Hard to see myself in descriptions of OCD

[Maxruff]

Hi all,

I’m still learning about I fit into the OCD mold. Most of my compulsions are mental. My therapist calls it ‘mental analysis’. For example, I have a dialogue I play in my head over and over and over again when I am stressed, particularly when I am stressed about personal conflict. Sometimes my compulsions take physical form when I need to follow up with people to try to get a response to something I’m worried about, for example, if I’m severely stressed about something at work or if my adult son won’t answer my texts.

I’ve been working with a therapist for a long time and have made progress, but I still find that I use distractions to push intrusive thoughts away rather than be able to let them ebb and flow. I have to be reading or playing video games or talking on the phone or listening to an audiobook *100 percent of the time* in order to be sure I don’t get hit with any intrusive thoughts. Does this count as a compulsion? I’ve tried some ERP, but I keep getting flooded and having panic attacks. I also struggle with having physical feelings of anxiety and trying to keep those at bay or eliminate them, but my attempts backfire and make me feel like things are even more wrong!

Most days I feel like I’m in a prison or my own making, almost like I have a cage on my head and I’m stuck in there with intrusive thoughts trying to chase me but I can’t escape them. I have trouble reading about OCD and understanding how to label the parts of my experience in terms of how others talk about obsessions, checking, compulsions, etc. I wonder if my inability to understand is also part of the disorder!

I’m lucky that despite all this, I’m relatively functional in life, as long as I have access to my distractions. But I’m suffering a great deal internally and want to try to make more progress. My therapist is really quite skilled, but I think I struggle to make progress because of the terror of the thoughts and the panic attacks that happen when I move too quickly in treatment.

Anyway, thanks for reading this far and thoughts welcome! I’m planning to sign up for the IOCD virtual sessions

[deValentin]

Mental compulsions can take the form of ruminations. For instance, you could try to find answers to questions that are tormenting your mind, figure out why you behave in a certain way, or review the validity of some words you said or the meaning of words said to you. There is a problem with ruminations when they come to nothing, take a disproportionate amount of your time, and in spite of that, you can't stop them. It's similar to some extent to what experiences a gambler who lost his house, job, and family, and still tries to borrow some money because he's absolutely sure that next time he'll win big enough to make up for everything.

Some people use distractions to keep intrusive thoughts at bay. It may sometimes work, but if unwanted intrusive thoughts return right after the distraction ends, it doesn't seem like a sustainable strategy. Personally, I open my mind to the possibility that ruminations may not settle the issue that's presently disturbing me. And I act accordingly, that is, I stop investing time and energy into them in such a way that whether they come to a successful conclusion or not, it's not a matter of life and death. When I behave that way, I weaken them because I care less about how they end. It's not always easy and it takes times, but it's worth it in the end.

I understand your need to go at a reasonable pace, because it's indeed difficult to see the value of a therapy in the middle of a panic attack. Some therapists are better judges than others of how far a client can be pushed.

[Maxruff in reply to deValentin]

Thank you. I think mine eventually decided to mostly do exposure during therapy sessions because it was triggering me so severely. I also tried a mindfulness based stress reduction course (basically mindfulness meditation) that uses body scans and mindful awareness and can help with exposure. But it was too much for me and panic ensued. It has truly been an uphill battle. The distractions do help me live my life and be productive, but ultimately they are just a cage.

[deValentin in reply to Maxruff]

You're welcome.

I have a question if you don't mind. Are you always absolutely sure your ruminations or inquiries will eventually settle the issue that's disturbing you at the time, or do you sometimes doubt they'll get you anywhere? If you question their validity and nevertheless give in to them, do you do it just as a way to silence them?

[Maxruff in reply to deValentin]

I definitely don’t consciously think ruminations are getting me anywhere. They just sort of come up and carry me away. It’s hard to combat - distractions are the only thing that has ever worked. I had a particular dialogue with middle school bullies that was my first experience with an obsession that I rehearsed in my head over and over and over for many years. I was eventually able to drop that one, but of course, other things have taken its place. I can turn away from my response to intrusive thoughts, but not for long without distractions. It’s hard to explain because it’s not mental rituals, per se, more like pounding thoughts.

[deValentin in reply to Maxruff]

“I definitely don’t consciously think ruminations are getting me anywhere”.

It’s not always easy to determine what we’re hoping to get from our ruminations. To stop our ruminations for a while and examine what thoughts come to our mind shows us what we’re hoping (against hope) to get from our ruminations and what positive role we’d like them to play in our lives.

“It’s hard to explain because it’s not mental rituals, per se, more like pounding thoughts.”

As you probably know, there are two parts in what some people call "Pure O" OCD: the pounding/harassing/disturbing thoughts, and the mental compulsions (mind churning, neutralizing thoughts, mental rituals, repetition of words, counting, etc.) that are meant to reduce the anxiety brought about by the tormenting thoughts. The moving from one state to the other is sometimes so quick that it's difficult to distinguish between the two.

One can't control the first part, our unwanted intrusive thoughts. Actually, trying to suppress them makes them stickier. However, the second part is more within our control. "You cannot keep birds from flying over your head but you can keep them from building a nest in your hair”, like they say. Anxiety gives rise to an urge to do a mental or physical compulsion, but ERP is supposed to help us refrain from satisfying that urge.

[Sallyskins]

One mental illness and many forms! It sounds as though you have what is sometimes called 'Pure O' where the activity all takes place within your head, rather than outside, such as washing your hands repeatedly.

There is, all the same, no need to put a precise label on yours. It's all OCD. I have a similar thing in that I sometimes feel a compulsion to do one thing to my satisfaction before I can allow myself to do anything else. A bit like your insistence on getting a response to a question or a text.

Try not to blame yourself or beat yourself up about ERP. I think it's important to go at your own pace - getting flooded just leads to setbacks. It isn't easy to do for anyone - if it was, there would be no OCD!

Distractions are good, though I do get that they've become rather a compulsion in themselves with you. It's certainly better than being idle, though, as OCD creeps into any idle corners!

Consider medication, if you're not already on it. It can help to dampen down the worst of the OCD intrusive thoughts, and make ERP easier to do.

[Alibarb]

Hi, I hope u continue to progress with your treatments and therapy. I totally understand how intrusive thoughts can be so disturbing. I, too have to stay busy to try to block my intrusive thoughts, especially when I am alone. That's the most difficult.

[Gavriel]

sounds right to me. Glad you are working with a skilled person,