Tag: health

Understanding OCD Through Relational Framework Theory

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Does this sound familiar?

You’re out enjoying your day, you feel happy, in fact you feel really good and then all of a sudden out of no where you get hit with an OCD obsession.  ‘Ugh you think, why now when I was having so much fun and feeling so happy?’    

Why indeed?

Well there’s a theory to why this happens and it’s called, ‘relational framework theory’ in fact it’s what ACT – acceptance commitment therapy – is built upon.

I’m sure I’m not going to be as good as the creators at explaining how it works so please go look up Steven C. Hayes if you have a chance but the theory is based upon the concept that humans think relationally. 

This basically means that humans can and do relate objects in their environment to other objects. Virtually in any possible way e.g. same as, better than, opposite of, greater than, faster than, part of, similar to or like, before and after, if/then, family relationships, near and far etc,
There are all sorts of ways in which we sort and link information in our minds and it has been amazing for our evolutionary progress however it also opens us up to the possibility of immense suffering.   

Lets dig a little deeper

As we grow as humans, we create vast networks of relationships in our brains.  We link objects together so we are better able to make sense of them and recall them when needed. 

Ever found that when learning something new if you can relate it to or build upon something you already know it’s far easier to remember?  Or when you try and recall someone’s name it can help to remember where you know them from? 

This is because your brain has linked ‘Julie from the gym’, with the gym in your head, therefore remembering the gym will help you recall Julie’s name. 

Julie from the gym might also have other connections such as she has a daughter who goes to the same school you used to attend or maybe she likes to play netball and so does your friend Jane – Jane and Julie will now be linked in your mental framework too.

Here’s a little game you can play to help demonstrate this further:

Write down one noun – any type of object or animal will do

Noun 1 _________________________

Now write down a second noun

Noun 2________________

Now answer the following 3 questions:

  1. How is the first noun related to the second one?
  2. How is the first noun better than the second one?
  3. How is the first one the parent of the second one? 

The third one can take a bit longer but given a bit of time an answer will come.

This exercise highlights how the brain can relate anything to anything else!!!!!!!  It is an interesting insight as ultimately not everything can be the parent of everything; however, the brain justifies these relations by features it abstracts from the related facts. Your mind can always find a justification for that relation!  Sound similar to OCD?

Bringing us back then to OCD and the start of this post.

We can see how obsessions (unwanted, intrusive, and distressing thoughts, images, urges, or feelings that repeatedly enter a person’s mind and cause significant anxiety.) can become linked to events, people, places, circumstances, actions, words, smells, music/sounds etc.

The obsession, whatever it is, can become attached to an existing relational framework in our brain, triggering our OCD every time we then come into contact with that object or framework in the future!

‘ARGH!!!!!!!!!’

Does this sound familiar? 

Can you think of any frameworks that OCD has latched onto?  Maybe something in your bedtime routine, perhaps when you cook a meal and get the knives out, maybe when left on your own with your kids, perhaps when the news comes on, or it could be when you get into your car, the things OCD can attach itself onto are literally endless.

And unfortunately, once it has attached itself, as far as I’m aware, there’s no easy way to unattach it again.

Having an awareness of this is so important for OCD recovery because we have to accept that we are going to get triggered, and if we fight it, push it away or try and block it out, it just makes it stronger and even more sticky.  You can’t unravel these networks they are too vast and convoluted.    

So what can we do?

We have to let go of the struggle.

There’s a lovely ACT metaphor which illustrates this nicely

Someone is standing in a battlefield fighting a war. The war is not going well.  The person fights harder and harder.  Losing is a devasting option, but unless the war is won the person fighting it thinks that living a worthwhile life will be impossible. So the war goes on. 
Unknown to this person however is that at any time they can quit the battlefield and begin to live life now.  The war may still go on and the battlefield may still be visible. The terrain may look very much as it did while the fighting was happening but the outcome of the war is no longer very important and the seemingly logical sequence, of having to win the war before beginning to really live has been abandoned. – Extract Taken from: Get out of your mind and into your life by Steven C. Hayes. 

Here we see that the way to move forward is to stop fighting, accept the obsession and carry on with our lives aligning to our values.  Eventually the brain sees the link to the framework as unimportant and stops bringing your attention to it so readily, however every now and then it will throw it back up to check if its important and it’s your job at this point to say:

‘thank you brain that’s exactly what I wanted to hear right now’

and then carry on with your day aligning to your values – for more information on values work check out my post here.


If you’re enjoying learning more about ACT therapy then I would highly recommend looking up Steven C. Hayes, which is who a lot of these ideas have come from. 

A small thank you at the end of this one for your ongoing support, this is my 100th blog post and definitely something which should be celebrated.

As always, Stay Strong xxx

Two things you need to cultivate to succeed in OCD recovery.

