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Just one piece of advice

Hi everyone,

I know that I have not been posting often and this has been a deliberate decision on my part. But I have not stopped blogging. With limited time on my part, I try to reply to as many emails as I can instead. People around the world email me and I have at least one or two new people emailing everyday. And, I will always reply to emails. I also try to limit the information on this blog to the essential bits. Information overload is present everywhere and it can get very confusing very quickly when we are trying to manage OCD.

On a more personal note, my little boy (Christian) is 7 months todays. He has been a great joy for us as parents and I am glad that I made the decision to tackle OCD head on almost 3 years ago. So I have been thinking and have been asked what sort of advice would be most useful, for  a rOCD sufferer.  Here is what I think:

 

Keep things simple. Take one day at a time. Do not focus on goals (e.g. getting “cured” from rOCD) but rather focus on the process (e.g. I will practice mindfulness for 15 minutes a day in the evening).

 

And that’s it. Useful things on the process could be: eating healthier, seeking for medical advice, getting the right medication, avoiding rumination, and many other things that I have already covered in this blog.

 

 

 

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Some other old notes

Hi everyone,

I was doing some Spring cleaning (not Spring yet) and found some old notes from my therapy and mindfulness sessions. They really helped me to understand rOCD and what the first steps are in getting better. Here they are:

  • OCD looks for areas of rigidity, where we are not very flexible in our beliefs and targets them.
  • Short term goal. When we have an rOCD thought – “this is an OCD thought about…”. Start labelling thoughts.
  • Long term goal . We should slowly start to include possibility statements in our self-talk. For example ” I really do not want to break up, my world would end” vs. “It wouldn’t be great, it would hurt but it could be possible”. This shows OCD that we are not afraid of it and once we take away the target, it will have less strength. This also brings flexibility to our thinking.
  • Our goal is to be able to observe thoughts without evaluating and judging them or analysing them.
  • Do not fight it. Give permission to come in but do not get involved with the thought.
  • When anxiety is a dominant emotion it is very difficult to feel everything else. Learn to recognise anxiety feelings.
  • I know it is OCD because once I seem to find comfort in a thought, and “solved” my problem mentally, another contradictory thought comes up to discredit the first.

My favourite - Thoughts are not facts!

You can’t stop the waves but you can learn to surf.John Kabat-Zinn

 

Book available for purchase on iTunes

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Hi everyone,

Good news. After a long review process by Apple staff the book is now available on iTunes. Here is the link.

https://itunes.apple.com/us/book/love-you-love-you-not/id803442922?ls=1&mt=11

What is the difference between the blog and the book?

The book is written with a start, middle and an end in mind. It explains a process. Some of the content from the blog has been abridged, condensed and included in the book. New content has been created to explain this process better.

Why isn’t the book free?

Between my wife and I, we have spent more than 60 hours writing, editing and researching, learning how to use iTunes software, formatting pictures, etc. From the buyers perspective, the book costs around 15 dollars and the buyer will be paying less than 25 cents an hour for the labour. iTunes will keep 30% of any sales proceedings. We could also say that it costs 2 hours of someone’s salary on the minimum wage in the US. So, we believe that this is fair price and that people are getting a good deal.

Can I read it before I buy it?

According to iTunes policy, the first few pages of the book are free. You can have a good idea of how the book is structured and if it suits you. If you want to support this blog maintenance costs and future posts please buy the book! I am also sure that the book will be very useful to get you started on your recovery journey and it will help other people with rOCD understand the disease and make it more “real”.

What next?

After many interested e-mails we will focus on Skype counselling next. We would like to offer an alternative to people that cannot afford expensive therapy care.  Our goal is to empower you with enough tools for you to take on the recovery journey confidently.

UPDATE – PDF download.

After several requests here is the Paypal link for the book purchase. Send me your Paypal reference and I will email you the book within 24 hours or sooner. If you have any problems – email me at pingfrance@hotmail. I have tried to do a redirect from Paypal to the PDF but it is not working…

Can’t shake it…

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Hi everyone. I have finally started working on the book. Working and helping taking care of a newborn baby takes a lot of time but it is well worth it!

I have picked some emails that I had not yet replied from rOCD sufferers and realised that there was something that I did not cover… “NOT JUST RIGHT EXPERIENCES” in OCD. Or NJREs as it is shortened.

From this link: http://www.ncbi.nlm.nih.gov/pubmed/12732376

Individuals with obsessive-compulsive disorder (OCD) frequently report uncomfortable sensations of things not being just right (“not just right experiences”; NJREs) and a need to ritualize until they quiet these sensations.

Imagine this – You started your rOCD recovery, things are starting to improve and you are obsessing a lot less. But there seems to be an issue – something kind of feels “off”, something is quite not right. You can’t pinpoint what it is. But it is there. What does this mean? How can you “fix” this feeling?

As with all feelings, there is nothing you can do change them straight away. Your experience in that particular moment is your experience. Nothing more, nothing less. By this I mean, there is no need for interpretation or trying to associate this phenomenon with some other things.

CBT teaches us that you can change the way you feel by changing the way you think. I think this is partly true. However, there are some processes that you can influence and others that you can’t. If you feel cold or hot – no amount of “thought changing” is going to fix this. I believe it is the same with NJREs. These are so characteristic of OCD that it becomes futile and tiring to try and change them. We should focus instead on changing what we can e.g. develop better mindfulness and acceptance habits.

The other thing with NJREs, is that they are a “great” way for our brains to bring us back to old rumination habits. Which in turn worsens our OCD and slows down our progress. So the best course of action is just to ignore them, resist the temptation of engaging and do something else.

Hollywood syndrome

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Hi everyone,

I have slowly started the book on rOCD and am still corresponding with some rOCD sufferers. I had a very interesting discussion with one of them. I will call this person P.

I have asked P to write a list of (misplaced) expectations in regards to her relationship and send it to me. She also kindly agreed to share them on this blog as our discussion might benefit other people. By the way, P did a great job recognising where some of the issues might lie!

I call these the “Hollywood syndrome” – where we set unrealistic expectations based on fairy tale type of relationships only seen in movies. This was one of the things that I had to learn as well!

My replies are in blue (by no means perfect either!).

  • I should feel in love with my boyfriend 24/7. Impossible thing – you can’t feel these hormones all the time. Even if you could, you would start getting immune to it. And wanting a higher kick. 
  • When I have a boyfriend whom I consider to be in love with, hence I should not feel attracted to other guys or find them good looking.Impossible. You can’t switch this off. It is like saying “I do not want to feel hunger anymore.”
  • If we are having fights over small issues that means we’re not meant to be. A right couple do not fight.Don’t know of any relationship that does not fight from time to time. The issue is how we do it, not that it happens.
  • If he is not doing enough things for me, then that means he doesn’t love me as much as I do. I probably should be with someone who does things for me more than I do. This is a communication issue and male/female thing. The important thing is that BOTH are willing to put on the effort to address this.
  • I shouldn’t feel bored of him if I love him. If I feel like getting out on my own spending a little time away from him than that must mean I’m bored of him. You don’t stop being an individual when you get into a relationship. You can become more flexible like watching action movies with boyfriend but you still like your chick flicks…
  • I shouldn’t marry him ’cause I already know him so much so after marriage it’ll be all same and boring. (spike given by a friend) - you make the relationship exciting if it needs be. When things tail off – the infatuation feeling – you need to make things kind of happen again. I had a really great time with my wife, playing bowling last week. You have to find the solutions. And you cannot feel excitement all the time, it is not healthy.
  • If I move in with him, I’ll get bored cause of living with the same person all the time. Our love might fade away. Yes, or it might grow to a deeper level. It does not grow deeper when people are apart. But it will require work.
  • If I find some other guy hot then that must means I’m not in love with my boyfriend 100%. Or it just means that you find the other guy hot.
  • If my boyfriend is a bit immature or isn’t upto the level of understanding about life and love and other things then we can’t work out. Every relationship is a compromise. You are not perfect either. But this is the point of love – growing together by means of compromise.
  • if I’m looking for signs then that must mean he is not the right one for me. How do I know this is the one for me?

    Or Is this Mr. Right or Mr. Right-now?!” Maybe I should keep looking for signs. Ultimately, no one knows. No one. Our best bet is to become Mr and Mrs. Right through a lot of work, patience and service. Becoming is reality. Being is fiction.

LOVE IS HARD WORK. By putting two imperfect people together, we can’t expect perfection to happen!
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Winding down…

Living with rOCD is very difficult. But it becomes easier over time if we adopt the right behaviours, mindsets and attitudes. We also should hang on to whatever positive things we have in our lives – our faith, friends, hope, etc. I am glad that I made the decision to stick it out, look for help and above all, take the necessary steps to change – stop thinking and start acting. Today, I can say that I am a rich person (not in monetary terms!). I love my wife very much and last Friday, I was blessed with a little boy. My personal belief is that if I can do it, everyone can do it…

So, I will be winding down on the blog to take care of my family. Next time you will hear from me, it will be about an rOCD book that I have been working on. This is the tentative structure:

Part A – Understanding ROCD

Part B -Q&A – based on questions that I get from different people

Part C – Common errors and misconceptions

Part D – recommended resources

If you would like me to address specific issues please leave a note below!

Guest post 2

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Hi everyone,

Recently, I received an update from someone that I had started helping out a few months back asked her to share her improvement story on this blog. This is not a testimonial to my counselling skills by any means but a testimonial to her perseverance, patience, positive thinking and effort. There is no magic trick here. Here is P’s story:

I had my first OCD thought when I was 19. Since then I was living in a vicious circle of psychiatrists, antidepressants and bad therapists, who never really believed I could ever get better. A couple of years ago I decided it was enough and found myself a proper therapist. With his help I managed to get rid of all my medication but started having terrible withdrawal symptoms and some of my OCD and anxiety came back (especially ROCD). I didn’t want to start taking any drugs again and was looking on the internet to find help. That’s when I discovered this blog. After some hesitation I emailed the blogger and he offered to help me straight away. He told me how he got better and introduced me to meditation and mindfulness. Most importantly he gave me hope! I followed his instructions, started exercising and eating healthy, bought a few books on mindfulness and really got into it. I started meditating every day and focusing on living in the moment. Few months on I feel like a different person! I get up in the morning and I’m not miserable. I go to work and I don’t think “what is this all for, why should I bother?”. I look at my boyfriend and instead of having a million questions in my head, I know I love him more than anything. I learned to accept that nothing will ever be certain and that there will be times when I won’t feel in love with him. And maybe he won’t feel in love with me. But that’s life and I feel like I’m now much better equipped to deal with setbacks and difficult situations. And I look forward to whatever life brings next.

