Some advice/guidance needed please.

[Goldenbuddha001]

Hello everyone, I am a new to this forum but I’m not new to obsessive-compulsive disorder. I had my diagnosis last year it was confirmed by two psychotherapists and by a psychiatrist as well as having borderline personality disorder. At the moment I am struggling with the volume of intrusive thoughts and obsessions which seem to be playing out. They seem to be quite prominent at the moment which I can only surmise is due to me currently withdrawing from diazepam that I took over the Christmas period because it was a stressful time being away from home etc.

I am quite insightful and knowledgeable when it comes to my condition although I am currently struggling trying to rationalise things. Even though I am used to having intrusive thoughts about everyone & anything and they are heightened currently like I say with coming off diazepam etc There is one thing that is really troubling me at the moment & that is a harm obsession towards my mother which is making it difficult to be around her.

It's making me feel that I don’t love her. I feel like my mind is tricking me into thinking that I don’t actually love her but that I hate her which is making me obsesses/ruminate even more. It’s a vicious circle that is causing great distress which leads to further intrusive thoughts. I just feel numb and when I ask myself if this is true and try to rationalise it I can’t seem to make sense as to why, the real root cause behind the obsession. Is there underlying anger? etc. I just feel that this is taking over my real self and taking over the rational part of my brain and I just don’t know what to believe anymore. I feel genuinely detached from my real self and I am terrified because having the intrusive harm thoughts is one thing but then thinking that I dislike and hate my mum is as equally distressing. I’m trying my best to keep occupied and busy at the moment by attending a lot of self help groups through the week and I’m waiting for long-term therapy.

I guess I could just appreciate some feedback as to what you think this could symbolise. I know obviously you don’t know me and I am willing to expand on any questions that you have to put my way but I just am just really struck with this at the moment and I don’t know if it is normal to feel to this degree the way I feel with me questioning my emotions & feelings towards a person because I have not come across this before regardless of my knowledge and insight. I know that there is a likely chance of it being further psychological trickery playing out possibly to get my attention but I’m just curious to see what you think and would appreciate any advice/feedback on the matter. Thank you for taking the time to read this.

[TomT]

Welcome to the forum golden!

The very fact that you are worrying about this means, you dont hate or feel an underlying hate towards her. Have you ever felt worry when you hated someone? Probably not. You are dealing with some HOCD some OCD issues are not solve by logic but with emotions, think how bad you would feel if you hurt your mother.

Dont worry buddy you are fine, there is no such anger or hate, there is just worry and fear. Anxiety loves to feed from those emotions


Tom

[Goldenbuddha001]

Thank you for taking the time to respond Tom. Much appreciated.

It would make sense that it's harm ocd trying to trick my own beliefs/perspective. Like I say socialising has become incredibly difficult as a result. Whenever I have seen her particularly afterwards the mind goes into complete overdrive with the harm thoughts & analyses/magnifies every thought/things she said in conversation/actions etc.

I feel guilty for thinking the way I do & then in the next instance I feel numb/like I don't care especially when I re-read the line 'Think how bad you would feel if you hurt your mother'. I find my mind constantly testing my reactions to the instrusive actions my brain seems to be producing. This particular obession has really got its claws into me & I am admittedly struggling to get through the days no matter what I apply my mind to doing. Even expressing sad emotion I am finding myself questioning whether it is sincere or not. Horrible. I am in total agreeance that it's how emotionally respond to the thoughts that is the issue.
When I have reasoned with the rational part there is always a part of my brain that says but wait... there is this or that aspect. Complete torture. etc

[TomT]

Remember most not to say all OCD related disorders are ego-dystonic (this one I learned from Terry). This means it makes you fear exactly what you wouldn't do, you would never hurt your mother for the very fact you are afraid of it. People that wanna hurt their mothers, are not afraid of the thought or if they are afraid is about what its going to happen to them, not around the damage they cause to another person.

