OCD Action

Unregistered

Hi BT,

On another thread (about OCD books), you asked me a while ago how Patrick McGrath Phd answered the question, “Is there any type of OCD that can’t be helped?” (In his question-and-answer style book, called “The OCD Answerbook”.)

I’ve dug out my copy of “The OCD Answerbook”, and he answers the above question with the following answer:

Question: “Is there any type of OCD that can’t be helped?”

Answer: “There is no known OCD obsession or compulsion that is impervious to CBT, ERP, medications, or surgery. However, there are individuals who have not gotten much assistance from any of these forms of treatment, yet there is no clear theme of obsessions or compulsions that goes across the board for these individuals. OCD treatment is effective and helps most people who seek it out if they are willing to stick to the treatment.

However, there will be individuals that will struggle with therapy. Therefore, instead of looking for a type of OCD that might be impervious to treatment, it may be better to search for personality traits that make accepting or responding to treatment more difficult. Or, brain scanning and imaging may, in the future, lead us to further understanding of why certain individuals have difficulty with treatment.”

(It’s a really interesting book, and I really liked the question and answer format. It makes it easy to pick the book up and just read the bits that you’re most interested in, if you don’t want to read the whole book.)

Fri Dec 2 2011 21:45:40 #
slogsweep
Member

Hi Londoner, it sounds like a great read. I'm coming to the end of Brain Lock which I'm rather sad about so am looking for another chunk of OCD learning, was the book expensive? Student budgeting means generally beans on toast and second hand books!

Sat Dec 3 2011 8:53:50 #
Unregistered

Hi Slogsweep,

"The OCD Answerbook" is £7.99 in the shops. (I bought it in Waterstones, because I'm old-fashioned. Or maybe I'm addicted to bookshops? I love spending an hour or two in a big bookshop - does anyone else?)

I'm sure that the more techno-savvy among you can get it on the internet cheaper than that!

I really loved that book.

(Note: when I was a student I never really bought text books -- I just sat in Waterstones for hours on end, reading them, then putting them back on the shelf! The big Waterstones are good for that -- especially the ones with comfy armchairs!)

Sat Dec 3 2011 9:07:45 #
Tess
Member

Hi Londoner
That's really interesting about people who don't respond to CBT. Most of the members of our support group say it hasn't helped them, whether that is a reflection on the quality of CBT in south east Cornwall or the fact thet it's only the patients who haven't been helped who get referred on to the support groups I don't know. But one thing I do know is that it is not because they haven't tried their best. One gentleman who has had a high flying career and who has the courage to speak out openly about his OCD in the media has paid privately for three courses of CBT at the best centre in the south west of England and says he just wasted his money and he now manages his OCD with a combination of medication and writing down his intrusive thoughts until they lose their power.
I've wondered if the reason why some don't respond to CBT may be due to a higher genetic component, yet this particular gentleman believes his OCD stemmed from being bullied unmercifully at boarding school - so that doesn't fit the theory.
I think the only important issue is that those who do not respond should not be subjected to attitudes which make them feel they haven't tried hard enough. OCD carries far too much guilt of it's own anyway and if someone has put their faith into CBT and it hsn't worked then they are going to be desperately upset anyway without having extra guilt heaped on top.

Sat Dec 3 2011 10:45:05 #
Unregistered

Hi Tess,

In his answer, Patrick McGrath mentions that "brain scans and imaging" might provide some of the answers in the future. (I take that to mean that he suspects that a better understanding of the chemical / biological elements of OCD might lead to better or alternative treatments for OCD in the future.)

I don't think that any OCD sufferers should ever feel like they're to blame, if their treatment is not successful. That would be like blaming a cancer patient, if radiotherapy or surgery didn't work for their cancer. There would be no sense in blaming the patient.

On the contrary, if an OCD sufferer is brave enough to try any type of treatment, I think everyone should say they have done a great thing. And if their treatment doesn't work, and they try it again, or they try something else, then that shows that they are very brave, and very strong.

In his lecture, David Veale said that if the therapist is not experienced enough, or not skilled enough in dealing with OCD, then this can impact on the success of the treatment. And Rob Willson talked in his lecture about how group therapy might be effective for some people, but that for a lot of OCD sufferers, it would need to be followed by a course of one-to-one therapy. (As the patient might not get enough help in group therapy to get rid of their OCD completely.) Those were just 2 of the ways they discussed that CBT can be unsuccessful, or only partially successful.

I can't see any reason why anyone should feel that they are "to blame" for their treatment not working. Just as the cancer patient shouldn't feel like they're to blame if the chemotherapy or surgery doesn't work, or if their cancer comes back again after it's been removed.

It can be really helpful to read about "cognitive errors", like "black and white thinking". Those sorts of CBT techniques really helped me to see how I had a lot of "bad thinking habits". (Things like "compare and despair"; "mind reading"; "Crystal ball gazing", and "all-or-nothing" thinking habits.)

OCD is hard enough. Blaming ourselves wouldn't do anything to help us.

