Feeling Right

[Stratocaster78]

Feeling Right

Feeling Right...

I'm a 73yo retired physician who's struggled with OCD most of my life. While initially tic like as a child, it has evolved into obsessive thoughts (like trying to figure out what time it would be if I interchanged the hands of a clock, constantly calculating exchange rates for money when I travelled overseas, figuring age differences between myself and someone else, to the month, etc), perfectionism (like cleaning shelves and countertops over and over until it felt right, screwing in a lightbulb until it felt right, often resulting in breaking it, etc.) But more recently small physical actions (like blinking 10 times in a row until it felt even, swallowing in a certain way until it felt right, often leading to drinking many glasses of water which I'd have to diurese the rest of the day, etc.)These are but a few if the myriad of symptoms that I get. It's like my mind sticks to things to keep it occupied. It's like there's a little dictator in my head that tells me what I need to do, and decides whether or not I did it right.

It has waxed and waned throughout my adulthood, but I've managed to have a successful career and social life. I'm married and have a 24 yo daughter. But it sabotages enjoyment and peace of mind. There seems to be no definite triggering obsession other than the stress of aging and retirement, but over the last few months it seems to be getting worse.

I had traditional therapy as a teenager, before OCD was considered a neuro disorder rather than from dysfunctional past experiences.

I've had OCD targeted therapy including groups with the Anxiety and Panic Treatment Center in Portland, OR, which kind of helped for a while. I do see a family oriented therapist for other issues.

As far as meds, once I conceded that I needed them, Paxil worked for a while, but had a side effect profile. Lexapro, although promising at first, doesn't seem to help much now.

So I'm considering entering more focused therapy. I'm open to whatever ERP can offer, although the symptoms change continually. And the role of mindfulness...

Sent from my iPhone

[TomFed]

Hello sir,

ERP in many cases is the best scientifically proven psychotherapy for OCD. There have been no studies in the past half century or more that would show "traditional" self-investigative therapies would be useful for us folks with OCD, in many cases they can make things worse, as OCD is not susceptible to logical think, I'm sure you know from your own life long experience, to the large extent you can't overpower OCD by rational thinking. Only way to successfully address OCD is by wilfully eradicating mental and physical compulsions and related compulsive behaviours.

So if you are in position to get assessed and treated by ERP therapist, I'd say definitely go for it. Three months of OCD therapy were life saving for me, and I use the tools that I've learned in the therapy successfully every day. Of course, there are other non medication means that can help to heal from OCD, like ACT therapy or self compassion based therapies, meditation and so on. But for most folks ERP is a first must if they want to heal from OCD.

[FirstResponder23]

hello,

I’m glad to hear you are looking into more therapy options. I know ERP Has helped me tremendously. With the evolvement of understanding OCD over the years, I know that ERP has been highly effective. Working with someone who is trained in OCD treatment really helps in doing exposure work in a controlled and properly adjusted setting.

I know my therapist tells me that chang won life is a party invite for ocd. It could be bad or good change. Any change is an invite because it alters our routine and gets our minds thinking and planning. I think you will find ERP to be very beneficial. Praying this offers some relief for you.

[beth196]

I got diagnosed with ocd after my third child but looking back it started in my teens by saying goodbye to my parents to keep them alive. I finally got the right diagnosis at Yale and I was put on 80mg prozac. I've tried a bunch but this works but is so slow to take affect I took 20mg of lexapro for 8 years which just is an anxiety dose and not an ocd dosage. The ocd dosage is 40-60 mg and my internist was concerned about the black box cardiac warnings. My pscyh put me back on prozac and tapered me off the lexapro. It's been 8 weeks of depression, anxiety and intrusive thoughts. was also on 2 mg klonopin. It's 8 weeks and I was able to drop the klonpin to 1mg and starting to feel like my happy self again. Prozac can take 4 more weeks to get max affect and I've only been on 80 for three weeks. This drug is a game changer for me and I need the high dosage.I don't know if you'll want to take high dose lexapro with suden death cardiac arrythmias. Mine involves contamination and fear of catching diseases. Ironically I was a nurse for 6 ,months and then did pharma sales for 11 years. sold xanax. could've used it myself. once I reach 80 mg I've been able to get off klonopin. I feel for you this disease sucks and is insatiable.

