Your Questions Answered
Please feel free to ask questions about OCD and OCD treatment here. The questions should be of general interest to everyone and not personal questions particular to your situation (those are best asked through private e-mail). Please forgive me in advance if I don’t answer your question timely or if it doesn’t get answered. For your answers look for my posts in this section rather than a reply to your comment.
Dear Dr Grayson,
Thank you for the wonderful website. I’m wondering about thoughts arising out of nowhere. I’m not sure they are the same as ‘intrusive’ thoughts as I’m not thinking them.
For example, I could be sitting there thinking about how bad my football team has played of late, then suddenly, something totally unrelated like ‘found the book’, or ‘there were six’ or anything just arises in my mind. The crucial thing here is that I do not (consciously at least) think them.
What are these arising out of nowhere?
Basically then, what are these arising phrases/conversations/words I am having?
Thank you very much for your time and effort
PS: I am seeing a psychologist soon.
I was wondering how to help a teen who is having trouble writing and taking notes in school and now having difficulty in verbally answering a direct question and speaking to others. Also this person is having trouble merely pointing to the correct answer on a paper.
Thanks so much.
currently in therapy and on medication for ocd and add.
Regina,
First, I’m hoping that the therapist you have is experienced in treating OCD or is receiving supervision from someone who is. If s/he hasn’t mentioned exposure and response prevention as part of the treatment method, then he is in conflict with the International OCD Foundation, the American Psychiatric Association’s treatment guidellines for OCD and the American Psychological Association. This was the easy part of the answer. I can only answer your question in general, since what I describe is usually the issue for reading and writing problems, but not always. Usually, the issue is wanting to be sure that everything they read or hear is perfectly understood, however, understanding is measured by feeling, not actual understanding. The feelings are very painful and compelling, so the sufferer feels sure that then need to do their rituals to understand. It is further complicated by the fact that the rituals actually interfere with understanding, which further reinforces the feeling in the individual that the rituals are necessary. Your teen may have ADD, but some sufferers with this problem get this as an diagnosis when the problem is purely OCD. Again, I don’t know your teen, so I don’t know if this is or isn’t true for him/her. As for notes and speaking, it is usually similar to the reading in that the sufferer wants to be exact in communicating and isn’t sure they will be properly understood. The first step of treatment is helping the individual understand the issue and helping them to learn to accept the uncertainty of not understanding or communicating perfectly. This is the hard part to do. The next part is designing exercises to challenge the OCD. The problem with what I’m telling you is that although I’m describing what we do, it doesn’t answer the critical magic question of exactly what can you do to help your teen take these steps. I’m afraid I would need much more information to have an idea of what to do, but I hope this provides you with some direction.
Mark,
This may seem strange to you, but there thoughts are never intrusive — that is, all thoughts are normal, whether they are horrific, abhorrent, or, as you say, random. The human mind is constantly coming up with all kinds of thoughts and situations. What makes a thought and OCD problem is when the individual wants to know something about the meaning of the thought (e.g. Why am I having this thought? What does it mean about me? Will I do something because of it?) or if the individual want the thought to stop. If the sufferer attempts to do either, the thoughts will become more frequent. One reason for this is that if you are trying to avoid a thought, the only way to do so is to look out for the thought, which means you think it and then exactly what you wish wouldn’t happen did. What you are describing sounds like a variation of what we call neutral obsessions. Neutral, because there is nothing obviously horrible or scary about the subject or content of the obsession other than the fact the sufferer is bothered by having the thoughts. If you would like an article on neutral obsessions, go to my center’s website: http://www.ocdphiladelphia.com, and e-mail me a request for the article.
Bernardo,
Sorry for the delayed response. You’ll be happy to know that we have seen this problem before. The short answer is that in all of life we live with risk. Every time you get into a car you risk death by some idiot crashing into you. If this isn’t your obsession, you take this risk without a thought. The situation you describe from the article is not common; that is, you are more likely to die in the car crash than from the double combination of getting cancer and having worsened by suggestion. So, if you need to avoid such low risk events, then you need to start avoiding many other dangers that you currently don’t. Or if you were going to attack OCD, it would mean that you want to take the goal of learning to live with uncertainty. That is, accepting that there is some possibility that your fears could come true, but that the effort of trying to avoid thinking negatively is so hard and stressful that it isn’t clear which is unhealthier. The bottom line is that it is sad that for all of your ritualizing, you never get the prize, safety from potential death. Treatment means learning to live with uncertainty (notice I say learning, it would be wonderful if it were as easy as a simple decision) and actually doing exposure and response prevention — not to prove that you can’t harm yourself with thoughts, but to get used to living with the risk of the thoughts, the same way you live with the risk of car crashes. And if you don’t drive, I can assure you that you are exposed to numerous other dangers that you fearlessly permit.
