Hey everyone. Just watched a YouTube clip from NOCD and it became clear that ERP appears to be best when your ocd is centered around a theme. Ie germs etc. one thing, not many things The struggle with pure O is that it’s not just one thing, it can be ALL things Is there hope for pure O with ERP ? Love to hear the group’s thoughts
I don't have pure o. I don't know a ton about it. Do you have mental rituals or avoidances?
It’s like wak a mole
I understand the confusion. There really is no clinical difference between any of the themes, and "Pure O" isn't really a theme to begin with. It's just a label used when the compulsions are largely mental rather than physical. I think this app confuses things a bit by putting "Pure O" in the same category as the other themes. I would suggest recognizing that all of these "themes" are nothing but labels placed on top of the same underlying disorder: OCD. Regardless of whether the content of the intrusive thoughts stay mostly the same, or change every 5 minutes, the driving force behind all of this madness is the compulsive need to gain 100% certainty and avoid any uncomfortable feelings. The purpose of ERP is to learn to sit with those uncomfortable feelings in a strategic way, without doing any compulsions. It's trickier with "Pure O" because mental compulsions can be more difficult to pin down. But a good ERP therapist would help you learn when you are ruminating, mentally checking, worrying, problem solving, etc. It doesn't matter if the topic of your intrusive thoughts remains the same, or changes every 5 minutes. Once you learn to recognize your compulsions, you can start making progress. At the end of the day, all of the therapeutic approaches for OCD focus on one ultimate goal: learning to be with the present moment despite the intrusive thoughts and uncomfortable feelings. It's our resistance to those things that keeps us trapped in the cycle.
@djflorio Sure… but if say ice is cleaning based it’s a lot more simple (respectfully) to train the patient to get more and more comfortable with less clean spaces as an example. So what would the process or framework look like for pure o, that to your point, changes all the time! But there is a lot of checking, googling, reassurance etc etc etc
@JMFH - The foundational framework for ERP is to notice when you want to do a compulsion, prevent yourself from doing it (to the best of your ability), and then allow yourself to feel the anxiety in a mindful way. The first step to any of this is to start becoming more aware of when you are doing compulsions. As you develop that skill, it won't matter what the theme of the day, hour, or minute is. All you need to know is whether or not you are compulsively trying to get rid of some uncomfortable feeling. That's enough to do ERP. So my suggestion is to start by noticing when you're ruminating, googling, worrying, etc. You may not realize it until you're in the middle of doing it (or even after you've done it), which is perfectly fine. *When* you realize you're doing some compulsively, simply acknowledge it. Take about 10-15 seconds to savor the fact that you've recognized a compulsion. As you get better with that, you'll start to develop a sense of what to do in the presence of a trigger. You'll be able to answer the questions, "what feeling am I trying to avoid right now?" and "how am I trying to avoid it?" Maybe you'll catch yourself googling symptoms of schizophrenia. You'll know, "ok, the idea of schizophrenia is making me very anxious, and I'm trying to get rid of that anxiety by googling." In this case, you'll know that the ERP move is to stop the googling, and allow yourself to feel the anxiety and uncertainty around it. Or maybe you'll catch yourself reviewing something you said to your friend over-and-over again. "Ok, I'm anxious that I said something dumb to my friend, and I'm trying to get rid of that anxiety by reviewing the conversation." In this case, you'll know that the ERP move is to think, "maybe I said something dumb, maybe I didn't," and direct your attention to something in the present moment while allowing the anxiety to be there. Think of ERP like a tool. Once you learn how to use the tool, you'll know how to apply it in any situation. When I know that I've been triggered, and it's not obvious to me what the obsessions or the compulsions are, I like to pause for 5 seconds and think, "what is it that I'm trying to avoid right now?" You can go pretty far with that question. Hope this helps!
@djflorio Thank you!
Been struggling with existential OCD lately. Very hard to describe the thoughts/feelings, but it is a constant feeling of being stuck in my head. Like what is consciousness and where do I think from? Like I think it’s OCD, maybe it is maybe it isn’t. But if it is, what would be good ERP exercises? Just existing (lol)? And what would be my response prevention? I’m not even sure what mental compulsions I may be doing.
I had just posted a summary of ERP for a group member, and I thought it might be useful for everybody. Here it is below (with a little extra added)…. ERP therapy is researched-based. Most other therapies don’t work. There have been people who have been literally stuck in their houses (from their OCD) who gained their lives back through ERP therapy. NOCD does ERP therapy exclusively. You can find it in other places too, but you have to ask around. There are two tenants of ERP therapy: The first one has to do with the repetitive thoughts inside our heads. These thoughts are actually defined as “obsessions”. You are not supposed to do anything with the obsessions. You are supposed to let them run through your head freely, without trying to fix them or stop them. Imagine a tree planted by a river. The leaves fall off and float down the river. You can see the leaves falling, but you don’t try to stop them or pick them up. You don’t try to fix them. You just let them float away. This is really important to do with your obsessive thoughts. The more you try to fight them off, the worse they get. I used to have blasphemous sentences running in my head 24/7. I felt like I had to put a “not” next to each sentence in order to “fix” it. But this just took hours of my time every day, and it was very scary, because I was worried that if I messed up, that I would go to hell. It was very freeing to learn later that I could just let those sentences run freely through my head without trying to fix them. The second part of ERP therapy is all about “denying your compulsions.” Every time OCD tells you that if you don’t do things a certain way that something really bad will happen, that is a compulsion. Once you recognize what your compulsions are, ERP therapy will have you practice stopping doing all of those things. For some people, that will mean stopping washing their hands or touching lights switches or, in my case, putting “fixing” words in their head. Compulsions are safety behaviors. During ERP therapy, you will practice stopping engaging with safety behaviors. All this is very hard to do and scary, so during therapy you will be given tools to help you deal with the fear. Often ERP therapy will take people from being non-functional to functional. I highly recommend it. ————————————————- PITFALL #1: After you have been doing ERP for a while and become somewhat successful, the OCD will try subtle little tricks to bring you down again. The first one is to tell you that your thoughts are REAL and not OCD, and therefore you can’t apply ERP therapy. Don’t fall for this trick! All thoughts are just thoughts. They are all meaningless. Don’t try to figure out what is real and what is OCD. Just treat all thoughts with ERP therapy. PITFALL #2: The second pitfall is that OCD will tell you that you can’t move forward unless you have absolute certainty that you will be safe. Hate to tell you this, folks, but there is no certainty in life. You will never know for SURE that you or your loved ones will be “safe” from the OCD rules. Therefore, you have to move forward in the uncertainty. It’s hard, but it gets easier with time and practice. We got this, guys !!!!!!
I'm trying to get my head around ERP. What is the best way to describe how it's a "solution." Imo I think OCD happens with people who are very concerned with their own genuine integrity and probably their own "morality." So when something (like an uncomfortable "real event" that actually happened) messes that up, it's hard to grapple with that...hence the endless rumination and trying to "problem solve" it. But the mind doesn't let you sleep (i.e. OCD) if something is controversial and doesn't sit with you. Or if you obsess over something and it's based on a rooted fear. You just can't "let it go," it has to be addressed and dealt with. But what happens when it is NEVER dealt with? How does ERP address that dilemma as a permanent solution? Or does ERP only address compulsions and anxiety, but it doesn't actually deal with the issue causing it. Do you ever get REAL peace of mind? Or is just something to make you feel "less anxious" etc? Thanks I just want peace of mind. I haven't had true peace of mind in several years.
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