OCD Action

jo
Member

Hi everyone,
A question for those that have done CBT, how did you decide where to start? I have been asked to pick one small thing to challenge my OCD but have so many little things I do I can't decide where would be best to start as they all seem important in my OCD mind, how did you decide what to pick on first? And did it help?
Jo

Wed Jul 21 2010 9:28:18 #
aishah
Member

Hi Jo,

I would start with the thing that is causing the most distress to you and then work back until you have covered all of the things that are a problem to you.

I have had several courses of CBT but the most recent course has been most helpful as I tackled the problems head on. I am pleased to say that I no longer clean and order all day long, tho I still have to have things at a certain standard.

The problem remaining for me is intrusive thoughts and how much they distress me, but CBT has taught me how to manage them better.

I wish you all the best with your CBT

Bridget

Wed Jul 21 2010 9:38:05 #
Unregistered

Hi Jo

I started well up my hierarchy as, unless I could stand on drains without having a panic attack, I could not leave my house. But as this amounted to 'flooding' (no not literally) it would not suit everyone. Having said this it is marvellous to be able to walk in a straight line down the High Street and to hold my husband's hand when we are out together instead of meandering all over the place and constantly changing sides. I still cannot go out everyday, but being able to stand on drains has enabled me to go to the hairdressers and actually enjoy the experience (without those constant 'did I' thoughts).I can also go clothes shopping and actually try on clothes and buy them (without horrid doubts e.g.- are they contaminated). As these are two of my favourite activities, it was well worth the pain of facing my fears. Doing this has also helped me to tackle the problem of sitting on seats in cafes and buses. As the fear was not so great, I found it easier to tackle after doing the drain one. So I guess I am working backwards.

If you are going to take a gradual approach I would pick something that causes you little anxiety to do and then this will build up your courage to do other more challenging tasks. The feeling of achievement will spur you on to greater things.

Very best of luck
Anne

Wed Jul 21 2010 9:51:13 #
Tess
Member

Hello Jo
I have never had CBT but I think I do it naturally all the time. I have never been brave enough to "flood", if I did I am not sure if I would know who I am anymore or even how to live my life and I am frightened that the level of stress which it would involve would wreck my marriage and affect my physical health. But I have managed to get at least 80% control, to keep stable so that the terrible fears and low moods do not happen any more, and basically to be happy in myself. I have done this with meds and then by challenging the OCD in a gradual way rather than head-on, tackling the easier things first and once these were no longer a problem moving on to the next issue.
I am not sure there is any 'right' way to start, only you know the level of stress and distress that challenging the OCD will cause you, and only you know your own limits. If you start on the easier things and overcome them you will be encouraged to move on to more difficult issues but if you start at the top end and fail then it could be harder to get back on track, depending on how you can deal with your own perceived failure. It sounds as though your therapist is taking the gradual approach and if you can't decide where to start maybe you could make a list and just pick one at random. You have to start somewhere and I don't think there are any hard and fast rules, it's the decision to start that matters most.
Best of luck.

Wed Jul 21 2010 10:19:58 #
Truddles
Member

Hi Jo,

I agree with everyone though I think the last paragraph that Tess wrote is really sound advice.

Brainstorm and make a list of all your OCD problems on your computer, that way you can keep moving them around until you reach a list of problems that are in the order that you think you can cope with. Don't be afraid of the extent of the list - remember it is only a list.

If you decide to try the gradual approach (baby steps) sometimes you need to break some of the problems into smaller steps.

Don't get despondent if you can't manage something the first time you attempt it, just try again. It will become easier with practise. It's just like a baby learning to walk, they do it step by step.

If you get stuck there are plenty of us that you can talk to. I spoke to a couple of friends on the forum when I got stuck with my list and it helped to put things into perspective.

Good luck.

Wed Jul 21 2010 10:34:34 #
jo
Member

Thanks everyone for your advice

Wed Jul 21 2010 22:58:56 #
Unregistered

Dear Jo, I take it from your message that your therapist is suggesting the baby steps approach, but has left the decision to you as to what you would prefer to challenge first. I would make a list and imagine facing each in turn, you will probably be able to gauge by your mental reaction which would worry you the least.

If we read many books and listen to several therapists, we soon realize there are many different ways to approach therapy. I found Anne and Bridget’s way the most successful in the past. However, an almost identical approach has since failed to help me.

I really do understand Tess’ point, there is the fear that taking on something too big could be negative. I actually do feel my last experience of extreme therapy affected my physical health and it did almost destroy my marriage.

Looking at it from the positive point of view, which, as I said, I have also experienced. I found facing all my worst fears at once led to a rapid recovery from my obsession with germs. It has stayed away now for over forty years. After years of living in fear, I was over the problem within a matter of weeks.

The one big difference between the past and now, is that my current obsession is more about contaminating my home than myself. Also, I have no fear of harm (I was not worried so much about the house, but did fear harm to myself and others, due to germs, when therapy worked so effectively).

Something that has never been explained to me, is how to deal with the aftermath of deliberately ‘contaminating’ your home, if therapy is not effective. That is what I fear now and why my family opposes this form of therapy. For this reason alone, I would now prefer the baby steps approach, even though I appreciate that a more drastic therapy could work much more quickly for many of us.

Many psychologists suggest choosing a trigger which is challenging, but not overwhelming. Our anxiety should fall quite quickly, anything from about half an hour to three hours.

Jo, what have you been told to do once you have faced exposure? Were you told to focus on your fear or refocus? This is another issue where the experts can’t agree.

Tricia x

Thu Jul 22 2010 13:59:12 #
Unregistered

P.S. I’ve been thinking back to the past. I was refocusing when therapy was successful. It’s ironic, because a specialist said the reason why my latest therapy was unsuccessful must have been because I was using distraction and not remaining focused on my anxiety. Actually, I was remaining focused at that time. I suppose it proves that it really is a case of trial and error. We are all so different.

Thu Jul 22 2010 14:05:58 #
Unregistered

Hi Jo,

Not too sure if I can add much to this, but as Aishah said, pick what's most distressing and work from there. Though try to pick somethingkinda small at first, one that dosen't frighten you too much, maybe just a little compulsion that drives you up the wall and round the bend and then keep building on that. Though try not to overload or overwork yourself as that will probley have a negitave affect in the long run.

Hope this helps.

- Jess

Fri Aug 6 2010 21:23:18 #