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Having had OCD for 30 years now I have a lot of experience with dealing with intrusive thoughts.  What are the two main things I’ve learnt you need to cultivate to succeed in OCD recovery?

Firstly, Trust in yourself & secondly, confidence in the process

First let’s take TRUST.  OCD after all is the doubt disorder and generally most of our distress comes from doubting ourselves and our ability to cope.  We must learn to trust ourselves completely and in the choices we make. 

This is by no means an easy task, OCD can make you feel like you don’t know yourself anymore, it can make you think up is down, left is right, and black is white. 
Over time you can lose complete confidence in yourself, asking others for their options and trusting what they think over your own.  A sad and possibly quite scary situation if you choose to trust the wrong person. Do you ask for reassurance a lot from a loved one?

So how do we learn to trust in ourselves? 

Firstly, work out your values – Examples of values include; honesty, kindness, loyalty, compassion, courage, creativity, responsibility, respectful, authenticity, and dependability. The list is endless and very personal. If you haven’t done this yet then take a few minutes now and work out who you want to present yourself to the world as.  Ask yourself, who do you want to show up as day to day? 

(Still not sure where to start with your values?  Then google ‘core values quiz’ and you’ll get multiple options to guide you.)

Quite often when we feel uncomfortable it’s because of something called cognitive dissonance; this is when our actions/thoughts don’t align with our values.  You can however think of that uncomfortable feeling as a good thing, it’s OCD misaligning with who you believe you are as a person.  It’s a sign that it’s OCD is playing its evil game and has nothing to do with who you are as a person. 

Secondly, work out your reason – when times get tough in OCD recovery – and they will – you’ll need to dig deep and the way to do this is to find your reason for recovery.  Write it down, know it inside out and when it’s hard think of that person, reason or version of yourself, which makes the effort it worth.

Thirdly, action – the brain believes what it sees, we must step forward no matter how hard it feels.  Some days it may feel impossible – I know I’ve been there – but the only way to build trust is to be your own advocate and align with your values. 

Moving onto confidence, confidence in ourselves but also in the ERP process. 

ERP (Exposure response prevention) therapy is hard, it involves working out what you’re scared of/avoiding and slowly allowing yourself to exposure yourself to it. It goes against everything your brain is telling you to do and feels horribly uncomfortable but until the brain sees that it can cope in the situation – whatever it may be – it will be scared and doubt (mistrust) your ability to cope.

The hardest part of this process is creating the trust and confidence.  If OCD has done it’s job well, you may be starting at zero on the trust scale.  How can you trust something with no evidence?  That’s what the brains telling you right?  Sure, the nice therapist is telling you it works but the brain only believes what it sees.

Somehow you have to step off the shore into the lake and realise its not as deep as you thought.  I admit it can feel like jumping out of an aeroplane with a parachute attached to your back not knowing if it’s been packed properly.  This is, I believe, why you either have to get to absolute rock bottom before you truly start on that road to recovery or your reason has to be bigger than you, to make the risk of jumping into the unknown worth it.

Of course, once you start on the process you start to build evidence quickly that it works, every time it’s easier to jump, so to speak, but it does take time and energy.  I love the analogy of OCD recovery being like a set of fairy lights.  It’s not all or nothing like a flashlight, it’s slow and gradual, they come on one at a time as the brain learns to trust in the process. 

We must make ERP a lifestyle choice, constantly building up that catalogue of evidence as proof to the brain that we are capable and can trust ourselves when the intrusive thoughts come along.  It is only once you have tried and see the desired outcome that your brain will learn that it can sit with the doubt & uncertainty. 

So, ask yourself, do you trust myself? 

I’d love to hear about some of the times you pushed outside of your comfort zones even though it was hard. If this resonates with you please share your experience below.

As always,
Stay Strong xxx 

OCD & Anxiety – The Intolerance of doubt and uncertainty

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The intolerance of doubt and uncertainty is a big one when it comes to OCD and anxiety.  Ultimately, it’s what it all comes down to – not being able to sit with that uncomfortable feeling and trying to certainty – which is impossible by the way.  

As humans we hate not knowing, we love to fix, sort and order things, it keeps us calm and gives us a sense of control.  Unfortunately, life doesn’t really work that way – especially a life worth living – it is full of risk, uncertainty and not knowing what’s around the next corner. 

Why does uncertainty feel so horrible, well it’s all to do with that organ up there inside our skull, the brain.  It’s number one job is to keep us alive and if it’s knows what’s coming next it’s chances of that are much higher.  It loves predictability, set routines and absolutely no surprises, that way it can relax and keep you safe, job done.  

However, if we do the same things all day every day life can get a bit dull and limited. As humans, we like to try new things, the brains not always so keen though. Why? Well If we’re going to try new things then it’s going to have to do some work.  If we’re going to risk stepping outside of our comfort zone, then the brain needs to make sure we’re safe and making sensible decisions and so it’s going to start sending some signals our way. 

