March 25, 2012

OCD Therapy Rant


I continue to do “well”.  And by that I mean that lately I am consistently applying my CBT, mindfulness and ERP skills.  But I am trying really hard not to take that for granted.  There are times throughout the week that I stop, and mindfully become aware of how well I am doing.  It’s amazing how I am even dealing so much better with stressful situations too.  But I am also aware that it’s all part of the process and ups and downs of life.  I am still doing ERP – watching movies with lesbian themes – and yes – it still gives me anxiety.  But I am able to let it all go so much quicker....and I am able to stop myself from compulsively analyzing every thought, feeling and sensation. 

I have been really busy with work and life in the last little while.  I’m not dating anyone at the moment, which isn’t for lack of trying.  I just haven’t met anyone that I am really interested in spending any time with.  Though this probably isn’t great for challenging my OCD (from an ERP perspective), I am also not trying to over-control my life either. 

Anyway, that’s my update. 

Today I want to comment about therapy for OCD.  And I want to get feedback from others – do they feel the same way as me?  Did they have the same impressions when they started therapy?  Please comment and let me know. 

It seems that there is a prevailing notion “out there” that CBT is a quick, short-term therapy.  That it’s a matter of teaching clients some simple, quick skills and techniques, and then you’re finished and life is good.  That ERP is as simple as spending a couple of hours writing a hierarchy, working through the hierarchy in a few weeks, and then you’re all better.  That you “just” face your fears, wait a few minutes and the anxiety will go away and then you will realize that there’s nothing to be scared of and your OCD will all go away. 

If you’ve spent any time reading my blog, you know that has not been my experience with therapy or OCD.  My “recovery” has not been that simple OR that linear.  I’m sure there are those who have had a quick, linear experience with therapy, just as there are those who have gone on medication and it has magically taken away all of their OCD.  But I would be willing to bet that those people are the outliers.  I bet that most people’s experience with OCD and therapy are more similar to mine – fraught with lots of bumps along the road.  In fact, I’ve stopped expecting that final destination called “recovery”.  Instead I’ve started to look at it as one big journey, with good days and bad days along the way.  Hopefully as time passes, the good days will outnumber the bad days, but there are no guarantees.   

In my opinion, the notion that CBT and ERP are “just do this and you’ll get better” techniques sets people up for failure.  For the longest time I would think to myself “I’m doing all of this stuff – why aren’t things getting better???”  I felt like a failure, which just made things worse.  In reality – none of this is easy.  Anxiety doesn’t always go away immediately after doing exposure.  Sometimes it can take DAYS for me to let go an obsession after doing exposure.  And if I knew how to recognize some of my irrational thoughts, and start thinking more rationally, I wouldn’t be in this situation in the first place! 

Lately I have changed some of my attitude and expectations.  I prefer not to think of any of my therapy for OCD as a “destination”.  I would say that even “recovered” OCD patients still have to utilize the skills they have learned, and still struggle sometimes.  It really is a journey.  The Buddhist saying “This too shall pass” has helped me to realize not to take for granted the OCD –free days, and to also know that the days when I am struggling with OCD torment, that it won’t last.  It never does. 

8 comments:

  1. I'm glad things are going well for you! That's good to hear.

    As for the amount of time it takes to do therapy, it's been 4 years since i first sought help and got some meds. When i was dealing with ocd symptoms on my own, not knowing they were ocd ( thot ocd) they'd take between 3 and 5 years to slowly disappear. Usually that would happen when i finally realized i didn't care anymore that the thot showed up. That i'd found a phrase or thot that in my mind said 'so what' to ocd. Then the thots would slowly disappear over a year or so. But some of these thots STILL show up once in a while. I just don't care. They have lost their power over me. For example: i tell myself that if i did actually molest tom while changing his diaper, then i'll just give him money to go to therapy. Since my real mind knows i didn't do anything, i know i'll not have to pay up. But it gets rid of the ocd dread/guilt feelings.

    ReplyDelete
  2. POC,

    Are you reading my mind? LOL Seriously, I have experienced the disappointment. I didn't think CBT would work overnight, but I thought it would be faster. My impatience resulted in me feeling really down on myself. You're right--it's not a quick fix. I don't think I'll ever use the words "recovered" or "in remission" with my OCD. It's there. It's how well it's being handled by me that is key.

