Tag: mental-illness

OCD: Stop trying to Control your Obsessions!

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Gremlin peeking out from a partially open wooden crate labeled 'Property of Gremlin's Cave - Do Not Open'

Are you trying to control your obsessions? Are they based around things you have no control over? Is this then a completely fruitless task?

Some interesting questions but lets take a step back for a second and clarify a couple of things. What is an OCD obsession anyway?

An OCD obsession is:
‘… a recurring, unwanted thought, image, urge, or impulse that repeatedly enters a person’s mind and causes significant anxiety, distress, or discomfort.’

Things we can’t control include: feelings, emotions, thoughts, images & urges. 

Take a moment now and recognise whether your OCD has come from something you have NO control over!

Hopefully that was a lightbulb moment.    

Woman having a bright idea with a light bulb above her head while studying at a desk

So much of OCD is focused in on the things we can’t control.  It can feel so powerful, and overwhelming at times, as if it deserves our time and attention but as a human we need to learn that we’re not fully in control of our internal environment and to allow these automatic ‘features’ of the human condition to just be.

We don’t have to believe every thought, feeling etc that comes into our head. Most of the time the brain is just throwing things out there to see if they stick and we have to be like Teflon, letting the thoughts just float through, showing the brain that they are irrelevant. Only then will it go off to find something else to throw your way instead, which you then need to allow to float through, so the brain sees that as irrelevant too. Get the idea?

It’s when we give these normal, automatic thoughts time and energy that the brain perks up and thinks they’re important.  It takes it as a sign that you want to see more of that content and so we can see how spirals start to happen. 

On days when I don’t let the thoughts stick it is unbelievable how many different thoughts come my way, the brain is throwing them out there constantly and it’s your job to just do nothing, in the same way it’s the brains job to keep throwing random thoughts and ideas your way. Occasionally it comes up with good ones too remember, they’re not all intrusive and unwanted.  

Why do we give away our power, focus and attention to things outside of our control?

Basically because the limbic system – emotional part of the brain – is more powerful than the cognitive one.  Yes, our thinking brain is not actually the one in control most of the time. As a result we have to learn to work with our emotional brain, not against it – as this is pretty much impossible. 

There’s a famous metaphor called: ‘The Rider and the Elephant’, which helps to describe this idea. 

The rider represents our thinking brain, good at analytics and planning, but small relative to the enormous elephant.  The elephant, represents our emotional brain, it’s vast, powerful, and often driven by instinct.  The rider has the reins but needs to work with the elephant in harmony, as when the elephant gets stirred it has the ability to dislodge the rider if it wishes. 

Person riding an elephant on a dirt path at sunrise with misty landscape

And so we have to work with, not against our emotional brain.  It is powerful and has the ability to hijack our rational thinking. 

We work with it by accepting the obsessions when they come in.  It’s worth noting here that accepting the obsessions doesn’t mean you like, agree with or want them in any way, it just shows the brain that they are irrelevant to you and so it doesn’t need to give them any of your time, attention or awareness.

It can feel impossible at times I know but the more we push back/away the stronger they become.  Like a tug of war, we have to let go of the rope not pull harder.  

My favourite phrase to use is:

‘Thank you brain, that’s exactly what I wanted to hear right now.’ 

This way you are acknowledging the obsession but not pushing it away or investing any time in it.

‘But how do I know if it’s OCD or something that does need paying attemtion to?’ I hear you ask.

Ask yourself the following questions: ‘Am I struggling?’ 

If the answer is ‘Yes!’, then its your OCD and you need to step away from the content. 

I think it’s so important to remind ourselves of these basics, as at times, especially when triggered, it can feel hard to remember that you didn’t ask for the obsession and as a result it doesn’t mean anything!

I really hope this helps, as always,
Stay Strong xxx

My issue with ERP Therapists

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Young woman talking to therapist in cozy, warmly lit room

I’ve been having a bit of a moan recently about ERP therapists.  It’s not that they’re not well intentioned but it’s my belief that they don’t show much empathy for just how hard ERP (Exposure Response Prevention) therapy actually is and it irritates me. 

Of course in theory ERP is straight forward:

  • Write a list of exposures
  • Push yourself into those exposures/outside of your comfort zone
  • Don’t complete any compulsions
  • Sit with the associated anxiety 

Easy right?

