possible perfectionism ocd?

@NOCD Therapist - Stacy Q. what if my insurance doesn’t cover therapy and I cannot afford to pay for every session? $170 per session is expensive

@DillonLee - I understand that, I think the first step is to determine whether your insurance will pay and then work from there. NOCD offers payment plans, there is also some great resources on the IOCDF website. I know that NOCD works hard to get more and more insurances to cover the cost of treatment.

@NOCD Therapist - Stacy Q. for me, I’m not from America, but right now NOCD only covers insurances from America

@DillonLee - Oh I see. That is definitely a bit harder. Sometimes NOCD runs specials for people who are outside of the states. I would suggest that you call and talk directly to them and see if there is anything like this that is available. I honestly do not have all of the information on how that works. I do truly hope you can get into treatment as I know it can be so helpful. If not though, I would suggest some free resources, youtube has many specialists in OCD you can learn a great deal from (Nathan Peterson, Natasha Daniels, etc.) you can also watch lives with Dr. McGrath nightly.

@NOCD Therapist - Stacy Q. I have watched them and have done some ERP myself. I’m not sure if it worked, but I think it did. Right now, I am just experiencing the same intrusive thoughts everyday even though I don’t feel any anxiety from them. Do you have any advice on how to deal with this? Thanks

@DillonLee - Honestly if you are not experiencing distress any longer form the thoughts then that is a good sign the treatment has been working- the thoughts may be there awhile, but the more you refuse to engage with them they will likely become quieter and quieter, often people say they go away- but even if they don't completely go away- you can get to a point where they are background noise.

@NOCD Therapist - Stacy Q. for me, my thought just goes ‘if you didn’t do this, you would be enjoying life so much more right now’ and I just find it irritating that this thought pops up whenever im enjoying myself and makes me unable to enjoy myself anymore

@NOCD Therapist - Stacy Q. Hello, I have one last question. How do I deal with intrusive thoughts popping up to ruin things when I’m enjoying myself? Im worried that it will pop up whenever I’m on holiday or just having a moment of peace. Even if I don’t engage with them, I will subconsciously direct my attention towards it

@DillonLee - I think that the hard part is that yes they will likely pop up- and yes you are indirectly scanning for whatever reaction you are afraid of in a sense- the key is not to allow the obsessions to stop you from living your life. Enjoy what you can in each moment- and don't engage with the OCD- eventually OCD shrinks and you are able to do more and more.

@NOCD Therapist - Stacy Q. even when I’m not ruminating or having intrusive thoughts, my brain will sometimes just go ‘hey, you haven’t ruminated or had intrusive thoughts in a while! Good job!’ And then sometimes the intrusive thoughts will come back in. I don’t know how to stop this mental checking to see how long I went without having any thoughts. Any advice? Thanks a lot

@NOCD Therapist - Stacy Q. OCD recovery means you don’t have to do compulsions anymore right?

@cantstopthinking - Yes the goal of treatment is that you do not engage in compulsions- the thoughts may still pop in but you don't give them the attention that they want and you instead respond differently or not at all.

@NOCD Therapist - Stacy Q. Oh okay, I’m just kind of confused because some people said ocd recovery is getting obsessions and doing compulsions but just without the ‘disorder’ part, which doesn’t make sense to me

@NOCD Therapist - Stacy Q. recently I have been managing thoughts well until my mind started automatically saying ‘no!’ everytime that thought pops up. How do I stop this? I didn’t plan on responding to it but now my mind is responding by itself. I really need help

@NOCD Therapist - Stacy Q. or is OCD the one making my brain say ‘no!’ to get me to ruminate on why it’s doing that on its own?

@cantstopthinking - IWhen you have OCD, I think it is important to not give attention to the thought- in this case it sounds like it is- 'no'-the more you pay attention to it and engage with it- the more it will be there- let it be there and don't let it affect what you are doing in each moment

@NOCD Therapist - Stacy Q. I’m just afraid that the ‘no’ response to the thought is a compulsion which will make my intrusive thought more powerful when I was already managing it well by not responding. It’s not something that I can stop, my brain just automatically says ‘no’ whenever the thought comes up even though I dont want to respond to it

@NOCD Therapist - Stacy Q. i dont mean to bug you, but if the ‘no’ response to the thought might be a compulsion since I shouldn’t respond to it, then shouldnt I find a way to make my mind stop saying ‘no’ whenever the intrusive thought comes up? Or is it OCD itself thats saying ‘no’ to trick me into rumination and thinking the ‘no’ is a compulsion?

@cantstopthinking - I think another trick OCD will play is the 'what if this is a compulsion now?' Thats why I always advise to not get caught up in that- instead say something like 'yah maybe I have a new compulsion, maybe I don't- who knows' but I am going to live my life- I cannot help what pops into my head randomly. I think what you will notice is that the less attention you give it, the less you try to identify what it means the less it will be there.

@NOCD Therapist - Stacy Q. so I shouldn’t figure out why my mind is suddenly automatically saying ‘no’ to the intrusive thought and just live life right?

@cantstopthinking - exactly.

@NOCD Therapist - Stacy Q. thanks a lot! So I should try to live with the uncertainty that the ‘no’ response to the intrusive thoughts might be a compulsion and might make the intrusive thoughts worse, instead of trying to figure out how to stop my mind from saying ‘no’?

@NOCD Therapist - Stacy Q. you have been a great help for me since I can’t access therapy. Thanks

@NOCD Therapist - Stacy Q. what is an example of replacing a bad thought with a good thought for OCD?

@NOCD Therapist - Stacy Q. what if my brain also suddenly says ‘shut up! is that all you got ?’ to the thought? Should I treat it like how I treated the ‘No!’ and just let it be? I’ve heard that saying ‘is that all you’ve got?’ can make thoughts worse

@cantstopthinking - I think that any response that 'feels' like OCD wanting to neutralize the obsession can become a compulsion- however I also think that often times people with OCD can get obsessive about whether or not they are doing compulsions- I think in the case that you are describing I would suggest not engaging with the thoughts at all. They can be there and pop in automatically but don't try and figure out whether or not it is a compulsion in this instance.

@cantstopthinking - Thank you so much. I appreciate that.

@cantstopthinking - So let's say you think to yourself- I am a failure, I just ruined the whole day. Then you instantly feel anxious or distressed, so you then say to yourself- this is a great day, no one can ruin it. But you do this in a compulsive manner- for example if you don't say the phrase right after then you feel distressed. make sense? In other words it's typically a phrase that one feels they need to say in order move on, neutralize or make something untrue.

@NOCD Therapist - Stacy Q. what if my brain says something like ‘no!’ to the intrusive thought and then I say ‘cool, love this thought’ to the intrusive thought to show my brain that I don’t care. Does that also count as neutralizing the ‘no’?

@NOCD Therapist - Stacy Q. because when I say ‘cool, love this thought’ I assume it’s a non-engagement response as well

@NOCD Therapist - Stacy Q. but doesn’t saying to yourself ‘I’m a failure’ count as negative self-talk? I heard that you are suppose to challenge negative self-talk

@cantstopthinking - This was just a example- I do think that challenging negative self-talk is appropriate, but what I am getting at is that with OCD if you are saying anything to combat a intrusive thought, due to a sense of urgency or immediacy or to relieve distress or anxiety then it is a red flag that it could be a compulsion. In these cases a better response would be none at all-non-engagement.