My answer will be easier said than done. The goal is to be uncertain, because research has shown that the only people who are certain are stupid people and most sufferers of OCD are above average intelligence, so certainty isn’t an option for you. To work on living with uncertainty, the way we would interfere with double checking is not only to not check, but to do things wrong. For example, if you double check locks, we would have you close the door, turn away from the door and turn the lock to the position that might be locked without looking. Doing this quickly and purposely not trying to feel the lock. Then there would also be a paper flap taped over the door lock, so that when you took your hand away, it would fall down and you wouldn’t be abld to accidentally check. Again the goal is learning to live with risk.
AJ, certainly I like to think that my book can be helpful. In the Philadelphia area there is a free support group that encourages and helps its members to work on exposure and response prevention. It meets in Bala Cynwyd and if you are interested, you can contact me through my center’s website: http://www.ocdphiladelphia.com, so that we can screen you for the group (screening is free). I hope this gives you some hope and a good place to start.
Hi Dr. Grayson,
No question……just a thank you for helping so many people and insisting that ERP be the treatment for OCD. I am so thankful that my son had the proper treatment. He went from having severe OCD at the age of 19 (not eating or being able to move from one particular chair) to being a successful college junior who is living his life fully. He has not even needed any medication for the last year and a half. And it’s all because of his and his therapists commitment to ERP therapy. Thank you for all you do and keep up the great work!
Hi Dr. Grayson,
From your experience, can taking birth control (e.g. Alesse) interfere with SSRIs (specifically Cipralex) and/or has birth control been known to aggravate OCD?
Thanks
Jane
Dr. Grayson,
If ocd is associated with disgust of an animal can erp work?
For example, being afraid of as well as disgusted with a specific animal which leads to compulsive need to clean everything that might have been touched by that animal. Will the animal phobia prevent erp from working?
Dear Dr. Grayson,
In your book, I noticed you mentioned fears of radiation as a possible symptom of OCD. So before reading any further, please rest assured that this question is not in any way a manifestation of my OCD. My OCD primarily centers on contamination and disorder fears.
My questions…
Has any research been done to date to determine if OCD behaviors lessen (or even resolve) in an electromagnetically ‘clean’ environment? I ask because I have read several books on the subject of radiation dangers including ‘Cross Currents’ and ‘The Body Electric’, both by Nobel prize nominee Dr. Robert O. Becker, and B. Blake Levitt’s ‘Cell Towers – Wireless Convenience? or Environmental Hazard?’ and ‘Electromagnetic Fields: A Consumer’s Guide to the Issues and How to Protect Ourselves’, and apparently genetic expression can be affected by these exposures to manmade sources of electromagnetic and microwave radiation. Could this be why identical twins don’t necessarily both go on to develop OCD?
Also, not only does my case of OCD mimic some of the most severe cases mentioned in your book, but I now experience debilitating symptoms upon exposure to things like fluorescent lights, cell phone and wifi towers, radio antennas, and the like…symptoms that sound a lot like Electrosensitivity (or Microwave Sickness).
I know I hadn’t even heard of OCD until an Oprah show in the 1980’s. Is it possible that OCD really was rare at one time and that exposure to some new technology is merely increasing the incidence of OCD?…like FM radio perhaps? or the very first cell phones? I know the severity of my OCD increased exponentially in the mid-90’s, right alongside the monumental increase in the number of cell phone users. By any chance do you have any stats on the incidence of OCD over the years?
Thanks for reading this and for an excellent book!
Carol
Dear Dr. Grayson,
I actually have such severe OCD that most of my house actually IS appearing disgusting and IS in desperate need of cleaning, even to so-called ‘normal people’, simply because I spend so much time OCD-ing one single item or one small corner of my home that I don’t get very much done and have seriously fallen behind as a result of all this.
