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CBT or Medication - which was right for you?

(43 posts) (13 voices)

Started 2 years ago by Truddles
Latest reply from Truddles
This topic is Not a support question

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Truddles
Member

Hi everyone,

I have just got in from the hospital and I was sad to note that when Glad started a topic entitled 'Is CBT right for me?' and that as it has became so confrontational she wants closed and for someone to start a new topic which I have.

Part of having OCD means that at times we may say something that offends others but providing we don't continue to do so there is no harm in venting your frustrations.

We all consider that when our OCD is really playing up that our OCD is worse than that of anyone else. And this is true as it is us that it is affecting and not anyone else.

This is a friendly forum and the nice thing about it is that we all respect the views of other people and no matter what our OCD is we are always willing to help and support each other.

So can we in a friendly and supportive way share our views on whether we found CBT, medication or a combination of both to be the best way to help our individual needs?

Please don't let it break down like the last topic. We can learn so much from each other by listening to both the positive and the negative experiences.

Thanks

Trudy

Thu Jan 14 2010 16:46:56 #
OCDLONELY
Member

Hello Trudy

I haven't read the topic you speak of but agree totally that everyone here should be supportive of each other and of differing views that we all may have. For me personally neither medication or CBT have helped me. I have tried pretty much everything that the nhs has to offer in way of medication and have had two doctors say to me in person that medication just doesn't work for me. Guess I'm just an anomaly lol. CBT looked and sounded good but when attempting it there were no improvements at all and if there were and I just wasn't aware of them they soon faded and I returned to my usual state. One thing I want to make clear though is that I'm not saying CBT and/or medication won't help anyone here it could be very succesful just that is hasn't been for me. Wishing everyone well

Daniel

Thu Jan 14 2010 17:50:01 #
Truddles
Member

Hi Daniel,

Thanks for your post. You're not an anomaly you're Daniel

Hi everyone,

So if CBT or medication haven't worked for some people what else have you tried?

It doesn't matter if it's worked or not for you, as it might work for other people.

Also don't forget it's sometimes just as useful to know what doesn't work as it is to know what does work

Keep posting

Trudy

Thu Jan 14 2010 18:49:13 #
aishah
Member

Hi everyone, I have mixed feelings about medication and CBT. When I had a breakdown 7 years ago and was diagnosed with ocd, I wouldn't have coped and got back to some kind of normality if it wasn't for CBT. It was immensely helpful at the time. I also started medication at the same time and it did help but not as much as I would have liked.
I have had several courses of CBT since then and 3 years of weekly pyschtherapy. The pyschotherapy was of no use at all as it wasn't structured but the most recent course of CBT I am having has been hugely beneficial. All of my life I have cleaned and ordered excessively but since adressing this issue head on I am no longer doing this and have surprised myself for acheiving this after such a long time.
I am now adressing the intrusive thought side of OCD which has been very distressing these last few weeks. I am doing as my therapist says and must say that I am not so frightened of the thoughts as I have a recording of my intrusive thoughts that I have to listen to everyday, this has helped but I have only had 3 sessions so far on tackling the intrusive thoughts.
I took antidepressants ( seroxat) for five years and thought I would be able to manage without them as I felt better, so I stopped taking them.. This was a big mistake as within a couple of weeks I was getting ill again and had to go back on them.
Apart from my recent change of medication ( which I feel worsened my OCD for the first few weeks but is now settling down) I'd say that I am better on medication than off it.

Best Wishes to you all
Bridget

Thu Jan 14 2010 20:17:45 #
Truddles
Member

Hi Bridget,

You say that you have had several courses of CBT and that you are finding this course to be of benefit. Does that mean that the previous courses were different to this one?

Trudy

Thu Jan 14 2010 20:53:44 #
aishah
Member

Hi Trudy, this course is different because it is dealing with OCD, whereas the other courses I have had have been to deal with anxiety and depression and just coping skills.
I have never before had CBT for OCD solely. It has only been brushed upon and to be honest I have realised my OCD has affected me badly for quite some time now and am pleased that it is being adressed finally.