I am really happy that P found the strength to carry on through a very difficult period. But mostly importantly, that she developed a very good mindfulness attitude about her future – that no matter the circumstances, she will be able to deal with it.

Introductions

imagesHi everyone,

It has been a busy couple of weeks but I am now back writing some posts. I have noticed that many more people have joined the blog subscription roll since I moved it to a .com domain. And many more people are e-mailing me asking similar questions. I will always reply to any emails, even though it might take me some time to do it due to the large number of people emailing me and work and family commitments.

Having said that, I would like to give out some general pointers that will be useful if you want to move forward:

1-  Take responsibility

It is your responsibility to look for ways to get better. Giving this responsibility to someone is not going to work. There are no miracle answers when it comes to rOCD. Just hard work. There are a lot of resources on this blog that will help start with this.

2- Take action

At a certain point you will have to stop thinking and start doing. Seeking for medical advice is a very good start. Seeking for a therapist can sometimes be tricky but it will be very useful. If you can’t afford any of these,  look into mindfulness practice. However, this is not a substitute for professional intervention.

3- You have to find the answers for yourself 

Many people tell me their story and ask me if I think it is rOCD or just “falling  out love”. My experience is that this is something that does not help very much. If I say it is rOCD, there will always going to be “what if’s” this and that. So I kind of stopped answering this question and just try to help people help themselves. A word of caution on this one – most often there is nothing wrong with the relationship but the problem lies with your own anxiety. If you want some clarity of mind, you will have to “fix” your anxiety first.

4- If you want to get better

If you really want to get better do not treat rOCD like flu or measles. That it will go away by itself. From all the people that I have spoken with so far there are always good periods where rOCD appears to disappear but it eventually comes back. You will have to commit yourself to daily change if you really want to see some progress. It is hard to retrain yourself and your brain in the beginning, but it will get a lot easier if you persist.

Negative behaviour #2

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First of all, I would like to congratulate all of those who have made some improvement in regards to their rOCD. I have been getting a lot of e-mails lately about people that apply some of the principles in this blog and to a lesser or bigger extent have moved a little bit forward. This motivates me to keep on running this blog.

This blog is not meant to give all the answers to rOCD questions but to share some principles that will help people in their rOCD journey. I do not have all the answers or principles either. But I can see when wrong principles are being applied.I receive a lot of e-mails from people around the world and I spent on most days 1-2 hours everyday answering people’s questions or doing Skype with them. A common theme seems to be reoccurring though.

This common theme is that of spending a lot of time online trying to solve the “rOCD riddle” – people do two things:

No.1 Googling symptoms such as “do I really love my partner” “how to know that you have fallen out of love” etc etc

No.2 Sharing their personal experiences in forums or Facebook groups, “trading spikes” e.g. “this what makes me spike and what about you?”, cross-matching symptoms, etc, etc.

Treating rOCD like a card game where you trade Pokemons (spikes, symptoms) or expecting Google to sort them out. Like there is a magic answer. There is no magic answer. There are only two things in these places – people trying to push their own Hollywood philosophy of what love is (most of these people giving advice are relationship “experts”) and other rOCD sufferers looking for reassurance.

The only thing worst than this for your recovery is rumination – Negative behaviour #1.

I can see the benefit of getting together with other rOCD sufferers and sharing coping strategies, positive behaviours and positive experiences with OCD treatments. If you are going to share something share positive things.Use the 1/99 rule. Spend 1% of the time talking about the problem and 99% of the time talking about solutions. Don’t feed your own reassurance monster or other people’s reassurance monster. You are better off doing a mindfulness exercise in the 20 minutes that you spend doing this.

Like I said in the beginning. I do not have all the answers but I do have the answer for this one. This is definitely something that you should NOT  do.

Roller coaster ride and chronic disease

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OK.I had promised myself and everyone else not to write anymore posts. I guess I will have to take that back as some people have asked me to write about specific topics and I see a need of writing a few more because of some of the feedback and observations of lately. I will start with this one today.

Something that is common to almost everyone that I speak with is what I call roller coaster behaviour. This is the sequence of events (or very similarly), I will explain:

1) There is  a strong rOCD trigger that leads to high anxiety and panic (spikes)

2) Starting to feeling very bad and looking for quick fixes – go to blogs, websites, speak with friends, offload onto partner, etc

3) Life kicks in and the mind/brain gets distracted – start being busy with other things

4) Anxiety decreases (and starts to think that does not have rOCD, it is actually not that bad and I can cope with it)

5) another trigger appears and the cycle starts all over again

So this rOCD has become a chronic disease, does not “kill” immediately but still lives in the background and goes through cycles. And then we wonder, why we do not see any improvement.

Real lasting improvement can only happen when we commit ourselves to daily change. No matter how much good advice we get – if we cannot apply it daily it is only a quick fix. We need to stop and really think about this.

Are there any other options to daily commitment? Yes, if we don’t want to get better.

May Update

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Hi everyone!

As you might have seen by now, the face of the blog has changed. I am trying to follow up on some requests from people that have been emailing me about the structure of the blog and other add-0ns that might help people to better navigate the blog.Some changes:

-I  have bought the domain relationshipocd.com for a year, which should make the blog easier to find for newcomers.

-I am in the process of splitting the posts into different categories – this should make posts easier to find

- and creating a 8 week program based on some of the posts. This will NOT cure your rOCD but should help you gain a better structure in your life for recovery to happen. Again, I stress recovery not cure (I have covered the why’s in another post).

- There is a recent comments box where you can share your views as well on the discussions there are currently taking place. Please do share your positive experiences that are enabling you to move forward. Some people have appreciated this very much.

- There is a page view counter at the end of the right hand column. The reason why is there is to remind everyone that there are lot of other people in the world struggling with the same problem!

- I am still reorganising the structure, so some posts might actually be harder to find until I finish the project!

Falling out of love

It has been a very busy two weeks for me. Work and most importantly family life has caught up with me. My wife ended up in Hospital for a week but she is back home now. Both herself and the baby are OK. This time apart made me realise how much I miss her when she is away. This is a far cry from where I was a couple of years ago with my rOCD. I had anxiety and panic attacks when I was with her. As I was replying to a message from a fellow rOCDer and we talked about falling out of love. I always wanted to discuss this but never really remembered doing it. SO here it goes:

From time to time, I receive an email from someone that is suffering from rOCD asking me if they fallen out of love because they can’t feel anything anymore. I will split this question into two parts: love and lost feelings (or not feeling).

1) Love – one of the biggest mistakes in any relationship is assuming that love is a static entity. What do I mean by this? I mean that we assume that if we find the “right” partner love will develop and flourish by itself and the flames will burn for eternity. This could not be farther away from the truth. Love is not a static entity. Love is a moveable or flexible entity. LOVE IS HARD WORK. If we want to feel more love for someone else then we need to give more than we normally give. Why do we hear about falling out of love? Because in most cases (excluding abuse and things alike), people at a certain time stopped giving and doing the things that NURTURE the relationship. Routines settled in, bills to pay, other interests, etc. The bottom line is that if you want to have a solid and long-lasting relationship you have to put effort in everyday. What starts as seed can only grow stronger if you water and feed it everyday. The problem is that we confuse the seed with the fruit.

2) Lost feelings – Can you feel depressed and feel happy at the same time? Can you feel anxiety and love at the same time? With rOCD the centre of our anxiety is our relationship. But the anxiety is not in our partner. The anxiety is inside ourselves. In certain cases our partners go blissfully unaware of our internal struggles and are very happy in the relationship. The first mistake we make is to try “force” feelings back. We put ourselves into two different situations. For example, we kiss our partner and wait to see how we feel. Or we imagine or see our partner with someone else and see how we react.   We do these mental tests that normally do more harm than good because we do not understand a basic principle: We cannot fill a cup that is already full! If we want to regain our ability to feel, first we must get rid of the anxiety that fills our cup.

So the concept of falling out of love is mostly a Hollywood concept and out of touch with the real world. People do distance themselves through choices they make. This is where we need to start taking responsibility as a society and not blame it purely on feelings.If someone works 12 hours a day, hardly sees his wife and spends most of the time interacting with an attractive colleague is it really a mystery finding the other person interesting and exciting?

It is even more complicated when we deal with people that suffer from anxiety disorders as another level (or levels) of emotions are layered on top of what we would like or hope to experience. So don’t be surprised if it is difficult to feel at this stage.

Hope this helps someone.

Feeling sorry for ourselves

imgresI could just not share this today, as I believe that there are at least 3-4 principles in this video that relate to rOCD. Thank you to one of the people that emailed me and typed rOCD and not Rocd or ROCD, in their message. The first form is the correct one.

There is no magic bullet for rOCD. It is not a flick of a switch. What it is, is a commitment to a daily change in attitude. Here is what I mean:

Change takes time. Change might take medication, therapy and other things but above all a quiet determination to make the most out of our present circumstance. OK, things might not be ideal but what is the next good thing?

Update

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Hi everyone,

This is just a quick update to all of those  people that subscribed to this blog.

1) As you have noticed, there have been some changes to the blog’s theme. The reason for this is that I had an email from one of you mentioning that the posts are hard to navigate. I am trying something different and would like your feedback. I will be trying different things to see what works best.

2) I have started writing a book about ROCD  with all my experiences and hopefully I will have it ready by the end of the year.

3) I am going to be a father to a baby boy for the first time at the end of August (I am sharing the picture that my wife posted today on her Facebook page). We are both very happy and excited! That would have never ever crossed my mind during my worst ROCD period. So there is hope for everyone! I had to fight anxiety, depression and OCD at the same time. And I imagine that a lot of you are in that same place too.

