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gooblax

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Thoughts are telling me to cancel my next session again, because I know it will upset me to even think about doing that.
The therapy homework seems pointless too - choose a style of clothing I want to wear to an upcoming event. I'll never think I look any good, even if I could get away with wearing what I wanted. So there's no use.
 

David Baxter

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Thoughts are telling me to cancel my next session again, because I know it will upset me to even think about doing that.

I'm not sure I understand this part. You want to cancel because you know that even thinking about canceling would upset you? Why would you want to intentionally upset yourself?

The therapy homework seems pointless too - choose a style of clothing I want to wear to an upcoming event. I'll never think I look any good, even if I could get away with wearing what I wanted. So there's no use.
Try this:

Instead of telling yourself you will never look any good, tell yourself that whether you think you look good or not, what outfit would make you feel better — more comfortable, more relaxed, more anything. How you think you look to other people or even to yourself is irrelevant. Base it solely on what would be the most comfortable or acceptable to you and pick that one.

Voila. Homework done. :)
 

gooblax

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I'm not sure I understand this part. You want to cancel because you know that even thinking about canceling would upset you? Why would you want to intentionally upset yourself?
Because I don't really deserve to keep seeing my psych. And because getting upset about that means I deserve to be upset to pay for my weakness
Try this:

Instead of telling yourself you will never look any good, tell yourself that whether you think you look good or not, what outfit would make you feel better — more comfortable, more relaxed, more anything. How you think you look to other people or even to yourself is irrelevant. Base it solely on what would be the most comfortable or acceptable to you and pick that one.

Voila. Homework done. :)
I guess but I'm also worried about inadvertently attracting hostility from random people. I guess that would be a risk however I looked but certain things are more likely to inspire certain reactions. Although the biggest risk I guess would be on the way home afterwards if I'm alone trying to catch a bus, so maybe I should pre-convince myself that I'll be getting an Uber home even though I hate doing that at least it would be safer and I wouldn't have to be thinking about the bus schedule.
 

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Because I don't really deserve to keep seeing my psych. And because getting upset about that means I deserve to be upset to pay for my weakness

That's just that mean horrible OCD voice talking again. It has no credibility in objective reality.

I guess but I'm also worried about inadvertently attracting hostility from random people. I guess that would be a risk however I looked but certain things are more likely to inspire certain reactions. Although the biggest risk I guess would be on the way home afterwards if I'm alone trying to catch a bus, so maybe I should pre-convince myself that I'll be getting an Uber home even though I hate doing that at least it would be safer and I wouldn't have to be thinking about the bus schedule.

That's good thinking. Plan ahead for contingencies.
 

Daniel

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Have you read blogs or biographies of other people with OCD?




Some historical examples:

The history of OCD | OCD-UK

Saint Ignatius of Loyola (1491–1556) the Spanish Basque priest, theologian and founder of the religious order called the Society of Jesus (Jesuits) wrote “After I have trodden a cross formed by two straws, or after I have thought, said, or done some other thing, there comes to me from ‘without’ a thought that I have sinned, and on the other hand it seems to me that I have not sinned; nevertheless I feel some uneasiness on the subject, inasmuch as I doubt and do not doubt. That is a real scruple and temptation which the enemy sets."
...As mentioned earlier much of the historical record of OCD descriptions are in the religious, rather than the medical literature. At the time religion was very much a prominent feature of everyday life and with OCD often fixating on things that are important to a person, it’s not surprising that many early accounts are religious based. Historically, it was not unusual for someone with ailments to turn to their local religious figures, who would become very familiar with some health issues, including issues of the mind, like scrupulosity, because of their day-to-day dealings with their parishioners rather than physicians.
 
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Daniel

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Then, what about other people with anxiety? Do you relate to them? Does reading about their experiences help?

But as researchers learn more and more about mental disorders, the more they see transdiagnostic processes/issues, e.g. rumination, cognitive inflexibility/rigidity, behavioral inhibition, low self-esteem/acceptance, low frustration tolerance and difficulty regulating emotions. As with OCD, most people with GAD (generalized anxiety disorder) desire more certainty than is helpful, etc. And your "inner bully" seems painfully familiar to me, as is your way of using rumination as a way to cope.

And, of course, a lot of therapists and even psychiatrists still see OCD as more about physical compulsions -- even though "pure O" is a common experience among those with OCD:

When Obsessive-Compulsive Thoughts Are 'Triggered'

One of the most ... misunderstood aspects of OCD," Wortmann tells NPR's Neal Conan, "is that many people believe that it has to involve visible physical compulsion, such as hand-washing or counting or organizing things."
That's one reason most people with OCD are diagnosed much later than sooner. And though some people do not necessarily benefit from a specific diagnosis, almost everything in mental health relates to a spectrum, e.g:

 
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gooblax

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Then, what about other people with anxiety? Do you relate to them? Does reading about their experiences help?
I don't really feel like I relate to much of it. Like the whole "worry thoughts" thing just doesn't click with me. And my anxiety often comes outwardly more like irritability/anger than concern/fear so even that's wrong (although I definitely do the avoidance thing).
What do you base that conclusion on, @gooblax?
For one, my psych doesn't think I have it (not that I tell him every time the negative thoughts come up, but still I did mention that you guys had raised the possibility). And more importantly I don't think that I'm preoccupied with the thoughts for the most part. They come up, I either buy into them or don't pay attention, if I do pay attention then I'll probably get upset for awhile if I entertain the thought, then move on and not think about it for awhile again. I still agree with the thoughts, or an somewhere on the spectrum of agreeance. I'm not "worried that having dumb feelings makes me weak and pathetic"; I "know that having dumb feelings makes me weak and pathetic" and sometimes I will be upset by that because I think about what that means in terms of what I want and will never have. That just doesn't fit my understanding of OCD.
 