The reality however is that you are asking someone to push into things that their brain – for whatever reason – has told them are dangerous and should be avoided/worked out/prioritised at all costs!  

This is a system which is designed to get people to ACT urgently.  A system which is so powerful it turns off the cognitive brain and takes over!! 

Our brains are designed to prioritise this system over all others to keep us safe.  It is instinctive, irrational and isn’t able to access the logical strategies that made complete sense in your therapists office.

Not only that but this system throws cortisol and adrenalin around our bodies, which is incredibly tiring, making ERP therapy exhausting! 

So what we’re really asking of someone with OCD, is for them to push themselves daily into a system which is designed to make you do the opposite.

Everyone has fears, things they don’t like/avoid and most people don’t have to push into them, maybe ever. 

So just know, when doing your exposures, you are being asked to do something that most other people avoid like the plague and you’re being asked to do it again and again and again by someone sitting comfortably in their office, probably not living the ERP lifestyle themselves. 

A lot of OCD therapists come from backgrounds with OCD so have some understanding BUT once you’ve done ERP for a while and you’re making good progress, it can be very easy to forget how hard it is. 

This happened to me recently when I started to learn to swim.  I’ve always had fears associated swimming, following an incident when I was younger, where I found myself out of my depth in a lake and basically freaked out. Since then I haven’t liked being out of my depth or putting my head under the water.

I was feeling pretty strong mentally so why not push further out of my comfort zone? Push into some of those long held fears, which start to become your identity!

We’ve all got them, finish this sentence for me: ‘I just don’t like________’


I’m great at this ERP malarky, I was thinking, little did I know what was coming my way!

To encourage myself to push into this one I signed myself up to a Sprint triathlon, the first part of which is a 400m swim. 
I started doing some lessons with one of my colleagues who’s a swim teacher and OMG putting my head under the water was completely terrifying.  I wanted nothing more than to get out of that water, go home and never get back in that pool again, not only that but the next day I was completely exhausted. Reality check for me and big reminder of how hard it can be.  

I knew I had to go back the following week and it was still hard, but maybe not 100%, perhaps 97%, my brain was still screaming at me to get out the whole time.

Honestly, I’m still making progress with this one, fears, especially ones held for a long time, do not disappear quickly and require continued exposure – sorry! 

Being able to recognise this and keep going is a skill we have to hone and it is extremely hard.  If you can master it, you are stronger mentally than 99% of the population. 
As people with OCD we’re already dealing with a fault in this system, alerting us unnecessarily daily and then we’re being asked to add more on top. 

Honestly, we deserve medals and more recognition for how tough this work is and it is work, HARD work! 

So here’s the biggest well done from me to you, for not giving up, for fighting every day for something you didn’t ask for and definitely don’t deserve. 

You are amazing, you are not alone,
Stay Strong xxx

Are You Falling into OCD’s Sneaky Trap?

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Two men labeled Reason and Logic pulling a large brain away from a creature labeled OCD

OCD can be so sneaky and when you’ve had it for a long time, if you’re not careful, you can start to form automatic habits around it. These can be so sneaky, you don’t even realise you’re doing them but these habits are actually sneaky compulsions keeping you stuck!!!!!

This has happened to me and probably still does when I don’t catch it in time.  One habit in particular stands out here, as I now realise it was/is a compulsion which has been keeping my OCD going, argh!!

What was I doing?

I was debating with my Pure O intrusive thoughts, here’s an example to show you what I mean:

An OCD intrusive thought/feeling/urge whatever comes in:

‘What if you picked up that knife now and hurt someone with it?’

What I should do:

‘Thanks OCD, that’s exactly what I wanted to hear right now’

And then carry on with my day, no more interaction, stopping it in it’s tracks. 

What I’ve been doing:

‘I wouldn’t do a thing like that, I’m a good person, look at all the kind things I’ve done which prove that – starts to list them off in my head.  I love my family/friend, why would I want to hurt them, that’s crazy.  This thought is obviously my OCD etc ect ect.’

What I’m doing here is engaging with the thought, even if its just to prove it wrong, its STILL a compulsion! 
I’m not directly worrying about the obsession or think I might action it but I’m trying to prove to myself with absolute certainty why it’s not something to worry about. This is a sneaky compulsion which I’ve been keeping going for YEARS! 

