Friday, March 2, 2012

CBT session #4: What does this have to do with OCD?

Let me preface this post by saying that I hope all of you in areas where tornadoes hit today are safe and well.
According to what I can glean from weather reports, I think all we’ll get in Central Virginia are thunderstorms.
Elizabeth, on her blog “Into My Own,” wrote an excellent post today about weather anxiety. If you haven’t read it, go here.
***
I had another cognitive behavioral therapy session today, and I left depressed and cried a good part of my drive home.
I have been experiencing a great deal of anxiety, the kind that causes my limbs to feel numb, makes me feel hyper and gives me a feeling of doom and fear.
I’ve tried to monitor myself enough to ask myself, when I felt this way, questions like, what am I thinking? What has happened? What am I doing?
The point was to find the triggers that promote the highest levels of obsessive-compulsive disorder symptoms and other anxiety. That was one of my assignments from last week’s therapy session.
Some of my worst anxiety occurs when I think about the clutter that I have around me. It’s mostly papers: paycheck stubs, paid bills, receipts and other records. I deem some of them too important to dispose of, but I don’t have enough space to store them, and the process of sorting through them is daunting.
Another time that provokes intense anxiety is when I’m writing for work. I have been working on limiting the time that I give myself to edit once I’ve written a piece, but I haven’t made a great deal of progress.
I have also had a lot of anxiety about workplace issues. I even woke up at 4 one morning this week thinking about work with anger and resentment. But I didn’t relate it to OCD.
The last couple of days, I’ve also been feeling depressed.
When my therapist asked me today how things had been going, I told him I have been feeling very anxious and depressed, and mentioned the work situation.
He jumped on that and asked questions about that specifically. Soon he was talking about the underlying anger that can make things like OCD and generalized anxiety disorder worse.
People with anxiety disorders tend to suffer from what he called “over niceness.” We don’t like conflict, so we tend to stuff our feelings, sweep our anger under the rug. But it bubbles up, he said, and, hence, aggravates OCD and GAD.
We spent the rest of the session talking about using empathy, assertiveness and respect to get our desired effect, not necessarily the desired outcome. We role-played. I cried, which I haven’t done in our other sessions.
At the end, I asked him if we could talk about OCD again. He said, of course, but he didn’t want me to avoid facing things like the conflicts we talked about today.

Sometimes, fire extinguishers are necessary.

He said he could give me tools that would work like a fire extinguisher on my OCD, but if gas (the stuffed anger and resentment) was poured on the fire, the fire extinguisher wouldn’t do any good.

So it was a session that didn’t help me with OCD. And I felt like, oh, here’s one more thing I’m doing wrong.
I’m sorry if this post sounds whiney. I went along with my therapist today and talked about the work conflicts. I’m sure I do need to work on facing conflict.
But I don’t want to deal with that right now. I want to deal with the OCD that plagues me and has plagued me for most of my life.
Yes, I cried during today’s session, which I admit could mean we were touching on a subject that is bothering me a lot. But I’ve also been depressed and hopeless. The tears could have been related to that too.
I don’t have another CBT session for two weeks, though I can call the office next week to see if the therapist has any cancellations. In the meantime, I am going to work on my OCD.
Any thoughts on this?

14 comments:

  1. Oh, Tina I'm so sorry! I have absolutely felt like this. The hopelessness that you are feeling - what specifically are you feeling hopeless about? Is it that you feel you will never get better? Because you will. I know, when the pain is intense we so much want it to end, right here, right now. It's so hard to wait for therapy to kick in.

    I cried all the time through my therapy appointments. I mean, sometimes I would just sob and sob. It's only been less than a year where I don't cry that much anymore. I think I'm mostly cried out! But you know, there is so much incredible pain to living with OCD. Ugh.

    I'm obviously not a doctor, but if you really want to just work only on your OCD, I don't see why there's anything wrong with requesting your doctor to stick with that, unless there happens to be something else you want to discuss on a particular day. There have been some times when my interpersonal issues were causing me real problems and my doc and I would talk about that instead. But often times she would bring it back to OCD because the honest truth is that sometimes it was easier for me to talk about that stuff rather than deal with the OCD and what I was going to do for exposures (and she knew that about me!).

