OCD Obsessive Compulsive Disorder

Let's talk about OCD!


https://www.facebook.com/share/p/1ENBWizLbU/


It seems lately that I have had a significant increase in clients reaching out to me for help with "OCD and related disorders", which would include OCD, hoarding, body dysmorphic disorder, and what is referred to as Body Focused Repetitive Behaviors. I will talk more about that in a separate post.



While there is no one-size-fits-all approach to any issue, hypnosis can help with certain aspects of these conditions. Evidence based treatment for OCD shows that Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention therapies (ERP) are most effective.



On average 1 in 100 people experience OCD, and it takes on average ***14 to 17 YEARS*** for someone to seek treatment. Once a person seeks treatment, 70% of people will benefit, and will show a 60% to 80% reduction in symptoms when engaged in Cognitive Behavioral Therapies.



Unfortunately, we can not "hypnotize away" OCD any more than we can "hypnotize away" diabetes. But in the same way that we can use hypnosis to control sugar cravings to address one component of diabetes, we can use hypnosis to assist in reducing the anxiety caused by uncertainty that underlies OCD patterns, to break the connections between an unwanted thought and fear of a consequence, to find acceptance of unwanted thoughts, etc. These are some of the main goals of evidence based treatment of OCD and related disorders. 


We find progress moves even faster when we can combine the work that we do in hypnosis with traditional Cognitive Behavioral Therapies.

 

 

Let's keep talking about OCD!


https://www.facebook.com/share/p/14BfRFy4Zk/


OCD has 2 major components. An obsession, and a compulsion that the individual engages in out of a desire to reduce the anxiety caused by the obsession. In reality, engaging in the compulsions only reinforces the cycle.



People tend to culturally think of OCD as being meticulous and orderly, but it is FAR more complex than that. I will discuss that in another post. It is important with treatment of OCD that clients have realistic expectations. Too often, their expectations are unrealistic. Here is what we CAN'T do, (either with hypnosis or with ANY treatment), as much as I wish we could.





But here is what we CAN do, and what evidence based treatment models show is effective in treating OCD.





The primary distortion of OCD deals with discomfort with uncertainty. "You feel as if you must have a 100% guarantee of safety or absolute certainty. Any hint of doubt, ambiguity, or the possibility of negative outcome (however small) is unacceptable."



One of the primary goals is to become more comfortable with uncertainty. The fact is that uncertainty is a fact of life. We DON'T know. That is a human experience. OCD fixates on that experience and inflates its importance. And rationalizing is not helpful. There may only be a .05% chance of something happening, but it isn't 0%. That's almost always true. And OCD cares about uncertainty, not probability. 



So learning to accept uncertainty is the goal. Not that you will ever LIKE uncertainty or be absolutely carefree about it, but that you come to a place where it is only a mild irritation (maybe a level 2 or 3) and not an anxiety provoking issue that causes anxiety at a 7 or higher.



Even more information about OCD!


https://www.facebook.com/share/p/1QCrc77fHn/


As I mentioned in my last post about realistic expectations and goals of OCD treatment, people tend to culturally think of OCD as "being meticulous and orderly." In reality there are MANY types of OCD and ways that they manifest. I could go into deep detail about any one of these, but at a high level here are some common ones:


These are the ones people are most familiar with:



I just want to point out that there is a difference between an OCD obsession and a values based behavior.



For instance, Relationship OCD is plagued by obsessive thoughts and fears that do not align with reality. A person is in an otherwise happy and fulfilling relationship but plagued by fear that may spark an obsession of constantly questioning, investigating, or seeking reassurance. This would be different than a values based behavior of a person who may have red flags that their partner is unfaithful and is gathering information to discern the truth.



Here is another: Some individuals truly ARE members of the LGBTQIA+ community, and it is reasonable for them to have thoughts, questions, perhaps even fears, regarding their authentic selves. In general though, authentic fears are *most often* dealing with how society will perceive them rather than an internal fear. This is appropriate values based questioning.