It seems you are in a bad cycle to my understanding, an intrusive thought comes, you make some checkings to see how yo react, anxiety confuses your response or interpretation of emotions, you feel numb and start isolating yourself due to the fear of harming others. Remember you are not going to hurt them, so exposing yourself to being around them its the best way to tackle this issue, it might be hard at first but you will get the grip really fast.

Deep inside you know how you feel and its totally normal to feel certain numbness due to the stress caused by this thoughts, but this too shall pass. Thoughts are just that, thoughts. OCD latches to your fear so you can avoid it, its a normal response of our bodies but our minds take it a few step further.

Anxiety might make you think you can become a monster but the truth is you are far from becoming that, and this goes to anyone here. Real monsters do not fear, they just act not caring about others.

Tom

[MyNameIsTerry]

Hi Golden and welcome to NMP

Can I tell you what I see here?

I see someone concerned about their thoughts & emotions and what they could mean or turn her into. I see someone who values her relationship with her mother because she cares what she may do if these thoughts could do that. I see someone who worries about violence.

I also see you have BPD. PD's are known to be much more ingrained into identity and so changing them is a harder piece of work than with an anxiety disorder alone. The updated form of CBT that works on this is DBT which was created to add in emotional work. That makes sense and you mention how emotions are a struggle. So, therapy is a good choice here because you will need to do lots of work on changing beliefs to sort out the BPD. But you come across as very calm, intelligent & rational, not someone falling to pieces as some people with PD's seem to come across or with views of their anxiety that are so strong no matter what we say we can't seen to get things across to them. This seems to be a really good indicator to how you will tackle your BPD and it seems like you already are.

Aside from that, back to the intrusive thoughts. Tom has told you lots of important stuff. He told you how intrusive thoughts, in medical literature, are categorised as "ego dystonic" which means the opposite of true beliefs, character and schemas. You should think about that. With a PD, your schemas & beliefs can be affected (it depend on your diagnosis since BPD is less specific than some other forms) yet you have this deep moral belief that violence to your mother is wrong. This is why it scares you.

I often explain it this way, you have a load of associations in your subconscious which are made up of many things including memories. When there is a trigger, checks get made against these. If it can't find an appropriate match, or the stimuli suggests something that must have a conscious decision, then the subconscious just fires of all the "data" to conscious mind which is really just "I don't know what to do, please tell me". You react with fear/panic/anxiety/worry, etc and it slowly teaches the subconscious that it should associate these thoughts, feelings, sensations, emotions, etc together. The more this happens, the more these are then also sent through to conscious brain again saying "here it is, what do I do". Now, you would think that if you train your subconscious to associate these, you would change them to become your new beliefs? Incorrect. Why? Because you have things like schemas and these are linked to your deeper sense of identity - things like right & wrong learnt at an early age. So, even though all this gets associated together, there is still a check against this criteria and it fails and sends it for a conscious decision. If you are familiar with computer programming and how exception handling works, you will see what I mean as that mirrors a lot of this.

Deep down you know that it is fundamentally wrong. So, unless you change that very deep belief, you will not act on them. Don't worry about that change either because these are so deep and connected to who you are that you are talking about the kind of brainwashing we see in films to achieve it.

A problem that can develop from this, one I've observed in several new people on this board since being here, and all had either POCD or harm based OCD. (HOCD is often for the gay/lesbian subtype, so I use this instead). They start raising threads about how these thoughts scare them and what they could mean. If you keep an eye on these threads for some time you start to see that their fears change away from this to a) lack of feeling/mood issues often seen as not caring or b) a feeling of even "liking" or wishing/willing it to happen.