4) I understand that a lot of you are still struggling finding the right support and navigating through the tons of information available. I am going to make myself available on Skype after work if you would like to ask questions about my experience. Drop me a line here if you are interested – pingfrance@hotmail.com. Don’t worry about videoing – we can talk using the voice chat facility.

Be more optimistic (Guest post)

*This was not written by me. This is a guest post.*

Hi, my name is Brandon and I have been suffering from ROCD for just over a year now. I have been with my amazing partner for a year and two months, but unfortunately most of this time has been spent on worrying about my relationship. Sure, ROCD is hell, but I know for a fact that if it wasn’t for the ROCD then my relationship would not have lasted this long. Why? Because ROCD (and any illness as a matter of fact!) always has its positive sides.

Now you’re probably thinking that I’m a mad man for what I have just said. “How can ROCD be good!?” You may ask. But think about it, once you have finally beaten this disease imagine how happy you and your partner will be together. You have gotten through the one disease that has the most chance of splitting you apart, and now you are happily living the rest of your lives together knowing that your relationship is so precious and strong that even your “own” thoughts and feelings could not come between you. (I say “own” because they are not really your real thoughts.)

I am a ROCD sufferer. And going through my ROCD journey was one of the most difficult and confusing periods of my life. I have started this blog as an attempt to help all those that are going through their ROCD journeys. And like me in the past, find it very difficult to find happiness and joy in everyday living. I am glad to say, that today, ROCD does not control me anymore and I live a very happy life with my beautiful wife.
I would like to focus this blog on finding ways to moving forward instead of getting trapped in our own thinking (which caused ROCD in the first place!).

Doesn’t that sound similar to what I have just said? This is from the very first article that was posted on this blog.

I know that most of you read this only took in the part that mentions about sadness and struggling to be happy, but now, if you have read the advice and tips on this blog, it is time to stop the self-pity and stop feeling sorry for ourselves. I know this disease is hard to live with and I know that right now you feel as if nothing will ever be the same again, but if we don’t start being more optimistic about things then we will never improve. There is hope, and you WILL get through this, but for now you’ve just got to try your best to be as happy as you can.

Tip #33 The 2 (or 3) brains

From some emails that I have received, I realised that some of you have been having problems with acceptance and mindfulness – and how to use these to not engage with your thoughts. I think a big part of the struggle is understanding why you should not engage with your thoughts. Once you understand this, I believe that you can make a little bit more progress.

There are at least 2 or 3 (according to the picture) ways to divide the brain. Some of you have come across the idea in psychology of  a reptilian brain and mammalian brain. Without getting too nerdy, I like to think of it as a part of the brain that you can control and the other one that you can’t.

You can’t control the processes that go on in the EMOTIONAL AND REPTILIAN BRAIN. But you can control the processes in the THINKING brain. The best you can do is using your THINKING brain to educate the responses from your EMOTIONAL AND REPTILIAN BRAIN. As with every form of education and training it will take time.

In ROCD, most of the stuff happens in the part of the brain that you cannot control. So trying to use your thinking brain to bring some order to this unruly part of the brain is not going to work. They – emotional and reptilian – do not respond to logic and reason very well. Most of the time you are not even aware that they are there and working. So trying to shut down something that you can’t see, does not hear you or understand what you are trying to explain is a complete waste of time. In fact, it is only to make matters worst. Because the only thing it understands is your emotional response – frustration.

And to make matters worst, your reptilian and mammalian brain will in MOST instances override your thinking brain. If this was not true, then you could switch off anxiety like you flick a button. But you can’t. The only thing you can do is to decrease your response to these stimuli and over time this will educate your other parts of the brain.

The dialogue is something like this:

Reptilian brain – “I better watch out. Something is wrong here. Why do I feel anxious? I need to run away. This feel uncomfortable. My stomach hurts.Better sound the alarm” Passes the message to the emotional brain.

Emotional brain – ” Why can’t I hear anything (feel any love)? Where is that annoying sound coming from?” Passes the message to the thinking brain.

Thinking brain – ” Hmm, there must be something wrong with the relationship because I am not feeling love or in love. I feel anxious now.  Passes the message to the reptilian brain.

Can you see the cycle here? A better mindful response could  be something like this:

Thinking brain - ” This is my experience in this particular moment. It just is.” Passes the message to the reptilian brain.

This last response defuses any need for overanalysing (feeding the reptilian and mammalian brain), for reassurance and for understanding. In practice, this teaches the part of the brain that we cannot control to feel less anxious and not to sound the alarm every time.

The good news is that this works. The bad news is that it will take time. You will have to go through this process of  rewiring many times before you start seeing some improvement.

p.s. this is the link for the picture. Some good content there by the way. http://copingskills4kids.net/Emotional_Coping_Brain.html

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Revisiting OCD

So that everyone knows that what I have been writing here is not complete nonsense :) , I decided to steal some paragraphs from PsychCentral - as always I do not advocate spending  a lot of time going from blog to blog and spending a lot of time reading other people’s experiences or discussing your own. The bottom line is that for those that want to get better they have to put some effort in…

Here is an excerpt of the story:

What if? What if… were constant questions in his mind. Sometimes he felt as if his brain were going to explode because it was racing a thousand miles per hour. He was sure about one thing: he needed 100 percent assurance regarding his thoughts and doubts. He spent countless hours looking for evidence to erase his doubts. It was never enough. He could never arrive at a feeling of peace.

Do you recognize this one?

Individuals with mental obsessions will try to pick apart their thoughts in order to figure them out and resist them.  They can spend hours scrutinizing the answers. It doesn’t matter how long they search through their mind for reassurance or how long it takes them to find the answer on the Internet. The answers will not satisfy the uncertainty they experience.

And what about this one?

And I really really really like how they ended the article:

When OCD tries to creep in, they will learn to recognize it and use the skills to keep it at bay. And lastly, they will learn that living with uncertainty is okay — because the truth is, uncertainties surround us all. Once people with OCD learn to accept this truth, they know they don’t have to be slaves to their OCD ever again.

The only thing that the article does not mention is MINDFULNESS. I think it is a good alternative for CBT and you can practice it at home at your own pace and getting a self-help and mp3′s is definitely worthwhile.

Here is the link for the article

http://psychcentral.com/lib/2012/what-ocd-feels-like-being-absolutely-uncertain/

The point I want to re-make is that the problem is not the R in ROCD. But rather the O.

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The wound – Follow up on weekly challenge

I had a great question today about letting thoughts be. Other people have asked me about this before and it is hard to explain this concept without you having it experienced first – alike to an electric shock. So I will do my best with the use of imagery and something that anyone can relate to:

You have a wound. It is uncomfortable, unpleasant and difficult to live with. It restricts your movement and you are not able to go places that you would like to go. The wound will take time to heal but there is a catch. You cannot scratch it. It will itch a lot but you must resist the temptation of scratching it or otherwise it will not get better. The more you scratch it, the longer it will take to heal because by now you are getting used to living with the wound and starting to tolerate the pain a bit better. A few weeks later if you keep scratching, scratching becomes a habit and it is almost a good thing to do because it provides temporary relief from the itch. But you do not seem to be getting better…and the wound looks like it is getting deeper and you do not understand why.

A couple of questions:

1- How can we apply this example to ROCD?

2 – When does scratching becomes an addiction?

3 – How can we stop scratching in a healthy way?

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Weekly Challenge No.1

Here is this week’s challenge for everyone. Do this properly for a week and you will see improvement in your ROCD. Please post comments below relating to any experiences or difficulties you have with this during the week.

DO NOT ENGAGE YOUR ROCD THOUGHTS.

DO NOT PUSH THEM AWAY EITHER.

LET THEM BE.

BE GENTLE WITH YOURSELF.

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Tip #31 3 Mistakes to avoid on the recovery road

So I have more than 30 posts here (did not think that I would get that far!) and I am thinking now if people are really benefiting from these tips.

I thought that if you give people the tools, they would be able to “fix” the problem. Maybe it was bit naive of me because they still need to learn how to use the tools. This is a very difficult thing to do without providing some sort of feedback like a therapist does. But I am not a therapist. So I can only share what I have learned. I would like to share what not to do. The three most common mistakes that people do (and that I have done) when they try to get better.Here they are:

No.1 – Thinking that you can solve the “ROCD problem” in your mind. 

“If I could just figure out if I love my partner then I would be out of this situation. I need to think about this some more”. And there you go again, thinking about it hours without end, analysing situations and  your feelings, etc, etc…Weeks go by, months and even years. If you can’t see this pattern in your life then most likely you are fighting a losing battle. Always falling for the same tricks that the brain plays on you.

No.2 – Not understanding the difference between treating “R” vs. “OCD” 

There is no magic solution to beating ROCD. In fact the worst thing you can do is to try and solve the “R” instead of the “OCD”. EVERYONE has “R” doubts, problems and questions. Happy and good moments. You are trying to solve the part of you that is NORMAL. Not everyone has OCD. This is what you should be trying to solve. The OCD side. This is the side that has drained your emotions, left you anxious, numb and feeling negative about life. The “R” WAS the side that brought happiness, joy and fulfilment to your life.

No.3 – Not challenging yourself enough and thinking that there is a magic “aha” moment and all will be allright.

I will say it again. There is no magic solution to ROCD. It will take a lot of daily work from your side. I only know of 2 solutions: medication and therapy (e.g. CBT/ERP/Mindfulness) . Sometimes you will need both and sometimes you will not.

It is 2013. Challenge yourself to improve at least 1% from your ROCD. One step at a time. Be patient with yourself. It does get better! I would have lost my beautiful companion if I had let ROCD ruin my relationship. And it almost did. But she stuck by me. In the midst of all my craziness.

My challenge for you in 2013:

1) Read a tip a day from this blog and see how you can implement it in your life, learn from it and try to educate your brain about it. Be gentle on yourself too. It is OK to forget things, not have all the answers.

