress was the big factor with a health issue and leaving a long term job. A combination of fluoxetine and cbt seemed to work well..but after a year I decided to come off medication so unsure if that is a factor as only been 10 weeks. The theme on my previous episode was harm intrusive thoughts which exposure to the thought seemed to work after a long fight with it..basically been taught loop tape procedures or writing the thought down over and over again or even saying the thought over and over..This technique doesn't seem as effective with paranioa or the fear of going mad..I have never tried the mindfulness side of cbt but going try a different therapist so will maybe try..

All In all still can't grasp if these paranoid thoughts our still ocd intrusive thoughts or anxiety ? Still bugs me.. And the issue over going mad still drives all of this...

[MyNameIsTerry]

Sorry Paul, I've not been on her much the last few days stop have yet to catch up on a few threads.

If you think about it, isn't paranoia just the opposite of harm OCD if it's centered around others harming you? If it's theme is more about the opinions of others eg "they must think I'm crazy" then you will find this is very common in any anxiety order and you will find it mentioned in Cognitive Distortions. It's not reality, it's just alight irrational inward focus by taking incorrect beliefs of reality and not seeing the truth eg unless we physically manifest our anxiety to show others, they have clue or wouldn't even know how to spot it plus people are usually busy thinking about their own lives and not concentrating on us even if they are looking at us at the time.

I don't think it's the OCD but because you have suffered any obsessive pattern, anxiety can use that against you through its other forms hence it driving this new paranoia.

Have a look at my threads because the CBT techniques you used are discussed in trends of exposure therapy in one I added to for a thorough practitioners guide. It's a guide explaining how therapy can not work, why and what to do so you might find some answers in there about tweaking yours. It also talks about the pitfalls of the techniques you describe when used for OCD.

Was it exposure therapy you had?

Mindfulness could help with all because it acts as relaxation technique as well so that you start to become calmer when experiencing these thoughts.

[Paul7]

Thanks for response again terry.. Yes your right thoughts do seem to be the opposite to me harming others...but In a nutshell all seen to come back and start from me questioning my sanity which is all fed from my obsession over going crazy.. The general paranioa is me looking at for danger constantly and just feeling spooked out.. Would you say that is still more general anxiety driven ? Because the thoughts still become obsessive it's really confusing..whatever way I look at it I need a new approach the exposure therapy didn't really work..so will take a look at the mindfulness app and books you mentioned I have tried the breathing bit only when am In full blown panic and doesn't see. To work as good so I suppose more practice at all times would be better..once again your views and advice on this have been brilliant.its difficult with a therapist at times as they have one approach to intrusive thoughts that they seem have to work with everyone

[MyNameIsTerry]

Yeah, as anthrokid explained on a CBT thread recently, some therapists are not multi disciplined like a psychologist will be so the NHS often ends up sending us for therapy that may not always work which the stepped care model is an example of in terms of how the NHS has chosen to use it.

However, the therapist needs to determine the way forward and get you to it but sadly is a badly self regulated industry so this may not always happen. This is being looked at in a Bill of Parliament so it will change in the years to come.

Breathing in Mindfulness is different to that of anti panic techniques because you breathe normally but in mediation form you use breathing inductions prior to the quiet phase where you let your thoughts come & go. I had 3 forms of induction; one bad on chest movement, one bad on visualisation of breath and one based on monitoring the muscles between the ribs. If you can't stop the thoughts in the quiet phase, you simply do some of this again as it's a distraction.

Rumination about the problems can just reinforce is need to be a valid set of thoughts. Is worth researching to a point bit it can become counter productive and you have to trust the tools to recover more. The paranoia can come with GAD or OCD or both anyway because of insecurity, obsessive tendencies and an inability to seed the real picture rather than focusing on the biased view. I know I did the constantly ensuring I was safe thing and was paranoid about my employer because they had pulled some strokes on me. A lot of people also very paranoid about how people are viewing them.