My question…why hasn’t this cured me? Isn’t this ‘exposure’ of the greatest magnitude? Some of the rooms in my home probably have not been vacuumed or dusted in over 6 years, yet I’m still bothered by the dirt and dust and disorder in those rooms and keep thinking about it.
I thought the anxiety was supposed to lessen over time? Instead, it seems like I just gave up on cleaning them at all? In fact, I think the only thought that gets me through is that I keep telling myself that one day e-v-e-n-t-u-a-l-l-y I will get to OCD cleaning those rooms, too…if I live long enough, that is…
Help?
Carol
Carol,
No this isn’t exposure. Despite the fact that the house is dirty, you are constantly wishing and attempting to clean up. Even the rooms you avoid, because you don’t get to them are not by a decision to confront the issue. Exposure is not only a behavioral situation, but a reflection of what the sufferer is trying to do. You are not wishing to cope with contamination, but are wishing it could be less and that you could clean more efficiently, but still relatively perfectly. I assume one reason it takes so long to clean anything is because you attempt to do so perfectly, thus your behavior is one of constantly ritualizing. Exposure is a decision to live with uncertainty and to cope with the potential consequences; again, it is not living in squalor and constantly fearing the potential consequences and engaging in rituals. I hope this explains some of your predicament to you.
OCD has been around for a very long time. It was under-diagnosed and thought to be rare, but this is more the result of sufferers hiding their symptoms and the mental health field not understanding the disorder. Even today, we frequently run into mental health professionals who mis-diagnose OCD if it doesn’t involve handwashing or simple checking. Becker’s book is considered controversial, so that not all of his conclusions are supported by the entire scientific community. The earlier sections on his book about the mammalian potential for regeneration has much research and further studies need to be done. Some of his concerns about the negative effects are still not considered substantiated. At this point in time there is no link between electromagnetism and OCD. In addition, if OCD were the result of electromagnetism, we wouldn’t be seeing the genetic linkage that we see that precedes the 1980’s when looking at family histories. Untreated OCD often does get worse over time, so your experience wouldn’t really be evidence.
No, what you describe is not a problem for treatment. The key issue is not only doing exposure, but what is your goal? Do you want to overcome disgust or be ruled by OCD and your feelings? If you want to learn to live with uncertainty (I assume in your case that this would be never knowing what has or has not been in contact with an animal), then proper treatment and dedication on your part will work.
Dear Dr. Grayson,
My wife became sick with the flu twice last year, Ever since i have gotten OCD of Germs. I dont want to go out, i dont eat out nor allow my wife or kids to eat out. We havent gone to the mall, restaurant or anywhere for that matter. I wash my hands 100 times a day. Havent seen friends or family members in this whole time fearing they might be sick and get my family sick. What can i do to get my old life back where i can go out and enjoy life like i did before. Also, Do you provide private therapy session on the Internet? Thank You
comment from Gil was answered privately
Dr. Grayson,
I have a problem of wanting the ideal ‘princess’ girlfriend that we see in childrens cartoons etc. When I first decided to ask my girlfriend out I thought she was cute and nice, but I wasn’t like ‘wow! shes completely beautiful!” I struggle because some girls give me that ‘wow’ aesthetic factor when I see them but I’m scared because my girlfriend matches me in personality and I love being with her. Her looks didn’t bother me a couple of months ago, now I find myself staring at her a lot and not wanting to look at pictures that she doesn’t look good in, only wanting to look at the ones she does look good in. Is there some way of getting over this or am I always going to be wanting ‘my girlfriend’ in that ‘princess body’?? Thank you!
My daugther is 20 years old and has been suffering from OCD since she was about 4 years old. She has had medication in the past, but has been off it for about 5 years now. She is now completely relasped….she doesn’t work, see her friends or basically leave her room. She was showering every time she used the bathroom and had to wash all her clothes and bedding each and everytime she used the bathroom. Now she only uses it twice a day…..but stays in the shower for about 1 1/2 hours each time…..and if she touches anything when she gets out she must start all over again. She also cries…..really howls because it is all too much for her and she can’t face having to do these rituals day after day. I brought her to our psych hosp but she presents so well that they said she does not need to be hospitalize. She is completely paralyzed….her life is an agony and I enable her so much because I cannot bear to see her in such pain. I dont know where to go or who to turn to…….