    On another note:

    I have nominated you for the HUG (Hope Unites Globally) Award. You can find out more about the award by going to http://ahopefortoday.com/2012/01/14/hope-unites-globally-hug-award-guidelines/.

    Please also check out my blog post about the nomination!
    http://bringingalongocd.blogspot.com/2012/03/spreading-hope.html

    Congratulations! You deserve it!

    Tina

    ReplyDelete
  3. I think part of our original thoughts that CBT as a quick fix is also a part of OCD. I've spent a lot of my life looking for that thing that would fix it, whether it is weight related, or anxiety related, or as a compulsion. It makes it dangerous for me to watch anything "as seen on TV" because frankly, I still have that instinct. "If i just do this one thing one more time, then this horrible thing won't happen." I think some of the OCD thoughts will pop up throughout the rest of my life, and what CBT and therapy can do is help me effectively cope so that it doesn't rule my life. I am also trying to focus on the journey and not the end result.

    I think you are doing remarkably well. You don't have to be perfect at CBT, just use it when you need it. And remember you have helped so so many people (including me) just by blogging your experiences.

    ReplyDelete
  4. I don't think the potential for ocd thots ever goes away. I DO think that having ctb and erp skills helps us to deal with them much quicker and with less angst or anxiety, thus leaving our energy available for more interesting persuits. Also the amount of time i have spent crying about how much i can't stand ocd has also gone away. When i head out the door or get up in the morning, ocd isn't the first thot on my mind anymore.

    yes, i still have to sit with some thots until the 'dread' disappears, or decide whether i will give in to ocd or not, but knowing that erp and cbt WORK makes it easier to do them instead of giving in to the ocd compulsion.

    but this did NOT come overnight, or after a 'quick' course. I needed to know i had a therapist who cared and would help me. The anxiety course i'm in now is a 10 week course, but even they say i can go another round if i still need the help. They don't kick you out after 10 weeks either. It is also mostly a review to remind me when and how to use the skills i have learned in the past 4 years.

    I look at it like learning a language or playing an instrument. At the beginning a lot of effort results in a little knowledge. AFter a while your knowledge and practise makes learning new words or songs easier. But it takes time.

    ReplyDelete
  5. I absolutely agree with you. All the therapists' books seem to present it this way, but then you look out in the real world, and there's almost no one to be found actually having that experience. And sure, some of those people just got "cured" and went on their merry way, so of course we don't hear about them. But wouldn't you think there'd be a few more people that would be around singing the praises of their success?

    I think perhaps it stems from the fact that "success" in research/scientific study terms might just be as simple as a 20-30% improvement.In theory, you could go from 40 on the YBOCS OCD scale (extreme OCD) to 32 on the YBOCS scale (extreme OCD) and be considered a success.

    ReplyDelete
  6. Very interesting post. I have to say, as an "outsider looking in," I have always thought the opposite......that CBT is long and tough, and anything but a "quick fix." I guess I base this on my son's experience as well as all of your blogs :). I think it's true that reading about CBT therapy and how it works gives the impression of an orderly sequence of happenings that will result in recovery.....certainly, as you say, almost everyone with OCD (and their families) agrees that's not typical. Thanks for the thought-provoking post!

    ReplyDelete
  7. Purely - I soooooo relate to that "I will suddenly find THE ANSWER" - whatever that is!!
    Karin - I agree - it just doesn't change overnight and thank goodness we have resources.
    Ann - yes that is what frustrates me - that the books make it seem so easy! But good point re: what researchers define success.
    Janet - Your perspective is interesting too!!

    ReplyDelete
  8. I AGREE. I AM ACREATURE OF HABIT AND TRAVELING ALWAYS LIFTS MY OCD A COUPLE OF NOTCHES. I RECENTLY TRAVELED TO CA. AND THE CROWD ON HOLLYWOOD BLVD, WAS SLIGHTLY OVERWHELMING. AND IF I MAY PLUG MYSELF. YESTERDAY MY BOOK, THE COPARAZZI, WAS RELEASED ON AMAZON AND BARNES 7 NOBLE.COM. HOWEVER, THIS WAS SUPPOSED TO HAPPEN LAST YEAR BUT MY NEGATIVE OCD REFUSED TO LET ME GO AHEAD. IT TOOK MY NON OCD WIFE TO CONSTANTLY PUSH ME1

    ReplyDelete