2) Try to incorporate mindfulness practice in your life. Here is a link with FREE MP3′s. I can help you with this with you have any questions.

https://www.dropbox.com/sh/e8o62697l6x1mwy/ofHiFWKWBh/Mindfulness%20Mark%20Williams

I really would like at least one of you to write a guest article on this blog in 3 months time and I am more than happy to help in any way I can. But I can’t pull you out. You will have to do it yourself. And you can do it if you avoid these 3 mistakes!

p.s. here is a video about mindfulness

http://www.ted.com/talks/andy_puddicombe_all_it_takes_is_10_mindful_minutes.html?utm_source=Web&utm_medium=twitter

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Tip #30 Psychological resilience

At the height of my ROCD anxieties, I stumbled upon mindfulness and decided to take a free course at University.  Before I could go on the course, I had to have an interview with the therapist in order to see if the course would be suited for me and most importantly if I was ready for the course.

A lot of people are exposed to a lot of different psychological techniques to get better but for some reason they decide (consciously or unconsciously) to take what I call – negative action. Negative action is expressed in some of the following behaviours:

1) Focusing on the problem rather than solution

2) Giving up too easily and wanting results quickly or in their own way

3) Not willing to give it a try and experience some discomfort

4) Indulging in self-destructive behaviours e.g. drinking, drugs, short-lived physical-based relationships, etc

4) Adopting self-pity as a best friend…and many others…

The direct result of this negative action is that they bury the problem deeper. Or ignore it, hoping it will go away. The sad truth is that it is impossible to get better by doing this. Some people are able to adopt more positive (action) behaviours. In the face of a problem they are able to do what is needed to solve or minimise the problem, patiently. Psychologists refer to this as psychological resilience.

Some people have it more than others. It is an inner strength that can be developed and grows over time even if you think you do not have it. Here is a link by the American Psychological Association that talks a little bit more about resilience and gives practical tips. http://www.apa.org/helpcenter/road-resilience.aspx#

When I was finishing my mindfulness sessions, I asked the psychologist what was the most important factor that differentiated people that were able to get better  from those that weren’t. Her answer was: psychological resilience. I had asked the same question to my ROCD therapist and she told me something very similar – “those people that get better are those that stick at it.”

Find the time in your life to get better. Give up something that it is not essential for your needs.

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Tip #29 Q&A

Some of you have emailed me asking some very pertinent questions in regards to ROCD. Most of the questions overlapped between individuals. As someone pointed out in a previous post, it could be beneficial to have access to the same “answers”. So here is a general summary or overview of my answers based on my own experience with ROCD:

How do I know it is truly ROCD and not me falling out of love with my partner?

This is one of the questions that I have been asked the most.

First, I always  like to stress that I am not a qualified mental health professional. I am just someone that went through a long period of ROCD and “recovered” from it. I like to make this clear because this is the right thing and fair thing to do. Ultimately, I encourage people to look for professional help if they can afford it or point them to books and other literature that helped me along the way. I think it is important for each of one of us to take personal responsibility for our recovery.

Second, the important bit is the OCD bit. Not the “R” bit. Everyone in a relationship at certain times will question the quality and truthfulness of the relationship. It is a NORMAL thing to do. Especially, if the relationship is under stress. The difference between a “normal” person and ROCD person is that in the ROCD sufferer the questioning becomes an obsession. The “normal” person is able to resume switch off the questioning. The ROCD sufferer can’t. So if you are obsessing about your relationship and this is impacting your thinking, feeling, etc then most likely it will be ROCD.

Third, there seems to be a huge misconception that the level of love in a relationship should remain static. Somedays, you will feel tired and unable to feel much love. Other days you will feel exactly the opposite. If our idea of being with the right person is based purely or mostly on the way we feel than we have fallen into the Hollywood trap – find the right person and you will be forever happy without any work from both parties.

Fourth, being in the “right” relationship is more about being the right person than being with the right person. If you share most of the same values, are both willing to work towards your happiness and there is no abuse in the relationship, most likely you are already in the “right” relationship. Again, this is more a choice than anything else. You can both decide to be happy. Growing apart is more about not nurturing the relationship than not being with the “right” person.

Why can’t I stop questioning or thinking about my relationship?

This is the obsessive side of the disease. It is not easy to switch off. Sometimes it will require medication, other times just therapy. It seems to increase or get worse when people are depressed or anxious. So improving from ROCD will most likely require improving from depression and anxiety.

Why can’t I feel the same way anymore when I want to feel the same again?

Over-thinking has a funny effect on the brain. Your emotions get depleted. It is much harder to feel something. When we feel depressed it is very hard to feel anything else. We just feel down. The other side of the coin is that the more you want to feel something, the more aware you become when it is not there. So this just reinforces the cycle of not being able to feel because you are raising your anxiety.

So to start feeling something again, we need to stop wanting feelings to be there when we expect them to be there and stop the over-thinking.

Why is it difficult for me to accept that I have ROCD?

OCD is also known as the doubting disease. Once we seemed to have found an answer, our brain will try to find an exception to our answer. This is what the brain does when it is anxious. It looks for possible signs of danger.

How can I get better?

Getting better will require medical advice to know if you need medication. Therapy to learn the right tools on how to cope with ROCD. And most importantly, COMMITMENT on your behalf not to give up. Sometimes finding the right medication and right therapists happens in the first instance, sometimes later. I was lucky enough with my medication as I did not have to switch to anything else. Not so lucky with my first therapists but managed to learn something useful from all of them.

Why can’t I feel sure about it one way or the other?

Wanting to feel certain is part of any type of OCD. It torments the sufferer and drives the condition. I like this quote:

There is no such thing as absolute certainty, but there is assurance sufficient for the purposes of human life.

John Stuart Mill

Will I ever feel normal or recover from ROCD?

Yes, if you are able to move from focusing on the problem to focusing on possible solutions.

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Tip #28 Chronicles of Narnia

Not sure if you have seen the movies or read the books (I have only watched the movies!) – Chronicles of Narnia by CS Lewis. He has written many other books, the one that I think applies to ROCD sufferers is called Mere Christianity. Here is what I think is one of the most important lessons from the book (I have split it into small chunks to make an easier read):

Being in love is a good thing, but it is not the best thing. There are many things below it, but there are also many things above it. You cannot make it the basis of a whole life. It is a noble feeling, but it is still a feeling. Now no feeling can be relied on to last in its full intensity, or even to last at all. Knowledge can last, principles can last, habits can last; but feelings come and go.

And in fact, whatever people say, the state called “being in love” usually does not last. If the old fairy-tale ending “They lived happily ever after” is taken to mean “They felt for the next fifty years exactly as they felt the day before they were married,” then it says what probably was never was or ever could be true, and would be highly undesirable if it were.Who could bear to live in that excitement for even five years? What would become of your work, your appetite, your sleep, your friendships?

But, of course, ceasing to be “in love” need not mean ceasing to love. Love in this second sense — love as distinct from “being in love” is not merely a feeling. It is a deep unity, maintained by the will and deliberately strengthened by habit; reinforced by (in Christian marriages) the grace which both parents ask, and receive, from God. They can have this love for each other even at those moments when they do not like each other; as you love yourself even when you do not like yourself.

They can retain this love even when each would easily, if they allowed themselves, be “in love” with someone else. “Being in love” first moved them to promise fidelity: this quieter love enables them to keep the promise. It is on this love that the engine of marriage is run: being in love was the explosion that started it.

There are at least 4 different themes in each of these 4 different paragraphs (maybe even more!): value-based living, setting realistic expectations, power to make our own choices despite circumstances and keeping our promises and commitments.

All these important in our recovery from ROCD. If you can spot any others, leave a comment below!

p.s. my wife shared this with me when I was going through a rough patch of ROCD (we were still boyfriend and girlfriend at the time).

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Tip #27 Extinction vs Instinct

OK. Let us start with a question. What is the end goal when treating rOCD? Think about this for 1-2 minutes. I will give my answer at the end of this post but explain the answer first.

I would like to share with you today an excerpt from an excellent article from Dr. Steven Phillipson, one of the most knowledge people in regards to OCD, specially the obsessive type (in my humble opinion!).

The article talks about two types of responses that are generated when we feel anxious about something: an instinctive response and an extinction response. You can only have pick one at a time. Imagine this, you have an ROCD thought and what do you do? Pick an instinctive response or extinction response? These are what they look like:

Instinctive Response

  • Relief Seeking – running away
  • Exerting an effort, cognitively or behaviorally, to neutralize the threat
  • Reassurance seeking
  • Reacting with intolerance toward being anxious
  • GET AN ANSWER!

Extinction Response

  • Choosing to accept the possibility that the risk is valid, yet not seeking escape
  • Making an allowance for one’s own brain to create these upsetting ideas
  • Creating mental space and tolerance toward the persistent nature of the unwanted thoughts and experience
  • “Letting it be there”
  • Focus on management strategies
  • Not relief seeking!

OK. I will let you think about these for the next couple of days and how you can change and give you the answer to my initial question. If you answered that you need to find answer to your ROCD question or to be completely “cured” than you are following an instinctive response. What does this mean in practice? It means that you are not helping the brain heal itself but rather reinforcing the anxiety cycle. 

The best answer to what is the end goal of treating ROCD is: being comfortable with the uncomfortable. Still having ROCD thoughts but not being bothered by them. Everyone has ROCD thoughts, even “normal” people. The difference is that their extinction responses are automatic.

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Tip #25 The pink elephant

There is a very interesting exercise that is sometimes played in psychology classes. It goes something like this:

  1. Imagine a pink elephant and then
  2. Try  not think about the pink elephant for as long as you can…

Are you still thinking about the pink elephant or have you managed to erase it from your mind ? You could try this with any other unusual thing, object or animal. The interesting thing is that not wanting to think about something sometimes leads to an increased number of thoughts about that same something. This is called a brain paradox.

So no matter how much power and strength you put into not wanting your brain to think about something, the most likely effect is that it will only increase the frequency of those same thoughts. 

How does this apply to ROCD sufferers?

In my opinion, trying to get rid of ROCD thoughts is not the best strategy and shouldn’t be the end goal. A much better strategy is to leave the thoughts alone, not giving them much importance. Accepting that they are there, not pushing them away and most importantly not engage with them. They are just thoughts not facts.The likelihood is that they will disappear by themselves. It is calculated that we have roughly 4,000 different thoughts a day. But we seem to get stuck in that ONE thought that causes all our anxiety and problems. That is the “O” in ROCD – obsessive.