Hello Dr. Grayson, I am a health care professional and my work requires me to read a lot of important information. I am having tough time reading and understanding. I feel like I’ll miss important information and I end my re-reading and further re-reading. Any suggestions of how to overcome this. I am trying to live with uncertainty but the anxiety is so overwhelming.
Thankyou
Hi Dr. Grayson,
I am an avid reader of your research and refer to your book continuously. I have a pernicious case of OCD as many people on this site do. I have obsessing about obsessing but my primary fear is that I will be constantly anxious or at least anxious enough to ruin my life (not have a job, GF, kids, etc.) Basically, I fear that I will not be able to continue coping (eventually committing suicide).
My question for you is what do I do when I am in a state of perpetual anxiety (which can last the majority of the day). In your book, you describe a case of a girl who must learn “that we don’t always feel the way we wish.” But, I have days where I am perpetually anxious and continuously ruminating about being poor, homeless, not being able to hold a job etc. I try to say this may happen but I am continually anxious. I feel like my brain is trying to avoid the anxiety. Then I fear what if I’m making my OCD worse? What if I’m ruminating, thus undermining ERP.
So when I am in the throes of panic I should just say “Ok I may be anxious forever and be unable to cope. This is my life. I’m not able to enjoy anything because my brain is in terror mode but I’ll just keep doing the things in life that are meaningful to me even though I am suffering.”
Also with the dot labels and “this is it” on my tape recorder, when I see the dot or hear the “this is it” do I consciously bring the thought to mind and ruminate on it?
Sorry if this is a lot but as you can see I need help,
I am in the midst of Clinical Psychology Doctoral Interviews and pretty much doubting everything.
To Tamara about her daughter:
You are describing a very difficult situation as you know without easy answers. Your daughter certainly needs someone experienced in the treatment of OCD and hopefully if you can find someone through the International OCD Foundation (www.ocfoundation.org). Your daughter may need an inpatient OCD program and three very good ones are the OCD Institute in Boston, the Houston OCD Treatment Center and Roger’s Memorial Hospital in Wisconsin. I know these may not be near you, but they are probably the three best specialized OCD inpatient units in the country. I hope this helps.
To DCO about his reading problem:
It is very good that you are attempting to cope with uncertainty, but to do so successfully means setting up a program in which you do more than simply read something once without re-reading. In treatment we have ways of making sure you will miss some things and we work on making re-reading more difficult. IAs you know, whatever you may be missing is nothing compared to what this is causing you to miss in life. Yes, you might miss an important piece of information, but the reality is that all of us periodically misread and you are attempting to cope with the fact that you could miss something and someone would fail to benefit because of that. In health care, as in every field, none of us are perfect and as much as we wish to avoid them, mistakes will happen. In fact, if I try to hard to make mistakes I will make them, because too much of my attention is on avoiding mistakes and not the task at hand. Part of living with uncertainty is deciding how you will try to cope with mistakes in a positive way (not I will give up and run away, but how will I work on coping with the guilt and other consequences and then continue in my career). Obviously the answers may be simple, but they are far from easy and can be hard to implement on your own.
Dear Sir,
I am Shambhavi Srivastava from India. One of my friend is going through Obsessive compulsive disorder. I was hoping you could guide me a little. While my friend consulted a psychiatrist, despite of the medication provided things have not really gotten any better. I had a few concerns and was wondering if you could be kind enough to help me out.
1) My friend has been trying to get off the medication and look at other ways to deal with his repeated thoughts and obsessing about it. Can getting addicted to having the medicine everyday be harmful for him? he tries to distract himself when such thoughts do come but it hardly provides any relief most of the time. Is there anything else that he can try apart from psychotherapy and medication ?
2) Is there anything that I can do to make him feel better in anyway possible considering I am the only one aware of his OCD apart from him.
I request you to please reply as soon as possible…….for I am absolutely clueless in relation to how to go about things and I’m afraid that things with him might be getting worse.
He constantly obsesses over thoughts of not being able to study or do his work, not being able to get the desired result, not being able to remember what he is studying while he studies……and ends up rereading or redoing the same two three lines again and again without any result. the moment he starts any work in office….he enters the circle of unending thoughts of what if he cant do it.
