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.
Dr. Grayson,
I am an OCD sufferer who has used prescription medications in the past, but noticed only slight results. It is possible that I did not stay on the medications long enough.
I would like to try medication again, but did not like the sexual side effects I experienced before.
What are your recommendations? Which medications have fewer sexual side effects?
Thank you very much.
Hello Dr. Grayson,
Can you please comment about reassurance seeking as a ritual? My OCD fears are related to self harm and the concern that my anxiety will get so bad that I’ll “feel like I have to die”. I have cut down drastically on seeking reassurance from others, but my therapist has said that I am still reassuring myself – especially in the midst of strong anxiety attacks and when I’m in triggering situations (hospitals, places I can’t leave, etc). Her advise is to listen to my script all the time, but especially in those moments.
Can you comment on self-reassurance as a ritual? I’ve found it hard to expose myself because my script only seems to effectively prompt fear when I’m in the throes of an anxiety attack (which happens infrequently). Sometimes I feel like if only I had contamination fears it would be easy to identify my exposures…
Thanks,
Canadian with OCD
Hello Dr. Grayson,
I have been doing exposure therapy for my obsessive thoughts (violent and sexual) and have been noticing improvement. Recently a doubt entered my mind about doing exposure therapy.
In your book you mention that the goal of exposure therapy is to habituate to the obsessions by purposeful prolonged exposure to reduce the associated anxiety. There has been some research that suggests that violent exposure (video games, tv, etc.) can lead to a greater propensity to violence and that exposure to pornography can lead to changed attitudes towards rape and abuse. If there is any truth in this then habituating to violent and sexual stimuli can lead to negative changes.
I find that many people who do not have ocd have a negative reaction to exposure therapy based on the above idea.
What are your thoughts about that?
I would be curious to read research studies which show that this is not the case.
Thank you for your time and for your dedicated efforts to helping people suffering with ocd.
My ocd feels more like an impulse control behaviour. I have this compulsion (which I believe I act upon and is noticed by others) to look at people’s private parts, whether they be male or female. I fear humiliating myself and embarassing or annoying the person I’m looking at in this manner. I know how my ocd started: It got triggered after a humiliating sexual situation where I felt degraded and practically molested (even though I was an adult at the time). I have done years of therapy and I’m not any closer to a solution. This has robbed me of my life. I find it very difficult to have any type of interpersonal interaction, even minor. Could you please give me specific steps as to what to do?
How do you feel about the new reality television series, “OBSESSED?” It seems to me that the therapists involve mostly adhere to your methods through how they handle exposure, but don’t seem to be as in line regarding learning to live with uncertainty.
I’d be curious to hear your opinion on it.
Dear Dr. Grayson,
I was reading a book the other day (the “Happiness Trap” by Russ Harris) and in the book thoughts are differentiated from mental images. He says that thoughts consists of words.
My question is that if this is true is then how does one approach obsessive mental images as opposed to thoughts using ERP.
I have problems with obsessive thoughts and obsessive images which do not necessarily occur together.
I agree with you Jen. They are using exposure and response prevention and I think this is good for the public to see. I do wish they would stress uncertainty more. Also, I wish they would do a better job of trying to help non-sufferers understand that although involves horrible suffering, that it isn’t crazy.
Aaron, with regard to ERP and images, I would have a few questions, before I can answer. First is what is the nature of the images? Second, and this is critical, what are the reasons you want the images to leave? Individuals can have many reasons and the kind of exposure would depend upon the reasons. For some, they simply don’t want the images. For others, they fear that having the images in their mind may mean something about them. And there are other possibilities. What applies to you?
