AMA (Ask Me Anything) event

@Jcfern30 We sit in uncertainty. We don’t try to figure it out. We remember that there is no ”perfect” way to do ERP or exposures. If the question comes up, say “maybe/maybe not” and do the exposure anyway 🙂

@Dannyk When we say things like “OCD content doesn’t matter” what we mean is that the content/theme itself does not mean anything more than describing how OCD is bothering you in this moment. All OCD themes are treated the same way, with ERP. There is no theme that is “worse” than another theme, they all suck and they are all just OCD dressed in different themes

@Anonymous Hi, I’m so sorry this is happening to your son. Unfortunately, I cannot offer specific help as I don’t know exactly what your son is dealing with. If he has OCD, get him into some Exposure Response Prevention therapy as it is the gold standard treatment for OCD.

@Anonymous Compulsions are the mental or physical rituals/behaviors that we do in response to obsessional fears, in making an attempt to neutralize them or escape the fear/anxiety. Compulsions are not technically anyone’s fault. When you do ERP, you learn that you CAN gain control over compulsions and make an active choice not to engage in them.

@MyStarlight Getting adequate sleep, eating/staying hydrated, basically doing self-care is a great place to start when dealing with any mental health disorder. Stress, illness, major life events/changes, hormones, and compulsions, all can make OCD symptoms flare-up more than usual.

@Anonymous Yes, many people have OCD but don’t get a proper assessment/diagnosis. Traumatic events can certainly have some part in it, but not necessarily a guaranteed way to get OCD.

@Crook Compulsions feed OCD by making us get stuck in doing these compulsions when obsessional fears are triggered. When we face our fears and stop compulsing, our brains learn that we don’t have to be afraid and don’t have to compulse, and over time, the OCD symptoms lessen and become more manageable

@NOCD Therapist - Tracie I. Thank you for the response

@Anonymous It can take time to “come back to actual reality” if you will, when we have spent a good portion of time compulsing and believing intrusive thoughts such as those about a relationship. We show up in our relationship allowing our core values to guide us in how we navigate our relationship. Living with some discomfort and uncertainty is part of the work we do as people with OCD. It gets easier with practice and time.

@Anonymous I hear that, and totally get that real world problems can affect us in so many different ways. Unfortunately, ERP can’t change politics, it can only help us learn how to manage through OCD and anxiety.

@Anonymous Sounds a lot like False Memory or Real Event OCD where we compulsively try to figure out what happened/didn’t happen. One unfortunate part of this compulsion is that it ends up doing the opposite of what you want it to do. Instead of gaining clarity, you get more and more uncertain and can even end up creating false memories. The best thing to do with the past is leave it in the past. Sit with the uncertainty. Yesterday is history, tomorrow is a mystery.

@NOCD Therapist - Tracie I. Thank you I appreciate that leave the past in the past

@LW18! I’ve fully recovered from emetophobia and used to struggle with it a ton. After years of therapy, it finally clicked with me when my therapist asked “what’s the worst that could happen if you puke in public?” I would always go to the humiliation part and he said “and?” I really sat with that and was able to get over it in time. There were times I worked myself up so much that I puked in front of others afterwards and realized it wasn’t that bad. It just was what it was and I survived it! Now, I don’t worry about it and know if it happens, it’s a normal bodily function. Easier said than done but this is something I haven’t dealt with in years so there’s hope!!

@LW18! Yes! ERP treats Emetophobia and I have treated it successfully many times over the past 20 years 🙂

@zsully I love this!

@Anonymous2008#kind I have had this in and off. I just let it be there and go on with my day. Not trying to get rid of it, not trying to figure out what it means, just leaving it be and coexisting with it.

@wmorris93 OCD is the doubting disorder. It makes you question everything, including whether or not you are faking it. The facts remain, cutting compulsions = less OCD symptom severity.

@Rita D. Sounds exactly like OCD to me. People with Schizophrenia don’t question their symptoms. ERP is the way out of this trap.