I have been through both a) & b) myself and my pattern matches to those I have seen on here. What I attribute this to is time & exposure. They keep experiencing all of this and through all the mistakes they unintentionally make (like the checking & analysing) they allow their subconscious to make further associations to strengthen these negative beliefs and this responds in these types of changes. They almost feel like the thoughts are expected and then they panic that they truly are turning into X or Y as they no longer panic over it or they get confused sensations/thoughts about the "liking" and panic over it as they belief they wish/will things to happen. What does that all mean about them? I am truly changing? It's all the same questions. I've been through it and come out the other side. What they say, how they talk about themselves, it's just like how I was except I have the benefit of coming through it. (like many other people)

So, emotions & thoughts get confused. I can see that in your posts. You are doing a lot of mental checking & questioning (compulsions) and these are just strengthening the disorder because the subconscious ONLY looks for negatives. By providing them, you complete the cycle. I often describe this as validation. The subconscious sees the thoughts as "valid", not "right". It has no concept of right outside of those beliefs & schemas I mentioned earlier, correct otherwise comes from the conscious brain.

You tend to have two options:

1) Challenge thoughts the CBT way. This means counter evidence, use a Thought Record. You challenge the evidence for the belief/thought with counter evidence and come up with a closing statement. This is an excellent way of getting the thought out of your head and into the physical world and I have found this can help because it makes it less likely for your conscious mind to work through a problem to solve it only to start again.

2) Observe thoughts. This is the Mindfulness way. Acceptance is part of this, hence acceptance strategies work too. Observing thoughts means neutrality. Option 1) above was about positive or neutral feedback, this one is about attributing nothing to it other than "a thought is just a thought with no meaning". You treat it with no more interest than any other thought that pops into your head, like walking through a supermarket and thinking "I need more milk". Why should that affect you? It won't because it's a reasonable thought and we want our subconscious to see your violent thoughts as the same. This doesn't mean agreeing with them, that's a different strategy therapist use which I have less knowledge of, but this one means to just let it float away without reaction.

I do, or have done both, but option 2) sorted my intrusive thoughts. They don't just go though and this is something you need to learn. ALL people have intrusive thoughts and research studies have confirmed this, people just don't realise it because they fly through so fast. So, it is a negative goal to say "I want them 100% gone" because you can't achieve it. There is always the possibility of strange thoughts. We get many. But what you can do is reduce their frequency & intensity.

Over time you see your reaction change too. I started smiling or laughing at how ludicrous mine were. I could give you a graphic example of one of mine and a stranger and I smiled automatically. The same with self harm ones with bridges. From here, things changed further and then they were rare.

So, through addressing them, be aware that these things happen but it doesn't mean you are turning into a monster, it can just be part of the recovery journey and how your subconscious it attempting to construct new core beliefs to these thoughts. ]

If you have read about core beliefs and read about the neuro side of anxiety, you will knows it's all neurons and the synapses that connect them. They build off each other in strands, create layers, etc. So, in changing core beliefs, they can seem a bit garbled at first but just keep going and the new one will form. It's a bit like those old telephone exchanges with the women pulling plugs out and inserting them in others to make connections.

Knowledge is important with Pure O style OCD, because you question a lot of things about what this all means but what if it's just part of resolving it? Some don't realise this, start to panic and undo the hard work hence why I've tried to give a lot of info.

Well done on those self help groups. Isn't that another point showing you know things need to change?

My last point is, do you know any violent people? Do you think they would be on here asking what you are? I have known violent people, I grew up in a rough city. Like Tom says, they only "get religion" when it suits them. They find remorse when it comes to reducing a sentence. True, some people reform but that takes a big shift and remember those schemas & beliefs? Many violent people were always that way. It's normal to them. They won't panic over harming someone and they might even enjoy it. Is that you? No chance, you wouldn't be on here for a start and the things you are talking about wouldn't enter the heads of the nutters I have met I my life. Some would be bragging about what they did as you lay in a coma.