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I don't really feel like I relate to much of it. Like the whole "worry thoughts" thing just doesn't click with me. And my anxiety often comes outwardly more like irritability/anger than concern/fear so even that's wrong (although I definitely do the avoidance thing).

For one, my psych doesn't think I have it (not that I tell him every time the negative thoughts come up, but still I did mention that you guys had raised the possibility). And more importantly I don't think that I'm preoccupied with the thoughts for the most part. They come up, I either buy into them or don't pay attention, if I do pay attention then I'll probably get upset for awhile if I entertain the thought, then move on and not think about it for awhile again. I still agree with the thoughts, or an somewhere on the spectrum of agreeance. I'm not "worried that having dumb feelings makes me weak and pathetic"; I "know that having dumb feelings makes me weak and pathetic" and sometimes I will be upset by that because I think about what that means in terms of what I want and will never have. That just doesn't fit my understanding of OCD.

That sounds like the textbook definition of Pure "O" OCD to me. The fact that your therapist "doesn't think [you] have it" doesn't surprise me: Many therapists know little about it and tend to dismiss it unless there are obvious compulsive disorders, which is one of the main reasons that it is often misdiagnosed as "just" general anxiety.




 

Daniel

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One way of looking at the OCD spectrum is that less than an hour a day of symptoms is a mild case of OCD. Or "higher functioning" or whatever.

OTOH, people tend to rationalize their mental health symptoms -- even when in severe distress, e.g. "I wish I was dead because I'm a hopeless loser" (as opposed to accepting one's clinical depression). Even people who agree that they have OCD will often find it difficult to see a particular symptom, such as excessive guilt or guilt sensitivity, as simply part of their OCD. My own level of insight is quite variable -- even throughout the day.

I still agree with the thoughts, or an somewhere on the spectrum of agreeance. I'm not "worried that having dumb feelings makes me weak and pathetic"; I "know that having dumb feelings makes me weak and pathetic" and sometimes I will be upset by that because I think about what that means in terms of what I want and will never have. That just doesn't fit my understanding of OCD.

Also see "fear of self," which is "believed to be highly relevant in OCD and related disorders."
 
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David Baxter

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By the way, I'm also aware that Pure "O" OCD was removed by the APA in DSM V. I consider that to be a mistake, not the only one and neither the first nor the last the APA has made in various versions of the DSM. I may be cynical but I do sometimes think that the APA makes such decisions based more on what and how they want to treat disorders with pharmaceuticals instead of what is helpful for patients/clients and therapists in psychotherapy. The majority of psychiatrists do not even practice psychotherapy... they just write prescriptions.
 

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Indeed, I would say that his been the main lesson I have learned from the Zoom OCD group. Almost all of them have rumination as their primary or only "complaint."

What kills me with most therapists, including many psychologists with decades of experience, is their various levels of ignorance about OCD. Even though they "don't know what they don't know," they can get expert insights by binge watching Psychotherapy.net. They don't even have to read! :D

I think more people with OCD would become therapists themselves except for the fact that many, like myself, have hyper-responsibility or harm OCD. But at least there is the magic of the Internet to help people relate.
 
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gooblax

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I still don't see it.
I can think of circumstances where I could have obsessed about certain thoughts in a way that matches those descriptions, but I didn't have that problem.
 

Daniel

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I "know that having dumb feelings makes me weak and pathetic" and sometimes I will be upset by that because I think about what that means in terms of what I want and will never have.


There is another alternative. Create a gap and just watch how minds work...

In that gap, a freer life can be built.
 
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Daniel

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High self-acceptance and interdependence were associated with decreased mortality risk, controlling for other psychological components (purpose, positive relations, growth, mastery) and potential confounders.
 
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Daniel

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And my anxiety often comes outwardly more like irritability/anger than concern/fear so even that's wrong (although I definitely do the avoidance thing).


One small study found that 50% of patients with OCD experience anger attacks...

Some of the most common reasons for anger occurring in people with OCD may include:
  • Reactions to medication
  • Constant stress and anxiety
  • Frustration with living with OCD and its symptoms
  • Compulsions being interrupted or done incorrectly
Understandably, it can be extremely frustrating to feel a lack of control in life and to feel as if something terrible is always around the corner. This can lead to bouts of anger or rage that can be scary — both for the person experiencing it and their loved ones.
 
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David Baxter

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I still don't see it.
I can think of circumstances where I could have obsessed about certain thoughts in a way that matches those descriptions, but I didn't have that problem.

Even if you disagree with the label or diagnosis, like many (maybe most) mental health conditions it's a spectrum and the techniques and strategies for treating Pure O OCD may still be very helpful for you, beyond anything that simple CBD can do.

Try to find a copy of Brain Lock by Jeffrey Schwartz. With or without OCD, that will help you.
 

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