OCD Action

Gladis
Member

Hi everyone

While looking in at the US (yahoo forum)yesterday, I read some very good threads about the benefits of modelling, re-focussing and distraction. In this case modelling not only implies watching your therapist and copying her behaviour but also basing your behaviour on that of a friend/relative/trusted person without OCD. Re-focussing implies doing the exposure and sitting out your fear. Distraction implies doing the exposure and then focussing your mind elsewhere.

With so many people on this forum undergoing CBT at the moment with a therapist or with the use of books, I thought it might be a good idea to share our experiences. This will, in turn, help other OCDers who log in or simply look in at the forum to find some tips on getting some control back.

I will kick off by saying that I have found all three methods beneficial. However,I am finding modelling extremely helpful at the moment in my new effort to get as much control back as possible now that I am on the upward swing again.

Anne
x

Fri Jul 23 2010 8:40:31 #
Tricia
Member

Anne, I have never tried modelling, but then I don't have your figure! Seriously, though, it does sound a useful therapy. I have been given inaccurate information over the refocusing, because I have always been told to shift my attention to something else, not just sit out the fear. The opposite to what you have been instructed to do. This becomes so confusing! Or is re-focussing different from refocusing?

Tricia x

Fri Jul 23 2010 13:32:47 #
Gladis
Member

Hi Tricia

As for modelling, I cannot get most of my dresses on at the mo! I think the citalopram has increased my appetite.

As for the other modelling, it has been extremely useful. I know on the US forum that someone suggested it could be a form of reassurance. This was suggested at the conference too. But as I pointed out, we OCDers get so used to our way of doing things that we tend to lose sight of how other people do things. A lady there at Kate d'Ath's wonderful talk said the same.

I have been succesful with cutting down on my handwashing after asking my hairdresser how many times she washes her hands a day. After about two months I am still sticking to the advice she gave me. My logic is that if it is good enough for her it is good enough for me. So it's well worth a try!

Will ask Andrea about the refocus bit. We had a long chat yesterday about this all and it made me realise what good therapists we OCDers can be.

Love
Anne

Fri Jul 23 2010 14:41:23 #
Tricia
Member

Dear Anne, Has Andrea explained about refocusing? I can only find the kind that Prof. Schwartz advocates, which is distraction.

Love, Tricia.

Mon Jul 26 2010 14:51:21 #
Gladis
Member

Hi Tricia

I honestly cannot find that posting now. I think it was a technique used for fear of flying. So rather than calling it refocusing lets say putting up with the fear or actually agreeing that you have carried out the feared task. So the question is: is staying with the fear more effective than distracting oneself and if so is agreeing that you have done what your OCD voice says the ultimate tool for fighting OCD?

Likewise, is flooding more effective than acting as if you don't have OCD by modelling your behaviour on your therapist or a trusted friend?

For me, staying with my fear is the most effective method as the fear is more likely to be less the next time I face the dreaded situation. I have tried agreeing with my voice when I have had a high degree of control (ie around 90%) but this is too hard for me if I do not.

As regards flooding and modelling, I find both are effective.I use modelling for behaviour that I have been using for years and years. For some OCDers who are too scared to do exposure, acting as if you do not have OCD seems to be a very good idea. I certainly do not see it as reassurance.

For me the most effective methods at the moment are modelling my behaviour on that of a trusted friend or my therapist or people who do not appear to have OCD. Of course this does not work for drains as the majority of people walking along the High Street seem to avoid walking on drains at all costs. As a friend once told me the tourble with my fears is that they are quite reasonable in that most people avoid drains and public conveniences. But, as I explained, this only touches on my problems.

