Confessions of a Redhead: July 2011

Sunday, July 31, 2011

Happy Sunday!

Snuggle someone you love today!

Friday, July 29, 2011

Places I Would Like To Go

Venice, Italy

I've ALWAYS wanted to go to Venice...

Thursday, July 28, 2011

More Laughter For The Day...

AAAAH! DOODLEBOB! Heh heh, no hard feelings, right?

Laugh For The Day.

This one is for my husband. It's one of his favorite lines:

Don’t you have to be stupid somewhere else?

Not until 4.

Wednesday, July 27, 2011

How Do Obsessive Compulsive People Think?

Fear of your thoughts and sensations.

Published on June 19, 2009 by Robert L. Leahy, Ph.D. in Anxiety Files

In a previous post Those D*** Unwanted Thoughts I indicated how your anxiety often is a result of your fear of your thoughts and sensations. Let's say that you are obsessive and you have the recurring thought, "Maybe I have cancer". But you don't. You've seen the doctor, she tells you that you are fine, you go home and begin thinking again, "Maybe she's wrong. Maybe I have cancer". Then you think, "The fact that I'm thinking that must mean that there is something to worry about. I need to know for sure. I need to do something." So you Google endlessly every possible cancer and expect to see your pretty face appear on the screen.

People with Obsessive Compulsive Disorder have intrusive thoughts (or images) that bother them. These can be thoughts about making mistakes, harming someone, contamination, disease, religious preoccupation, fears of impulses or desires, or just about anything that you might consider dangerous, disgusting or dirty. Examples of obsessions are, "I made a mistake at work and it will blow up on me", "I touched the chair and it's contaminated", "I had a violent fantasy and now I will lose control", "I left the gas on (the doors unlocked, the cat in the washing machine)" or "I did something that God will punish me for". Once you have the intrusive thought you begin looking for more examples of these thoughts. "Oh God! I just had that thought again." You now are watching yourself, totally self-conscious, fearing every possible thought or intrusion that does not reflect a pure and good mind. Your theory of your mind is that you should only have certain thoughts. Everything else is bad or dangerous.

So what do you do when you have these unwanted intrusive thoughts? Do you shout at yourself, STOP? Do you try to get reassurance from someone, "Does this look like cancer to you?" Perhaps you pray for peace, or you have a drink, or you binge eat. Or maybe you ruminate, thinking over and over, "Why am I having these thoughts? Am I crazy?

How to Understand Your OCD

The diagram below (which, I admit, is a little obsessive itself) is from my book, Anxiety Free: Unravel Your Fears Before they Unravel You. It lays out a detailed schematic on the nature of OCD. Let's take a look at each step.

1. Triggers: These are the events or stimuli that set you off. It could be touching something (contamination), leaving the house (something is unlocked, the gas is on), driving at night (I ran over something), thinking of sex (God will punish me, I will lose control).

2. Odd thoughts or images: You have some thoughts or sensations that you don't like. "Why am I having those bizarre, sick, disgusting, unwanted thoughts?"

3. Negative evaluation of thoughts: You think there is something wrong with your thinking-as if you should only have pure and good thoughts and feelings. You have a lot of "shoulds" about the way you should think and feel. You think that now that you have the thought, you have a responsibility to get reassurance, get control or get rid of it. Having the thought is equivalent to being SENT ON A MISSION. You have become THE THOUGHT POLICE.

4. Self-monitoring: You watch yourself like a hawk-looking for those thoughts. Of course, simply because you have to think about what you are looking for ("I am looking for that disgusting and dangerous thought"), you always have to find it. It's like holding up a mirror to yourself and saying, "I am looking for a mirror. OH MY GOD! THERE IT IS!!!!"

5. Demand for certainty: You think you should know for sure whether you will act out, lose control, or are contaminated. Nothing short of perfection and certainty will suffice.

6. Thought-action fusion: You equate having a thought with committing an action. "If I think I will get violent, I will". Or, a thought is the same thing as reality. "If I think I have cancer, then I must be a dead man". Thoughts, actions and reality are all one. All in your mind.

7. Thought-suppression: Your first line of "defense" is to try to stop having these thoughts. You tell yourself, "Don't think that". It works, for three minutes. But your failure to permanently suppress these thoughts leads you to believe

8. "I've lost control": You now equate control in your life to eliminating unwanted thoughts. Now you feel more out of control as you desperately try to control your thoughts more and more. It's like slapping the water and drowning.

9. Compulsions: You now perform some neutralizing ritual. Perhaps you wash your hands excessively, pray, repeat "No", walk a certain way, wash a certain way, arrange things, go back and check, check again. You find yourself frenetically doing these things until you have a

10. Felt sense of completion: You say, "I can stop now because I feel I have done enough. This felt sense of completion now becomes your new rulebook for rituals. "I need to do them until I feel I did enough". You are hooked on your rituals.