Dear Dr. Grayson,
I am from the EU and suffering from periodic OCD. I try to cut my questions short, most will be of interest for other sufferers:
Do you have any clinical experiences with vitamin ,,Inositol”-treatment for OCD. Does one really need to take 18 grams to see
benefits? Can ERP also be used for pure obsessions; would ERP also be useful for other anxiety disorders like GAD?
Most european experts agree that OCD is biologcally and learned based. However my OCD is running on and off, 2 years of
beeing normal and happy follow months of OCD pain, ruminating and anxiety with total exhaustion, then after some month the
OCD is again fading even w/o SSRIs. If I or ,,we, the sufferers” who have it on and off have learned something wrong, then why
we do not have it 24/7? Or is it rather rare that one has pure obsessions cyclical? Is that something close to bipolar disorder
only without the highs, just cycling between normal and OCD?
Thank you very much!
GF
Hi Dr Grayson,
I have suffered from OCD since I was a little girl. At that time OCD manifested itself as frequent hand-washing, Religious rumination etc. As I grew into adult hood and started dating the main theme has been what the message boards seem to call “ROCD” or “Relationship OCD” which im sure you are familiar with. Practically every relationship i’ve had has been ruined due to this – i.e picking faults in a partner, thinking the worst possible thing about them until I cant handle it anymore and break up with them.
I’ve been with my current partner for about 16 months. We get on really well and im comfortable with him. BUT (the big but) Every day there are these horrific ruminating anxieties – e.g “You have no friends therefore You’re a Loser, you’re not good enough for me, Your eyes are too big” (the list goes on) and its the constant catastrophic thinking that upsets me so much.
Im currently seeing a therapist and also a psychiatrist who has put me on new medications to calm the anxiety – But, I often feel like although they are doing a good job of treating me, I really feel like because ROCD is not widely known that im not getting the proper “treatment” for this debilitating form of OCD – when you dont know if what you are thinking about this person is true or not. Also baring in mind that I live outside USA/UK in a smaller country where very little is known about the different types of OCD.
I dont want it to ruin another relationship!
If ERP is the “gold standard” for OCD, how do you expose yourself to fears when the fear is the relationship itself?
Is there anything I can do/tell my therapist that might help my treatment better going forward? (They are open to it being this type of “Relationship Substantiation OCD” however I think the treatment would be rather different than to someone who say, has frequent hand-washing compulsions seeing as mine are just thoughts and not compulsions.
I thank you for your help.
Regards
I find that Ambien somehow helps with my severe ocd. It is almost like Ambien attacks the unwanted thoughts at the subscious level. Unfornuately, it is also why I take 2 Ambien a day.
Posted by somebody else on another forum – interesting.
This is just a hypothesis of mine, but I do believe that the Ambien allows your subconscious mind to receive more rest as in you get more REM sleep at night and therefore your brain is “ready to go” much more then without the Ambien. With your condition it should really help afterward because lack of REM sleep will cause your brain to become tired which in turn would cause any mental illnesses or disorders, like OCD, to become worse and more pronounced. As to why it helps my RSD/CRPS while on it, I think it is something similar but instead more to do with my central nervous system in its entirety. This is just a guess, but a logical one, so don’t take it as fact! I am not a Doctor and I did not sleep at a Holiday Inn last night either, rofl.
hi i have had ocd for 2 years onset was around my first pregnancy adn now i am pregnant agian. i went to see an expert on cbt. he told me that i could be ‘cured’ and that he doesnt believe that exposure therapy will be 100% effective for me because i will not get that instant feedback that no harm came from the exposure e.g. like someone afraid of height would if they climbed up a ladder and didnt fall off. i am very disheartened because i have had some success with exposure therapy but had a big scare a “unanticipated exposure to blood at a water silde whilst trying to give my son a normal day out. i just didn’t know how to get back on that horse after that. what do you say f someone is doing exposure e.g. writes a list of fears grades them and works through them and half way through this gets exposed to there greastst fear? my therapist that i did the exposure with did say at the start he knows exposure therapy but from the point of view of social phobias not ocd. unfortunately he did not know how to answer question i just asked you. i really dont know where to turn as the guy that does cbt without exposre is an expert i had to go to the big city and pay alot of money to see him and all he seems to say is that i’m stupid. which i know already i mean i know the probabilites of the possibility of the things that scare me actually occuring are ridiculiosly low i always have. but the ocd part of my brain is screaming at me that there still a chance do the ritual or youll never hear the end of it. do you think cbt can effectively treat ocd without exposure? ow i forgot to say i live in rural australia and once had another (not previously mentioned) the local psychologist tell me i fully justified in been cautious because they have found sperm on shopping trolleys! so the resources here arent great. do you know of someone in australia who does good exposure? i am totally incapacitated at the moment e.g. cant leave hte house ect n am very worried about how all this crap is affecting my family.