Mon Jul 26 2010 17:27:49 #
mama
Member

Well hello ladies, sorry I have not gotten to this sooner as Anne asked me to post about refocusing and modeling. I am not entirely certain what the doctors say about refocusing, but in my experience, and in the experience of a few of my friends there is a blended sort of technique we use. I will use my recent exposure as an example.
I have a fear that my garage is highly contaminated...it is very high on the hierarchy for me. Well my homeowner's association wrote a letter saying that we all had to start keeping our bins in the garage. I have my hands tied with no choice but to do the exposure on this. I want to live as 'normal' as possible, so I am doing what my neighbors are doing. So my 'modeling' is that of my neighbors...they would all equally use my garage...so I must learn to. Easier said than done though for me so I needed to modify it a bit to get closer. My husband took the garbage out and put the bin in the garage...he went to work and when he came home he was bringing in the 'contamination' through the house. I was very panicked the first day. He walked through the house and all I wanted to do was vacuum the house and spray dissinfectant everywhere but I knew I must not. So my anxiety was rising while he was in the shower...I didnt want to let my kids walk where he walked but I knew I must. I had to distract myself from focusing on the 'contaminated areas' and my anxiety I had to just let rise and fall as it would...So lucky for me my son had a baseball game to attend. I had the choice to stay in the house while they went or go with them. I decided going to the game would allow time for my anxiety to come down and I would not be able to compulsively vacuum as I would just sitting there staring at the 'contaminated spots'. So we came home and my anxiety was down some, but we had dinner guests coming so I still couldnt 'fix' the problem areas and just had to 'act normal' while the guests were there. The longer I acted normal in the house with guests as a distraction, the more my anxiety naturally fell, but not a ton. It was enough distraction to keep me from doing my compusions, but it didnt fix or alieviate anxiety all the way. I was anxious the next day but not as anxious.
Then the next time he took the garbage to the bins in the garage was the next day. I was anxious before he got home knowing I would not have anywhere to go to distract myself from compulsions. BUT, this time it was easier because I knew I done it before and my anxiety had come down on its own. So this time I wasnt as anxious and I didnt need to leave the house to keep from comulsively cleaning or focusing obsessively just on the contamination.
The third time he took the trash to the bins in the garage I had some anxiety but just pushed through and carried on like 'normal' with things that needed to be done. Tah Dah! I've habituated for the most part and can still function like 'normal' people would after taking the garbage(I guess I should say 'rubbish') to the garage.
Its the long way of saying that I think you need to be careful WHY you are distracting yourself for it to be effective. There is a difference between 'avoidance' (which can amount to reasurrance) and 'distraction' or 'refocussing' to aid in successfully withstanding the compulsion and also to aid in not mentally rituallizing over all of the 'what if's'.
Hope that makes sense...and yes, I missed you guys.
Andrea

Mon Jul 26 2010 19:19:41 #
aishah
Member

Hi Andrea and all,

From what you describe, this is the same as exposure or has it changed it's name to modelling.

Take care
Bridget

Mon Jul 26 2010 19:57:04 #
aishah
Member

Mon Jul 26 2010 19:57:32 #
mama
Member

yes it is. i'm not too good at describing what Anne is reffering to as 'modeling'. I think of it as a way to motivate yourself into an exposure. Does that make sense? I will live my life 'normally' today and anytime OCD pops in I will just let the anxiety come but not ritualize. It is difficult sometimes to see what is 'normal' so we look to what others are doing...best if its a trusted friend you know does not have OCD. For instance, when I take my kids to the park, I feel like its 'normal' to make my kids bathe after...I've done that for so long. But do my close friends do this with their children? No...so, because I want to live a less limited life and I especially want my kids to not be limited by my fears, I dont make them bathe anymore unless they are covered in mud or something. I would shower after going to the cinema....my friend just told me she does not...I remember I used to go to cinema without showering...so I have to use my friend and former self as a 'model' to follow in exposing myself to not showering after going to the cinema. . .I thinkits like a tool to help you use the exposure tool. In my mind it is anyway. Nothing earth shattering, but it works for me as a motivator.
Andrea

Mon Jul 26 2010 20:38:48 #
Tricia
Member

Thanks for this Anne and Andrea. It seems to me, Andrea, that you are successfully combining modelling with exposure, using refocusing. You were using your friends as models for your behaviour, you were then exposing yourself to the contaminant you fear (which you knew they were also doing - albeit without the fear!) and, by going to the baseball game, you were distracting yourself or refocusing (this is what Jeffrey Schwartz suggests in ‘Brain Lock’).