***WARNING to readers: If you are depressed you may not want to read this since it contains depressing thoughts and reasons to commit suicide. ***
Dear Dr. Grayson,
It seems like my OCD is trying to force me to be depressed and suicidal. Clinically, I may be a little depressed, but definitely not at all suicidal. I have never attempted suicide, I am not impulsive, and I have no plan. Yet, I keep thinking “I hate life” “Nothing matters” “I want to die” “I should shoot myself in the head.” And the OCD will address me specifically and say “You are going to die anyway so you may as well do it on YOUR terms“ “Life is too difficult; your corpse will be a protest” “There is nothing to live for” “No one should try to prevent you from committing suicide unless he does not really love you since your life is causing suffering” “You have the right to kill yourself” “You do not need to put up with mental pain; you can kill yourself.” Before I know it I will start to write a suicide note in my head. Then the OCD says “Aha! So you ARE suicidal! After all, why write a note unless you are suicidal?” I answer that these are just thoughts and then the OCD says “Oh, reassuring yourself, huh? Looks like you are not being treatment compliant. Looks like someone is trying to practice thought suppression. Haven’t you read Wagner’s book? You really are not good at dealing with these thoughts at all.” OCD also says “If you keep having these thoughts you will be depressed and suicidal so you better stop them” or it says “You ARE depressed and suicidal” or it says “If these thoughts do not bother you then maybe you will commit suicide” or it will find within me a feeling of sadness and say “So, you ARE depressed and hence suicide MAY be an option for you. Better do something to prevent that.” Yet I have insight. If I didn’t maybe I would call 911 and say “I think I am suicidal!” That would be terrible.
For now, to deal with this, I try to remind myself that I do not believe these thoughts but then I am accused (by myself) of not being treatment compliant. So then I remind myself that even that thought is OCD. The cycle continues and I try to ignore it, viewing it as annoying noise. Any thoughts? Should I listen to my depressing and suicidal thoughts repeatedly? Thanks!
Oscar
Hello Dr. Grayson,
I was looking at purchasing your book on Amazon, but it seems that many customers also buy “The OCD Workbook: Your Guide To Breaking Free From Obsessive-Compulsive Disorder” by Bruce M. Hyman, along with your own — the two appear quite similar. I wonder if you’re familiar with this guy and if you think using both books would be a wise idea? He does go further into what he calls “imaginal” exposure techniques, or exposure “in vivo,” and I figured it would be helpful to me since I suffer from extreme pure-o Religious OCD. Perhaps in combo with your “accepting uncertainty” approach, which he too uses but may not stress as much.
Any thoughts?
Regards,
Armin
I have similar OCD thoughts to Oscar, but mine are more specifically: “I could get so anxious and feel so awful that I won’t be able to hold on and will kill myself” or “I could get so anxious that I won’t know what to do and will feel like I have to die”. Often these are accompanied by images of hospitals, me ‘losing it’ in public, having to be forceable medicated or intervened upon, note being able to work and live a ‘normal’ life, etc. etc. etc.
I should note that the ’suicide’ specific thoughts only present themselves typically in high stress situations/times. The exposure script I use says “my anxiety could get so bad that I will feel like relief is impossible. It could get so bad that I will feel like death is the only escape, etc. It could get so bad that I will have to go on disability, etc”. The script does not really raise my anxiety though. My therapist has suggested that this doesn’t really matter, but I am bothered that it doesn’t raise my fear level. I worry that it isn’t adequately challenging/exposing me. Perhaps more OCD?
Thanks,
Jen
Hi everyone. i’m new here. i appreciate much if someone can answer my question and put my mind a bit at rest. Does anyone know if people with ocd do have a greater chance of developing bipolar disorder?
Thanks.
Dr. Grayson,
How does an OCD suffer use Exposure/Response therapy for movement-type obsessions. Specifically,numerous times during the day, I must move my head/neck and shoulders a certain way & a certain number of times because I dont feel my body is balanced. Also, I must stare into space with my eyes a certain way many times a day to check that I am not going blind. This type of problem doesnt seem as clear cut to work on as “touching toilet seats”.
Thanks for any suggestions!
