Questioning my therapist

[disneyandme]

Hi guys, I was wondering if you could give me your opinion on something. I really like my therapist, and I really enjoy therapy, and I've definitely made progress with my OCD (I hope, my OCD likes to tell me I haven't). I have a few concerns when it comes to my therapist.

I worry that she's not taking my exposure work far enough. I hear of other therapists taking their clients exposure work much farther than mine. So far I do scripts and writing feared sentences in a way that agrees with them. My OCD also makes me want to do ERP perfectly, and I don't like when she doesn't make it clear how I'm supposed to do things as far as exposures. For example, when I read back a script, do I just read the words, or really make myself visualize and connect with the emotion of if this were a real scenario?? She seemed to think I should just read it and see what happens, whatever that means. She also seemed to think that visualizing it really happening was a compulsion, but I've read elsewhere that it's not.

Another thing- I follow OCD therapists on instagram that talk a lot about how thought stopping is bad for OCD and your therapist shouldn't teach thought stopping. I'm unclear on what that really means. My therapist tells me to visualize a stop sign when I notice myself doing a compulsion, and to then move on to something else. It has worked for me so far and helped me cut out a lot of rumination/questioning. I asked recently if it's considered thought stopping and she said technically yes. Now I'm panicked she's not treated me right.

The same OCD therapists I follow on instagram also say you shouldn't like going to therapy. But I really like when my appointment rolls around, and I leave there satisfied and empowered. Am I not supposed to feel that way? Am I supposed to not like being there? I guess I can see why i shouldn't, because you should be confronting your fears, but it's not that I don't...

I don't know, let me know what you guys think. I think maybe I'm having relationship OCD with my therapist, LOL. I'm just so concerned about making sure I get the right treatment and fix myself, I think it's maybe even become an obsession.

[Aleese]

Hi Disneyandme-

Please try not to over read. OCD would like to bring confusion. Any questions or concerns you may want to bring up with your therapist and go from there.

As far as you reading: we should not like to go to therapy...well, if you didn’t build a trust and connection with your therapist how could you trust her? I had great attatchment to mine which probably had OCD in it but as you grow you will need less of that attatchment or maybe a better word is connection. If you analyze too much you will get overwhelmed.

But, being open with your therapist may be the way to go. Remember, no one is perfect and what works for one person may not work for another.

Hope you will have a peaceful evening😊🕊

Aleese-

[disneyandme in reply to Aleese]

Hi Aleese-

I definitely think this past week I've slipped into an obsession with the treatment of OCD in general. I've been overwhelming myself with knowing exactly how to react to each thing OCD throws at me. It's trying to make confusion within ERP and telling me I have to do it perfectly. I've been compulsively reading OCD workbooks and overwhelming myself with the information. And on top of that, OCD is trying to make me not trust my therapist anymore (probably because she's become something I value). It's hard, because I rely on the information I've learned to treat my OCD, but now my OCD is telling me it's all wrong and doesn't work and I don't know how to do it right.

I've been going to therapy every other week, but I decided to go this week as well because of this, so I'm going Wednesday. Hoping I can make the most of the session and do my best to trust her. I'm always honest with her about my obsessions, but I'd feel so wrong telling her that OCD wants me to not trust her/think she's knowledgeable.

[Wheeloffortune in reply to disneyandme]

Tell your therapist your thoughts! Maybe she’s doing it right, maybe not???? Of course OCD wants you to be 100% certain! Maybe you could be doing more??? What if??? What if it’s not “just right”??

You’ve got this😍🤟🏻💪🏻

[disneyandme in reply to Wheeloffortune]

You are so right. Thank you for helping me get some perspective on this! Not sure how I fell into that trap, but I guess that's just how OCD is. I'll get better with practice

[Wheeloffortune in reply to disneyandme]

OCD is so tricky 🤨🤨 you are doing great!!!

[mozart56]

Thought-stopping or thought suppression is usually not recommended, because trying to suppress the intrusive thoughts only makes them stronger. Picture a pink bear in your mind. Then try deliberately not to think about it any more. It’s almost impossible not to think of it if you try to push the thought away.