Sat Dec 3 2011 11:34:47 #
wannabefree
Member

I agree... OCD tries to make me feel guilty for not being clean enough with my hands, and then when I cannot help asking for reassurance, I end up feeling stupid... To combat this, I just go with the flow when I can, and then it's only about forgiving myself for something that may never happen, cos my hands are clean enough, I just have to believe so... But its' all good stuff!
wannabe

Sat Dec 3 2011 20:36:39 #
BT
Member

Sorry, Londoner, only just seen this thread. Thank you very much for taking the time to reply to me. You quoted from the book: “Therefore, instead of looking for a type of OCD that might be impervious to treatment, it may be better to search for personality traits that make accepting or responding to treatment more difficult.” I am in touch with quite a number of people who have not benefited from therapy. In the main, I don’t feel it was due to their not accepting treatment. It certainly seems clear (judging by the effort some have put into CBT) that a small percentage does not respond positively, despite their best efforts. Although personality traits can make a difference - I have a close friend whose personality clearly makes her incapable of accepting treatment - I feel that is not the most common reason for a lack of response.

Tess, I do realise that some people can recall a time when their OCD began, but I’m wondering (as in the case of the man who was bullied at boarding school) whether genetics could still be the dominant factor, even when a traumatic event appears to have triggered it. He was, after all, relatively young, and many people don’t develop OCD until teens, or even early twenties, anyway. I am not sure whether you are saying that he did notice symptoms at the time, though (I’m recalling the Radio Cornwall interviews, but may have a different man in mind). If symptoms begin a long time after a traumatic incident, I don’t think anyone can be sure if the past event was responsible (wholly or partly). Unfortunately, some psychologists still feel there is always a traumatic event that precedes OCD and they will delve and put ideas in patients’ minds. This is concerning, especially as these professionals often believe that finding the cause will lead to the cure. This is happening to a friend of mine right now and he is so desperate to find the ‘answer’ (which he hopes will then lead to the cure). He is convinced the suggestion made by his therapist (about childhood trauma) must be the reason he has OCD. I feel there is always a genetic predisposition, because many people experience horrendous events in their lives and don’t develop OCD. Possibly when young children display symptoms there could be a greater biological influence (as David Veale and Rob Willson state). However, I still feel genetics could be entirely responsible when people develop OCD in their twenties, because so many people I know were in their twenties and they have family members who also have OCD. This can’t be mere coincidence, can it?!

Londoner, I fully agree that dealing with the condition is hard enough without apportioning blame. Sadly, many relatives do this and even fellow OCD sufferers - to themselves and others. There are few conditions where so much responsibility (and blame) is placed upon an individual’s shoulders. Alas, even some professionals do this. I won’t name him, but a leading OCD expert has told people that they have wasted decades of their lives and the choice of whether to have OCD is entirely in their hands. Surely this is blaming an individual?

Mon Dec 5 2011 12:22:09 #
Tess
Member

Hi BT
Yes, the man I mentioned who attributes his OCD to being bullied is the same one who spoke on Radio Cornwall. Incidentally there is another programme on Radio Cornwall this Wed 7th on the Lawrence Reed show at 1pm which you will be able to listen to on I Player about mental health issues in general. It is a prerecorded debate and very interesting. It starts with a question by me about OCD awareness and ends with a question about OCD and SAD by the gentleman referred to above but all the other questions are about other mental health issues.
I personally think you may well be right about genetics being at the root of this gentleman's OCD and the bullying triggered a predisposition into development of full blown OCD. My ancestry shows OCD in nearly every descendant of my paternal grandmother and most of our support group members have OCD in their family history. There is only one whom seems to have no family history of it whatsover.
I didn't realise that some psychologists are still delving into the past to try to establih causes. Back in the 80's I became so convinced by psychiatrists that my OCD must have been caused by sexual abuse as a child that I actually developed a false memory of pain. I tried so hard to remember an event that never happened in a vain attempt to cure my OCD that my brain actually invented it. These techniques should have vanished long ago from psychiatric practice as they just perpetuate misery in the sufferer.
I was in my early twenties when I developed OCD, so was my son and I think the gentleman who was bullied must have been a similar age. He had an excellent job, then one day he was walking along a corridor and he thought all his pens had dropped out of his pocket - he could still see them in there but couldn't stop searching for them on the ground - and that was the start and from then on his life became more and more difficult. This was before the days of modern treatments and the OCD destroyed his career and his marriage. I know he won't mind me saying this because he will talk about it freely to the media to help public understanding and awareness.
BT, I am absolutely with you on what you say in your post but at present the medical jury remains out and we all have to wait for the truth to emerge whatever that may be.

Mon Dec 5 2011 13:05:54 #
BT
Member

Tess, Thank you for letting us know about the Radio Cornwall programme. I will definitely listen in via iPlayer.

I was also surprised, and alarmed, to hear that many psychologists still believe in the Freudian theories. None of the OCD experts appear to, which is a relief, but some professionals still seem to cling on to these outdated and damaging theories.

Tue Dec 6 2011 13:04:01 #