I’ve been running an OCD support group in Miami, FL for about 10 months. Originally, I tried to follow your G.O.A.L.S. format: topic discussion, goal review/setting, and lastly normal venting. Due to my own troubles and the group’s reluctance to set goals, we eventually skipped the first two parts and just vented. Eventually, I got frustrated with the group’s lack of direction and progress, so I brought back all three sections again recently. Some of the members were excited about this renewed sense of order (and hope). My question: How strict should I be on keeping people on topic? I find people tend to drift off topic and I’m not sure if I’m doing them a service by reminding them that they can vent later after we cover topics and goals. Also, should new members be given more leeway to get off subject since they have more to say and haven’t yet bonded to the group? Thank you!
It is hard to keep people on task, but it is very important. Try to gently remind people before the discussion that you will be doing this. Remind that the support group is to help with OCD and the structure is to help everyone.
“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)”
Dr Grayson, can I contact you through a private e-mail? How do I do this, I don’t know where to send my specific questions. Thank your for answering me
Nina
Dr. Grayson, is there anyway to write you a confidential email? I wasn’t able to find any email address listed. Thank you.
Dr. Grayson, I have OCD and my problem is that when I’m confronted in a social or work setting I stare surreptitiously at peoples privates (like nina in another post) I’ve had this condition for about 15 years and I’m at my wits end. I’m a guy and my problem occurs when with both men and women — it has nothing to do with my sexual orientation or sexual frustration; I’m straight and I have a girlfriend. I have comorbid BDD and so feelings of being perceived as a freak are also in play. It’s the ultimate self-sabotage; the most humiliating thing I can do — and of course, I don’t want to do it. My question concerns how to create an effective ERP program. Should I make a scrapbook of clothed fashion photos (interestingly enough, naked people and pornographic photos are completely non-threatening) and then go through the ritual of trying not to stare, staring anyway and feeling anxious and terrible? I can induce the same feelings and anxiety this way. In the real world, I don’t stare directly, but surreptitiously. So, should I be staring directly or surreptitiously at the privates in the photos? How long per day? What are the scripts that should accompany this? Any suggestions would be welcome! Thank you, Simon.
Not particularly greater.
Dear DR. Grayson, My husband suffers with the most severe OCD that involves incessant checking. It’s not just locks, faucets, etc.–it’s everything!! He even walks backwards at times to see if anything dropped. He checks pockets in clothing,my handbag,& it takes forever to get him out of the house or if we go anywhere he has to check under tables or chairs. I won’t take him to any store due to his checking. At times his checking looks so suspicious to others that they think he doing something wrong. He’s on some meds but they don’t help much. It’s very frustrating living with him, but I love him & he’s smart, funny, articulate. He can’t work due to his ocd & has been either fired or asked to leave a job after a short time. Do you have any ideas that would help him to try to control his checking. Please help. Thank you
Felica, obviously the answer to your questions could be/are a whole book. For a brief answer, check out my post: The Right Treatment For OCD
hi!dr grayson ,i suffer from a form of ocd where i cant stop noticing things like noises or noticing my eyes blinking or noticing songs repeating i have a hard time concentrating on my studies,i live in india and have suffered badly at the hand of doctors here,they either sedate me or hand me prescription drugs that always worsen my condition,please tell if could purchase your matter regarding dis form of ocd ,or do u offer treatment in phone calls which work overseas,the society here is ignorant over these conditions and i cant even seem to share it with my parents..thanku in advance
Dr Grayson,
I have your book, and I read it often to help me. Its inspiring, but also tough love, and I appreciate that. I have homosexuality as the obsession of my OCD (I have been diagnosed 3 times) and I really, really struggle with the idea of acceptance. I am among the 40% of people who feel some sort of arousal/groinal response to the thoughts (which disturbs me) and so I am curious to hear how I can accept not only the intrusive thoughts but the automatic physical components to my obsession? I feel as though “acceptance” is meaning its true, and as hard as I try I cannot get myself to fully accept being gay. I can tolerate the posibility, but do I have to say it?
Dear Dr. Grayson,
I’ve read your book and really enjoyed it. You wrote a bit about reading compulsions and the feeling that one has not understood what she has read. However, I wondered if you had any tips for exposure exercises targeting perfectionism related to writing?