Initially I didn’t realise it was a compulsion at all and it was only when my OCD wasn’t getting better that I dug a bit deeper and realised that by trying to prove the OCD thought wrong, I was keeping it alive! 


Say it with me now:

Boy with brown hair wearing orange shirt and blue jeans shouting angrily with clenched fists outside

It wasn’t a great feeling when I worked this one out and I still find it really hard not to engage with the thoughts to this day.

For whatever reason I feel like I have to prove to my brain, beyond any shadow of doubt, that I’m a good person. I take myself off on a positivity spiral, desperately trying to affirm my character but of course this is fruitless when it comes to OCD, as I’ve proven to myself over the last few years. 

Remember OCD has imagination at its fingertips, where there will always be another ‘what if?’ or ‘maybe?’ coming your way.

This is how OCD’s sneaky trap keeps you stuck inside your head, distracted and not fully engaging in the real world. You’re trying to solve an unsolvable puzzle, debating with your own imagination – sneaky or what!

When I don’t do this compulsion, I have to leave the obsession ‘open’, which my brain hates. This is of course ERP (Exposure Response Prevention) therapy in action and exactly what we need to do.  

Do you find yourself doing this? 
I’d love to know if anyone else has fallen into this sneaky trap.

As always, Stay Strong xxx   

Overcoming OCD: A leap of Faith

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Make OCD words slightly darker

You could look at OCD as being a fault in the ‘good enough’ system.  For whatever reason in people with OCD the brain’s ability to dismiss thoughts which ‘normal’ people can, seems impossible. 

Thoughts are stickier, they hang around and as a result our fight or flight nervous system gets triggered, making the thoughts (obsessions) feel more visceral and real – they’re not of course but try telling yourself that when you’re triggered! 

When we’re stuck in an OCD spiral it can feel overwhelming, all consuming and urgent.  It feels like working out the thought is the only thing that matters but of course investing any time in the thought is always going to make it worse.

OCD asks us to take a leap of faith, and this is why recovery is so hard.  We’re basically saying to ourselves:

‘I know every instinct in your body is telling you to work this out right now but you need to do the exact opposite and have faith, not proof, not certainty but blind faith, that what your brain is telling you is wrong. ‘

Bring creepy character closer to foreground

I’ve had a few occasions over the years where I’ve been stuck in a spiral for days and eventually, I’ve just had to take that first step and trust that all will be OK.

It feels impossible I know, like jumping out of a plane not knowing whether your parachute is packed correctly but the alternative of being stuck is also not that appealing.

It’s only when we’re brave enough to keep going, letting the thoughts be, that the brain starts to see, ‘oh that thing I’ve been stressing about didn’t actually happen’ – this is called expectancy violation and it’s incredibly powerful. 

Each time we prove to our brain that what we thought might happen didn’t, the thoughts start to ease a bit and the next time it’s slightly easier and the time after that a bit easier again and so on. 

OCD recovery happens slowly, particularly when it’s been around for a while.  It’s needs a lot of proof that all is well before it starts to relax. 

This is why ERP – exposure response prevention – is that gold standard for OCD recovery, as it requires us to push into our OCD obsessions and carry on regardless of how we feel. It’s only through this action and continued exposures that the brain starts to chill. 

I do believe ERP needs to be supported with psychoeducation and nervous system support to give you the best opportunity for success.  Gaining knowledge and understanding of how OCD works has been so empowering for me and it’s why I write this blog.  It acts as a reminder for me to not give into compulsions but hopefully also helps others understand OCD better. 

I really hope it helps,
Stay Strong xxx   

6 Strategies to Combat OCD Spirals

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Person standing outdoors at night looking up at the Milky Way galaxy in the star-filled sky

This week I’ve been under the weather, nothing too extreme just a cold but the impact it’s had on my mental health and resilience levels I thought was worth highlighting. 

I’ve spoken before about the threat bucket and how each day we wake up with a base level of resilience.  This can change day-to-day depending on how we feel, how well we’ve taken care of ourselves, what’s going on with our health as well as what’s happening in the world around us. So many things can knock our resilience day to day, not to mention our OCD. 

Understandably then as I got slowly more poorly over the weekend my resilience levels got lower.