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Tip #24 The emperor’s new clothes


 Starving for attention

The truth is that with ROCD, the content of the thought does not really matter. IF it wasn’t that particular thought it would be something else to annoy you. The ROCD brain is always looking for something to captivate and hold your attention. And it uses the content of the thought to do that.

The brain just goes and looks for the thing that might bother you the most or  that you hold dearest is what gets attacked the most. And the more you pay attention to it the more attention it wants.  And once that thought stops bothering you, the brain will go and look for something else. The solution is to try and attach no meaning to the thought. Once you attach meaning to the thought it gets “marked” in the brain and the brain will check at a certain time if it is still important to you or not. Of course, once it checks the thought will come into your mind again driving your anxiety.

Content vs.process

I do not think that the brain recognizes content very much but rather processes. Imagine this, the brain shoots 20 different thoughts and only one is really disturbing for some reason. For example, for people with ROCD this thought  “is this really love ?” is the one that sticks.The  anxiety will go up and generate a self-reinforcing cycle. And it is this heightened anxiety cycle that the brain recognizes. So if you feel stressed about something and this generates anxiety this might trigger ROCD thoughts because the brain has associated in the past anxiety with ROCD. This is why I talked about association in one of my previous posts.

Conclusion

It is not really the content of the thought that is important. It is how we react to the thought that is important. And this is what a lot of people with ROCD do not understand and fail to get better because they fight the thought and not the anxiety process.

To get better, we need to let go of the question that is driving our ROCD and focus on re-educating our brain to respond better to these thoughts. Everyone without ROCD has these thoughts as well…but they react differently! If you want to be “normal”, you need to start reacting “normal”.

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Tip #24 What we should learn through ROCD

“The most beautiful people we have known are those who have known defeat, known suffering, known struggle, known loss, and have found their way out of the depths. These persons have an appreciation, a sensitivity, and an understanding of life that fills them with compassion, gentleness, and a deep loving concern. Beautiful people do not just happen.”

Elizabeth Kubler-Ross

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Tip #23 The chicken and egg


I can’t think of a better example than the story about the chicken and the egg to describe what goes on with anxiety and ROCD. What comes first? ROCD thoughts or anxiety? If we could go back to the beginning of our personal story maybe we would be able to tell…

Anxiety can take many shapes in the body, mind(thoughts) and spirit (emotions). If you want an exhaustive list you can see one here: http://www.anxietycentre.com/anxiety-symptoms.shtml

It is well known that ROCD thoughts can trigger anxiety. What is less known is that anxiety (and depression) can trigger ROCD thoughts. This happens because our brains learned to make this connection after a while.I call this the ROCD – anxiety – ROCD cycle. Why is this important? Because it tell us that in order to improve from ROCD it is also important to tackle our anxiety and learn how to break this cycle.

Once we learn how to do this  with the help of CBT, ERP, Mindfulness or medication, our ROCD improves greatly.

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Tip #22 Some links worth visiting

This week, I have decided to give everyone a break from this blog and recommend some other links.

The first link is related to ROCD research that is going on in the  psychological community. It is about a group based in Israel led by Dr. Doron. They have done extensive research on the causes and mechanics of ROCD. They also have a questionnaire relating to ROCD diagnosis available. Not sure if they intended to use it to diagnose ROCD patients or not but it looks pretty simple and effective.

It is also interesting that they have split ROCD into two different groups: type I or type II. The only downside is that I could not find much information about the effectiveness of different treatments for ROCD i.e. what works best and what doesn’t to improve ROCD.

https://sites.google.com/site/drguydoron/rocd

The questionnaire is here:

http://rocd.net/measures/

This second link is for an NHS website relating to tools in mental health. I really liked these tools as I have used the depression tool with my family doctor before and after I started my medication and counselling. It was great to see how I had improved my score over time. You will find more tools there to measure mood, stress and depression. What I really like about this link is that after you do the tests, it will give you a score, interpret it and direct you to other websites on how to improve your current situation.

http://www.nhs.uk/Tools/Pages/Toolslibrary.aspx?Tag=Mental+health

Exercise

Ask yourself – Is this information going to help me move towards better mental health? Is it providing short, medium and long term solutions for my ROCD, anxiety and depression?

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Tip #21 Take some time off from ROCD

For me, getting better from ROCD means thinking and focusing less and less on our anxiety and discomfort on our daily lives. And slowly enjoying life with our partners more. But in order to do this we need to learn how to take some time off from ROCD. 

I will start with bad ways of taking time off. If you have learned a bit about CBT and psychotherapy techniques maybe you have learned about thought stopping and worry time.

Thought stopping is “forcing” yourself to stop thinking about something that causes anxiety with the help of a sensory cue. An elastic band on wrist that is stretched and released every you want to stop a thought.  This kind of helps you snap out of the thinking rut. Worry time is scheduling a particular time of the day to worry about something and every time you think about your worries you remember that you have a worry time and postpone the action.

Even though these techniques are useful in other types of mental disorders,  from personal experience I do not think they are very useful in the long term in ROCD.

OK, now for the good way of taking some time off. Let’s say, an ROCD thought comes in. You either engage with it or not (i.e. discuss with yourself if it is true or not). You decide not to engage with it. You leave there and do not pay any attention to it. If you do, you just say to yourself “that is an interesting thought” and carry on what you were doing. You do not attribute it a good or bad value. It is neutral and it is just a thought. If it comes back again and again, remember that it is just a thought and do not engage. It is just a little child wanting some attention.

Remember: this is a skill that you will learn over time. Doing it once will not cure away ROCD. Give yourself plenty of time to master this skill. Try it for a week and drop me an email to let me know how you are doing.

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Tip #20 The radar

Your brain is always looking for signs danger and possible signs of trouble, ESPECIALLY in people with anxiety and ROCD.

Let’s look at this example:

You have been in a relationship for some time. ROCD kicks in. Your boyfriend or girlfriend buys you a present. Your anxiety kicks in because this means things are getting serious and you start to think a lot about possible meanings, and the story continues… Now, the opposite. He or she does not buy you a present. You might be waiting for one. You start to think the he/she is inconsiderate. Your start to think again that maybe this is not the type of person that you want to be in a relationship with…and ROCD and anxiety kick in strongly…

So, see? Damn if you do, damn if you don’t. The brain will always look for a sign of danger even if it is not there! It will make up new  dangers as well.

The solution

Put your brain into neutral. Do not pay much attention to these false alarms and accept each day as it comes. Remember, you can only live in the present not the future.

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Tip #19 The nagging feeling

One of the problems that many people face when dating or are in a relationship is that they are looking for the wrong type of love. The type of love that Hollywood sells. You meet “the ONE” and everything is perfect. You will never have any doubts for one second  and everyone else in the world does not exist. Needless to say that this is part of the unrealistic expectations that other people and WE put on ourselves.

Have you ever wondered, how it would feel like to find “the ONE”?  Maybe you think that because you feel the anxiety and question everything,  then the person you are with is not “the ONE”…and that if you just meet “the ONE”, you will have no more anxiety and the questioning will stop.

Now ask yourself this question: “How many people have found “the ONE”, only to split up a few months later? Had a dream wedding and relationship only to be divorced soon after?” Yes, just look at any Hollywood tabloid paper…

So relying on a feeling of “rightness” to make a good choice is not the best strategy.Especially, when we know that people with OCD are driven by this feeling of something not being quite right. Remember that OCD person that washes their hands 50 times a day because something is just not right?

The cause of this is in our brains. That “not quite right” feeling or that something is wrong. The uneasiness that we cannot explain. The answer that we must constantly find and validate.Then in order to relieve this feeling we develop compulsions. Most common being the CHECKING compulsion. Checking your feelings constantly. The irony here is that the more you check the less you will feel. The more you pay attention to the nagging the more nagging you will get. It is like an hunger that can never be satisfied. I guess that is why there is an “O” that stands for obsession in ROCD.

Once you learn to let go of control, things will start to get better.So, there is two parts in getting better:

  1. Learn to mindfully ignore this nagging feeling which in turn will decrease over time
  2. Transform your relationship from “feelings” based to a value based relationship
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Tip #18 Building your own ROCD prison pt.2

In the previous post, I talked about how important it is to understand how our unrealistic expectations affect our ROCD. This post will cover the subject of comparisons in relationships.

What do I mean by comparisons? I mean benchmarking your relationship against other relationships. Sometimes in ROCD, we look for clues that our relationship is a “good” relationship and it is according to the “standard”.  Of course that for our broken brains, the standard is perfection. What we see in movies and what we    assume  it will be in an ideal world with perfect people.

Problems start when we do not realise  some things:

  1. Every relationship is different
  2. When we observe others we only see the tip of the iceberg
  3. Good and strong relationships are built over time and take effort from both sides, not in an instant we find our “soulmates”
  4. Being loved up, infatuated, in love is not the same as loving someone
  5. That our ability to love our partners is not dependant on how we feel at the moment
  6. We need to decide beforehand what we want in a relationship – this is best done by what we are willing to give. We cannot expect to receive something that we are not willing to give.

It is true that every relationship should have a foundation. My personal favourites are: trust, respect, friendship, commitment, patience, flexibilty and love. If we start here, instead of comparing it  to other relationships our chances of being successful in the long term are far greater.The other thing that happens is that our ability to be happier increases as it is not dependant on other people but ourselves.

Exercise

How am I comparing my relationship to other people’s relationship? Am I setting unrealistic expectations in the process?

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Tip #17 Building our own ROCD prison

It is said that we are the makers of our own prisons. It could not be more true for people with ROCD. Without knowing we slowly build the walls of our mental prisons by using different “bricks”. I will talk about two particular bricks: unrealistic expectations and comparisons. I am sure there are a lot more but these two seem the ones that are used the most.

Unrealistic expectations

Everytime we want to feel a certain way when we are with our partners we are building unrealistic expectations. If we expect to feel love all the time in their presence, it will not happen. If we expect the same feelings of infatuation and discovery that we had in the beginning of the relationship to be present all the time or continue throughout the relationship, it will not happen.

The truth is that we have no power or control about the way we want to feel in a particular moment. The only power or control we have is to put ourselves in a situation where the desired outcomes or feelings will happen “naturally” or over time.  And this is more likely to happen when we forget about it.

