Christmas skills

Merry Christmas to you all.  We hope that you had a restful day, but it is a good time to remember that this can be a difficult few days for people with OCD.  I have blogged about this previously, but for those of you who are new to my blogs, newly aware of OCD, recently diagnosed or have taken a downturn, here are some points to remember:

The absurdity of certainty

When my clients first arrive for therapy I’m under no illusion.  At that stage they don’t really want therapy, coping skills or even their life to be more functional. What they would really like from me is certainty.  So they say things like, ‘If only I could trust my mind………’, ‘I used to be certain and I don’t understand how that changed.’ And ‘I need to know this is OCD.’.  This initial therapy phase is very predictable and reliable, unlike certainty. To be honest, I don’t even like that word and it’s generally associated with things that aren’t always pleasant, like death, DNA tests and doomsayer predictions. I also don’t like it because the apparent lack of it drives OCD forward to much bigger and more ominous things. I say apparent, because there is no such thing as certainty and therein lies the illusion of OCD.

Time for some stuff about me. Damn. Anyway, my OCD road well traveled...

I have OCD. I am also the founder of OCDFirstAid, a London-based OCD treatment centre. My OCD began as I entered my teens in the late 80’s/90's. I had no idea that there was a name for the strange stuff in my head, let alone treatment. Doing everything 4 times (or multiples thereof), associating bar codes with death, avoiding the colour red, amongst 100’s of other wierd symptoms. After hobbling along for 10 years I tripped over CBT in my early 20’s and adapted it to my own OCD, courtesy of a kindly therapist who freely admitted she knew little about the condition. The lack of knowledge, help and support for people and families of people with OCD was all-pervasive. OCD treatment was a rare and elusive thing.

10 Things you can do today to help your OCD

Recovering or ‘re-recovering’ from OCD can seem like a huge insurmountable problem. Delaying or procrastinating on helpful ways forward with your OCD can be tackled in the same way as all procrastination – break the problem down! Smaller steps and actions are more achievable, measurable and, as you tick them off, produce a sense of achievement and movement. Remember that you will need to keep redirecting yourself away from the problem and towards solutions. Another key component of any effective action plan is ‘life-adaptability’ – the ability to be able to incorporate your steps in to your life. The more you can harmonise long-term action steps with your daily routine, the more likely you are to maintain them. So here are some suggestions for steps you can take today…………

OCD & Eating Disorders - it's complicated!

The link between eating disorders & OCD has been documented since 1939. Kaye et al (2004)* concluded that 64% of eating disorders sufferers had at least one concurrent anxiety condition and 41% of these had OCD specifically.  An article by Neziroglu & Sandler** differentiated between OCD and eating disorders for the purposes of diagnosis according to behavioural and motivational/obsessional criteria. I believe that a comprehensive diagnosis is more complicated and cannot be reduced to these two criteria alone. It will hinge on evaluating possible OCD according to the presenting food-related behaviours and obsessions together with past or present secondary OCD symptoms.

Don’t reassure me!

One of the first-occurring and easiest means of dealing with anxiety is reassurance. This can be done instantly online or obtained quickly from our nearest and dearest. We have learnt since childhood that our parents offer immediate, soothing reassurance as is their practice. Not only was this one of our first coping mechanisms but it was freely given and parents are conditioned to emotionally rescue their children, believing that it was the one thing they could do well. It’s quick, cheap and seems like good parenting. However, in the case of OCD reassurance seeking, this is most certainly a compulsion and very quickly exacerbates the OCD and establishes poor coping skills.  

OCD's favourite tools

OCD as a condition is very manipulative and darkly seductive. It draws clients inwards to focus on thoughts, feelings and emotions. As they withdraw mentally (and often physically) they become increasingly insular and narrowly focused. Spontaneity and natural characteristics melt away and these are replaced with what I’ve come to recognise as ‘the OCD stare’ – that glazed expression which allows the person to be present but entirely absent, locked in thoughts and constant analysis, evaluation and comparison. There are a number of tools and traits that OCD uses to facilitate and maintain this process. Cleverly, it finds existing traits and adapts them to be unhelpful and self-sabotaging.

Questions to ask yourself before starting psychotherapy for OCD

Any mental health therapy isn’t easy. It is never a straight upward line. It is a tough, often frustrating process that needs regular commitment for the long-term. In addition to a time investment, it may well involve a financial investment too. So before beginning on the biggest journey you will ever make, it important to ask yourself some key questions

What makes OCD unique (and not in a good way)?

All mental health disorders and conditions have a multitude of negative aspects. All of them are tough, with no quick fix, despite what pharmaceutical companies would have us believe. OCD is difficult to treat and has distinctive characteristics, idiosyncrasies and challenges which is why we recommend treatment with an OCD specialist and not a general therapist.

OCD is nothing to be ashamed of....

Have you been embarrassed about having OCD? Attitudes and awareness of OCD are certainly better than just 10 years ago. OCD is featured more frequently in the press, films and TV and the portrayal can be more accurate, empathetic and insightful than previously. There is a wealth of info and commentary on social media (some helpful and some not so). Nevertheless, OCD stigma still exists and we see clients struggle with the concept of informing friends, employers, family and partners.

Is it OCD, or am I a bad person?

If this question is familiar to you then you are almost certainly dealing with responsibility OCD on a daily basis. Responsibility OCD far outnumbers contamination OCD in terms of clients presenting for therapy now whereas the opposite was true in 2003 when I first started my practice. And confusingly, responsibility OCD can also be ‘disguised’ as contamination OCD therefore it takes some expertise to disseminate the two and get to the root of the problem.

Is the media scared of a little POCD?

It is true that POCD or Paedophilia OCD is widely discussed on the internet by sufferers and their carers. As far as I know, in contrast with other sub-types, it has yet to be dealt with by the media. 10 years ago a national TV company shot a documentary featuring a segment on POCD. A young client was filmed talking about his fears of harming children. He was barely more than a child himself.  It was brave for all parties, compelling and ground-breaking. It was also completely cut from the final version.

Relationship OCD (ROCD) – Hidden in Plain Sight

In 2004 I first noticed my clients presenting with relationship obsessions.  Naturally,  OCD sub-types can have a cultural or sociological influence (HIV, CJD, paedophilia obsessions), but pathological obsessions about one’s relationship? Could this be a hitherto unrecognised sub-type? It didn't feature in the accepted assessments for OCD. And how might these obsessions differ from the growing cultural absorption with all things relationship? 

How to beat the post-Christmas lows

1. If you are working, use work to be mindful. Make a big effort to focus outside your head on your environment, the people within it and the daily tasks
2. Take care of your diet. Use Glycemic Index science to steer away from refined carbs/sugar/fruit and get lots of protein, veggies and complex carbs. Don't neglect nourishing fats like olive/coconut/flaxseed oils - great brain food
3. Keep hydrated. It really helps. Dump the fizzy drinks/alcohol for a few weeks & treat your body. Drink lots of chamomile/liquorice/ginger tea - warming, calming & comforting for your tum and your mind

Post Christmas is a notoriously tough time for OCD. The reasons are numerous but are connected with:
1. Having less to do for the holiday period. OCD loves an unoccupied mind. Christmas and downtime gives OCD space to create thoughts and obsessions and the time to think about them. Christmas can be an insular time. 

Is there such a thing?

Well, it's not yet a science, but there are helpful dietary tips that are conducive to managing anxiety levels and mood. Having just discussed diet recommendations with the clients attending our recent intensive course, I thought others would be interested. Below are my recommendations based upon client feedback and personal experience.