I observed as Saturday went on how the thoughts became stickier and by bedtime on Saturday an old theme had come in and had properly taken hold, as a result I did not sleep well. 

Sunday was tricky, already dysregulated because of my cold, add on top my bad night’s sleep and the ability to sit with the OCD thoughts as they came in became much more challenging.

What to do then when things are stacking up against you, despite your best efforts.

I found it useful once again to refer to my notebook, as I said in last weeks post, it’s vital to prepare for the hard times when you’re feeling good, try and make a compilation of all the things that help and uplift you, so you can refer to them when you’re not thinking as cognitively.

Anything that is going to switch your thinking brain back on, is going to be useful, become curious, be creative or find awe in the world. 

At 4am on Saturday morning the birds started singing outside and that bought me some peace, I have always found awe and wonder in birds, and this helps to pull me out of the depths of OCD spirals. 

I’ve written about these before, but I think they’re worth repeating.  Here are 6 of the best ways I know to pull yourself out of a spiral (fight or flight):

  1. Creativity – this will mean different things for different people but creativity is amazing at switching on a different part of the brain, drawing your attention away from the catastrophizing part. Quite often if you can focus on creating something, whether it be a piece of art, a yoga sequence, something in the kitchen, garden, workshop, on the computer, anything that gets you thinking outside the box, you will start to draw your attention back to a more balance place.
    What’s your creative outlet?
  2. Curiosity – This can be curiosity about anything, quite often when we become curious and interested in something it grounds us and pulls us away from that extreme black and white thinking. Try asking why? Maybe investigate how something works or why it’s the way it is.
    Have you ever wondered about anything?
  3. Humour – is fabulous for getting the brain to switch modes. It works because its unexpected, remember the brain is a prediction machine and it’s pretty good at it. When a joke comes along and it doesn’t end where the brain think it will, BAM! You’re out of default mode and the brain is switched on and listening.
    Do you like any comedians? Go and look up one of their new sets online.
  4. Awe – part of the joy of being human is our ability to find awe. It can really give you some perspective when you look at the stars, birds, clouds, landscape etc. Going out into the world and finding things that make you think, wow! Is very important to our wellbeing and it helps us reset.  What brings you that feeling of awe?
  5. A Challenge – this can be tricky when you’re in fight or flight but something which I found fun – from Martha Becks book – was to try and write your signature backwards. It takes a huge amount of focus and is very grounding. Go on, give it a try!
  6. Foundations Work – movement, nutrition, sleep, relaxation & social connection.  This takes an element of doing what you know is good for you, even when you don’t feel like it. We must take action first, do the things we know make us feel better in the long run, your body and brain will thank you.

 These have all been great for me at different times, give them a go and see if they help you too. 

But are these compulsions I hear you ask?  I would argue if you’re not doing them out of a desperate need, then no.  If you feel low and dysregulated then doing things to reregulate your system such as eating well, socialising or being creative are constructive and recommended by professionals, however if you find you’re doing them compulsively then step away!

I really hope it helps,
Stay Strong xxx

Navigating OCD: Essential Tips During Tough Times

Posted in Anxiety, Mental Health, Mental Wellbeing, OCD, OCD Coping Strategies, OCD GeneralTagged , , , , , , , , , 2 Comments
Books and notes about obsessive-compulsive disorder with highlighted coping strategies and sticky notes

Having had OCD for 30 years I’ve come to realise how important it is to have a few easily accessible resources and a plan of action in place for those times that, despite our best efforts, we end up spiralling.  

It’s very easy in the good times to forget how hard and dark it can be but when we are feeling good we should take a bit of time to get organised with what helps, just in case.

Let me try to explain in a bit more detail what I mean. 

In an ideal world we would learn how OCD works – a glitch in the good enough system – get really good at sitting with that uncomfortable feeling (doubt and uncertainty), let our nervous system do its thing and reset on its own back to base line and carry on with our day. 

And while this is all good in theory and doable a fair amount of the time, it is my experience that recovery isn’t a straight line and there will still be times when we get caught by an OCD obsession. 

Here are some examples of circumstances that can make OCD stickier;  Nighttime can be tricky, as well as when I’m particularly tired, if I’m already sitting with a trigger and then another one piles on top, time of the month for ladies, a new theme appears and takes you by surprise, or a difficult life circumstance such as illness, coping with loss, or stress to name a few. 