In Britain, David Veale and Paul Salkovskis believe in staying with the fear, without attempting refocusing (distraction). Anne, I believe you are saying this works best for you. Both focusing on the fear and distraction can work well. It’s only by each of us attempting different methods that we find what works best for us. I wish we had accurate figures indicating which therapy works best for the majority. Experts on both sides of the Atlantic seem to bitterly oppose each other’s methods, but obviously each has a good success rate.

Modelling is, of course, what I was doing subconsciously at boarding school. I was aware of what my peers were doing and this allowed me to face exposure with slightly less fear. I was also subconsciously using distraction (refocusing) because I had no choice but to participate in lessons etc. The reasons I responded so well and overcame my fears, back then, are becoming more clear to me. I also feared a consequence (illness and death) which is no longer the case. I do appreciate people can overcome obsessions when there is no feared consequence, but it is more difficult. Cognitive therapy also played a large part in my recovery. I assessed my current situation and came to the conclusion that living in fear was actually worse than any risk of illness or even death, because I had no quality of life at all. I also appreciated that avoiding all germs was impossible and our immune systems actually benefit from a certain amount of exposure.

I’m glad we’ve sorted the refocusing out, because it was all becoming rather confusing!

Tue Jul 27 2010 11:53:43 #
Truddles
Member

This started off as a very confused thread with statements that didn’t reflect the meaning of either focussing or distraction.
So a big thanks to both Andrea and Tricia for helping to clarify the meanings of not only focussing and modelling but also of distraction. Not only that but they also sited examples of all three.

Wed Jul 28 2010 13:14:18 #
Truddles
Member

I typed focussing when each time I meant refocussing. Perhaps I should have been focussing on what I was typing I left it to late to edit it is it possible for it to be corrected?

Wed Jul 28 2010 13:25:22 #
Truddles
Member

My sincere apologies for the serious typo errors in my last two posts. I've not got used to the new medication to control my blood sugar and so didn't realise that my blood sugar was quite so low Sorry to have added to the confusion
Anyway what I meant to say in my first post was the following:

This started off as a very confused thread with statements that didn’t reflect the meaning of either refocusing or distraction.
So a big thanks to both Andrea and Tricia for helping to clarify the meanings of not only refocusing and modelling but also of distraction. Not only that but they also cited examples of all three.

Wed Jul 28 2010 15:24:38 #
Gladis
Member

Hi everyone.

What is clear from this thread is that there are so many different ways of getting our OCD under control.

My Maudsley-trained therapist and I do not use labels for different tools. So this is proably why I sometimes get the titles wrong. We use a mixture of the different CBT tools, including those of Paul Salkovskis, Jeoffrey Schwartz, David Veale and Rob Willson, O'Connor, Aardema and Pelissier, and my own modelling therapy I worked out with a therapist at the Bethlem. The last one comprises behaving as if I do not have OCD and modelling on trusted friends. Some on the US form do this with their therapists. I am now trying out the Moritz/Jelinek attention splitting therapy which looks exceedingly promising for me.

With my OCD 80% under control and only the thoughts bothering me, I guess it is working. I walked on every drain in town yesterday and also did the escaltor up in high heels.

Anne

Fri Jul 30 2010 10:52:24 #
Gladis
Member

Hi
Sorry. I need to correct an error in my last post. It is Moritz/Jelinek 'Association Splitting', and the aim is to reduce Obsessive Thoughts. I will be including their research in my book as I am taking part in the trial. So sorry Lena - how careless of me...have been a bit stressed today due to too much multi-tasking.

Anne

Fri Jul 30 2010 16:12:14 #