I have severe hit and run OCD. not sure who is on this app but wanted to connect with other people with OCD. I always worry I hit someone while driving and have to go back to check and make sure there’s no one on the ground. Anyone else out there dealing with this?

Hope you are doing ok. Any advice or encouragement is appreciated. I am in ERP treatment for ocd but struggling with depression as well. thanks for the reply

mind. ‘Real-life’exposure and response prevention Jack’s experience of doing real-life exposure is a good example of ‘It’s not what you do, it’s the way that you do it’. You see, several of the safety behaviors he used while driving were quite subtle –undetectable to anyone observing him unless they knew what to look for. At first, Jack became quite frustrated when he learned that he would have to practice a different way of driving in order to overcome the obsessions related to it. He thought, ‘I’ve done lots of driving and all that’s happened is that my obsessions have got worse. I just can’t see how driving more will help.’After thinking more carefully, he realized it wasn’t just more driving he needed to do to overcome his OCD; he had to drive differently. He practiced driving ‘as if’he were his twin brother who did not worry excessively about harming a cyclist. This meant resisting the urge to give cyclists an unnecessarily wide berth, resisting checking in his rear-view mirror after passing a cyclist, and resisting the temptation to retrace his car journey if he did experience anxiety about hitting someone. He also became aware that he was listening carefully as he drove for anything that might sound like a collision, and that he was scanning the road ahead for cyclists. All these are ‘safety-seeking behaviors’and are counterproductive, because at times they can be dangerous (like giving an extra-wide berth to a cyclist and nearly colliding with oncoming traffic, or not focusing enough on the road ahead). Safety-seeking behaviors also prevented Jack from testing out his Theory B, as each time he carried out a safety-seeking behavior he believed that he had had a close shave and might have killed a cyclist had he not taken evasive action.

I used to, yes.

Like so many other people who have OCD, at the heart of Jack’s obsessions was the meaning he attached to his intrusive thoughts. Before treatment, Jack was basing his interpretation on the assumption that he was a careless and bad driver, and so had to try very hard to prevent harm occurring to vulnerable cyclists. We label this as Theory A. The solution to Theory A seemed to work, because so far as he knew he had not harmed any cyclists. Theory B provided an alternative explanation: namely, that Jack’s problem was worrying excessively about harming a cyclist, and that by trying too hard to solve it as a careless driver problem he was making his worries worse. His problems were, therefore, being maintained by the meaning that he attached to the thought of a cyclist being run over and the way he had responded to this image in his avoidance and safety behaviors. He believed that the thought of killing a cyclist must have some relevance, otherwise it would not pop into his head, and that it was a warning to him to be more careful. He found the intrusive thought ‘Kill. Go on Jack, do it’even more upsetting, interpreting it as a sign that he was a ‘dangerous murderer’and that he must control his behavior. With encouragement, Jack began to entertain the alternative explanation that he was in fact a very responsible person who had become excessively worried about causing harm to a vulnerable cyclist. Jack collected evidence supporting this theory by looking at a specific episode in which he felt his car bump (see Figure 4.2). As we can see from the ‘vicious flower’diagram (Figure 4.2), his problem was driven by the way he interpreted his intrusive thoughts. He misunderstood these thoughts to mean that he was a dangerous and bad person; his solution was to be overcautious and to seek reassurance, which only served to feed his beliefs about being bad so that they became self-perpetuating.