All of these will affect our resilience and ability to manage our OCD effectively; I’ve definitely noticed that the exact same thought can effect me differently depending on my resilience level.   

At these times, when we’re spiralling despite our best efforts to let things be, I’ve found it can be helpful to have a few resources to hand, they help remind me of OCD’s wicked and insidious ways and switch on the prefrontal cortex enough to pull me back. 

I personally have a notebook filled with all my favourite advice and information from a wealth of people and books I’ve read over the years.  Some of which I’ve shared below. 

As well as this I’ve finally started to populate my resources page, if you get a chance go and check it out and let me know what you think or if you know of any other useful resources I can add.  I will continue to update this page as time goes on.

I really hope it helps! 

Highlights from my notebook

A thought on Thought-Action-Fusion

Why would you torture yourself over anything less than 100% certainty?  Fear lives in the vague after all and it’s my guess, it’s just a thought (obsession), attached to a feeling of uncertainty, that you’re basing your rumination on, not facts. 
Your brain is probably desperately trying to work out whether there is something genuine to be concerned about, you should take this as your sign that there isn’t

A couple of quotes from Dr Stephen Phillipson

‘You can’t use feelings to make determinations based on whether a threat is real. Doing so is like asking the devil for directions to heaven’.

‘Why focus on something you have NO control over?’
‘It’s never going to not feel scary. ‘

An insight from Martha Beck

Ask yourself:  ‘Am I struggling?’  If the answer is ‘yes!’ then you’re spiralling, step away. 

Useful information from Prof. Steve Peters:

‘If you wake during the night, any thoughts or feelings you might have are from you chimp (emotional) brain and they are very often disturbing, catastrophic and lacking in perspective.  In the morning you are likely to regret engaging with these thoughts and feelings because you will see things differently. ‘

Some ponderings from me:

  1. At night time the rule I try to stick to is – Don’t engage between 10.30pm-6am – acknowledge the thought and set aside some ‘worry time’ the following day if needed, when the rational brain is switched on and working.
  • Know that giving into a compulsion will trigger your fight or flight response and once this happens all reason and logic will disappear.  There is no good outcome to giving into a compulsion, it just confirms to the brain there is something to be concerned about and keeps the OCD cycle going. 
  • There’s always another ‘what if?’ or ‘maybe?’, remember logic is limited but imagination isn’t.

There’s so much more from where these came from, so don’t forget to like and subscribe to make sure you don’t miss out! 

Let me know if any of these are useful to you too in the comments below. 

As always, you’re not alone, your thoughts are not special and you’re stronger than you know!
Stay Strong xxx

OCD – The Thief of Joy

Posted in Getting Help, Mental Health, Mental Wellbeing, Mindfulness, OCD, OCD Coping Strategies, OCD GeneralTagged , , , , , , , , , , , , Leave a comment
Raccoon wearing a beanie and striped sweater carrying a glowing 'Joy' sign and a bag labeled 'Sorted Treasures'

You may have heard that famous quote:

‘Comparison is the thief of joy’ – Theodore Roosevelt

and well this is no doubt true, I would argue that OCD is actually a pretty good contender too. 

To experience joy, we must be open to experiences, receptive to others and be able to appreciate the world we live in, not only that we also need to feel like we deserve to be joyful.

All of these things require us to be in our parasympathetic nervous system (rest and digest); we need to feel relaxed and at ease with the world around us, not overwhelmed by it.    

Unfortunately when we have OCD, we are rarely in our parasympathetic nervous system, we spend a lot of time in our own heads, dysregulating ourselves (fight or flight) with imagined realities, compulsions and overthinking.  All this means we are less receptive to the world around us, less productive and sadly less able to experience joy. 

Add to this the fact that when you have OCD you don’t always feel like you deserve to have joy in your life.  In fact you can feel quite the opposite, that you’re not a great person and instead of trying to find joy you beat yourself up and make yourself feel even worse! 

Remember, OCD is not your friend, it’s not trying to help you, build you up or make you feel good.  In fact given the opportunity it will tear you down piece by piece until there’s nothing left.  Yes, it sounds brutal and relentless and just like the high school bully, that’s exactly what it is!!!! 