Confusing? Let me put this into context. You have ROCD. You had intense feelings for your partner in the beginning of your relationship. You do not feel those feelings anymore. That makes you spike badly. You CONSTANTLY checking to see if you have those feelings back.  As already discussed in previous posts, checking is one of the worst things you can do.

From my personal experience, this sort of behaviour did not bring my feelings back. In fact it only made my anxiety worst. I had to be patient, try to solve my anxiety through a combination of  medication, self-help exercises, therapy and deciding to love my partner throughout my anxiety.

Our brain wants to fix the ROCD dilemma (is this love? is love gone?) so that we are able to fix the anxiety problem. But we need to fix the anxiety problem first to be able to feel love again. Living with anxiety  constantly can make you emotionally numb and exhausted, so do not feel surprised if it is hard to feel again during your anxiety period.

I will talk about comparisons in a following post.

Exercise:

Can you think about other unrealistic expectations that we put ourselves/partners under? They can be related to feeling or thinking or behaving a certain way.

Do you COMPARE yourself often to others as well? And in what ways? How do you think this is impacting your current happiness and living in the present?

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Tip #16 How can mindfulness help?

There are different ways of defining mindfulness and mindfulness practice. I like to think about mindfulness as a tool that help us realise that our bodies and minds are entities of their own and that we are not at fault for most of the things that are going own. For example, if you have a bad thought that does not make you a bad person. If you have a thought that comes into your mind, that does not mean that the thought is true either.

Mindfulness goes beyond raising awareness of thoughts and looks at feelings and other bodily sensations. We start slowly to realize that we go through cycles of feelings, body sensations and thoughts and that all these are part of being human. If we are serious about recovering from ROCD then we need to develop serious mindfulness skills.

By increasing our awareness, we also increase our acceptance. By increasing our acceptance, we start to become comfortable with the uncomfortable and our anxiety decreases. We start to see more clearly with this new understanding. The objective is not to feel better but to feel better.

In my previous posts I have talked about other techniques and they can be put in context like this:

CBT – Understand and disarm your enemy

ERP – Fight your enemy

Mindfulness – Do not mind your enemy

I have also given quotes for the other two therapies. The quote for Mindfulness would be this one:

The greatest victory, is the battle not fought. Chinese Proverb

Exercises:

Read more about mindfulness, buy a book on the subject, watch some videos on Youtube

Here is a good starting point – MINDFULNESS VIDEO

 

Think and visualise your anxious thoughts as leaves in a stream. Observe the constant flow of thoughts coming and going.

Learn how to incorporate mindfulness practice into your daily routine. 

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Tip #15 How can ERP help?

ERP stands for exposure and response prevention. It is one of the psychological treatments of choice for Obsessive and Compulsive Disorders.

The idea behind it is to decrease your anxiety levels by exposing you to the things that make your anxiety spike. This sort of therapy normally starts by gradual increase of anxiety triggers e.g. start with the things that might you spike less and slowly work towards those that make you spike more.

I read a quote once that said something like this: “It is best to suffer the worse right now than to live in perpetual fear of it”

The same it is with anxiety related ROCD. And this is what ERP intends to do: to take the perpetual fear of something and put it into the present, enabling us to face our fears. The more we do this, the less fearful or anxious we become.There are different methods of delivery for this type of therapy: self-help through books, online-phone sessions and face to face sessions. One might be more beneficial for some than others.

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Tip #14 How can CBT help?

CBT stands for cognitive behavioral therapy and it seems to help sufferers in many types of mental disorders. It can be a complement to medication or stand alone therapy. I will not go into much detail about CBT as there are entire books written about it. I would rather explain how CBT can help people with ROCD.

CBT intends to explain the relationship between thoughts, bodily emotions and feelings. And it goes beyond explanation to help change and develop better thinking habits. It is helpful in a number of ways for people with ROCD:

  1. Starting to realise that the cause of anxiety is internal rather than external
  2.  Develop healthier thinking patterns
  3. Develop more realistic expectations
  4. Understand that latent anxiety can also trigger ROCD thoughts i.e. sometimes we do not realise that having anxiety in our bodies (physical reactions) can trigger thoughts in our minds (not just vice-versa) See below


5. Understand the anxiety cycle (below)

By gaining a better understanding of our own thinking and learned/automatic behaviors we are much more equipped to “battle” OCD. Check out the quote below:

It is said that if you know your enemies and know yourself, you will not be imperiled in a hundred battles; if you do not know your enemies but do know yourself, you will win one and lose one; if you do not know your enemies nor yourself, you will be imperiled in every single battle. Sun Tzu

Drawing from personal experience, I do not believe that CBT is a complete approach for “solving” ROCD. The reason for this is that sometimes ROCD sufferers develop different obsessive problems about their partners and the themes just change without “solving” anything, The REAL problem that needs to be solved is that of obsessive thinking that causes anxiety. I believe Mindfulness and ERP can help much more here – I will cover these in my next posts.

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Tip #13 Lies and more rOCD lies

A ROCD brain is like Pinocchio. It likes to tell a lie here and then by sending false messages. The only difference is that it has no nose to grow and thus making it very difficult to spot the lies. Sometimes, we can see a nose growing when our anxiety increases…

Some of the ROCD brain’s favourite lies are:

“If I am attracted to other people, then I do not love my boyfriend/girlfriend” – Attraction is part of human nature. It is not like a switch that can be switched on and off. Choice is what makes us love our partners.

“If I find the right person, I will not feel anxiety anymore” – The anxiety is not caused by the other person. It is caused by how our brains interpret a possible danger.

“I always feel anxiety when I am around my boyfriend/girlfriend so there must be a problem with our relationship” – Same as above.

“I can’t feel anything anymore, this means I do not love her/him.” Feelings of infatuation will run its course over time. In addition, it is not unusual for people with high levels of anxiety to become emotionally drained or numb.

“Why can’t I feel that special feeling. Maybe this is not right anymore” – From experience, wanting to feel a certain way whenever something happens is not realistic. For example, the first kiss will not be the same as the tenth kiss as the excitement might be gone.

And much more

There is only one truth in all these lies. The brain wants to keep itself engaged with rumination and analysis. This will not solve the ROCD problem and will only make it worst over time. The only way to get better is to stop this cycle.

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Tip #12 Meds or no Meds

A few weeks ago, I came across a blog advocating the non-use of drugs for mental illnesses such as depression and anxiety. People that wrote this blog were trying to say that pharmaceutical companies do not have the evidence to support drug use in these types of mental diseases and only have interest in their “agenda”. Funny enough, at the end of the same blog the authors were pushing their own agenda – selling their alternative therapeutic services.

I think this is quite an irresponsible way of approaching the issue of drugs in a mental health setting, so I decided to write this post.

One thing that many people do not realize is that treating a mental condition is not the same as treating diabetes or high cholesterol. It is much more complex due to the mental factors. What might work for me in regards to my anxiety or depression might not work for another person. Drugs can be processed by our body differently amongst  different individuals (due to genetics) which might explain why certain drugs work for certain people and others not. It also explains why treating the same condition might require different daily doses.

A couple of things to take into consideration:

-Is the drug treating anxiety, depression or OCD? -(Unfortunately no ROCD drug exists!)

-What is the drug supposed to do? (This helps build better expectations about the drugs)

-What are the possible side effects?

-How long will the drugs need to start making a noticeable effect?

During my initial ROCD period, I was treated with a drug for anxiety and depression. Even though the initial two weeks of treatment were difficult because of the side effects, “fixing” my anxiety and depression symptoms helped me put my mind and body in a better place to benefit from psychotherapy and mindfulness. I also worked with my doctor in setting my daily doses. I was very reluctant in taking high doses because I knew that it might take me longer to get off them.

Will drugs be needed in every case? No. Can drugs benefit certain individuals progress faster? Yes. Ultimately, the decision to take these types of drugs is ours and no one else’s. What we shouldn’t do is take someone else’s experience as the main yardstick in our decision making.

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Tip #11 Focus on action not results

One thing that we might not realise is that our focus as ROCD sufferers should shift from results to action. I will explain this further:

We have ROCD. We want to be better or get cured from ROCD. It is only natural. But at the same time we are building this expectation into the brain – getting better or getting cured. What this does is to instruct the brain to check regularly if we are better or cured. And once anything “strange” pops up this will flair up our anxiety and sometimes ROCD. Someone once said that “If you dig deep enough you will struck oil” the same it is with our brains…

If we focus on actions rather than results it turns out to be a more powerful approach. And ask ourselves the question: “Are we doing all we can do get better?” This might mean practicing some CBT exercises, mindfulness, meditation, yoga, and learning about other things about OCD. In addition, learn to do this with a compassionate approach to yourself. New routines are difficult to build so don’t expect to fall into a new one straight way.

Remember: Our long term goal is to be comfortable with the uncomfortable. Once we learn how to do that we will start to enjoy life a lot more. ROCD will turn from a large stone around our neck into a small pebble inside our shoe.

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Tip #10 Tough love

*For the benefit of our non-native English speakers ROCD friends*

Tough love is an expression used when someone treats another person harshly or sternly with the intent to help them in the long runWikipedia  (Not really the picture but I thought it would be fun to have a play on meanings…). Now for the more “serious” stuff…

Ask yourself this question. How long have I been suffering from ROCD? Think about that for a few seconds. Now ask yourself why.Think about that for a few more seconds.

If you treated yourself harshly or started to feel sorry for yourself or re-assessed if you are making or made the right choices in regards to your relationship,  then I would have to say that these are the real reasons why you are not really progressing.

If we focus too much on the problem it is going to be very difficult to find solutions to the problem!

Seems simple and obvious but this appears to be what people like ourselves, that have ROCD, do best. True that we need SOME thinking in regards to what we are experiencing. But if your thinking is totally devoted to the  problem and symptoms- specially what if’s or If I’s - we are not going to conquer our ROCD.

Furthermore, this sort of mental attitude becomes addictive, reinforces negative behaviours and develops compulsions. Think about another thing…how much time have you devoted to reading other ROCD stories only to spike more without finding solutions? Or discussing the finer details of your what if’s and if’s with a internet stranger?

It is fine for a while, to find support and comfort but then you have to move on to a more the solution focused mindset.