dr grayson
hello again i have question related to your post no one should do exposure and response prevention. you mentioned that “There is a 1 in 4 chance your children may have OCD and your behavior teaches them that OCD is something to cope with or not.”
what is the source of this stat? im curious as to whether it is based on something like twin studies raised apart e.g. purely genetic factors or a combination of both.
i mean r u saying that the fact i have ocd means my child has a 25% of getting based on observing my behaviours or just based on a predisposition i have passed along to him.
in a long grapple with the decision of whether to take previously untrailled medication for my ocd symptoms which have both onset and excerbated in pregnancy. i have spoken with a geneticist/tetraologist by the name of debra kennedy at the royal womans hospital in sydney.
she gave me some general stats. because i basically i had to weigh up the risks associated with taking ssris in pregnancy with the effects of my worsening symptoms on my toddler.
She said there is a 1 in ten chance based on purely genetic factors that a child with one parent with a mental disorder i.e chemical imbalance some view ocd as syptomatic of.
if there both parents have a mental disorder there is a 50/ 50 chance.
She said that there is nothing you can do about the genetics. and unfortunately as it is not ethical to have controls (e.g.non symptomatic groups of pregnant women taking ssris) that they just do not know the long term effects of these meds on these children, but if there is it s nothing glaringly obvious. my questions centred around behavioural and intellectual development not only in the formative years but when a lot of this kicks in at puberty. Which there have been no studies done on except on one ssri.
Also there was a 6x increase in the risk of the baby developing pulmonary hypotension which can be hard to diagnose and as the baby is been deprived of oxygen until it is daignoised; brain and possibly life threatening. i mean these are psycoactive drugs i would be exposing my fetus to.
her overall recommendation was that in trails done of 3 groups of woman and their childrens development up to the age of eight. (unmedicated, medicated in ppregnancy and breastfeeding and medicated when breastfeeding) the group who did not take the meds had the worse outcomes (milestone delay ect). My situation was unsual in that onset of ocd had developed in my first pregnancy and because of pregnancy and breastfeeding i had never trailled the ssris so after been told there a 50% chance that any ssri will have any affect and only a 30% reduction in symptoms at best i told her to go fuck herself.
Then again i am hanging on by the skin of my teeth. so if anyone reading this is on the meds and pregnant i think this is a very personal decision and either way your screwed so good on you for doing the best you can.
sorry i tend to waffle my question is where is this one in four stat from.? does it differentiate between people who actively sought treatment i.e either cbt meds or both an parents who didn’t?
also does mindfulness conflict with either cbt or exposure?
hi
i just have one more question.
my ocd expert said that he didn’t see the value in impatient treatment his reasoning was twofold one that ocd is a battle that should be fought in yu r own environment. and two that often group therapy is not streamlined (in australia). he said that others in his field get excited with initial improvements are made but he said when they get home this is harder to put into practice and often of no long term benefit. what do you think have you seen people benefit from inpatient programs?
i dont know if this is my ocd but when i contacted a few of the major public hospital in sydney they said that in austraia our public system is overloaded which crisis situations and therefore only deal with panic attacks and ocd if the sufferer is about to jump off a building(ie literally sucicidal).
they also said often ocd especially my subtype (contamination) get worse in hospital.
my ocd was very happy with the last comment because i do make effort to try and do things despite been frightened of stuff like having to share a bathroom come in contact with people of unknown hep c status all the ocd crap.but here was a health professional saying yeah your ocd is right.
in australia the private hospitals do offer ocd tailered preograms this is what my ‘expert’ was commenting on when he said there often not streamlined.”what some gradutae sitting there reading everything out of a manual” however his strength is not erp. as someone who actively practises erp if you believe there is value in impatient programs for people with “garden variety” cointamination ocd. and if so what sorts of question should i ask them to ascertain if they have e3xpertise and an erp program that is likely to be beneficial?