A large student with crossed arms confronts a smaller student smiling and holding books in a school hallway with lockers and bulletin board

OCD – The distractor

I’ve been reading some yoga books recently and I came across the following quote, from Brightening our inner skies (beautiful title) by Norman Blair, which really resonated with me:

‘My disorderly awareness deprived me in the midst of plenty’ – John Tarrant

In the book Norman talks of reasons people seek out meditation, this was John’s reason. 

You don’t have to have OCD to notice that the mind likes to pull you away from the present.  In fact, in today’s society, with our attention being a source of income for big companies, it’s getting ever harder to just be ‘in the moment’. 

It also resonated with me on an OCD level.  I realised that my OCD constantly pulls me away from the things I care about, my life and family, depriving me from experiencing joy and happiness and disrupting my memories – oh yes, when dysregulated memory gets distorted too. 

How then do we stay present when OCD is so intent on pulling us into an alternate reality, of its own making, to distract us from all that we have and want to be? 

Are you able to pause and notice the nonsense? 

When I have days where the OCD is less sticky, I am able to see the constantly changing nature of thoughts and the mind for what it is.  It’s truly fascinating just how many avenues the mind tries to pull us down daily. 

It’s like standing in the middle of a storm, the wind is trying to pull you in one direction, the rain is pushing you in the other.  Your job is to stand there and watch with no attachment or investment in any way.   

Man in green raincoat with backpack bracing against cold wind and rain by stormy seaside

So much energy and mental effort for what?  In times of dysregulation the brain can take you anywhere and tell you anything and it all seems plausible.  It can make you think that repeating actions, counting numbers, replaying conversations, has a point, when in reality, it’s all just wasted time and energy. 

Once you recognise this and stop, it can all start to feel a bit empty.  Maybe regretful that you’ve wasted so much time and energy on an imagined reality.

How do you feel about finding stillness and being more present?  Is it tricky for you?

Maybe sit now and take a breath, notice what’s around you, feel the ground underneath your feet and the air on your lip as you breath in.

Does it feel easy, hard? 

It can take time, the brain won’t like it to start but think how much more energy you will have and more connected you will feel when you stop letting OCD steal your mental headspace and joy.    

I would love to know your thoughts on my ramblings, do you feel like joy is hard when OCD is loud?  Have you found any good ways to ground and reset your nervous system?

As Always, you are not alone,
Stay Strong xxx

Glimmers: Hope Amidst the OCD Noise

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GLIMMERS text over a silhouette of a person looking at the Milky Way galaxy.

When you have OCD your brain can feel so loud you think it’ll never be quiet again.  We catastrophise the world, always thinking worst case scenario, our brains are living in survival mode, unable to fully relax.

Anyone suffering from OCD will know how distressing and difficult it can be and at times our brains can feel like very dark places to inhabit. 

When I had my nervous breakdown back in 2021 my nervous system felt so dysregulated that the noise was unbelievably loud and constant!  Waking up was noisy, all day it was noisy and going to sleep was near impossible.    

At times I would sit outside in the garden, feeling pretty numb and watch the birds – mini glimmers I now realise.  I would find awe and beauty in watching them and they helped me remember that life is beautiful.     

What is a glimmer?

A Glimmer is a small, daily moment that sparks joy, safety, awe or gratitude.  It acts as the opposite of an OCD trigger.

I love the word ‘glimmers’ as it speaks to something magical and when you experience them they do feel magical. 

When everything is incredibly loud a ‘glimmer’ can feel like a bright light, pushing its way through the intense darkness – similar to a star in the night sky, all the more beautiful because of the darkness surrounding it. 

My OCD has taken a lot from me over the years but one thing it has given me is the ability to truly appreciate the small, beautiful things in life – which I believe most people miss.    

I can remember a time, not too long after my nervous breakdown, I’d come back from the school run and sat down on the sofa, I then had a moment of quiet.  It wasn’t long and I didn’t recognise the fact until after it had happened, but this little glimmer gave me hope.  It was enough to show me that it was possible for my brain to be quiet again.  This moment has stayed with me and was and still is highly significant to me in my recovery journey.

Can you think of any times when you’ve had a ‘glimmer’? They really are magical moments.

Remember to always look for the light in the darkness, like a moth to a flame, head for that light and hold onto it with all you have.