[disneyandme in reply to mozart56]

The thing is, I'm not stopping the intrusive thought. It happened, and then I responded with analysis/question/rumination. I picture a stop sign then move on to something else to stop that compulsion

[mozart56]

I gotcha. Sorry, I was confused there for a moment. Seems to me that visualizing a stop sign in this case (in order to get you stop the compulsion loop) might be a good idea. We want to not do our compulsions, obviously, so if doing this has helped you in that regard, I might try it myself! Good luck.

[disneyandme in reply to mozart56]

No need to be sorry, I hope you know I wasn't responding in a bad way! Just realized I wasn't explaining thoroughly enough 🙂 she also suggested visualizing a wrong way sign, pretty much anything to make me snap out of it and move on to something value based. Thanks for your response!!

[Selesnya]

Hi disneyandme,

I don't think that I'll have time to reply with everything that I want to say tonight, so I'll start with the things that I want to say the most.

I love going to therapy. It is my favorite part of the week because I feel like I'm doing something to combat the OCD that has been encroaching so much upon my life. I get awesome ideas in therapy about how to attack OCD and do some good exposures, I get some good perspective, reasoned and grounded thinking, and I get to talk to someone that is going to offer encouragement (though not really reassurance). You can't get much better than that, even if they are going to encourage me to do things that I really, really don't want to do when I'm doing ERP on my own. I'm sure the exposures are the part that the therapists are saying that you shouldn't be looking forward to, but I do most of my exposures on my own and outside of sessions. If you're feeling that your exposures aren't causing you enough anxiety then I certainly think that it would be worth mentioning that you would like to step up your difficulty.

Do you have an OCD support group near you that you might be able to attend? If so, there might be some other therapists there that you could ask questions.

If you think that wanting to get the perfect treatment is turning into a compulsion then there are things that you can do about it. You can agree with the thoughts and say that you're not getting the right treatment and that you're not doing your therapy perfectly. I always have a list of things that I want to talk to my therapist about, and we have been working on making it so that I'm leaving therapy with the feeling that we haven't done things right. Generally there will be things I want to talk about that we won't have a chance to get to. You could come up with ways to leave therapy feeling "not right".

As far as researching OCD, that's sort of a fine line. I think that there is a lot of good information to learn about OCD. Knowing more about it really helps get after it. I think that there is a line too far in researching OCD. If you are just researching and not trying to put your new information into action and change your behavior then maybe it is better to cut back on your researching and live with some of the uncertainty about your treatment.

Paul

[disneyandme in reply to Selesnya]

Selesnya, you are so smart and well articulated. You took the words out my mouth when describing how you feel towards therapy - I feel the EXACT same. Thank you so much for rationalizing this for me. I didn't get a chance until now to respond to this post, but I read it the night you posted it. I did what you said- agreed with the thoughts about getting the right treatment/doing therapy perfectly. It's already helped tremendously- my week turned around for the better. Thank you- really. I agree about there being a fine line with researching OCD. Having knowledge about it is power. I just need to be honest with myself whether I'm researching OCD out of fear (in a compulsive manner) or out of genuine curiosity and plans to put it into action. Thanks for the help you've given me in this community Paul. You've put so much time and effort into trying to help out others. You are a great person- don't let OCD tell you that you're not.

[NotSheldon1994]

Becoming willing, and more comfortable with uncertainty is part of treating OCD. So the fact that your therapist will not give you clear instructions on an assignment, And tells you to read it and see what happens, is in fact an exposure. Exposures are not always formally identified or announced, there are times they slip into the process of life or therapy very naturally.

[disneyandme in reply to NotSheldon1994]

Wow, thanks for making me realize this. You're so right, my therapist always gives me uncertainty during our sessions and this is probably just another "test"/exposure. Thanks!!