Bridget

Fri Jan 15 2010 8:25:10 #
Truddles
Member

Hi everyone,

Thanks for replying.

Please read the topic that shelleykts has started entitled 'Im on the mend!' as it links with this topic regarding OCD treatment. It just goes to show that there is no one definitive treatment for OCD. The treatment for OCD is clearly not a 'One size fits all' situation. Not everybody responds to the same treatment.

Trudy

Fri Jan 15 2010 12:05:54 #
Truddles
Member

Fri Jan 15 2010 12:06:32 #
Truddles
Member

Sorry I sent a blank post as I sneezed

Fri Jan 15 2010 12:07:15 #
Nimrod
Key Master

Bless you.

Fri Jan 15 2010 12:46:24 #
Truddles
Member

Thanks!

Fri Jan 15 2010 13:03:44 #
Unregistered

Hi Bridget and Trudy,

I think the loop tape thought-reading is more beneficial than one may expect. It was standard treatment when I went to the Bethlem. I started it again a few weeks ago (but reading and re-reading my thoughts in large bold type) and it had better results this time round. Your brain does really get bored of the thoughts after a while. I have read somewhere that you should do it for 45 minutes a day for 7 days. But I would be fast asleep long before the end of each session. I have managed 30 minutes and went from anxious to bored in that time.

I do not know if others have tried it and if so if it has worked for them.It is most certainly worth a try.

Best

Anne
xx

Sat Jan 16 2010 15:24:08 #
DEAD!
Blocked

CBT is best for me or maybe it's just me doctor - plus I don't want to be a failure for her.

I did this tapping thing a while ago - it was pointless though and I didn't see her long.

Sat Jan 16 2010 15:29:52 #
Unregistered

Not wanting to be a failure suggests that you have a really good relationship with your doctor. I feel the same about my therapist.

I don't know whether or not tapping works for many kinds of OCD. It is certainly good for Post Traumatic Stress Disorder. So I guess it's best for getting a distressing picture out of your mind.

The thought reading is useful though and so is exposure therapy provided you can cope with the fear. But I guess a different combination is right for each different person.

Sat Jan 16 2010 16:10:09 #
Unregistered

Dear Anne, I have several friends who, over the years, have pretended to have improved more than they have, because they didn’t want to upset their therapists!

By the way, I seem to recall that Professor Salkovskis first came up with the idea of loop tapes. I’ve just checked an article that I copied a few years ago, where he stated the following in reply to a patient’s question:

"Strangely enough I have to confess that I invented this technique back in 1982! However things have moved on a bit and this should not be used on its own.

One of the key question is why it is that you find these thoughts so upsetting. For many people it's because they feel that having the thoughts means that they are a wicked person, may be responsible for harm or even that the thought might come true because they thought it. Dealing with those ideas is the first step and then the loop tape can help you confirm that nothing happens even if you don't 'fix' the thought. Also, you can learn that if you ignore the thought the anxiety goes away and it becomes a bit boring."

Sat Jan 16 2010 16:27:48 #
Unregistered

P.S. It didn't work for me, and Frederick Toates talks about the therapy in his book, which alas also failed to help him.

Love, Tricia.

Sat Jan 16 2010 16:30:07 #
Unregistered

Hi Tricia
Yes I did that with all my therapists until I went to the Bethlem. I did not want to let them down. But it is equally true that I did not believe what they said as I had lost my trust in everybody. I remember that one mental health nurse said to me: 'You wouldn't believe it was true even if Almighty God told you.' I knew he was right.

The first person I really trusted was Jonathon Ash at the Bethlem but I also trust my new therapist. With both, it was something to do with the body langauage and the positive vibes. The moment I met them I knew I would be able to do what they asked.

As for thoughts, with me it is an inherited condition I think. I do not feel guilty in any way - just very afraid and perhaps rather angry. No amount of talking about my childhood ever helped. Nor did I 100% believe I had gone down the drain. It was just that the thoughts were so real that I had to check over and over again, wash myself and wash my clothes and then start all over again. The reading helps because my brain gets tired of the words. They are still there but it is now far easier for me to say 'Whatever, sad glad!'