Remember you are not alone,  
As always, Stay Strong xxx   

Overcoming OCD: The Role of Expectancy Violation

Posted in Mental Health, Mental Wellbeing, OCD, OCD Awareness Week, OCD Coping Strategies, OCD GeneralTagged , , , , , , , , , Leave a comment

In last weeks post I touched on the subject of expectancy violation and I thought it was such an important topic that it deserved its own post.   

What is Expectancy Violation I hear you ask?

It is a core mechanism in Exposure and Response Prevention (ERP) therapy, where a patient’s obsession is disproven by facing the fear (obsession) without doing the compulsion. By violating this expectation, the patient learns that their fear (obsession) is manageable, and their obsessive beliefs are false, which promotes long-term recovery. 

ERP therapy is all about proving to your brain that your OCD obsessions are unfounded and based on dodgy data.  We can only prove this to our brains by sitting with the obsession when it comes in and not partaking in the compulsion. 

Sounds easy right?  Well last weeks post was all about how the brain can make, ‘just sitting with it’, feel like a life or death situation and no I’m not exaggerating, anyone suffering from OCD knows this first hand.

The brain believes what it sees and it’s only action or sometimes inaction that can rewire the ‘faulty OCD circuitry’, currently running.    

I realise ‘taking action’ can be hard and sometimes it can feel useful to sit and consume podcasts, books, blog posts and reels on OCD instead. This can make us feel like we’re ‘doing the work’, and don’t get me wrong I do truly believe psychoeducation plays a large part in OCD recovery but the real work is done out there in the real world, when you’re not making your life smaller to avoid triggers.

It’s only when you take part in your exposures, reframe from doing the compulsion and see that the ‘expected’ outcome doesn’t actually happen, that you receive this unbelievably important input – the expectancy violation – which then starts to rewire your brain with better more accurate data.

You have to remember to keep on pushing outwards so OCD can’t push you inwards. In my experience if you don’t continue to push yourself out of your comfort zone regularly then the ‘weeds’ (OCD obessions) start to sneak back in.

My advice therefore is to try and make ERP a lifestyle choice. When we accept our anxiety, knowing it’s a normal part of being human and carry on anyway we are winning against OCD. 

Are you still pushing out of your comfort zone each week? I’d love to know what you’ve been up to, let me know in the comments below so we can help inspire each other.

If you, like me, need a reminder now and again to keep on trying new challenges and exposures, then you might find one of my wellbeing journals useful. They have a weekly ‘Comfort Zone Cracker’, where you can set yourself small manageable targets to hit. It’s a fab companion for ERP therapy and life in general, they’re available from amazon and you can find the links to them here.

I really hope this post has been helpful,
As always, Stay Strong xxx

A Missing Piece in OCD Recovery

Posted in Mental Health, OCD, OCD Awareness Week, OCD Coping Strategies, OCD GeneralTagged , , , , , , , , , Leave a comment

Perhaps you’ve had OCD for a while or maybe you’ve recently been diagnosed and you’re looking for helpful information, either way I feel like the following can be useful going into OCD recovery and isn’t always highlighted by therapists.

If you receive therapy through the standard route then you’ll be advised to undertake a course of CBT therapy in the form of ERP (Exposure response prevention), which is the current gold standard for OCD treatment.  

Here you’ll be introduced to the OCD cycle

And then told the way to break this cycle is to create a hierarchy of your OCD obsessions and then slowly and in a controlled way, exposure yourself to these obsessions and sit with the associated anxiety, rather than complete your compulsion.

This is indeed a very successful treatment for OCD and sounds wonderfully simple, fantastic you think, I can do this, my OCD will be gone in a matter of weeks and yes this could well be true.  

You’ll hear about how you must ‘sit with the anxiety’ and ‘ride the wave’, because any amount of paying attention to the obsession or taking part in the compulsion will just feed the cycle and make it worse, again all true. 

You sit in the safety of your therapist’s office and think, ‘yes I can do this, it all makes sense’ and it does, I’m not debating the logic and success of ERP therapy, it really is the best way to get rid of OCD.  But what, in my opinion, they don’t pay enough attention to, is how unbelievably hard it is to sit with anxiety, particularly at the start.