To begin with, I am a perfectly good writer. There is no real reason for me to be concerned that anything I am writing will not be up to standard. However, one of the areas that my OCD impacts the most is my ability to write prose. This is a huge problem, as I am a student at an Ivy League university and therefore have to do quite a bit of writing for my classes.
I spend an ENORMOUS amount of time changing the wording and phrasing of my sentences until they are “just right” and have the right “flow.”
I have a lot of trouble devising ERP’s that I can actually follow through on. It is very difficult for me to “just write faster.” My exacting standards are so ingrained in me that I can spend hours on a single paragraph without even realizing it. I write and rewrite and tweak the wording until the cows come home–and most of the time, I am largely unaware that I’m doing this. I just get sucked in. And even when I do realize that I’m engaging in the compulsions, it’s very hard for me to stop. It’s terribly easy for me to slip back into my usual way of writing (and rewriting, and re-rewriting).
I have major issues producing rough drafts. It’s like the writing has to be perfect before I can move on.
I have tried using timers, but doing so does not really change **how** ‘m going about the writing–I just end up not finishing the paragraph within the allotted time.
Please, do you have any ideas for ERP’s I could do to try to address this? I spend my entire life just trying to finish my school work (which I usually don’t)–to the exclusion of pursuing anything that is remotely meaningful to me. There are so many things I want to do with my life, but instead I am spending hours in front of the computer screen trying to finish this sentence or that. It’s miserable.
Thank you in advance,
Sarah
hi.
how i can try the expose/response and “acceptance” in a “paranormal” pure o – OCD? example: my sister maybe is possesed by a demon? (im not supertitious or religious!).
I cant accept the existence of posession or evil souls so…
the “maybe yes, she is posessed” dont work…
pd: sorry for my english, im from spain.
To Jota,
You say that you can’t do ERP to the possibility that your sister is possessed by a demon. The fact you aren’t religious or superstitious doesn’t play a role. The critical question in developing an exposure for you depends upon your feared consequence. If you are going to say that you know she can’t be, but spend time trying to convince yourself that it is utterly impossible, I would argue that you ERP would need to focus on the possibility. If on the other hand, the worst fear regarding this obsession has nothing to do with the possibility of her being possessed, then what is painful about the thought. One possibility is that what you hate most about it is simply having the thought and it seems to you that the constant thought just ruins everything. If this is the case it is functioning like a ‘neutral obsession,’ that is, where the feared consequence is simply that it won’t stop, your life will be ruined and nothing more. Later this month, an article I wrote about neutral obsessions will be available on my home website (www.ocdphiladelphia.com). However, if this is your feared consequence, write me and I will e-mail you a copy. If it isn’t a neutral obsession, then what is your worst fear regarding this thought, without trying to figure out whether or not it makes sense?
Dr Grayson,
Based on the comments i see above I too have pure o neutral obsessions where the feared consequence is that my obsessions will ruin my life whether that obsession is a song stuck in my head, when im sad fearing i might get clinical depression, fearing my OCD itself is/will ruin my life. I went through a period when my girlfriend told me she had a ghost in her house and i obsessed over the possibility i might have one in MY house. It wasnt fear of the ghost per se but the thought i might believe it and how that might lead to abandonment by people and my life would be ruined. Im doing ERP around the consequences of what could happen if I got clinical depression and since im somewhat sad now im afraid i might get worse from doing this. With these neutral obsessions, driven by a fear of ruining your life what is a good approach? I read your article Obsessing about Obsessing but i didnt quite understand the ERP approach mentioned. Can you comment on this? Thanks!
Hi Dr. Grayson,
I was wondering if you could address the comments above by Oscar and Jen. I too fear that the anxiety will become so overwhelming that I will eventually kill myself. When I do exposure, should I just focus on the possibility that my life will be ruined by my anxiety and that I may never have a family, job (eventually kill myself). Your book and obsessing about obsessing article give me hope. Its just that every time I flood myself with the thoughts my OCD seems to get worse and I become more hypervigilant.