Exercise

Having ROCD and suffering from ROCD are two completely different things. Can you tell the difference?

Remember:

What holds your attention holds you and finally becomes you.

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Tip #9 Misery loves company

One of the most difficult things for people with ROCD is that in most cases they have to battle not only ROCD but anxiety and depression as well. So it is a triple fight. Sometimes even other forms of OCD.And this can be a very hard process. So give yourself a break.

The good thing is that by tackling anxiety and depression your ROCD symptoms will likely improve because the techniques to treat these conditions tend to be the same or shame similar principles.

What this means:

Learn to recognise the first symptoms of anxiety or depression. Have set strategies to deal with them. These could range from shopping to mindfulness meditation to watching a funny tv show. The important thing is to not let yourself be sucked into the spiral of depression and anxiety.

Exercise:

Write down 3 things that you notice about yourself when you start to think anxious and depressed and what led to them.

Now write down things you can do to help you cope with them. Remember that the long term objective is not help you run away from it but to be comfortable in their presence.

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Tip #8 How long is a piece of string

For those that are not familiar with the expression “How long is a piece of string?” this expression normally implies that the answer is hard to tell, find out or very complex for varied reasons.  For example if someone asks me: “How long will take me to recover from ROCD?” I would have to reply: “How long is a piece of string?”

The important thing is not to focus on a time frame but on the process of getting better. For some people it might take 6 months, 12 months, a year or a lifetime. It does not really matter. What matters is that we learn to live with ROCD and that we are able to enjoy our relationships.

Then, the important question becomes “what do I need to do to enjoy my relationship more fully?” In my mind and experience, there are three sets of strategies that we can adopt to cope with ROCD with different effect durations. As for effect, I mean in this case release from anxiety and improvement from ROCD symptoms.

Short term solutions (look for immediate release)

  • Running away or avoidance
  • Thought stopping (not recommended in the long term)
  • Worry time (not recommended in the long term)
  • Distractions
  • Breathing exercises

Medium term solutions (look for better understanding of thought processes or cognition)

  • Cognitive behaviour therapies (CBT)
  • Acceptance and commitment therapies (ACT)
  • Medication for anxiety/depression

Long term solutions (look for desensitization)

  • Exposure therapies
  • Mindfulness

I am sure that there are more therapies and strategies, but these are the ones that I have had experience with.There is merit in most of them for all of us. The other aspect is that those therapies that will produce the better long term  effects will take longer to master, so be patient with yourself!

Exercise:

On your ROCD journey, can you see if your focus has been mostly in one of the groups? Or are you trying to find a balance of short, medium and long term solutions?

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Tip #7 Where are you now?


A big part of getting better from ROCD is making a plan on how to get better (I will cover this in a later blog!). But before we start this recovery journey, we need to understand where we are. The reason why we need to do this is simple. It will help us decide the next steps to take. Not everyone is at the same stage in their ROCD journey to recovery. Speaking with many different ROCD sufferers, I realised that not everyone has the same level of understanding of the condition, how to tackle it and how to cope living with it.

Knowing where we are in our journey can sometimes  be a very difficult thing to do as well. On my road to recovery from ROCD, there were some very distinguishable landmarks:

  1. Finding out about ROCD
  2. Figuring out if I had ROCD
  3. Accepting ROCD
  4. Committing to daily change
  5. Learn and develop better coping strategies
  6. Moving forward with courage and patience
  7. Accepting and embracing uncertainty

I guess a big part of ROCD sufferers are stuck in number 2. And the worst thing is that they do not even realise it. What we need to understand is that knowing that we do have ROCD is not the end of our journey but just the beginning. And we should treat it as such. Even if you do not have ROCD, most likely you are suffering from some sort of anxiety related condition that will need proper attention as well.

Can you see where you are on your ROCD journey?

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Tip #6 Consider your options

When it comes to us, “ROCD people”, we like to dwell on the symptoms of our condition and replay different options and scenarios in our minds. We do this in hopes to find a solution or answer that we never seen before. And this goes on and on and on…… This is not a very good way of moving forward and improving our ROCD. In reality there are only two options:

Option 1 – Continue doing what have been doing so far –> ruminate and reinforce the cycle

This is what we do best. Getting lost in our thoughts, creating more anxiety in a non-ending stream of possibilities and deep analysis. This only makes ROCD worst. We develop other compulsions (specially checking types for feelings). This is not very productive and will only end up making us emotionally numb, anxious and depressed. But we still keep on doing it, day after day…I guess that is why it is called an obsession.

Option 2 –  Try another approach –> commit yourself to change and break the cycle 

For us to get better, we need to try a different approach. The very first step is to commit oneself to a change in behaviors, thoughts and actions. We can get all the necessary tools to get better but if we are not committed daily to change then we will never achieve our desired goal. Being committed is one of the hardest parts of the process of change. You have to be very strong minded to be able to achieve this. Strong minded because it will take time to see the results and not everything that you will try will work. Somethings will not work, others will work very quickly and others very slowly. Accepting this is part of this commitment to change.

Exercise

Can you identify thoughts, actions and behaviors that reinforce your ROCD addiction cycle?

Can you  identify positive ways of breaking the cycle?

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Tip #5 Slooooow Down

ROCD fuels anxiety and anxiety fuels ROCD. And all these are fuelled by OVER-THINKING. I wrote a bit about this in my brain shovel post (tip #3)

In order to get better from ROCD and anxiety, we need to recognize when we are over-thinking things too much…and need to SLOW DOWN.

Imagine this:

Your brain keeps spinning trying to find an answer. The more it spins the more confused and frustrated you get. And this is how your anxiety is being fuelled. By OVERTHINKING. The technical term for this is RUMINATION. It is well known that rumination is at the root of depression and anxiety.

You will not feel better or find the answer by thinking too much. In fact, it is only going to make it worst. You will start to feel better when you learn to STOP thinking. This is only a short term fix. But this is where you need to start to put yourself in a healthier position to start your road to recovery.

How to stop over-thinking or ruminating (changing your focus). The first two are short term fixes. The last one is more long term and is related to mindfulness.

1) Learn to identify when you are engaging in this negative behaviour. I good question to ask is “how long have I been thinking about this today?” If it is more than 20 minutes, I would say that is too much…

2) Find something to distract you – music, tv show, go outside for while, see some fail videos on youtube. Find your own coping strategy!

3) If you get pulled in again into overthinking, GENTLY bring your thoughts to something else. Don’t be mad about it. Be nice to yourself. This is a long term skill that needs to be practised to be effective. More about this on a later post.

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Tip #4 Sleight of hand

Well, don’t ever think that you can be smarter than your brain. It will get you in ways that you have never  thought possible before. I had to learn this the hard way with my ROCD. But once I knew how the trick was done I wasn’t fooled again (at least as easily!).

See this video and realise how un-awesome it is at the end. http://www.youtube.com/watch?v=YN0I-TZFn58

Our brain has its own tricks for survival and functioning. The problem is when these same tricks are the cause of much wrong doing in ROCD. From my experience the most common ones are:

  • Association
  • Exclusion
  • Addiction

I call this the sleight of hand of the brain in ROCD. Those who are familiar with the English language know what the expression sleight of hand means. For those who aren’t here is the wikipedia link. http://en.wikipedia.org/wiki/Sleight_of_hand

Association starts with the expectation of wanting to feel/think or not feel/think a certain way. For example, the boyfriend or girlfriend is away for awhile and we do not miss him much for some reason. If that happens it is because we do not have real feelings for that person. Can you see the sleight of hand here of association? We might have been very busy,  tired or we just not are the missing type very much. But the brain went and decided that that association is true. And from what I have seen in OCD not just ROCD, it tends to go and pick the worst case scenario. The other classic one is I feel anxiety when I am with the other person then if this was right I would not be feeling this way.

Exclusion is another funny one. Once we make our minds about something the brain goes and looks for an exclusion to the rule. Ufff, I finally found out that I have ROCD. Once you achieve that “certainty” your brain starts to think about the exception. “Maybe it isn’t true because this and this happened or I feel this and that way” and there it goes 3.5 hours of thinking down the drain.

Addiction, this one is less obvious. But simple to explain. The more we think about something the more we want to think about it. It is very true with ROCD and it creates almost an addiction to trying to find the answers or evidence to our questions. The fact that we engage in problem solving  with our brain is almost a release from stress. Only to find out something that we do not want to find out with our questioning. YOUR BRAIN WANTS YOU TO KEEP LOOKING FOR AN ANSWER. Then we start all over again. Oh, and another extension of this is being obsessed about our symptoms and talking endlessly about them. More about this in the next post.

Here is an exercise for you. Can you think about how you are falling prey to any of these brain tricks by your ROCD?

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Tip #3 The brain shovel

The lesson that I took from my ROCD experience is that I cannot “out-think” my brain. In other words, if my brain has a problem or is imbalanced, any thinking that I do with it has the risk or not being very good. Using the heart as an example, it is like having a heart attack and then trying to run a marathon afterwards. This is what we ROCD sufferers do with our brains. The irony is that ROCD is caused by a defective brain and we try to get rid of ROCD by using the same tools that caused ROCD in the first place. Something like using a shovel or pick-axe (picture) to get out of a hole.

Think about these  questions:

1) How is my brain asking me to use a shovel to get out of the ROCD hole? What do I need to do to get out of the hole?

2) What does this quote from Einstein means?

“Problems cannot be solved at the same level of awareness that created them.” – Albert Einstein

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Diagnosing rOCD

One of the most difficult things about rOCD is to get a proper diagnosis of the condition/disease. A lot of people focus on the relationship aspect but the real problem is the obsessive aspect (OCD) and this is what needs to be diagnosed. The relationship is a symptom not the real disease.Imagine this – someone has a brain tumour that is causing huge headaches. We keep on taking headache pills and trying to solve this, when this is just a symptom.It is not going to be very effective. This is why I have used the designation rOCD and not ROCD throughout this blog.

Although I am not clinically trained (psychology/psychotherapy/medical) , I believe a lot of sufferers go on misdiagnosed or not diagnosed at all. This is partly due to two reasons:

Reason 1

the “newness” of the condition leading to lack of awareness from mental health professionals AND

Reason 2

because rOCD can also overlap with “normal” relationship problems and other mental health issues.