Dear Dr.Grayson,
If I want to get the treatment from you, how can I make an appointment, do you have evening or weekend hours.
Thanks
Namasi
Dear Dr Grayson,
My daughter is adopted from China and is now 17 years old. She was diagnosed with Tourettes Syndrome when 5 and has been on many medications but is now just on Abilify(15mg) and concerta(18mg). She has never been in therapy for OCD but her pattern of behavior lately has been magnified. She has since 10 bought traded and swapped electronics. She has had over the years dozens of cell phones, and i-phones. Within a day or so of getting a new electronic will claim it was broken and return it or trade it for another model. She may switch back and forth between cell phones to Iphones to the latest upgrade in any electronic and most recently has traded in a new i-pad, claiming it was broken, had it replaced and traded it for a PC and finally traded that in for 100 in cash. This becoming a predictable pattern.Thousands of dollars have been spent over the years Just this week she took a debit card and had the bank convert it into a credit card and bought a $200 cell phone. Naturally we are in touch with the bank and will have the card removed. The card was issued by a well wisher who wanted to teach her how to budget and prepare for college.Because she presents well most people don’t know she has a disorder and think they are helping.Although her behavior does not seem to match any of the disorders mentioned in your book I believe it has a ritualistic quality or a cyclical pattern to it. We live in Brooklyn and would like to have her seen by a therapist ASAP.
Hi Dr. Grayson,
I have started seeing a behavioral psychologist regarding my OCD, and I have not had any luck with medications that don’t have untenable side effects. I have primary mental compulsions, mostly with reading just about everything I see, repeating what I’ve read over and over, and counting just about everything, my breaths included. My psychologist is working with me on these issues. She suggested I contact you regarding one particular issue, however. While my compulsions are primarily mental, they have a physical component as well. I have divided my mouth into four quadrants- top-left, top-right, bottom-left, bottom-right. Everything I do, including reading, repeating, counting, and breathing, needs to fit into these four quadrants. The movements aren’t obvious enough to where others notice, but the muscle movement is sufficiently significant that on my bad days, my mouth muscles end up hurting. Do you have any suggestions I can try to help alleviate this symptom?
Thank you,
Douglas
I am wondering if Douglas has tried Exposure Response Prevention Therapy in regard to these “quadrants?” Maybe start off by forcing yourself not to put your breathing into a quadrant for a certain amount of time, and work your way through these compulsions……
I’m not a professional…just putting my two cents in!
Good Luck!
I had problems with meditation up until recently. I kinda couldn’t focus. I think staying focused is what matters and that’s why doing meditation doesn’t work for everyone. I found a quiet place for me in my house and that gave me the extra focus I needed. It works better now!
Dear Dr. Grayson,
I read you book a few years ago and still think it is one of the best written about OCD. My OCD is writing down every thought I think may be of some value.
While in a conversation sometimes I will be holding three or four thoughts I feel I need to remember and become more focused on that than the conversation, If I happen to forget one of the thoughts before I get it written down I will obsess any where from hours to days trying to remember what it was even if it it insignificant. If I do remember the anxiety will subside and I will feel free to forget it with no anxiety. Sometimes I have filled pages of paper with random thoughts that seem like madness to someone who would glance at the page. I have seen similar writing that Charles Manson has done in prison. My writing can be sideways upside down all around the paper in no type of order. I try to resist the compulsion to write down such minor thoughts and write only things which will require my action. I tell myself I can let the little things go like a line from a movie I heard in my head, a piece of a conversation, or the last commercial on TV. I still find the thoughts repeating in my head until I do forget then the anxiety sets in for hours or days. I went to an OCD doctor in my area but he was no help and only prescribed medication which was minimal help at best.
I am unsure how to apply your methods to my OCD.
I would like to know more about rage and OCD specifically as it relates to school age children.
How common is rage and severe behavioral issues occuring with OCD. Especially when these did not exist before OCD?