Not sure if this is your case, but I would imagine that testing yourself for ethics/morals could be a compulsion? Especially if it's your theme, but better to discuss further with an OCD therapist

@misereri Groinal response, otherwise known as feelings or reactions in your genital region, are something that can happen to people with OCD and cause a lot of confusion and fear. A common compulsion is using groinal response as a “test” to see if something is “true” or if you “really” do like/not like something. This is a compulsion and not an actual true test of feelings or anything else. Groinal response is something that can be related to something called ANC, Arousal Non-Concordance, which basically means that your bodily reactions do not necessarily match/represent what you really feel/like/agree with. My suggestion is to stop this “testing” compulsion. 🙂

@NOCD Therapist - Tracie I. What if I think I'm gonna react positively?

@Anonymous This is it! Ask away and I’ll answer here.

@NOCD Therapist - Tracie I. Oh the NOCD team told me it was live video of you answering the questions

@mitchw I used to be years ago. I am not now. I use 100% ERP to stay well. Many people find being on medication and using ERP together is helpful. We are all different and have different chemical makeups, so we all have to do what works best for us 🙂

@Andy_mae This is not a question I can answer, sorry

@Anonymousc PTSD is often treated with Prolonged Exposure that teaches you how to face those triggers and manage through the discomfort. OCD often latches on to traumas. I always face my fears, avoidance can be a compulsion. Always best to work with a Therapist who can assist with the best path forward for you individually

@User947383 Is having vivid dreams a part of ocd? How about if you remember them for years ?

@User947383 Yes! This is something I have posted about on my Instagram @tabootracie many times. OCD lives in our brain. It can show up anytime when we are awake or asleep. We do not try to figure out whether something is a dream or a memory, we simply wake up, realize we had a disturbing dream, get out of bed, and leave it be. Let it sit there as a maybe/maybe not, and go on with your day. Otherwise you will spend your morning compulsively trying to figure it out and making OCD symptoms worse, and in fact, you will not figure it out.

@TapDrumRoll I never heard of this before . What’s a sniffing tic ?

@Yazzz Tics are sudden uncontrollable body jerks that are usually part of Tourette’s. Head jerks, sniffing, blinking, smiling, snapping fingers, clapping even vocal ones like yelling, humming and more. You should google it. Many times it’s livable but some interfere with everyday life.

@TapDrumRoll ERP for sure! Learning how to tolerate the discomfort that is triggered and sets it off is the main goal. Using non-engagement responses to get through that discomfort is key!

@HSOCD #1 recommendation is literally stop 🛑 checking at all. Checking does not actually give you REAL information, it is just a compulsion that makes you feel worse and worse and more confused. We can control checking because it is a behavior. 🙂

@NancyT I’m so sorry to hear that. It’s so unfortunate that so many people continue to suffer. Some places do offer Medicaid covered services for higher levels of care that you may want to check with including www.charliehealth.com and if for some reason they can’t provide services, they do provide resources and referrals. Best of luck with that 🙂

@Anonymous It’s so difficult dealing with OCD because the intrusive content feels real and disturbing. The fact is, we give it power when we decide it has true meaning, and start compulsively trying to seek a solution. When we stop engaging in compulsions and seeking certainty, the intrusive content will feel less and less important and won’t feel as triggering/distressing.

@Crook We do not have control over wishing our intrusive thoughts would go away. I’m pretty sure everyone with OCD wishes that. We also do not have to do anything specific to accept uncertainty. I love telling people this fact: We do not have to accept uncertainty, because uncertainty is the reality of most things in life, whether or not we accept it 🙃

@NOCD Therapist - Tracie I. Ok, I have been hung up on this part of my treatment for awhile. I will try to remember this.

@Lilly2442! You don’t scream and you continue to go out and live your life. You don’t give in to it even if it causes anxiety, you just feel the anxiety and move on with your day. That is pretty much ERP. Tell yourself “maybe I will scream, maybe I won’t” and continue on living. Soon it was get less and less and you won’t have those thoughts as much anymore.