Dr. Grayson,
I have an interesting form of OCD, at least I think so, that involves my relationship. My fiancee’ and I moved in together last October. Prior to this, everything was great in our relationship, with a lot of love. About a week after she moved in, I started to obsess over whether or not I found her attractive, which led to “do I find her sexually attractive” which led to “I should break up with her.” I became depressed and saw my medical doctor, who prescribed medication for me for the depression and generalized anxiety disorder. The medication worked for a time, and I felt like my old self again. Well, recently, I’ve fallen right back into the hole. Now, I am focusing on my fiancee’s looks, and constantly compare her to other girls, with the returning thought “I find those other girls attractive” which leads to “I should break up with her.” It is a constant thought, lasts 24 hours a day, and leads me to consistently check her pictures, as well as stare at her to compare her to other girls. In normal times, this does not happen. Does this sound like some sort of OCD, or am I making this up as a front for a deeper issue? Thanks for any advice. I’d be very interested to know if this could be correctable with some sort of therapy.
Patrick,
It is very hard to cope with obsessing about obsessing, because if feels like your worst fears are actually coming true; that is, if I obsess life will be terrible. And, indeed, while you are obsessing life feels terrible. In addition, explaining and understanding the goal of treatment in this case is somewhat abstract. I’m glad you found the article helpful (which will soon be available with some other articles on my website: http://www.ocdphiladelphia.com), because sufferers often misinterpret what I say and think it translates to: just live with it.
I think part of the problem with the exposures you are doing is that you are including the feared consequences, but reminding yourself why you want to do treatment or what you expect to get. Again, the goal isn’t to stop the thoughts, but to get to the point that you don’t care they are there. In the article I remind people that if a loved one were to die, two weeks after the death, thoughts about them would pop in your mind, interfere with your concentration and you wouldn’t be able to get rid of them. You wouldn’t call these obsession, but the reason isn’t because they are real, but because you don’t try to get rid of them or stop them.
Again, this is a treatable problem, but not a simple one. A lesser exposure you might try is making a tape/cd/mp3 that every 40 seconds to 90 seconds just says it. It is to remind you of your obsession, so that while the script is playing, it won’t be possible to get your obsession out of your mind. I would have this playing day and night and only turning it off when I’m in a place where it isn’t appropriate to wear headphones (business meeting). You could wear it with family, friends, while watching tv, etc. The goal isn’t to focus on your obsessions more or less. If they increase because of this, that is okay and if they decrease that is okay. The core goal of the tape is that it helps to interfere with wishing the obsession would stop, since that can’t happen while the tape is on. This is very important, because whenever this wish occurs, you do become depressed. It is still advisable to seek the help of a professional and if they aren’t familiar with OCD, I’d be happy to consult with them.
Hi doc,
1.Is medication needed forever to control ocd, in severe ocd? before treatment it was severe, now i’m free from symptoms after CBT+medication therapy.
2.will the dose can be redcued after a while, or may the dose that bring you symptom free should continue?
Thank you,
Yaron from Israel.
Dr Grayson,
I see a lot of writing out there about OCD behaviours such as a fear of germs, but I was wondering if you could comment on a type of OCD that involves touching or moving things certain amounts of times until they feel “right”?
To use myself as an example, I will often put down a glass and then feel like the place it is sitting or the way it is turned is wrong, and will have to pick it up and put it down numerous times. Often I will try to avoid putting it down a certain number of times (like 4 or 6) because that number feels wrong somehow. Sometimes I will put the glass down on odd numbers to try and “cancel out” the wrong placements with right ones, and then finish with a “right” placement. I will do the same with touching things, like a curtain or my hair. My obsession with “right” numbers even extends to reading sentences over or writing things more than once.
I was wondering what thoughts you had on this type of OCD, and whether exposure and response therapy can be used to treat this problem? Any thoughts on the matter would be greatly appreciated. Thank you.
Hi Doc,
I’ve been told by my therapist I have severe, “just right” ocd. I have not had success with meds, Luvox and zoloft. I get STUCK in an action/movement. I willhavw to repeat this action, until I figure out or feel I can let it go, stop, and move on.