A gender identity or sexual orientation obsession is different. It would manifest as continuous intrusive and anxiety provoking thoughts such as "What if I'm really homosexual? What if I'm not really my gender? What if I'm really asexual? What if I'm really bi? What if I never figure it out? What if I'm in denial?" When you ask them, "What would you be doing if you never had this intrusive thought" they tend to answer, "I'd be happily living my life with my partner."



And one more: It is reasonable and values based behavior to seek medical intervention for a person experiencing frequent headaches. But a Health Obsession would become fixated. This would be the person who has a brain MRI and has ruled out any serious issues. 


They would tend to question the diagnosis. Get another doctor. Have more tests and more MRI's done. Constantly checking and confirming. Constantly researching and questioning results.



RUMINATING THOUGHTS (ANXIETY AND OCD)


https://www.facebook.com/share/p/1DdUemeyY5/



Distressing, Unwanted, Obsessive, or Ruminating Thoughts: THINGS YOU NEED TO KNOW

If you have ever taken meds for anxiety, I have important information at the end of this article.



Distressing, unwanted, unhelpful, ruminating thoughts. They happen to all of us from time to time and are a normal part of being a healthy, fully functioning individual. Even those really gross ones- they happen to us all. The fact that distressing thoughts exist may be unwanted or uncomfortable when they pop up, but in most cases, they are not problematic. But what happens when they DO become problematic, intrusive, and disruptive to our daily lives and general sense of peace?



My purpose here is not to give a step-by-step of how to deal with this issue, but to fly up to about 500 feet and look at the big picture goals.



Let's look at what is happening inside the brain. Think of **EVERYTHING** that you have a concept of as having its own box inside your brain. Boxes are connected to other boxes. Some of those links may be very weak and some may be very strong. There is a saying that "Neurons that fire together wire together." What does this mean? It means that the more a link is reinforced inside the brain, the stronger that link becomes. Emotions have the role of telling the brain which of those is important. The problem is NOT "having a distressing thought", but the person's emotional relationship to the thought. When a distressing thought arises and you respond with very strong emotion, your response tells the brain that "this is REALLY important and we NEED to hold onto this for survival." A strong emotional response actually strengthens the link, strengthens the thought or image, and in this example, strengthens the distress.



There is another saying that "What you resist, persists." So when it comes to distressing or obsessive thoughts, AVOIDANCE DOES NOT WORK. It actually has the opposite effect of increasing anxiety, strengthening that unwanted link, and makes the brain EVEN MORE prone to serving up that unwanted or distressing thought or image. It is impossible to "just not think that."



The GOAL is to desensitize to the thought. To reduce the amount of emotional reactivity. To be able to simply observe the thought such as "Oh! Hi thought. There you are. I see you." and to come to the place where emotional distress is diminished. When this happens, the lack of reactivity gives your brain the space that it needs to weaken that link, to recognize it as less important, and to focus on other things. Eventually that unwanted thought has the freedom to either go away or to just simply fade into the background and be less intrusive.



I wish that doctors would provide more psycho-education about this when they prescribe medications for anxiety. Not everyone needs prescriptions. But if you do, they work as ONE approach to treat anxiety and obsessive, ruminating thoughts (you still need to work with a therapist to help with all of the other pieces necessary to successfully combat this situation). Meds are a mixed bag filled with pros and cons. 



As a con, they tend to dull the senses and make ALL emotions less reactive- even the positive and desirable ones. We don't get to choose which emotions they dull. But on the other hand, by decreasing the emotional reactivity to those highly distressing and intrusive thoughts, it gives the brain a break and the space it needs to begin to weaken the links. Then, when the time comes that you and your doctor decide to end prescription interventions, the brain has had a chance to "re-wire" so to speak. That is the goal of prescriptions for anxiety. You do still need therapy to help you learn what you need to heal and maintain as the other prongs of approach.



If more people understood the big picture and understood the goals, they would have more agency in recognizing success or in even knowing how to define success. They would be more involved in their own recovery rather than automatically assuming that meds are necessarily a "life sentence."