Overcoming obsessive compulsions

Most OCD is manageable with the right help

It’s not easy – but it is possible, bear in mind though, you will need to seriously explore yourself, your life, your thoughts and be prepared to lean into the fear a little.

I have been helping people to manage and overcome these anxiety based problems for many years and I am always amazed at how common OCD is and how intricately it can ‘hook’ and ‘play’ the individual. In my therapy career I have seen and heard every symptom of OCD and every excuse that the poor experiencer uses to justify their irrational thinking and frustrating behaviours, they often try to avoid social situations unless they can ‘hide’ their rituals or have a safe way to leave without feeling silly and if they are interrupted or can’t complete a ritual, they may often become very anxious or use anger to control or defuse the situation.

The sufferer typically feels exhausted, anxious, frustrated, fed-up, may feel like a burden to others and often feels quite trapped. In addition, they are usually intelligent and competent individuals with analytical minds and are often very creative. Times of stress intensify the worry and anxiety and stress can often be defined as things out of their control – people, exams, change, scrutiny etc.

If this sounds like you (and if you REALLY) want to change – I think I can truly help you to understand what is happening and teach you what you need to do to let go of this ball and chain.

 

 

Symptoms of OCD at a glance

Obsessive compulsions take on many differing forms (although the underlying causes of OCD are very common) below is a very simplistic classification of the symptoms of OCD. One thing to note is that (for a few people) they don’t realise that OCD is actually an anxiety disorder and the reason they do all the rituals is fundamentally to avoid being overwhelmed by their emotions.

Ritual OCD
This is where a person has (very real) thoughts that force them to follow some form of  activity – and by performing that ritual they avoid becoming really stressed, anxious and panicky (or a full blown panic attack). These rituals can be very diverse and include:

  • Touching things
  • Counting things
  • Avoiding germs
  • Personal cleanliness
  • Hoarding things
  • Neat and tidyness
  • Excessive exercise
  • Eating in certain ways
  • Securing the house
  • symmetry and balance
  • Praying
  • Repeating phrases
  • Avoiding numbers and times
Body fear OCD
In this form the person has intense focus on what the body is doing and has intensely scary thoughts that something is desperately wrong that may be terminal. To allay these fears certain thinking or behavioural activities need to be performed to ‘stop’ the worst thing happening, such as;

  • Fear of dying
  • Always scanning body
  • Breathing a special way
  • Swallowing a certain way
  • Hypochondriacal behaviours
  • Excessive use of medicine
  • Symptoms & illness internet research
  • Fear of being left alone
  • Fearing excercise
  • Fearing flying
  • Fearing driving – especially motorways
Scary Rumination OCD
Here, the intrusive thoughts are of an intensely scary nature (even paranoia based) and force the individual to perform certain rituals (as mentioned in the other groups) to avoid something ‘very bad’ happening to them or a loved one. Examples of this may include;

  • Fear of loved ones dying
  • Fear of harming someone
  • Fear of the devil
  • Needing to say phrases
  • Fear of abusing a child
  • A feeling of being watched
  • Fear of strangling a person
  • Fear of stabbing a person
  • Needing to own up to things like stealing and arson (even though you didn’t do it)

It is important to note that although the thoughts may be of an intense nature to harm a person, they are never acted upon (in OCD).

 
The reality about OCD is….
It has nothing to do with your ruminations, or your rituals, it is all about the anxiety and fear of what “might” happen if you don’t do them – you know that really – although you find it almost impossible to go there as the fear and anxiety become too overwhelming. Therefore, it is nonsensical to focus on the actual thinking or the behavioural rituals – you need help to address what is behind them, assuming you want your life to become calmer and freer.

The four main ways people cope with OCD

I am being very general here, but, typically, if the person has some obsessive compulsions they tend to live their life in one of four ways until they decide to get some help and very often they don’t even know the depth to which they are being controlled because to them it is just ‘normal’. I must just reiterate that in the majority of cases OCD affects intelligent, articulate, very capable individuals.

The stay at home prisoner

Often anxious thinking starts at a very young age and intensifies during adolescence where the events of parenting, school and life either compound their problems or alleviate them. It is very common for individuals to struggle through school (anxiety not intelligence) and even university (which are both quite regimented environments), but once they are faced with having to get a job, socialise, find a partner and face up to environments which are often out of their control or if they need to travel a lot – it may overwhelm them, especially after a few intense panic attacks.

Their rituals, fears, frustrations and intense thinking can become overwhelming and they struggle to leave their house and become quite reclusive and trapped within their own home (or even bedroom). In these situations there is often a ‘carer’ that looks after them (parent, sibling, grandparent) and often unknowingly this perpetuates their predicament.

For some women after raising their children they find it very hard to get back into an external life – in these instances their issues are normally germ / infection / cleanliness related and the idea of going to work places, shopping centres or other public areas can be fearful and distressing, so it becomes easier to stay at home in a sanitised environment.

The technical loner

This group learn how to manage their ruminations and compulsions by losing themselves in distracting thought processes or complex mental tasks like science based activities and technical careers where they can often work alone or in small groups. These ‘nerd’ like careers mean that social interaction can be managed and other people, such as, managers will have to face the outside world instead of them. They often attract partners who are also technical or happy to live in a more enclosed and structured living environment.

The self employed controller

For some, it is so much easier to manage their OCD compulsions by working for themselves, and I have always been amazed at how many business owners have varying degrees of compulsive behaviours and scary intrusive thoughts. Not only do they work for themselves, they usually only have one or two employees or they employ family members to assist them, this way, they can still earn a living and can more easily cover up their compulsions or do them in the privacy of their own office. If their office is in their home – all the better.