11. Avoidance of triggers. You remind yourself, I wouldn't have any of these thoughts if I simply avoided the triggers. So you avoid touching things, avoid public restrooms, avoid shaking hands, avoid movies with Satan, avoid people that make you have feelings that are bad and disgusting feelings. Avoid, avoid and avoid. You are running away from the world.

This is how you think. All in the name of being responsible, conscientious---all in the name of avoiding losing control, going crazy or becoming irresponsible. All because you need to be in control. And it doesn't work. Take a look at the schematic and let us know where you see yourself. In a later post, we will discuss what you can do.

But the first step is understanding how your OCD makes "sense" to you.

From: Anxiety Free: Unravel Your Fears Before They Unravel You by Robert L. Leahy, Ph.D.

The Many Flavors of OCD

Like ice cream, OCD comes in different flavors. This expressoin is a good metaphor for the idea that OCD can present as different symptom subsets. Some of these subsets are familiar to most people, but others are less common, and sometimes less recongizeable as OCD. Let's examine a few of these OCD flavors:

Cleaning is related to washing, but the focus for the person with OCD is not so much one's body as a thing or a place (like a bedroom). The place or thing needs to be avoided or thoroughly washed, often in a ritualistic way, before the person with OCD will willingly come in contact with it.Checking is another one of the well-known OCD presentations, but in addition to making sure that the locks are locked, the gas range is off, and the water faucet is not dripping, other, more subtle forms of checking exist. This is often in the form of repeated questions, and can be anything from, "Mommy, do you love me?" to "Are you sure it is safe?" Any repeated attempt to seek reassurance from another person is in fact a form of checking.

Washing, perhaps the most commonly known, is the vanilla of OCD. Obsessions have to do with becoming contaminated or in some way dirty from sources such as bodily fluids or chemicals, but even this most common of OCD flavors can have an unusual twist. So, for instance another person may be percieved as contaminated, not because of the sweat, urine, or microbes that might be on that person, but because that person is just who they are. The person with OCD might say: "If I come into contact with that person, something bad will happen," or "I will become that person," or "I will take on characteristics of that person." These obsessions result in the same kinds of avoidance and/or compulsive washing rituals as with the standard contamination fears

Repeating. If we continue with our ice cream metaphor, repeating might be a lemon or cherry flavor. While not one of the major standards, is clearly a common alternative, repeating can be a result of a specific obsession: "I thought the word 'death' to myself while I walked through the doorway, and so now I have to go back through it and repeat the behavior while thinking the word 'life' in order to 'erase' or 'undo' the previous activity." It can also be an attempt to merely ward off a bad feeling: "I need to repeat standing up and sitting down again until it feels 'right' and then I can stay seated."

"Hit and Run OCD," also called "MVA OCD" for Motor Vehicle Accident, is a specific instance of a checking behavior, which is so common that it should be mentioned separately. Drivers obsess that maybe they hit someone without realizing it when driving, and then drive back repeatedly to check the area for bodies and/or police or ambulance activity. They will then go home and check the papers and local TV reports for stories about hit-and-run accidents. An interesting twist about this particular OCD flavor is that people with it tend not to focus so much on whether they actually killed somebody, but more on whether or not they will be caught, punished, and publicly humiliated.

Orderliness involves things having to be exactly in their place, sometimes facing in a particular direction, or a specific distance from another object.

Need for Symmetry is the need for things to be equal, or equally weighted. The classic comic gag of the barber trimming a customer's mustache, and repeatedly finding that one side is longer than the other requring further trimming to "even it out" until there is no mustache left is a good example of this flavor.

Sexual obsessions, most commonly a fear that one is really gay or a pedophile when in fact there has been no sexual arousal, sexual fantasies, or sexual behaviors that would support this is yet another OCD twist. This flavor is more common than you might imagine, but sometimes will take a while for persons with OCD or family members to recognize that this problem is in fact an OCD flavor and not a struggle with sexual identity or sexual perversion.

Fear of loss of impulse control is yet another lesser known flavor. This behavior is more along the lines of a chocolate chip mint or cheesecake ice cream, the behavior is not always available but still out there. This involves the obsession that one will act out in some way, temporarily "go insane" and then just as quickly "snap out of it" and then be stuck with the consequences of their actions. Common presentations of this flavor include fear of stabbing one's family members, fear of blurting out inapporpriate statements or curse words in public, fear of jumping out of a moving car, or fear of stealing something from a store. Avoidance of potentially dangerous or embarrassing situations is usually the response, or else engaging in some kind of safety behavior, such as hiding the knives and locking them away or going places with a certain person who will "keep an eye" on the person.

Other flavors exist as well, or flavor twists where one or more flavors co-exist or intermingle. Hypochondriasis or health anxiety, Hoarding, Scrupulosity—the list goes on and on. The themes are always the same, however: A sense of uncertainty or incompleteness that needs to berighted in some way is the obsessive experience. This results in a compulisve or avoidant behavior designed to avert a danger or allow for normal functioning to return.