[Karla12]

Hi disneyandme. I seem to have the same ocd theme as you. Constantly looking on line on how to control my ocd. I accidentally said something private to a friend and at the time didn’t really give it a second thought. However later I couldnt sleep with the thoughts going over and over how to get reassurance about the thought. A quick fix I know, because if it wasn’t that thought I would latch on to another scenario maybe tomorrow or next week. When I read other stories of what other people say helps them and techniques on how to manage the obsessive rumination, when it doesn’t work for me I feel overwhelmed and panic that I will never get better and I’m not doing i t right . I got up today, anxiety ragging, then I remembered a post that I did read. It basically said it’s not about getting reassurance and getting rid of the thought, it’s the anxiety that is the problem. This has helped me realise today that the thoughts regardless of what they are, are irrelevant. The anxiety is the focus of the problem. This has helped me to stop interacting with the thought and regain my reaction to the anxiety. Don’t know if this makes any sence(complicated I know) but hope if might be helpful to anyone Also to remember what works for one person and not another is not set in stone.

[Selesnya in reply to Karla12]

It's not so much that the anxiety itself is the problem, it's engaging with the anxiety and giving it meaning that is the problem. If you try to neutralize the anxiety by doing compulsions then you are engaging with the thoughts and giving them meaning when they don't deserve that. You can be anxious and choose not to respond, just as you are doing.

[Karla12 in reply to Selesnya]

Yes it’s letting the anxiety just be there, and with ocd it is an anxiety disorder so the anxiety is the problem causing distress, which comes when you attach yourself to a thought which you fear. Realising that this is an anxiety problem helps to ground yourself and just let the anxiety be there without giving it attention. Trying to get rid of the thought doesn’t work it just feeds the anxiety. So by realising this you can just let the anxiety take its course and it will eventually fade

[MyOCD123]

Hi! I’ve been wanting to reply to this for a couple of days now because I think it is a really intriguing topic and I am sorry I am just now am getting the chance to do so. That being said here are some of my thoughts!

First, I am glad that you are seeing a therapist who specializes in OCD and can provide you with ERP. This is key to successful treatment. Second, I think it is normal at times to doubt your therapist when receiving treatment. OCD is called the doubting disease for a good reason and your skepticism could very well be an obsession of sorts.

When I started ERP I also worked with statements and scripts for the first few months, and I still work with them regarding certain obsessions. I do not think it is beneficial for you to compare your journey with what others are doing in therapy. Everyone is different and progresses at a different rate, but if you feel that you are ready to step it up then I would definitely talk to your therapist about this.

I totally understand wanting your ERP to be perfect, but remember that can be OCD speaking so if it does not feel perfect and you can tolerate that feeling than that is a good thing! As for the scripts the point is to visualize the best you can and put yourself in that hypothetical situation. You want to get your anxiety as high as you can and work on resisting compulsions and sitting with the anxiety until it starts to naturally dissipate.

As for the Instagram therapists I also follow a few but I would urge you to remember that they are not your actual therapist and only offering broad advice that may not always be relevant to your situation. When it comes to thought stopping being bad that is referring not to compulsions but unwanted and intrusive thoughts. If you try to stop those scary thoughts than your brain will perceive them as dangerous and they will become more often and the urge to do compulsions will worsen. I am not a therapist but I do not see anything wrong with visualizing a stop sign when you are doing compulsions. The goal of therapy is to be able to resist compulsions and for me personally my compulsions are primarily mental so I begin doing them before I realize. There is nothing wrong with observing what I am doing and making a choice to stop. I hope that makes sense regarding thought stopping?

And in regards to Instagram therapists saying you should not enjoy going to therapy - again they are not your therapist and I think that some tips from Instagram can be misconstrued. I myself look forward to going to therapy because I know I can speak freely with my therapist and I do leave feeling relieved for the most part, and empowered the next day when I resist compulsions to contact her. That being said, during therapy we do scripts or other exercises to get my anxiety as high as possible so that part is not so much fun. You are entitled to feel however you want about therapy! I think you are right in recognizing that this could be becoming an obsession.

Try not to worry too much about what others are doing and what Instagram therapists are saying. If you are truly worried you are not receiving the right help then have that conversation with your therapist. Sorry for the long response but I hope this helps! And again, this is just my advice and opinion and if you feel differently that is perfectly understandable!