The ‘get on with it anywaypragmatist

This is by far the biggest group and in some ways they have the hardest time as they are always being faced with their fears, and in another way they are the most free of the four groups as they still go about life and just restrict the things that they can control. For some in this group they may not know that they have OCD and for others they know full well. This group also sub divides into those who keep the compulsions secret from others and those who make it public (to some) therefore they may get support from them. This group find that their compulsions and ruminations will increase with stress and change, therefore holidays, Christmas, job interviews, dating, travel and surprise events are times of great anxiety and can be mentally exhausting.

 

It is exhausting!

However, you (knowingly or unknowingly) trap yourself with OCD like behaviours and worrying thoughts, it is exhausting and often tires you mentally, emotionally and physically (which further adds to the stress!) So an important part of your recovery is learn how to detach from some of the thoughts and realise exactly what is happening within your body – so you can mitigate some of this misuse of your energy, coupled with the fatigue comes the fogging of your mind and the lessening of your ability to make big decisions – thus trapping you deeper in the mire.

An OCD mind map

For those who have a visual way of looking at the world you may find it interesting to see a small subset of OCD behaviours in this format, in my experience people usually have two or three main obsessions and a few smaller ones and this list is not exhaustive. Click on the image to enlarge.

OCD Mind Map

 

Getting help to overcome OCD

OCD Treatment – I help people to understand that OCD is not a disease and their mind is not broken, in fact, it is quite the opposite, their mind is so creative it can come up with incredible thoughts that feel like they are true, so true in fact, that even their body responds as if it was true and it scares them, I guess at a certain level everybody does that, surely that is what a nightmare or a fantasy is?

By teaching you how the mind works, where the thoughts come from and how the body responds to the thoughts as if they were real, you can begin to interrupt the ruminations and slowly release the rituals.

Then you are ready for the next step which is working with the unconscious mind which has automated your fear responses so they just ‘fire off’ when the old stimulus arises i.e. when you see a discarded sticky plaster on the floor thoughts of germs may jump into your mind and the body just automatically (and unconsciously) jumps into an alert stress mode. We need to work together to ‘retrain’ your mind to let go of those out of date responses. It is not easy but it is possible, however, you will need to be vigilant, dedicated and you will have to lean into the fear a little.

The last step is about facing life in new ways – if you have spent many years covering up certain behaviours and avoiding certain situations your confidence and self-esteem will have been knocked and we need to rebuild it back up again, in addition, you’ll need to understand in great depth how other people think and feel so that you are no longer comparing yourself to others or predicting what you think they may be thinking of you.

Hidden OCD

For some people they will absolutely deny that they have a problem with OCD, perhaps they just “like things tidy” or “like driving that route” and they don’t get physically anxious if they can’t tidy up – but it will niggle them and so they tend to do these things over and over and it becomes quite a habit. The real issue in these instances is actually how they affect other peoples behaviours and cause stress. This mild for of OCD is often a cause of many relationship issues.

Treatment for OCD starts with a new point of view

In my experience OCD is a very unhelpful label, people do not have OCD, it’s not an illness – many people lead very normal lives before (and after) the onset of this obsessive and anxiety ridden way of thinking, behaving and unconsciously processing information.

I call it COD not OCD, Carefully Orchestrated Dilemmas – typically, anxious people run dozens of ‘what if’ scenarios in their minds until they begin to frighten themselves. They feel that they are not in control, however, the reverse is true, they are very in-control of what they do (or don’t do), they are very in-control of stopping people around them doing things, they are very in-control of not going to work, not facing the world, not going shopping…..

In fact, they don’t want to follow other peoples rules (they feel they are exempt).  They don’t want to do the very things that everybody else has to do. They think they are the victim, however, they are the ones trying to control everything. Spend a moment or two to think about this, because it is an important part of changing the rules.

It’s true that some aspects of the brain may get a little disrupted after traumatic events (abuse, bereavement, losing a baby or giving a child away for adoption, rejection, experiences that lower self esteem etc.) or periods of extended stress and anxiety

Typically, it is the Caudate Nucleus part of the brain that tends to dysfunction when obsessive behaviours are being experienced. This part acts much like a switch, when it is off everything is OK and we are calm, however, when it is on we feel like some form of  action is required.

A person whose experiences this anxiety disorder may find that due to excessive worrying and lots of negative introspection over a long period of time their Caudate Nucleus gets stuck in the ‘on’ position. Normally, you might check if the door is locked (switch set to ‘on’ therefore you need an action) so, you lock the door (switch get sets to ‘off’ so you can relax).

For a person who has re-programmed themselves via prolonged and excessive negative thoughts the switch does not flip back to the off position after the initial action, so they remain fearful. This applies not only to physical actions like checking doors, washing hands etc. but also, for thoughts and ruminations “if I don’t spend time thinking about X then something bad may happen etc.

Luckily our brain is very malleable and is quick to adapt when new strategies are applied so this minor dysfunction can be circumnavigated and whilst your levels of stress and anxiety decrease it often reverts back to normal.

So, because this automatic switching part of the brain is temporarily out of order I will show you how to do this manually – how you can use conscious thoughts and a more thorough understanding of your emotions to give the brain the time it needs to rewire itself.

If any of this resonates with you, give me a call and we can talk about it, no obligation, just a chat to see what is possible 01280 860687.