Now I’m not trying to scare you or make you feel any worse than you probably already do but it’s important to understand the reality of ‘sitting with anxiety’ as it is, I believe, a life changing skill you have to learn. 

When you’re in your therapist’s office, away from your triggers, having a nice chat about anxiety and the OCD cycle, this is a whole different ball game to being out there in the real world and so you need to set yourself up for success. 

Picture this, you leave your therapists office full of optimism and hope for your OCD recovery. You get home and get yourself organised, you feel positive, confident and hopeful and then have a go at your first exposure, the anxiety sets in, you feel overwhelmed, all logic goes out the window and you complete the compulsion, after all, ‘just this once wont matter, I’ll sit with it next time’.

So why does it feel so manageable and make so much sense in the therapist’s office but then when you come to do, ‘the work’ it feels impossible?   

Well, when you get triggered by your obsessions, you are thrown into your sympathetic nervous system, (fight or flight), this system is there to keep you safe and alive from potential threats and for whatever reason your brain sees your OCD obsession as a threatening situation – OCD is actually a ‘fault’ in this system.
 
When in fight or flight your brain is designed to get you out and away from these situations asap and so ‘just sitting with it’ although good in theory, can feel unbelievably impossible.
This system is powerful and it overrides your thinking brain, you lose the ability to access logic, perspective taking, rational thinking and working memory among other things – I’ve talked more about this in a pervious post if you’d like more information here. 

Suddenly what made perfect sense in your therapists office, seems impossible to even access, let alone execute successfully.  Your brain is literally telling you to get out of this situation as quick as possible, do the compulsion, whatever it takes to relieve the anxiety and distress.      

Now I’m not telling you that you don’t have to find a way to sit with this survival mechanism, which by the way has kept the human species alive for thousands of years, it just means you need to have the knowledge and tools in place beforehand, so you’re prepared.  All this will help you to sit with that feeling when it comes and not complete the compulsion.

Know that your brain will think you’re in a life or death, all or nothing situation and that that is normal! 

It will feel like you’re about to jump out of a plane not knowing if your parachute is packed correctly. This might sound extreme, but this is what your brain thinks the OCD obsession means and it will do everything it can to keep you safe.    

Knowing this has helped me on numerous occasions to keep moving forward, take that next step and sit with it, it has given me the grit to move past OCD obsessions which in the moment have felt too much to handle. 

So how do you prepare yourself?

You need to have this information accessible for when you are triggered, it will confirm that how you’re feeling is normal, as when you’re in a dysregulated state of mind you won’t be able to remember. 

I can’t count how many times this has helped me sit with the anxiety and not complete the compulsion.

Ah but does this become a compulsion in itself? I hear you ask…

…I don’t believe so, as eventually, it WILL build a new pathway in the brain and you WON’T need the notes, you’ll notice you’re in fight or flight and you’ll have the knowledge and experience that this is normal and it will pass, I’m not in a life-or-death situation, it’s just my OCD. 

But you only get to this stage by sitting through it at least a few times and proving that to yourself.   Remember the brain learns from experience and expectancy violation (a core mechanism in Exposure and Response Prevention (ERP) therapy, where a patient’s feared outcome is disproven by facing the fear without doing the compulsion. By violating this expectation, the patient learns that their fear is manageable, and their obsessive beliefs are false, which promotes long-term recovery. ) is unbelievably powerful in all aspects of our lives, not just OCD recovery. 

So use the notes to disprove the need for the compulsion and once your brain has enough evidence to know the compulsion is useless, you won’t need the notes anymore. 

I know it can feel impossible; it’s supposed to and that’s completely normal.  Know that when your therapist says, ‘just sit with it’, what they’re actually saying is:

‘your brain is going to tell you that the world is going to end and you have to do nothing about it’. 

The good news is that once you’ve sat through it a few times you start to see that the obsession didn’t happen and it was just OCD.  This is the moment you start to take your life back and boy what a feeling that is. 

Remember your brain is just trying to keep you safe from what it thinks is a life-or-death situation and it is going to do everything it can to stop you. You have to say:

‘thank you brain, I see that I’m having an OCD thought, I’m going to let it be and carry on with my day, aligning to my values’.    

Quite a tough one today but having confirmation of how hard it can be and what you’re up against is important for recovery.
I really hope it helps you as much as it has me,
As always, Stay Strong xxx