Imaginal exposure Jack was quite right to be unsure of the advice of the therapist who had taught him to say ‘Stop!’and to transform his thought into ‘Kill your speed’. In Chapter 2 we showed how trying to suppress or neutralize intrusive thoughts will only increase their frequency. It is important to stop mental rituals; but the inexperienced therapist had just taught Jack to suppress the thought and to adopt a type of neutralizing by trying to transform it. It would have been more helpful to do the opposite of what the therapist had advocated, and to ask Jack to imagine a scenario in which he deliberately ran over a cyclist. Initially, Jack was very unsure about deliberately imagining hurting someone, because he thought it was a callous and uncaring thing to do. However, he later decided that it was a reasonable way to test out Theory B. Because he was not actually hurting anyone, and he was so concerned about the effect his OCD was having on him, he felt it was worth doing something ‘abnormal’to tackle the problem. So, for around forty-five minutes a day for two weeks, Jack deliberately imagined himself hitting a cyclist in his car. He conjured up a picture of the body lying on the road covered in blood, and followed that by a scene in which the police arrived to arrest him. At first Jack wrote the scenario out in detail in order to help himself focus on it. During the exposure he tried to keep the imagery as vivid as he could; he also tried to draw the scene. He found it helpful to think of this as ‘taking the horror out’of the mental picture, not belittling the event should it ever happen. As he persevered, Jack found that his distress reduced when he practiced holding the image in his mind and not responding to it. If he did experience any spontaneous intrusive images he found that his discomfort began to reduce as he increasingly practiced keeping the image in his mind.

Before starting to overcome his OCD, Jack believed that if he did accidentally kill a cyclist it would be entirely his fault: that is, he thought he would be 100 per cent responsible. As part of developing a more helpful way of thinking about accidentally knocking down a cyclist in the road, Jack developed a responsibility pie chart (Figure 4.3). He listed all the factors that might contribute to such an accident, and placed himself last on the list. He then divided a circle into segments that roughly represented the level of responsibility for each contributing factor. The list of possible contributing factors he developed included: Figure 4.3 Jack’s ‘responsibility pie chart’•   the road being poorly lit if it was dark; •   the cyclist not using lights or bright clothing, making it difficult to see him; •   the road being bumpy or uneven, causing the cyclist to swerve unpredictably; •   other road users parking badly or driving badly, causing Jack or the cyclist to swerve, or leading Jack to be distracted; •   the cyclist not taking proper care or not paying attention; •   bad weather, leading to skidding or poor visibility; •   Jack not driving with proper care or attention Jack found that working through the responsibility pie chart helped him to ‘really’see that it was very unlikely that accidentally killing a pedestrian would be his fault entirely. He concluded that, although it made sense to take some safety measures such as having his car maintained, being aware of other road users, and not driving excessively fast, he had really been overdoing his ‘precautions’.

Developing an appropriate sense of responsibility As we have seen already, a central theme in many people’s OCD is a fear of being responsible for harm coming to either themselves or others (indeed, the two can overlap). Here we focus on the fear of causing harm to someone else, commonly someone that we perceive as being vulnerable. Two key demands that people with this kind of OCD tend to make are ‘I must be sure that I don’t to something that will cause harm’(such as accidentally knocking someone down a flight of stairs) and ‘I must be sure that I don’t fail to do something that might protect someone from harm’. Whereas most people will try to live somewhere within the spirit of these ideals, individuals with OCD will tend to try to follow them to the letter as prescriptions –at least in a specific aspect of the world about which they have had an intrusive thought. The attitude to adopt in order to overcome this form of OCD is to assume an appropriate, flexible, and non-extreme level of social responsibility. The balance to strike is attending to the protection of others on the one hand, while on the other allowing yourself the usual rights to a life that is not plagued by anxiety and guilt. Jack ultimately concluded that he could allow himself to be free of his excessive concern about hitting a cyclist with his car when he considered the following practical points: •   The precautions he was taking would reduce the chance of his having an accident by only a tiny amount. •   OCD was not the most effective way of living according to his wishes to be a ‘decent’person, and was in fact preventing him from making the best contributions to society of which he was capable. •   His OCD was itself causing harm to both himself and his family (distress, worry). •   Giving up obsessional excessive concern was not proof of lack of caring, just proof of the need to tolerate a small degree of risk in order to function in the real world –just like everyone else!

Thank you for the detailed information

Your goals •   accept intrusive thoughts and images of killing a cyclist as a normal human experience without responding to them in any way; •   drive the way he used to drive before he had OCD, without excessive safety behaviors; •   stop retracing his journey, phoning the police, conducting mental reviews, and seeking reassurance at the end of his journey.

The best $5 you'll ever spent. book – "The Complete Guide to Overcoming OCD: (ebook bundle) (Overcoming Books)" by David Veale, Rob Willson.

I have been stuck in it for a few years but now I am working on it .