Having said this, if the thoughts are the main part of the OCD and regard self harm, harming others or the like, I would imagine that the talking part of the CBT was extrememly important. Otherwise, reading the thoughts might make things worse. I have had friends wiht this sort of OCd but did not have the courage to ask. I was afraid of making things worse for them.

Sat Jan 16 2010 16:44:45 #
DEAD!
Blocked

Not wanting to be a failure suggests that you have a really good relationship with your doctor. I feel the same about my therapist.

Yeah I do
I wouldn't lie to her though - she'd know anyway if I did. It's like she just knows.

I only tried the tapping once - I saw her 4 times - she said we were trying to early. She wanted to go into the past as well - which was pointless, it had nothing to do with my OCD.
That was in 2007 before I saw a psychologist, but 2008 was awesome and I got the coolest doctor ever

Sat Jan 16 2010 17:44:46 #
Sazzle
Member

I have found a combination of the two useful. I think that it's because SSRIs and suchlike bring your neurological serotonin levels to a "normal" level, such that you can respond positively to any CBT therapy that you receive.

but that's just me

Sazzle xxx

Fri Jan 22 2010 14:38:56 #
Unregistered

Hello Sazzle, It's not just you! Professor Toates, who is an eminent psychologist and OCD sufferer, states in his book that it's his belief the best treatment is a combination of medication and CBT.

Tricia x

Fri Jan 22 2010 14:45:56 #
Truddles
Member

Hi Tricia and Sazzle,

I agree that some people need medication in order to be able to get the most from CBT. I personally am struggling to cope with CBT as not only do I not have any medication for the OCD and depression I also need my epilepsy medication reviewed so that I am able to be more receptive to the CBT. I hasten to add that in the meantime I am doing my best to deal with the CBT, it's not easy though.

Trudy

Fri Jan 22 2010 15:28:18 #
Unregistered

Hi again
Because the forum is a bit quiet, I thought that I would revive this topic too as it fits in with my new one.

I was just reading from Tricia's post that Paul S. invented the idea of loop tapes. It is a very good tool in my opinion and can work even if (like me) you have no idea what you are actually afraid of. I use this in combination with ERP and meds. Read the thoughts first and then do the therapy. This does, of course, increase the fear at first because it is a sort of double exposure. But, with the meds taking the edge off the fear it is bearable. While the exposure gets you used to facing your fear, the loop tape (thought reading) seems to get your brain bored with the thoughts. For me, the end result was a lot of control within four months. Of course you have to keep it up as, otherwise, you start to slip backwards, especially if you are stressed or under pressure.

It may not work for some of you, but it is worth a try, especially for those who are working backwards through their fears. Having said this, I did it for the first time with the support of my therapist, Morgan, and it is helpful to have a willing patner who will support you when you are on your own. My husband loved this idea and was most supportive and extrememly proud of my achievment.

Anne

Fri Jul 23 2010 12:01:41 #
Unregistered

Anne, I am not sure whether to be pleased you resurrected this old thread or not! The reason I say that is because I believe I have observed a glaring error in something I have previously written. It could start a new compulsion of re-reading every message I have written on the forums (my messages total thousands, so it would keep my mind off other things! Also, bore everyone senseless as I list all the corrections!). Talking of which, where is our dear friend Michael? He used my ‘essays’ for his insomnia. I haven’t seen him on the new forum and he is sorely missed. Michael, I do hope I haven’t rendered you unconscious. I still visualize you ‘committing genocide’ in your garden.

Back to the error! I am fairly sure that in Fred Toates’ summary, he stated that in his opinion the best combination was medication and behaviour therapy (I don’t think he included cognitive therapy, which is how I worded my previous message here).

Anne, I am interested in the loop tapes. I’ve only tried them for an earlier obsession and I wasn’t successful, but I’ve never attempted using them for my contamination issues. You know what my fear is. If you were me, how would you go about phrasing what you were going to record onto a tape? I would ask their creator, but I think I’ve shot myself in the foot there!