[Natureloverpeace]

I highly recommend the book Freedom from OCD by Jonathan Grayson, Ph.D. Jon is one of the top experts in the field. Also, check out the IOCDF website at iocdf.org. You will find many resources there, including the OCD therapist and clinic directory, as well as how to access their livestreams. ERP has evolved in the last 10 plus years or so. It’s not just habituation anymore.

[Winchester2022]

I relate to so many of the symptoms you describe. I had OCD for most of my life, but didn't learn what it was until the internet came out and I was able to google the symptoms I was having. When I was 12 or 13 I had to do things a certain number of timeg (12 and 13 were also my lucky numbers). I've also had the need to figure out things because of OCD. I used to do things like add the digits that were displayed for the time on a digital clock. I would do this forward and backward a certain number of times.

When I was twenty ( I am 43 now) and finally knew the name for what I had, I went into the book store looking for a book on OCD and was lucky to find the book "Brain Lock" by Jeffrey Schwartz. That changed my life and I went from Cs, Ds, and Fs in school to straight As. Schwartz is a psychiatrist with an undergraduate degree in philosophy. The combinations of these two degrees gave him a very interesting perspective. His method is a four step method to deal with obsessive thoughts (called the "four steps"). You can google this or search for it on youtube. The steps all also known as the "four Rs": Relabel, Reattribute, Refocus, and Revalue. I really only needed to use the first three steps to get significantly better. Relabel means taking a step aside when confronted with an obsessive thought and calling the thought what it really is: an obsession- a brain misfire, a false alarm, or whatever other term you want to give it that helps you remember this is not a real thought. A helpful line that Schwartz gives that you can use to relabel thoughts is to say: "It's not me, it's my OCD!". Or, "that's not a real thought, it's an obsession!")

Reattribute is then telling yourself the reason you are getting the obsessive thought- i.e that you have OCD which is a chemical imbalance in the brain giving the false sense of urgency to certain unwanted thoughts. Some people think of the picture of a brain scan with someone with OCD which literally shows the changes in the brain taking place during an obsession (which then goes back to normal!- after doing the four steps or other OCD treatments like other types of mindfulness or exposure). Knowing the reason you are getting the obsession makes it easier to look at it dispassionately from the side. I loved Schwartz's metaphor of the "impartial spectator", which he borrowed from Adam Smith. The impartial spectator is the one who looks at our own thoughts from the side and judges them as an impartial third party would. We all have an impartial spectator, and we can imagine it looks at our thoughts and thinks of them the way our friend without OCD would. E.g. the impartial spectator in you sees that trying to figure out the age difference between ourself and a friend, to the month, is not a useful endeavor. You can use the impartial spectator whenever you get an obsession.

The third step, and this is key, is refocus. That is, instead of acting out the obsession (i.e. doing a compulsion), instead refocus, even if initially only for a few minutes, on a positive activity you actually enjoy. It could be playing an instrument, reading a medical journal, or even watching a movie. This way you train your mind not to do the compulsions which only snowball the obsessions.

The first three steps were so helpful that I didn't even need to get to the fourth!

One final golden nugget from Schwartz which I'll mention is this: sometimes we might not be sure if a thought is a legitimate thought or an obsession. The test here to determine if something is a real thought or an obsessions is: "If it sounds like it MIGHT be OCD, it IS OCD! OCD mimicks reality, but reality never mimicks OCD." For example, if you were at home and a fire alarm went off, it would not be OCD to check into the cause of the alarm going off. This is a real situation, so it wouldn't feel like OCD. So any time something even feels that it could possibly be OCD, it is.

I still have OCD sometimes, but it used to take up 2-8 hours of my time per day. Now it typically takes up only a few minutes a day or nothing at all. In bad cases when I am under stress, I might have it for an hour or two but that is not common for me (maybe once a month or every other month at most). When that happens I got back to what I've learned before or come to the forum for help or have a therapy session.

Getting better is very doable! All the best in your journey.

[Stratocaster78 in reply to Winchester2022]

Thank you. It's goog to know I'm not alone.

Happy NY 😇

[Winchester2022]

Thanks and Happy NY as well!