[Goldenbuddha001]

Thank you for taking the time to write such a detailed and eloquent response. You mentioned DBT. I am in the process of waiting for some psychodynamic treatment (Democratic therapeutic community) but it could be up to a 12 months wait but I am hoping that I hear from them in a few months time as to where I'm up to on that waiting list. It's been roughly 5 months now so I am hoping they will invite me for an assessment soon. It would appear I am a likely candidate for such treatment which will help delve into past traumas and particularly focus on the borderline side of things so it's going to be quite intensive treatment which potentially could last up to 15 months. I am eager for this to commence. I have had 20 weeks CBT last year & I am currently waiting for further CBT which should hopefully take place in February. In essence 20 weeks of cbt doesn't sound a great deal but it is a source of help as you know that helps with beneficial coping mechanisms. I think with some individuals it may take a serious of attempts for it to click & perhaps resonate with the strategies provided. I have kept all my notes that I made from last years sessions but finding it hard to incorporate it into my daily life due to the intensity of anxiety & poor concentration levels. I am currently experiencing being in a bit of rut with the emphasis being as you know on my mother. What makes it harder & more complex is that I feel incredibly irritated by her, or maybe I am just highly irritable in general & the anxiety is making me somehow believe that she is contributing towards it which fuels the anxiety further.

I am quite a strong willed person so I believe I will get through this it's just trying to rationalise myself through it. I was on that many different medications last year to assist as a temporary hand rail but none of which have helped, if anything they have magnified my symptoms & subsequently made me feel quite poorly. It would appear that I am quite sensitive to most pharmaceutics so I am currently without anything. My body most likely doesn't know where it's at & most likely still experiencing the come down of the Valium. I really don't like taking that either due to the problem of dependency & long term use isn't advised.

I have abstained from self medicating with cannabis/smoking & been clean for nearly a year & six months now.
Absolutely do I internally recognise that something needs to change, you're most certainly right there, that's why I have taken it upon myself to be pro active in getting out & attending self help groups 3-4 times a week. The structure/routine really helps whilst I await my treatment.

I have come an incredibly long way with the OCD playing through various themes particularly last year. The harm theme seems to be the hardest to deal with no matter how much I try accept its existence.



I really do appreciate the extremely helpful feedback, definitely some food for thought in what you have expressed & have found myself today reverting back this thread.

Best wishes Terry mate.

---------- Post added at 03:18 ---------- Previous post was at 00:47 ----------



---------- Post added at 03:19 ---------- Previous post was at 03:18 ----------

I have just noticed Terry that you have confused me with another user on here 'KJX' in another thread. Even though there are some eerily strong similarities in the content of this persons post may I firmly establish we are not the same person, I only have one account on here plus I don't have a brother! Lol.

Anyway I hope that this thread helps that individual with their current situation.

[MyNameIsTerry]

No problem Golden, as explained I have updated that thread to address the confusion.

I'm glad if any of what I have said helps you. I've looked into my OCD, and that of others too, as I think it's vital as some of the forms could easily be mistaken for something more sinister. POCD is one that certainly scares people that join here and who wouldn't be, given the emotive content. Harm-based is very similar in that respect, it's one of the shockers given the potential consequences to your life and others of that perception that you could act.

I found it takes the sting out a but just realising that it's documented in OCD and to at least consciously know the truth. Then comes the hard battle to convince your subconscious!

There are a couple of other members on here with PD's, one I've seen has BPD. My therapist thought I may have Obsessive Compulsive Personality Disorder (OCPD) because I had the minimum 4 of it's criteria. But after doing some of my own research (she said it was above her level to diagnose and was discharging me anyway at that point back to my GP) I found out that it's not just about the criteria, it's about the mindset too and I didn't hold the views expected in OCPD that would make me so resistant to therapy. My resistance issues are more common to GAD & OCD and seen on this forum in many, if not all, others.

So, it must be even harder for you needing to tackle these too. I hope you get into that group soon to get working on it. Is that one of those peer groups where you work together against the problems? Group work seems very useful as there is solidarity with others. Some people on here have had group CBT and said it helped them being in a group. I used to go to walk-in groups at a local charity before I came here and found them very useful but in a different way.