Let me talk about reason number 1 first. The first time I experienced rOCD symptoms I looked for help from a qualified person. I was a complete emotional mess. I did not understand what was happening to me and I was totally confused. I only had two sessions as our sessions were turning into psychoanalysis sessions e.g. how my parents’ relationship affected me. I wanted some quick relief of my symptoms not a never ending talk about the past.

In the meanwhile I was also looking for help from my family doctor (GP how we call it in the UK). I knew that I had had some depression symptoms in the past and I always managed to manage it. Everyone has some bad days, right? What was slowly “killing me ” was the sleepless nights due to anxiety and sometimes panic attacks. When I first went to see my GP, she signed me off from work for a while to get some rest. I thought I was possessed because I felt “bad” or uneasy all the time (apparently feeling possessed is a common  description of anxiety among religious people). Funny enough my girlfriend’s sister picked up on this when I was trying to break up with her sister (now my wife!) due to my anxiety symptoms. She gave me some calming medicine which helped and advised me to look for medical help.

So I was on the road to “fixing” some of my physical symptoms. After I dropped the word depression in my GP’s office, I did a computer test for the severity of my depression and I was prescribed a drug Citalopram. It was a rough ride in the beginning but it did help with my anxiety and depression in the long run. Now I am off my meds.

After deciding to look for another therapist, I ended up going to my University’s help centre run by psychologists and other mental health professionals. There I was, a grown man in his 30′s having to ask for psychological help after having to stop my post graduate studies for a while. Unfortunately,  the two psychotherapists that I saw had no knowledge of ROCD and approached it from a CBT point of view. That is basically changing the way that you think to change the way that you feel.  I felt I was closer to the answer but I wasn’t there yet. It was kind of helping with my anxiety and depression but I was running scared of losing my girlfriend.

Then I decided to look for help online by googling my symptoms and found out about rOCD. I found a professional that understood rOCD, had 4 sessions costing me around £300 but “finally” had an answer to it. Once you know what you are fighting against, your chances of winning greatly increase. I felt I was on the right path but I had to end at the 4 session mark because I could not afford more. This was all done on the phone using the regular 50 minute talk format. I picked up a lot of things from it, made me move forward with hope and had a new resolve in life.

One of the things I learned about in the previous process was mindfulness. I went back to the University centre and enrolled on short course on mindfulness. It was agreat and helped me gain a better understanding on how to tackle rOCD.

Now for reason number 2, how to distinguish rOCD from “normal” relationship problems? This might be the thing that keeps most rOCD sufferers awake at night and that drives the anxiety and constant barrage of thoughts. If this is the case, in my experience, most likely it is ROCD. It does not help when everything else  tells us otherwise:

  • Friends that we go to and discuss these things with them and they project our fears on us (some of them truly help though)
  • Hollywood, TV and magazines that portray “real love” i.e. if it is true love, they will live happily ever after
  • Our misconceptions about love and relationships caused by our own perception or poor role models
  • Our brain that is constantly looking for exceptions and making associations e.g. “if this was love I would be feeling this way”

Summing up, Reason no.1 + Reason no.2 = complete mess in diagnosis

The answer: Seek (r)OCD specialists AND find the answer for yourself.

I say “and” because even with my diagnosis being made by a specialist rOCD therapist, I had  a lot of trouble accepting it.  Sometimes the symptoms are there screaming rOCD but it is very difficult for rOCD sufferers to even accept the diagnosis. How can we be sure about something when the problem IS being sure about something? Confusing? Yes, we both know it is. First, we have to put the brain in a better place to get there. I will address this further in my next post.

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What is rOCD?

If you are here, most likely you already know that rOCD stands for relationship obsessive compulsive disorder. You have read about rOCD and your biggest question might be “do I really have rOCD?” I will get into this question in another post…

I guess that rOCD is a different experience for everyone because we are all different. However, many stories from rOCD sufferers share similar elements. Similar obsessions, compulsions, behaviors, warped thinking, etc…

There are many different ways of defining rOCD. I really like this definition taken from OCD-UK (http://www.ocduk.org/rocd)

ROCD is commonly used to refer to fears associated with Relationship OCD, where sufferers obsessively question whether their current partner is really the right person for them, and whether they actually love their partner or not, even in the most loving of relationships.

Many good relationships are thrown away because of this dreadful condition. It can impact lives very strongly and because there are no obvious compulsions those around us do not really understand what is going on inside our minds and how we feel. It takes both a physical and psychological toll.  In most causes it is associated with depression and anxiety and because of that the focus tend to be on these two “symptoms” and not on the root cause -rOCD.

Some old notes

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Hi everyone,

It has been really crazy lately. Loads of emails to reply to (I will reply to everyone when possible), busy at home and extremely busy at work.I have been going through some old OCD notes in preparation for the final draft of the rOCD book and found something really good that I just had to share. These notes are taken from one of the best OCD books that I ever read. The book is called “The Imp of the Mind” – you can find it on Amazon here.

Here are some of the notes:

What is the imp
The word “Imp” is taken from a title of a poem from Edgar Alan Poe “The imp of the perverse”. It describes the natural tendency that our brains have to think and being attracted to evil. Pierre Janet called this “association by contrast” whereas patients feel driven to do the exact opposite of what they want to do.
Bad thoughts happen to everyone. Some people just seem to cling to these more strongly thus in time developing obsessions. These bad thoughts tend to be the most inappropriate things to think at the most inappropriate times. What you consider the most awful or shameful thing to do is normally the subject of these thoughts.

Thought suppression and Rebound effect
The more you try to get rid of something, the more you are aware of it. That is why thought suppression is not a very effective technique. Fighting or avoiding situations where these thoughts might occur is only likely to increase the intensity and frequency of these thoughts. A rebound effect might also occur after we give up on suppressing thoughts i.e. thoughts come to the mind at a higher frequency than before suppressing them. After we abandon control of these thoughts, they become less bothersome and are less noticed.The more you try to avoid situations that trigger unwanted thoughts, the worse your problem will become.

OCD and depression
It appears that depression impairs the normal functioning of the brain and this results in the patients being more vulnerable to bad thoughts. Interpreting these bad thoughts in a wrong way can also lead to further depression. It also appears that people with depression are more 5-6x more likely to have bad thoughts than people without depression (based on a study done on post-partum patients). When we are depressed we tend to think the worst of ourselves.
Some patients with bad thoughts seem to report that these started when everything in life started to go well and happiness was “reached”. Almost like the mind has come up with something to worry about and ruin things.
One of the biggest fears seem to be that of loss of control. That you would snap and do something that you would not normally do.
Sexual obsessions seem to be present in more than 1/4 of people with OCD. Self-medication sometimes occurs in the form of alcohol and drugs to try and deaden the obsessions.

Absolute certainty vs. enough certainty
There seems to be a need to feel certainty absolutely before being able to move on.The slightest doubt is a tormentor. The very act of trying to attain perfect certainty is often the worst source of distress. This is why the French call OCD the “doubting disease”. Part of the success consists in stop checking for reassurances.
What is like to feel absolute certainty and how will you know you have achieved it? Nobody knows and even if you could, your brain will tell you that it is not because it is too good to be true. Hence people are tormented by doubt caused by a need of feeling certain.

There is no such thing as absolute certainty, but there is assurance sufficient for the purposes of human life.

John Stuart Mill

Common cognitive error for people with OCD:

  • attributing too much importance to thoughts
  • thinking that they need to be able to control thoughts (or are capable of doing so!)
  • exaggerating the danger of a situation
  • intolerance of uncertainty
  • perfectionism
  • excessive responsibility

Happy 2014 – and other news.

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Happy New Year everyone! Hope everyone is doing OK and looking forward to 2014. I have great news in regards to the blog and book. The book is in its last stages and it will be available through iTunes very soon. The book is called “Love you, Love you not: breaking free from relationship OCD”. If there is enough demand I will work on a kindle version as well. There are 4 main chapters (with different subsections) in the book:

-Understanding rOCD

-Understanding Love

-Question and Answers (I have pooled anonymously all the questions that I have received  on personal email, in the past 18 months)

-Planning your recovery

Some material from the blog has been condensed and other material not on the blog added to the book. My wife has been helping me do this and I have been learning a lot from her in the process. She is also doing the final edit on the book.Not sure if I ever mentioned in any posts before but my wife has both a bachelors and post-graduate degree in Psychology. She is self-employed as a counsellor/life skills coach.  She has agreed to spend some of her time doing online Skype Counselling/life skills training for people in need. Her background and knowledge helped me a lot before we got married! This will be a paid service but I managed to get a discount from her  as many people have contacted me with difficulties either finding an appropriate therapist or being able to afford expensive care. Please drop me a line if you have any questions about this – pingfrance@hotmail.com

I am still trying to catch up on my backlog of emails but I will eventually reply to everyone that has written me! If you think that your email has slipped my net please email me again.

So, in summary:

1- the book will come out soon. Drop me a line if would like to see a kindle format as well.

2- Online Skype sessions will be available for those interested. These sessions will be run by my wife which is much more qualified than me!

3- Have a great 2014!

 

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Antibiotics

When doctors treat infections, have you ever considered why in most cases they prescribe a course of antibiotics that could last more than a week? And you have to take them more than 2 or 3 times a day?

The simple answer is that in order for the drugs to be effective, they have to reach an x dose for an x period of time. So just taking the medication once, will not do any good. Starting one day and forgetting about the rest will do no good either. The reason for this is that once you take the drug, your body will do its best to get rid of it  (in most cases through the urine, sometimes through your breath if it is alcohol!).

So again, for a drug to be effective it needs to be taken at regular intervals for a certain period of time. How does this apply to rOCD?

There is no emergency medication. If you are not taking your daily dose of anti-rOCD “medication”, do not expect for things to be any different. Sure, in some cases rOCD will fly under the radar because your mind is busy with something else or because of any other reason. But when stress knocks at the door and things do not go as planned then rOCD will come out to haunt you. Until treating rOCD becomes a daily priority in your life, do not expect much improvement. The good news is that 15-20 minutes a day will do wonders. The bad news is that it will take some time and effort to get there. The choice is yours.