…Whoops I didn’t finish, sorry. Sometimes I’ll look down at something, spot, crumb, etc. on the floor and feel the need to keep looking at it or pick it up. I’ll be trapped and paralyzed for hours because of this. But at least I will come through it, and get unstuck, move on with life.
But the real problem is, sometimes no matter what I do, it doesn’t work and I’m STUCK on an action for years! Time moves on, but I don’t. Simply bending over a sink counter to place an object back in drawer, I glanced down at another object and in that INSTANT became stuck. Searching, urge to inspect, repeating to find what I need to feel to “get passed” it.
I’m suffering with a stuck event right now! A day year ago! What could I do to get passed an event/movement/action that you feel you absolutely must, to feel yourself again! How could I apply a technique or ERP on a passed action. I’ve certainly tried everything. Even contimplated destroying the object still there.
Thank you for any advice or suggestions!
Hi Dr.Grayson,
Met you at the OCF conference back in August and went on your “virtual camping” trip. I was impressed how you helped people with a number of fears. Did you see Nightline on Monday? I was on that segment, with you. (Faye with the germ obsession)
Since the conference I’v worked really hard on the germ/contamination stuff, but I’m now flaring up with something different. Scrupulosity. When I worked on the germ fear, the scrupulosity got worse. I’m afraid even if I can overcome, or mostly overcome the scrupulosity, that something else will spring up. Please help. Also can scrupulosity be treated with erp? Thanks for your time!
I have been performing ERP for the last few weeks. I have OCD which focuses on my love for my bf. My problem is that now I feel numb. The panic is easing but the love has not come back, I just feel like I have accepted that I dont love him and that is it? Is this a normal stage in recovery and how do I get past it? He is the best person I have ever met and loves me more than anything, there is nothing that has changed in our relationship other than he asked me if I was sure I was happy in our relationship and bam everything went wrong!
Anyhow just wondering really if this is normal!
Thanks
Hi Dr. Grayson,
Can you please comment about dealing with obsessions that change over time? I’ve had OCD for years and my fears have not always been consistent (although I recognize themes). Can you also please comment on why OCD comes and goes? and what to do when you feel ‘good’? When I feel good, I feel relief and don’t expose or listen to my tapes. Partly this is due to the fact that I feel like I deserve to relax into good feelings but also because they don’t provoke anything in me on good days, so I don’t bother!
Inevitably though, I have a bad day…
Dr Grayson
I’ve read your book and I think I have Religious OCD but I’m not sure. your book really helped me but I’m still suffering. I live in iran and I want to know what else I can do to help me? any books? or… .
and how i could be sure that my problem is OCD?
Dr. Grayson-
How do deal with a smart, stubborn teenager with scrupulous OCD who is adamant about not getting treatment? He fears he will anger G-d if he receives any tx?
thanks for your time
Liz
I have a mental OCD and part of my compulsion is reassurance seeking. I am trying to not seek it, but I also don’t want to feel hopeless. What can reassure me? For example, is it okay to take reassurance in the fact that I didn’t lose my mind today?
Liz, it is always very hard to give suggestions about how to help someone who is refusing treatment. You have three difficult issues going on at once. The first is that he is a teenager and so all of the normal problems teenagers bring will be funneled into this. The second, and this is critical, if you can get him to go to treatment, are there any OCD specialists in your area. Scrupulosity is a very treatable form of OCD, but it is one in which the therapist’s knowledge of OCD is critical. The International OCD Foundation (www.ocfoundation.org) has a list of therapists who may be near you. However, after finding a name on the list, you may want to call them to find out if they know anything more about that provider. Last, depending upon the form of scrupulosity, much of how we try to get someone into treatment has to do with helping them to recognize the uncertainty within their own beliefs. For example, I might point out that if God always knows what is in their heart, even if they don’t, then why would it be a sin to listen as opposed to an act of faith. In fact, their refusal to see a therapist could be sinful, since it assumes that God wouldn’t be able to tell the difference. However, this approach depends on knowing more about that individual’s system of scrupulosity and, again, an experienced therapists is very important. I’m sorry I don’t have the answer that works, your situation is a very hard one to be in.
