- User type
- Therapist
- Date posted
- 5y
I find separating triggers and thoughts easy enough, but separating obsessions from compulsions more difficult, especially when your compulsions are things like mental rumination.
Thank you for your input. It is much appreciated! I agree that the obsessive thought tends to run right into the compulsion. It’s hard to slow down enough to catch these things isn’t it!
For me at least, sometimes when you have mental compulsions, it almost feels like there is an “automatic transition” from obsession to compulsion. What I do is this, when that happens: 1) I first identify that I just did a mental compulsion (mental compulsions is when I purposely try to push my thoughts out of my head by reassuring myself, reviewing past events, etc) 2) then after I identify the mental compulsion, I accept the thought saying “maybe this (insert thought) is true, I’ll accept the uncertainty”. This gives me an opportunity to practice response prevention in the moment.
@NOCD Advocate - Stephen Smith By practicing response prevention after I did the compulsion, I look at this as a “retry”
I like the “retry”! Thank you for breaking that down too. That’s very helpful!
My compulsions are physical (i.e. touching the stove to ensure it's off). I already know hours in advance that I will start becoming anxious at a specific time of the day and will start doing compulsions. Once I start a compulsion, it is very difficult for me to stop because I know I'm letting my emotions overtake my logical thinking. I have to stop and think outloud, "What is it going to take for me to get this!" Then I panic and go back to doing the compulsion.
I've been through scary moments in the past and was able to get through it, so I'm asking myself why can't I get over this dumb fear !? The fear now is "being okay" with not doing any compulsions rather than the feared "worst case scenario" (stove causing a fire) because I already know the latter is highly unlikely.
I find my compulsions sometimes hard to identify too like maybe sometimes I don’t know if it is an obsession or a compulsion I don’t know if I am obsessing about a past event or if it is a compulsion to prove a point (that I am a terrible personn, a narcissist,...)
It makes a lot of sense. And sorry for the late reply. Thank you all for your posts, it’s super helpful for others to know they are not alone in these situations. I hear so often, how difficult it is to separate the trigger from the obsessive thought and to separate the compulsion from the obsessive thought. That’s why I call it a toxic cycle! It feeds itself. The self monitoring worksheet is very helpful. It breaks it down and possibly will help you to think differently about each part. I like to recommend that you listen to your body - when it starts to become uncomfortable, just that small flutter of worry, that is the obsessive thought. Sometimes it’s easier to think of the unwanted thought. The thought you are thinking that you don’t want to think but do not seem to have control over. Catch the thought and you can back track to the trigger. See a trained ERP therapist and they can help you do this. Once you have separated the trigger from the unwanted thought, image, urge it is much easier to see the behavior you are doing to distract, suppress, neutralize or make that though go away! Let me know what you think and thanks again for being here.
Hi bluegrass, I couldn’t pull that up but I can assure you there are lots of examples of the worksheet online, try therapistaid. You can find all kinds of workbooks etc. However, these tools are much more successful when you work with a professional that has been trained to do ERP. I shared a post about being a therapist for 20yrs. I’ve worked with many OCD clients using CBT and since joining NOCD I have been extensively trained to use ERP. My clients are more successful and obtained positive benefits - moments of peace from their obsessive thoughts came much quicker using ERP. I hope that is helpful!
My NOCD therapist (who has been awesome) and I are both struggling to identify ways in which I can practice exposure therapy while in-session, because the vast majority of my OCD symptoms are mental compulsions. For example: indecision and inability to commit to a choice; seeking reassurance on decisions from friends and family; mental review of things that have just happened / social situations; over-thinking and catastrophizing. I also have some other hallmark symptoms (contamination fears, moral scrupulosity, etc) but those tend to be inconsistent too. It’s hard to really practice these during my sessions because so many are in the moment and fleeting. By the time I join my session they are no longer active. How can we establish exposure responses during my sessions, if most of my OCD involves mental rumination and overthinking patterns/thought loops that only occur “in the moments - rather than specific or consistent compulsions (such as hand washing)?
I’m new to treatment and only realized I have OCD a few months ago. I went through a tough and abusive marriage and ended up getting divorced. I had my first panic attack several years ago and ended up needing to go on Lexapro. This helped me significantly and allowed me to leave my partner. Several years later and I decided to stop Lexapro because I thought I was good to go. I’m in a very healthy relationship, have a great job, friends/family, go to the gym and have a wonderful life. It’s been about a year off the meds and I’ve had some panic, but I’ve been able to manage it. For some reason, the last three weeks has been really difficult for me. I have different spirals and different thought processes: what if I’m schizophrenic? What if I have a deeper mental disorder? What if I hurt someone? What if I need to leave my partner? What if I end up becoming so depressed that I end up hurting myself? My brain just goes from one what if to the next and once I conquer one, the next one pops up with even more intensity. I started taking NAC and inositol and I’m taking saffron during the day because I really don’t wanna go on back on medication but sometimes my thoughts scare me and I’m convinced that I’m not gonna get better and I know that’s just the OCD loop, but I’m wondering if this resonates with anyone else!
Hi all! I was wondering if anyone being treated with ROCD and/or SOOCD has some advice on how they handle the things *with* their partner. For context, my ex and I were together ~7 months before we broke up a year ago, in large part due to my severe anxiety from untreated ROCD/SOOCD. I’ve gotten a lot better through NOCD treatment and we’ve been friends since then. But we’re currently in a “situationship” kind of stage, where I think we’re both trying to figure out if the relationship is still feasible, and I’m finding that I’m a lot more triggered as the relationship nears becoming “serious” again. We’re both really trying to figure out the healthiest way to handle when things get hard for me. Does anyone have input about what they’ve learned or found what has worked in their own relationships? Some specific questions: - I’ve found that when getting really triggered in my own head, I have no clue if I should explain how I’m feeling to my partner or how we should address it together. How do you differentiate between communicating versus falling into the confessing/reassurance trap? - Related to the above, my partner and I are both a bit lost on the best way for him to respond when I’m really paranoid (for examples, I have major I’m-being-cheated-on paranoia and overanalyze if I’m enjoying sex enough), or if I’m overreacting to feeling rejected/misunderstood (e.g. “he didn’t respond to my comment just now, he doesn’t care/he doesn’t get me/maybe we shouldn’t be together…”) - How much does your partner know about ROCD/SOOCD in general? How much have you shared with them about your thoughts and experiences? I’ve explained both subtypes and some of my thought processes to him, but definitely not all of it, and I’m not sure how much is helpful for him to know. Answers to any or all of the questions are very much appreciated. Thanks so much in advance! Hope you’re all well 💗
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