I agree with you on the CBT. I had 12 sessions and a couple of follow up reviews. The reviews were really for them though. I didn't get far I CBT but my therapist introduced me to Mindfulness and I kept this going. Months after my CBT ended I started wanting to work on early goals that I just couldn't start in the CBT. If I had gone back into CBT later, I would have made a lot more progress. I think for me, my GAD was making my OCD fever pitch and by employing Mindfulness I also managed to pull the rug from under it by reducing my overall anxiety levels. This meant working on my OCD more directly became easier and this was when I started to see a great reduction in the intrusive thoughts.

I've spoken to others on here with OCD or GAD & OCD. They say the same about the overall anxiety level issue spiking their OCD. It's common sense really when you think about it. I watch the HA board quite a lot too and I've seen them suffer the same. OCD is one of the disorders under the HA banner (HA isn't the name of a disorder afterall) and many of them have obsessive-compulsive traits and/or cycles. When something in their life adds stress, their HA often spikes, just like us.

Anxiety makes us irritable and what I think is that we have less boundaries with our loved one than we tend to with strangers. Some people have none with stranger and would treat people badly without worry but I think we are sensitive caring people and we wouldn't. Loved ones tend to snap and same things that cut us more and I just think it's how the boundaries fade away easier in arguments or under pressure. So, I can understand how it would interfere with the rest for you and I remember some of this myself when I became irritated with mine. I've also had irrational outbursts and this is just not like me. This goes though as your anxiety decreases overall, I've not had those problems for years now and it was only at the worst stages.

Well done for stopping the cannabis/smoking too. It's very tempting and I think obsessive-compulsive disorders lend themselves to addictive or self harming behaviour. I think the self harming element is the cycles themselves and how we keep ourselves trapped in them, like a form of mental self harm, if that makes sense?

Meds are a tricky one. I doubt there is an expert out there who could determine what is best for each individual, it's all so unique to each person. Everyone on here says that. Some meds I think are more "activating" than others based on what exactly they interact with. SNRI's are a good example of this. I'm on Duloxetine and before I started the 60mg dose I only had some obsessive issues with my work that had increased as I started to relapse and my traits that had always been there and never bothered me. I later learnt that 60mg is when that med changes from just a SSRI to work with norepinephrine (adrenaline) and all my agitation started at this point. Within weeks all the OCD exploded into compulsions I never had. I've spoken to others on here who have said the same about increased OCD or just OCD out of nowhere. We all know they can do this at the start but to do it on a more permanent basis is a big problem.

[Goldenbuddha001]

Hi Terry, apologies for the late response.

I had group CBT therapy last year. I had one-to-one initially and then I began group CBT. There were three other individuals who attended the group and just as I was starting to really get into it we reached the 10 week mark and that was it. I extracted some positives but it seems to be the policy now particularly in the area I'm located (due to long waiting lists/people to be seen quicker) to have 8-10 week sessions. So, the group psychotherapist concluded that I would benefit from this DTC which I found out yesterday I could now be waiting up to 9-10 months. They could well have an open day before then so I may have an opportunity to meet the team.


In regards to medication I tried nine different types last year reluctantly after about a decade of not resorting to pharmaceutics but I guess when you reach levels of desperation you reconsider certain things & it came to mind that perhaps I may have overlooked a few meds that I hadn't previously tried, plus there is nothing wrong with having a temporary hand rail to assist you whilst you're in recovery. Like you say, everyone's body chemistry is different as to how they respond to things. It's a bit like trial & error really. I have tried different SSRIs/antidepressants/antipsychotics & it confirmed to me that I am quite sensitive to medication & found that it exacerbated & magnified my symptoms which as a result with one particular med (Sertraline) was the catalyst for me being in hospital as an in patient for over a month for the first time in my life. It was a profound experience to say the least but if that hadn't of happened I probably would of been left by the wayside, wouldn't have had my diagnosis & also in the addition to that I wouldn't have the therapeutic relationship that I do with my psychiatrist, who's the most competent & genuinely caring shrink I have ever had the privilege to meet.