I am curious how dealing with rage fits in with treatment.
In the last three years or so I was diagnosed with OCD. I recently read an article called emotional contamination. Bascially anything that I associate with a horrible roommate that I had in the past I have the urge to throw out, because it makes me feel “dirty”.
Eventually everything becomes contaminated because the contamination spreads from one object to the next. I have thrown out clothes sold tvs and even sold my car in the pursuit of “decontaminating” my life but nothing works.
I was on meds for awhile which seemed to help some. I am no longer on medication and recently seeked helped from a physiologist, however he had never heard of emotional contamination.
I know that I need help but I have no idea where to find it. I have tried to seek help, but as of yet have not found a psychiatrist/physiologist familiar this sub type of OCD. If you know anyone in the Philadelphia area that is familiar with this sub type of OCD PLEASE let me know so I can get in a treatment program.
Hello Dr Grayson,
My son is 25. He has had OCD since age 11. Right now he is trying to direct his own treatment, using ERP. It seems his primary fear seems to be dying, but it also has the component of being confined, closed in, under, or immersed in water. He has told an oral account of his own death by drowning, with many vivid descriptions of his feelings and sensations. I felt he should write down this story, but he says he is not able to. If he writes it, he says it then becomes “set” and it is far too fearful for him. He did write the one word, drowning, on a paper, but he quickly neutralized it by thinking of another way of dying, a less scary way, like having his throat cut. When he works on accepting that there is always a risk he could die by drowning, how does he prepare himself to deal with the aftermath of his own death? Does imagine how others will grieve for him, who will drive his car, what will become of his possessions? It just seems confusing. Thanks if you can comment on this.
I just read Jen’s post and would like to say that I think a therapist trained in Exposure Response Prevention Therapy could definitely help with your OCD. They would work with you on exposing yourself to items you feel are contaminated while you resist your compulsions. Good Luck! As I’ve said before, I’m not a professional……I’ve just been through a lot with my son who had severe OCD (he’s doing great now, thanks to ERP Therapy).
To Kathy whose son has OCD focused on fears of dying. The difficulties he is having with directing his own treatment may reflect the need for a professional to help, since I can’t really provide more than some suggestions in a forum like this. You mention that his feared consequence of writing down the story is that it will be set. I don’t know if he has additional feared consequences regarding death; that is, I don’t know if he cares about the distribution of his worldly goods after his death. His scripts should only include the fears and feared consequences he has. What he has revealed to himself is that part of overcoming OCD is risking an obsession to become set and if it did become set, what would be a positive way of coping this.
Dear Dr.Grayson,
First, I wanted to say thank you for this website. I seem to be stuck on an OCD theme that does not seem to be talked about much. I am talking about false memories. My mind will take random scenarios at a party from years ago and say that perhaps I slept with some guy there and forgot. Then my mind creates that memory and although I know deep down I did not sleep with anyone at that party, the “false memory” feels so real. When I tried to do ERP, I became even more confuses and started believing the memory even more. Could you please tell me if ERP is wrong for this type of obsession? I have had it for 2 years now and I would really appreciate if you could help me out. I feel hopeless. Thank you so much!
Hello and thank you for this blog,
I started several heavy medications to treat OCD because I was having extreme panic attacks. Now I feel sedated and am starting the ERP but I’m having a hard time getting anxious in the exposures. I’m still having intrusive thoughts that annoy me but I don’t feel as panicked as I did before starting the heavy medications. Would you suggest going down on the medication so I can work on ERP? Have you ever recommended this?
Hello Dr. Grayson, Thank you for your reply dated Dec 16. It just clicked for me when you described how my son revealed something to himself by realizing he cannot write about the fear or it will become set. So writing it would be like having to face it head on, whereas just saying words about it, the words would be said and gone. But the writing remains, and acts as a mechanism to make the thought unavoidable and thus the need to adjust to it. So then he should be considering how to make himself write this down. Because he is so very afraid, he might have to start by writing out small scenes, like being in a boat leaking far away from shore? I honestly don’t know if that scene would raise his anxiety at all. I will discuss this with him and talk about what might work. In the next couple days, he is planning to enter a partial hospitalization program. He pleaded to go to this program and now that it is arranged, he is hedging. He needs it very urgently. Thank you again.