Ten Things You Need To Know To Overcome OCD

[Retired]

Ten Things You Need To Know To Overcome OCD
By Fred Penzel, Ph.D

Because of the length of this excellent and insightful article into some of the realities of OCD, the entire article is attached as a file for download / viewing / printing.

Here is an excerpt:

Some of these points may seem obvious, but it has always struck me as remarkable how little of this information my new patients, who are otherwise intelligent and informed people, are seen to possess coming into therapy.

You may not like some of the things on this list, as they may not be what you wish to hear. You don't have to like them. However, if you wish to change, you will need to accept them. The concepts of change and acceptance go hand-in-hand, and define each other. There are some things you will be able to change, and some you will have to accept. It is important to discriminate between the two, so as to not end up misdirecting your efforts.

1. OCD is chronic.

2. Two of OCD's main features are doubt and guilt.

3. Although you can resist performing a compulsion, you cannot refuse to think an obsessive thought.

4. Cognitive/Behavioral Therapy is the best form of treatment for OCD.

5. While medication is a help, it is not a complete treatment in itself.

6. You cannot and should not depend upon the help of others to manage your anxiety or to get well.

7. The goal of any good treatment is to teach you to become your own therapist.

8. You cannot rely upon your own intuition in deciding how to deal with OCD.

9. Getting recovered takes time.

10. Relapse is a potential risk that must be guarded against.

Each point is elaborated on in the complete attached article

Also attached is an overview article titled "The Different Types of OCD" from OCD-UK.org

 

[Daniel E.]

Intense Fear Of Guilt May Be At The Heart Of Obsessive-Compulsive Disorder | HuffPost

...Cognitive behavioral therapy is currently the most effective treatment for OCD. Melli suggests that therapists with patients who may have high guilt sensitivity should help them focus on strategies for challenging their feelings of excessive responsibility to others and cultivating a greater acceptance of guilt.

“When checking rituals are primarily involved,” he said, “cognitive behavioral therapists should target also beliefs concerning the intolerability and dangerousness of experiencing guilt.”

 

[Daniel E.]

Real Event OCD

...OCD sufferers engage in cognitive distortions, where the human mind frames life situations in irrational and exaggerated ways. ‘All or nothing thinking’ is a form of perfectionism where a person views situations in two extremes rather than on a continuum. The problem with this form of thinking is that you must be perfect or you are unacceptable. Even a small mistake puts you in a ‘bad’ category with killers, rapists and pedophiles. Without recognition of the ‘all or nothing’ distortion, an OCD sufferer will engage in mental and physical compulsions to ensure they are a good person and experience an urgent need to disprove they are bad...

 

[Daniel E.]

Table 3.13, DSM-IV to DSM-5 Obsessive-Compulsive Disorder Comparison - Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health - NCBI Bookshelf

With good or fair insight: The individual recognizes that obsessive-compulsive beliefs are definitely or probably not true or that they may or may not be true.

With poor insight: The individual thinks obsessive-compulsive disorder beliefs are probably true.

With absent insight/delusional beliefs: The individual is completely convinced that obsessive-compulsive disorder beliefs are true.

 

[Daniel E.]

Obsessive Compulsive-Disorder Overview

Obsessive-compulsive disorder (OCD) is a mental disorder in which people experience disruptive obsessions and compulsions. Learn more about OCD.

www.verywellmind.com

Insight also pertains to how a person views OCD in their day-to-day life. Someone with OCD may recognize the irrationality of their obsessions and compulsions but fail to understand or acknowledge that OCD has affected their ability to function...

While there is some disagreement, poor or absent insight into OCD symptoms is thought to predict a worse response to psychological and medical treatments.

Poor or absent insight can make it harder for someone with OCD to feel motivated, do the hard work that therapy requires, or stick to taking medication (especially if there are unpleasant side effects).

People with poor insight may also be less likely to attend regular appointments or contact a healthcare provider at all...

Insight into OCD symptoms and the effect they have on functioning can also change after treatment with psychotherapy or medication. However, these changes usually occur slowly and can also fluctuate over time.

 

[Daniel E.]

Are You “Terminally Unique”? — Keith Woythaler, Psychologist, PC

I hope not. Let me explain. I believe we are all unique in our own way, whether it’s our interests and hobbies, the music we listen to, the way we dress and style our hair, etc., and I fully support individuality - it’s the spice to life that often keeps things interestin

southnassaucbt.com

I wish this was a rare phenomenon; however, over the years, I have met many people who felt that their OCD, depression, etc. was so different or so much more severe than anyone else, that they felt treatment was not going to work for them - spending time and energy trying to convince others around them (myself included) that their condition was unique beyond help…If they were to funnel that same time and energy into treatment itself, very often, success and progress can be the result.

Not only is someone who deems themselves terminally unique less likely to seek treatment or actively engage in it even if they are actually in treatment, but they are also less likely to seek the support of those around them (family, friends, etc.), including others with the same condition, because even people with the same diagnosis “are nothing like me”...

You are NOT so different that no one could possibly understand the pain and difficulties that you live with; you might have a relatively unique set of life circumstances, but your issues are more common than you could imagine.

 

[Daniel E.]

Obsessive-compulsive disorder differential diagnosis - wikidoc

www.wikidoc.org

Untreated OCD is often regarded as one of the most vexing and frustrating of the major anxiety disorders because sufferers are consciously aware of their irrationality but powerless to push it away. Most OCD sufferers will hide their behaviors from others to avoid negative attention because they understand the abnormal nature of their compulsions. This, combined with the fact that the compulsions in some sufferers are entirely mental, has earned the disease the moniker "the secret illness."

 

[Daniel E.]

Toward Understanding the Heterogeneity in OCD: Evidence from narratives in adult patients - PMC

Current attempts at understanding the heterogeneity in OCD have relied on quantitative methods. The results of such work point towards a dimensional structure for OCD. Existing qualitative work in OCD has focused on understanding specific aspects of ...

www.ncbi.nlm.nih.gov

Our most significant novel finding is that individuals with OCD vary in their ability to utilize execution of their compulsions as a coping mechanism for anxiety from other sources. Our data suggest a spectrum of experiences, ranging from participants who would actively seek out OCD triggers to cope with stress and generalized anxiety, to those who found that their OCD had no value in this regard.

If replicated, such a finding could have implications for psychotherapeutic approaches to OCD, as patients who have found adaptive uses for their OCD may be less motivated for challenging therapies that have the potential to increase anxiety in the short term.

In addition, this finding highlights how illness behaviors may take on changing significance and instrumental function over time, in a way not well captured by usual conceptions of signs and symptoms in this disorder.

 

[Daniel E.]

OCD Tips #4: Motivation – Why does it lag and what can I do about it? - The Cognitive Behavior Therapy Center of Southern California

(Part four of a continuing series by the Cognitive Behavior Therapy Center of Southern California’s OCD experts) We come to therapy for OCD (Obsessive Compulsive Disorder) because we are in PAIN. We come to therapy when what we have been doing to try to contain our fears isn’t working and we...

cbtsocal.com

If we are only motivated by our pain, as it diminishes, so does our motivation to continue the rest of the way to root out the OCD. It’s ironic, but common, that as we feel better to have the therapy stall a bit.

What are we to do about this? As we can see, it’s not enough to be “pushed” by our pain, we must be “pulled” by something too...