Say you want to go and try a new gym.  You used to love exercise and you’ve been really keen to get back to it since having your kids.  You haven’t been to the gym for a good few years now and there’s likely been some changes, which means there’s going to be things you’re uncertain about – cue the brain, tactic one – talk you out of it   

‘You’re not in as good a shape as you used to be, and you don’t know if you’ll be able to get through the class.  ‘  

‘There are lots of different classes on the timetable which you don’t recognise, what if you book onto the wrong one?’ 

‘You don’t know anyone there, what if no one talks to you?’ 

‘You won’t know your way round, what if you get lost on the way to a class and people think you’re stupid?’  

You get the idea, lots, and LOTS of uncertainty, things you don’t know about the place, other bits you’ll have to work out when you’re there and maybe you’ll feel a bit uncomfortable and embarrassed because everyone else knows what they’re doing and where they’re going.

Cue the brain again,

‘Are you sure you want to do all that?  Seems like a lot of effort.  Wouldn’t it be easier not to?  We could just stay at home like we normally do and chill on the sofa with the family.  We enjoy that and then we don’t have to go through any of those horrible feelings ‘

How would you react to this situation, does it sound familiar?  Are you good at talking yourself out of things? 

This is intolerance of uncertainty!!  The brain hates it, it will try and talk you out of it any way it can. 

However if you don’t listen and go anyway the brain steps it up a notch by throwing some nerves/apprehension/anxiety your way.  It’s worth saying at this point that this is very NORMAL, we should feel nervous when we go into new territory this is the brain telling you to ‘be careful/vigilant, there might be danger ahead’.

Trying new things, pushing outside of your comfort zone and attempting to grow as a person is ALWAYS going to feel uncomfortable.  The only way to show the brain that the situation is safe is to go through it.    

Let’s look at a couple of ways we can reframe the thoughts above:

Brain – ‘You’re not in as good a shape as you used to be, and you don’t know if you’ll be able to get through the class? ‘  

Try – ‘Everyone has to start somewhere and who cares if I make it to the end of the class, any exercise is better than no exercise – which is what I’m doing now – just getting there will be a great achievement.  It’s completely normal to feel a bit anxious in this situation. ‘  

Brain – ‘There are lots of different classes on the timetable which you don’t recognise, what if you book onto the wrong one?’ 

Try – ‘If I book the wrong class, I’ll give it a try and then I’ll know whether I’ll like it for next time, it’ll be fun to try something new and I might even find a class I love, thanks brain.  ‘ 

Brain – ‘You don’t know anyone there, what if no one talks to you?’ 

Try – ‘Why wouldn’t anyone talk to me, that’s pretty negative brain.  If I come in with a smile, I’m sure people will be pleasant but even if they aren’t I’ll be fine, I’m a big girl but thanks for checking in brain.’      

Brain – ‘You won’t know your way round, what if you get lost on the way to a class and people think you’re stupid?’  

Try – ‘If I get lost, I’ll ask someone the way and I’ll work it out, I always have in the past but thanks for taking care of me brain.’    

OCD feeds into this a lot to, whatever your theme may be, it most likely boils down to the fact that you’re not willing to sit with uncertainty in some way. 

Examples may include:

‘Maybe that red spot I touched was blood and now I have a horrible disease’.

‘Maybe I hit someone on the drive home from work’.

‘If I don’t do ______ 4 times _____ will happen’.

‘If I don’t double check the oven is off the house might burn down’.

‘If I don’t double check the front door is locked, we might get burgled’.

There are loads of these but ultimately OCD will just feed into the areas of your life where you are unable to sit with uncertainty and they will most likely be the things you love and care about the most.  It normally all comes down to a core belief that you won’t be able to cope if _________ happens. 

So we have to get better at sitting with that icky feeling and not just white knuckling our way through it either, you have to expect it to come and accept it’s presence WILLINGLY. 

Why not try out some of the following next time you’re in a situation where you’re feeling a bit anxious, and your brain starts throwing things your way.

‘I can see I feel a bit anxious, that’s completely normal in this situation, thanks for keeping me safe brain’.

‘That’s exactly the thought I want right now’.

‘I want this feeling because it means that I’m growing as a person and that’s exciting’. 

Then get straight back to whatever you’re working on. 

All this being said we do need to work with the brain and build it up slowly, if you are having panic attacks every time you get into a car following an accident, then perhaps you need to sit in the car with the door open on the drive a few times and show your brain all’s fine before going off and taking a 3 hour drive on the motorway.  Only you will know what’s tolerable to sit with and what’s not. 

Have a good think about how you can push into uncertainty and strengthen your ability to sit with those uncomfortable feelings. 

Good luck!  This is not easy work but keep those end goals in focus and they will give you the strength to get through those uncomfortable feelings and start taking back control of your life.

Stay Strong

Fiona Fox