Tricia x

Fri Jul 23 2010 12:58:34 #
Unregistered

Dear Tricia
You have had me in stitches - and boy don't we all need a laugh from time to time....

Well, this is going to be embarassing - excrutiatingly so -as the forum was small when I last posted this.

So my obsession, the last in a long line of contamination obsessions, is that I have gone down a sewage drain (any) or put my clothes,washing powder, comb, washing, garden chair cushions and even my duvet (yes my double duvet- I do not know how I managed that one) down the sewage drain outside my house.
The fear is unimaginable and therefore had to be faced to stop me from staying in for the rest of my life and boring myself to death with my ruminations:

So this is what I wrote on my computer (or put on a loop tape in your case ).
'I went outside against my will and took off the drain cover and climbed down my drain. I am coverd with sewage, my clothes are covered in sewage. I am contaminated, my clothes are contaminated.' I read these thoughts to myself out loud from my computer for thirty minutes a day for about two weeks. After that time, I got really bored with hearing them and the voice started to fade to a quiet whisper.

When I wrote them out just now, I started laughing - so it must still work. I have had a laugh with a few of you about this recently too.

The next step was to stand on the offending drain until the fear subsided (in the wind rain and snow). After a couple of months, it was really beginning to work. As some of you recall I walked on every drain in town on New Years Eve in my best clothes.

So that is the gist of it .

Love
Anne

Having told you all I can now say this in the book in my own chapter whew!

Fri Jul 23 2010 14:29:48 #
Unregistered

Dear Anne, I don't believe I am very good at this kind of therapy. I have a friend who has the same fear as me, and she panics even reading or hearing certain words that are related to her fear. I don't react like that. I have been writing and saying aloud the worst scenario for me, but it doesn't upset me because it isn't real. Perhaps I am doing something wrong?

Love, Tricia.

Sat Jul 24 2010 14:42:29 #
Unregistered

Hi Tricia

Yes you have to be fearful while you read it for it to work. You have to imagine that you are doing the thing you are reading out loud as hard as you can and then you have to put up with the fear. This may mean greatly exaggerating or writing it in graphic detail. When I did this at the Bethlem it did not work as they did not explain this. Morgan made it clear that for it to work you have to experience the fear.

Love
Anne

Sat Jul 24 2010 15:09:14 #
resentment
Member

Hi there, I'm sorry if this sounds a bit off on a tangent as i know we are discussing CBT and medication but doesn't anyone know if Counselling can help those with OCD?
Sorry about the intrusion!

Sun Jul 25 2010 11:33:13 #
Unregistered

Hi there and welcome to the forum.

I think it is quite appropriate to put other therapies on here.

I think opinion is divided on this. But, my personal opinion is that if your OCD has been aggravated by trauma such as suicides in the family, sexual or physical abuse and the such, counseliing can help. But I do think you need CBT and or meds as well. I say this because, in the end, to get control back you do have to face your fears and stop reacting to them.

Anne

Sun Jul 25 2010 11:57:59 #
resentment
Member

Thank you Anne
My problem is that my husband (who is the one suffering with OCD) does not believe it is a psychological problem that can be cured with such therapies as CBT, medication or counselling etc. He thinks it is a spiritual problem and thinks he needs an exorcist... He went to see an exorcist who told him that that was not what he needed but he refuses to believe him! Are OCD sufferers also very stubborn?!?!
God must be trying to tell me something but i am only very confused!
Suffering wife, Catherine

Sun Jul 25 2010 12:55:40 #
Unregistered

Dear Catherine, I used to think exactly the same. I begged my vicar to perform an exorcism. Yes, people with OCD can be incredibly stubborn. However, it's very easy to feel an entity is controlling our minds and for a few years I was convinced this was what was happening. I'm in a rush today, I'll try to come back tomorrow.

Anne, I did come to reply to your message. Again, I'll try to return tomorrow!!

Tricia x

Sun Jul 25 2010 13:02:51 #

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