Kim, if you will check some other posts on this site, you will discover that at the core of your OCD (and everyone’s) is not wanting to tolerate uncertainty in the area of your concern. The goal of treatment is not trying to get to be certain – or reassured – but to learn to live with uncertainty. In areas of your life not affected by OCD, you do this constantly. When your loved ones aren’t with you, you don’t know if they just died in an accident, but you don’t check – you decide that because you feel they aren’t hurt that they are not hurt. However, this belief isn’t a truth. So your plan to deal with them possibly being hurt is to hope they are okay and wait. I believe that you don’t want to be maimed and paralyzed. However, every time you get into a car, you risk some idiot ramming you and leaving you this way. And you drive any way. You may even risk death to see a movie. Why? Do you know that you won’t be hurt? However, you can’t simply decide to live with uncertainty, but you can decide you want to learn how. This doesn’t answer your question simply, but if I were able to do that in a short paragraph, then you would figured this out long ago. Obviously treatment with an experienced OCD therapist would be good. There are good books about OCD and, as you would expect, I like mine the best (see sidebar of blog for info about it). I hope this is helpful.
Dr. Grayson,
I asked you an earlier question about reassurance. I have read your book and I am working off of it now. I thought I had this pure-o obsession licked a year ago, but I’ve had a terrible relapse. The truth is, I never really dealt with my most terrible fear: hurting my children.
Now, I’ve started the higher hierarchy exposures, but I’m afraid I wasn’t ready for them. Instead of having reasons to work on OCD, love my kids, my husband, etc. I keep thinking I should just leave them, that it’s just not worth the risk and they’d be better off without me.
I’m having trouble with hopelessness. I’m not taking any medicine, I’m starting to worry that I’m depressed and that this will lead me to actually act on my fears.
Please give me advice. I desperately need it.
Dr Grayson,
I’ve been diagnosed with OCD (harm annd sexual) a year ago after suffering for 20 years. A year later after intensive outpatient(IOP) therapy and weekly psychotherapy sessions I’ve made remarkable improvements. But it seems that my OCD bothers me when I think back to memories of my youth and teen age years. Like everybody I did stupid things as a youth, but it seems I dwell on them more than others. And allot of “what if” questions keep poping up. Is this OCD or something else? .
I also have problems when I’ll never see someone again. I avoid them or try to leave them quickly. I recently had my therapist walk me to the lobby on our last visit because of the high anxiety and fear that i’d have a harm thought and never see her again. I fear travelling more that 20 or so miles away because of this. Is there a way of tackling these problems? Thank you.
Dear Dr. Grayson,
I’m reading a book by Lee baer titled “The Imp of the Mind” about bad thoughts and urges and there is a passage there that confused me and ( i have to say) spiked me a bit.
here it is:
“All of us have witnessed friends who drink too much alcohol and then act inappropriately, perhaps doing some of the embarassing or dangerous things that OCD sufferers fear doing. Why is this? What is happening in the brain to cause this? Dr. Savage explains that alcohol and or recreational drugs such as barbiturates suppress the activity of our brain’s frontal cortex, whose main job is to control and supress the primitive aggressive and sexual impulses from the lower areas of our brain. When we drink or use drugs , our frontal cortex is no longer able to do its job properly making us more likely to act on our impulses.
Because of this for any one who worries about doing something dangerous or embarassing- such as someone with OCD- getting intoxicated with any substance is usually a bad idea.”
Does it mean that an OCD sufferer with thoughts about killing people is more prone to act on this thoughts under the influence of alcohol or drugs than any regular person?
The author also refers that some people with OCD who got drunk (and blackout) obsess in the morning after about what they did while under the influence of alcohol (false memories etc).
but in this case avoiding alcohol might not be (at least in theory) avoiding expusure?
Thank you
Mike,
Your what if questions certainly sound like OCD. The goal with memories is not trying to get rid of them and if you don’t like what you did back then, not trying to feel good about them. However, the what iffing about how life may have been different if you hadn’t done those things is a very specific fantasy assuming life would have been better if you had behaved differently. Actually, if may have been worse, you will never get to know. Remember real life is never as good as a fantasy, because we don’t put garbage in our fantasies.