@Emma34 Thank you so much for your comment but I’ve been struggling with this thought for 4 years now and I still think I’ll eventually lose control of myself and just say horrible things and it just causes so much anxiety and I have no desire to scream at all I’m just so scared I will. It’s so exhausting and I do ERP eveeeyday but the anxiety that comes with the thought is so so exhausting and overwhelming

@Lilly2442! I posted about this exact thing on my Instagram @tabootracie recently. Intrusive urges are what makes us feel like we might do something like scream or freak out. Something called thought-action fusion (TAF) is where people with OCD think that having an intrusive thought/image/urge/feeling is going to make us actually do that thing. But we are not puppets and have control over our body, such as screaming. When this happens to me on airplanes or in quiet theaters, I sit with the discomfort and the thoughts and urges and say “yep, totally could happen, I guess we will find out” and of course, it never has happened 🙃

@Lilly2442! I have this with my OCD as well. See my comment above where I explain how thought-action fusion (TAF) tricks people into thinking they will do something just because they feel the intrusive urge, or have the intrusive thought/image.

@Orca I’m sorry you and your family are suffering as a result of OCD. This comes up a lot. I also have this OCD theme. Getting help for your OCD is the first step. Learning how to stop all of those cleaning/contamination rituals so that you can live your life and your family can live theirs, is the way to manage this situation. When our family members do compulsions we ask them to do because of our OCD fears, it actually makes our OCD worse. I hope you get the help that you need so you can all heal as a family 🙂

@Orca See my answer to the question right above yours. Much of that answer applies here. OCD is invisible so it’s hard to imagine for other people, why we do the things we do. The more people around us accommodate our OCD, the worse our OCD gets, and with time, it demands more and more of us and those around us. It’s so difficult, I totally understand why it feels unfair.

@Anonymous All of the same things apply across all themes of OCD. In short, sitting with uncertainty, not trying to figure things out that don’t actually have a 100% certain answer, and not seeking reassurance from our partner, not confessing our intrusive thoughts to our partner. NOCD has some great blogs on ROCD and so does Kimberly Quinlan on her website

@Orca Yes! Guilt and shame are very common in OCD, but we NEVER deserve to feel bad about having a mental illness and how it affects us or our loved ones. There is a fabulous workbook called The Self-Compassion With OCD Workbook by Kimberly Quinlan that I highly recommend when suffering with guilt and shame over OCD. You deserve self-compassion and self-kindness, we all do. Having OCD sucks and is exhausting.

@Anonymous We do the same ERP skills we use outside of work. For instance, I sometimes get thoughts that I will suddenly yell out insults to my boss, or say something really offensive about someone important to him. I just let the discomfort/anxiety and possibility sit there, and do my best to focus on what I need to do at work.

@Anonymous12345** It sounds like you are “evaluating” if you like them or not. Just let them be there.

@Anonymous12345** It is common in OCD, yes. And it is a compulsion to try to “figure it out”

@btwerling Honestly, all OCD themes are best treated with ERP. Existential OCD makes you try to find meanings and purpose where there are not 100% certain/factual answers. Most things are actually uncertainty and unanswerable, and this is true of all existential questions

@NOCD Therapist - Tracie I. Thank you! Do you happen to have advice on support from afar?

@AnonymousAlly Response Prevention Messages are when we take an obsessional fear and turn it into an uncertainty statement, such as: “I may or may not harm my cat, I will have to wait and see”. Non-Engagement Responses are ways to respond to intrusive content by disengaging from it, so not labeling it as “bad” or “good” and just allowing it to exist, without trying to figure it out or anything, just acknowledging that it is present.

@NOCD Therapist - Tracie I. Thank you! I feel like I’ve got a good handle (well as good of a handle as one can have) in RPMs when working though my exposure list. I’ve just really been struggling with using NERs when an intrusive thought passes my mind. I feel the immediate need to engage with the thought. Maybe even try to figure it out! Thanks this info is helpful though!

@wmorris93 Awww thanks! OCD makes us question what is real and not real and always has endless intrusive doubt for everything you care about. Your values cannot be changed by OCD, but it will make you question it endlessly. Allow your values to guide you.

@Anonymous Don’t listen to any of them! Live by your values, not your fears/doubts

@mitchw Yes! Compulsive online researching is the worst! Don’t do it

@Jacob A. Sending them factual articles is one way to help educate. NOCD and IOCDF have great info that can be shared with family and loved ones. Unfortunately, not everyone will be understanding or supportive, especially if they grew up in a culture where mental illness is not validated or supported.