I have not taken a diazepam for nearly two weeks now so I am still feeling the withdrawal effects from that and like I mentioned in my previous message my irritability/anxiety is pretty bad. I know deep down though that any positive effect that perhaps I once had from taking it has long gone, the last one I took made me feel a bit manic.


Admittedly as I am composing this message I am feeling hugely anxious about later today which is my usual routine to go weekly shopping with my mum & since September the day & night before that occurs my anxiety just absolutely goes into overdrive, complete pandemonium & I find myself experiencing different emotions all at once.

It feels like I'm angry & frustrated, past occurrences/events/past hurts/traumas with my Mum play out on a loop. It's becoming increasingly hard I feel at this point in time to be around her specifically because of how strong the intrusive thoughts are with what feels like anger & frustration, I just feel a deep sense of dread by all the different thoughts in my head which urges me to try and avoid the situation which I know effectively is gonna make it worse, or, to basically break away from the relationship altogether & to sever ties.

I just don't know what to do about it really. I'm trying so hard to keep myself mentally occupied by having a good & balanced structure to my week. I am passionate about music especially and I am even struggling to even listen to that whilst doing my art work because I find myself being swamped under by the thoughts.

[Goldenbuddha001]

P.s. From my own experience I found Duloxetine difficult to take. It brought out other obsessional behaviours! By the way, does 'HA' stand for Harm anxiety?

[MyNameIsTerry]

Hi Golden,

Lots of people on here show how NHS CBT is getting shorter & shorter. I had 12 sessions but I've seen a far few have 6. God knows how the NHS think that is going to help. I've only heard one person on here so far who said it did.

It's what we get with the creation of IAPT. Quick access but it comes at the price of shorter therapy to keep the momentum. IAPT gets criticised for quality too. My CBT taught me very little, looking back it was more a long self help course. The therapist was very nice though. I wonder if IAPT therapists are just lost fighting against cases too complex for them.

I just can't get my head around SNRI's like Duloxetine and Venlafaxine. I can't see how increasing adrenaline in someone with too much already being a good thing. Yet, they help some people. Sadly, my GP insisted it was "my anxiety" despite it all happening so quickly after that dose and many of the symptoms I have, and still do, deal with have come from that point. I trusted him, I knew nothing back then. Speaking to people on here opened my eyes to meds and so I started researching from there.

Sertraline has done that to others on here. MrAndy has talked about his experience doing much the same to him. Some people say the same on Citalopram, some on Mirtazapine, etc. It's just a minefield with all the experts guessing. Sadly, the meds rollercoaster can be damaging like you say and all that team makes all the underpinnings worse.

HA stands for Health Anxiety on here. There is another board for it, the busiest by far on NMP since I joined, and some people on there have OCD too. HA is a misunderstood condition really, there is no such thing in the major medical manuals, it's an umbrella term used to make it sound easier I guess.

How did it go on your shopping trip? Like you say, avoidance will certainty make it harder by associating your fear to her even more. Some of us just can't avoid our triggers even if we wanted to, we have to interact with them. This makes it so hard because it's like you are taking a constant pounding alongside trying to help yourself.

I guess the anger & frustration is not only fuelled by past scenarios but also in how you are frustrated with yourself over your mental health? BPD must make it much harder too?

There are plenty of people on here who will understand how you feel about your healthy hobbies. Nothing was enjoyable for me at the worst of it and I also couldn't think of anything to be bothered even trying. For me, the symptoms were the worst and the compulsions from the OCD. I coped better with the intrusive thoughts and some of the thinking. Things change though in some stages and one became worse than the other or perhaps just became more apparent as it was no longer masked by a greater one.