Thursday, January 19, 2012

Start of a worthwhile journey

I had my first session with the psychologist today who will be leading me in cognitive behavioral therapy.
I won’t be doing exposure response and prevention therapy after all. Rather, the doctor will be providing what he referred to as the “third wave” of CBT. It’s the therapy Dr. Jeffrey Schwartz outlines in his book “Brain Lock.”
Let me say first of all that I felt comfortable with the doctor and believe we can work well together. He is a clinical psychologist who is very familiar with OCD. He has written about religiosity in OCD in particular.
He asked me a lot of questions, and we talked about what areas of OCD were affecting my life the most.
Just talking out loud about what I obsess about, what I worry about, and how I live my life was revealing to me.
I talked about the “what ifs” that I fear with writing, with cleaning, with checking. I talked about the avoidance and procrastination that I practice in order to avoid the anxiety that writing and cleaning stimulates in me. I also told him about my religious doubting.
He explained how we would work on a focused area that was causing me, on a scale of one to 10, about a six or seven anxiety level. (Based on one being no anxiety and 10 being the worst ever.)
Bringing that the level of anxiety down for that area would in turn help the other areas too.
He said it sounded like I had some social anxiety in addition to the OCD and generalized anxiety. That and the OCD have isolated me in a lot of ways.
At our next visit, in two weeks, we’ll prioritize what I aspects of OCD I want to work on the most. I already know it will be the writing and the cleaning.
The treatment usually runs from eight to 16 sessions. I like having an end in sight.
Meanwhile, my doctor suggested I read the first couple of chapters of Schwartz’s book. He said that when Schwartz came out with his book, it was rather radical because it wasn’t thought that the brain could be changed. That’s why he made his case in such a “long winded” manner, my doctor said. Now, his ideas don’t seem so radical.
I’m still getting my head around today’s session. I will write more specifically about things as time goes on.
I feel like I’m starting a worthwhile journey.


  1. Good luck with this. I used some of his ideas while doing my exposures. His ideas are more humane than what i've heard about some exposure therapies. In the book Train Your Mind, Change YOur Brain P139 says: Schwartz had another objection to erp: its cruelty. He looked for alternatives that were both more humane and more effective.

  2. Thanks, Karin. Yes, the therapist called ERP a kind of "in your face" therapy.

    I'm anxious to begin. I want to move forward. I am tired of being in a rut.

  3. Hi Tina! I was actually thinking about you and praying for you today and wondering how your appointment went. I'm glad you felt comfortable w/the doc. That is so important. I'm definitely interested to hear how this therapy will go as I don't know a tremendous amount about it beyond what I read about in Dr. Schwartz's book. I thought that the first intro chapter explaining the brain was outstanding. Unfortunately, though, I did not find his treatment methods particularly helpful to me in fighting my OCD. That could just be me though. Hopefully w/your doc's help it will be a real positive and successful experience for you. Best wishes and keep us updated. We're rooting for you!

  4. Sunny, Thank you for the prayers!

    I will definitely need the doctor's help. I have read at least part of the book before. I bought it, according to the date I wrote in it when I bought it, in March 1996. I wasn't in therapy then. That is probably a main reason why what was in the book just didn't help for any length of time.

    I think I will like more of an emphasis on mindfulness, which I think is part of it.

    Again, thank you for thinking of me and rooting for me!

  5. Hi Tina. Me again. OK - so I think I'm being OCD about this, but I'm re-thinking my comment to you and I'm wondering if it was discouraging to you because I shared my personal difficulties w/Schwartz's book. The last thing I want to do is discourage you, so if I've done that - I totally apologize! It was not my intention.

  6. No, no, you were not discouraging, Sunny. I didn't take it that way at all. Different approaches will help different people. That's OK. The important thing is to move toward getting better.

    You are actually very encouraging! Don't worry!

  7. Tina,

    I believe in the neuroplasticisity of the brain (like Schwartz says, we have the ability to change the way the brain responds to certain triggers).

    I do not do the aggressive ERT that some people blog about. You actually couldn't pay me to do it!

    The therapy I do is CBT (cognitive behavior therapy) which works so well for me. I don't have the pressure of "getting everything sorted out" in a certain set amount of sessions. I can see my therapist for as long as I want to and the goal of therpay is to work with my brain and get it to begin to question, step back from and change the way in which I respond to certain situations.

    To me, CBT is beautiful, hard work and a huge blessing in my life.

    Good luck,

  8. Elizabeth, My doctor told me the CBT I'll be doing will be hard work, and that's OK. I want to feel like I'm doing something about the OCD. I'm glad it has been a blessing to you. I hope it will be a blessing to me, too. Thank you for your support!

  9. My therapist has been adding more mindfulness to his ERP practice--he sees them as very connected. When I'm obsessing, I'm not present in the moment, I'm too busy fleeing, which just intensifies all the fear. ERP in my experience has little of the tv drama aspect--my therapist never moved faster than I was willing to go. He used to say just existing was an exposure for me!

  10. Expwoman, Thanks for your comment. Mindfulness is not easy, is it? But it makes sense that when we're caught up in the "what ifs," we're definitely not "in the moment."

  11. I find the ERP versus "standard" CBT debate fascinating. In my opinion, if you use CBT to learn that your compulsions are unnecessary, you'll ultimately be doing ERP, really. Just taking a different route to get there, and perhaps a slightly more gentle slope.

    I say, whatever works for you!

    1. Ann, I agree--whatever works! I think the exposure is mixed in with what I'll be doing too, but you relabel and reattribute the obsessions and compulsions as you have them. Then you try to refocus on something else.

  12. I am glad you are feeling positive about your doctor and therapy and really look forward to hearing more about it. Because ERP Therapy was so successful for my son, we never pursued other therapies, and I know little about Dr. Schwartz's book. I am excited to follow your journey and wish you lots of success...Good Luck!

    1. Thank you, ocdtalk. I hope I can give helpful accounts of what I go through and how it affects me. I am excited to really get going. For now, while I wait for my next appointment, I'm doing some reading and doing some practice of the steps.


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