As for your second issue, exposure and response prevention is still the treatment. It is true, you may never see them again. And if you are thinking that your harm thought may be the cause of this, then treatment will have you take that risk. Not to prove you can’t make that happen. All we know about your ‘powers’ is that you have a low hit rate. So we would have you working on having the harm thoughts and if someone did die, we would want to help you live with that, to never know for sure if you played a role and to stay in treatment. Now let’s say you ‘kill’ a second person on a separate occasion, we still want you to stay in treatment. However, if you can get rid of three people on separate occasions (three people in one car crash would only count as one), then we want to figure out something else to do with you and we’ll call the CIA, because they will probably have some use for you. The goal is learning to live with uncertainty, learning to live with potential loss, and learning to have any kind of thought in your head and having you learn to be comfortable without trying to control your thoughts or behaviors.
I think Lee is saying that for someone with this kind of OCD, drugs or alcohol seem particularly scary. I wouldn’t say do exposure by getting high and intoxicated nightly. However, if you don’t have an alcohol problem then we would encourage drinking in your usual way as exposure.
Dear Dr. Grayson,
I got spiked yesterday reading an article on Newscientist about people becoming sick or dying by sugestion, they call this process “nocebo effect”
My questions are:
For example, how can an OCD sufferer scared of cancer deals with this situation?
The more he tells himself that he will not die of cancer , the more he will think that he will die of cancer which may create in this way a “nocebo effect”.
It seems like a catch-22 situation.
Furthermore, In case I don’t follow a certain OCD ritual (as an exposure exercise) how can I avoid being sugested by my mind of the “negative consequences” of my action?
I don’t know if I was clear , but I would greatly appreciate your answer.
Thank you
yours,
Bernardo
Hello Dr. Grayson,
The more I look into it, the more I realize I do have OCD. I’ve worried excessively over harming myself, harming loved ones, but lately my biggest worry has been “obsessing over obsessing”. I hate the fact that I may have to deal with OCD forever. My biggest fear is, like several others here have said, that I won’t be able to tolerate my worries and may end up killing myself. I realize that is absolutely not what I want to do, I’m not suicidal, I’ve got far too much to live for. It’s the fact that I have so much to live for, however, that makes the idea of suicide even more worrisome. The more I think about it, the more it feels like some day it could become reality. (I can totally relate to everything Oscar said). I have a wonderful life with a wonderful, supportive (although not reinforcing) girlfriend of four years, and when I’m going through periods of anxiety, I feel like I’m not the boyfriend she deserves.
I’ve definitely been through periods of remission and happiness, and the periods of time where I can accept anxiety and be happy regardless far outweigh the times when I’m consumed by worry, but when I’m in those times of worry, it feels like it’s just never going to let up. I feel like I have a relatively good understanding of my OCD because I like to consider myself an intelligent person (definitely a “thinker”, which contributes to rumination). I understand the irrationality of my thoughts, but it bothers me that I worry about them despite my realizing their irrationality.
I’m willing to do as much as I can for treatment, but as a college student (it feels like college is what brought this on in the first place), I have little time and little money. What are some good treatment options for someone like me? I plan on buying your book as soon as I can, and thankfully, I’m in the Philadelphia area, where there seems to be a lot of resources on OCD. I’m scheduled to see a Psychologist for free through my school on the 23rd, so hopefully with medication and therapy, I’ll be able to return to the times when I can let my anxieties pass easily.
The point of my question is that I find it’s very easy to lose hope in my ability to reclaim life, and I was wondering if you had any suggestions on how a stressed-out college student like me can help myself.
Thanks and God Bless,
A.J.
Dear Dr. Grayson,
I had a question about double checking. I have ocd about double checking everything. It’s so ingrained in brain that without thinking I double check. I want to stop the double check but that 2nd check causes more uncertainity.
I don’t know how to break the cycle.
Thankyou