    And no, you are not doing "one more thing wrong." This illness affects every part of our life, what we do, how we think, how we perceive the world, how we interact with others. I think it's totally normal it would affect conflict issues. It has for me.

    I think it's good that you are going to work on the OCD in the meantime. Any ideas what you are going to work on and how you are going to do it? I'd love to know so I can cheer you on. Plus, I've found that it helps to have a plan of attack. Even if you don't get even a third of your list done, you're at least that much further than when you started. It might be helpful to try to pick things you know you can do. This will help you feel accomplishment and may help with further motivation. Don't minimize any tiny achievements either. One little step is one little step further. I'm rooting for ya!

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  2. Sunny, Thank you so much for your empathy and encouragement. It means so much to me.

    I'm feeling hopeless about my life getting better and about my chances of getting better and accomplishing anything of worth. I keep thinking, I'm almost 49, and I am still having to work on stuff like facing conflict? I know it's the depression talking.

    My therapist told me if I wanted to work on OCD, we would, so I think I can "direct" the focus. I just felt frustrated today because we didn't talk about OCD. I felt like I allowed us to get sidetracked. But the therapist seemed to think it was so important to talk about the work conflict. I'm sure I need to work on it, but I'm feeling spread too thin with all I have to work on!

    As far as working on the OCD in the meantime:
    *Set time goals/limits to writing and editing my pieces at work and deal with the anxiety that comes about and makes me want to reread and check it "one more time."
    *Make a plan for beginning to deal with the clutter. I need to list the steps that will go into sorting and throwing away/filing and do it one step at a time.
    *Set specific times to do my own writing, and if I can't think of what to write and feel panicky about it, "freewrite" (just writing nonstop, no editing or judging) for 10 minutes.
    *Continue with the work on checking. Reattribute, refocus, and move on.
    *Make it my mantra for a while: Motivation comes after action. I need to get out of bed and act!
    *Meditate and seek God's grace.

    Thank you for your wise counsel. It encourages me so much to know that you understand and are rooting for me!

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  3. Hi Tina,
    I'm so sorry you are feeling this way, and I understand everything you are saying, but when I read your post, I can't help thinking you were working on your OCD with your therapist, just not in the way you expected. I'm referring to his analogy with the fire extinguisher.....he wants to make sure there aren't things going on in your life that will totally block the benefits of therapy for your OCD, so these things are important to address......don't know if that makes any sense; it's just the way it appears to me.
    I think it's great that you have set those specific goals for yourself....I too am sure that things will get better for you..I am always rooting for you!

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  4. I've been there and done that many times. You may not feel like you were working on the OCD, but you truly were. Those things you were discussing are all interrelated to the OCD. The OCD helps to create the circumstances that lead to them, and they in turn affect your OCD. It's all part of the cycle. It's no one more thing you're doing wrong, it's just another aspect of the OCD. I often cry when addressing issues like this during therapy as it's tough and does make you feel like it's "one more thing..." (one more thing you're doing wrong, one more thing you have to deal with, one more thing you have to fix....). Truly, you will begin to be able to process it and understand how it all relates, it just takes some time.

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  5. First of all, thank you for mentioning my post :-)

    I have found that everything can trigger OCD and anxiety and depression. Everything. Work situations, family situations... relationships of any kind can trigger the OCD process.

    I tell my therapist about everything because basically, many day to day thing contribute to the OCD process as well as the anxiety and depression cycle.

    Work situations are VERY stressful for me and when there is anything going on that makes me angry or worried... the OCD kicks in and the anxiety ramps up and depression usually is at the other end of anxiety.

    Basically, I have found that relationships.. no matter what kind, are major triggers for all kinds of OCD for me.

    Big Hugs,
    Elizabeth

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  6. Janet, You're right. My therapist and I were working on OCD, just not in the way I expected, and most importantly, not how I WANTED to.

    Kat, You're right, too. OCD is not a separate entity in my life. It's inter-related with the other anxieties and the depression. I didn't consider that yesterday. And patience is not one of my virtues! :-)

    Elizabeth, You're right, too. Work situations are high-stress for me, too, and stress and anxiety from any source can ramp up the OCD.

    After some sleep and some perspective, and after reading the helpful comments I have received, I understand better that my time in the therapist's office yesterday was not wasted. I must deal with the many facets of OCD! Thank you all for helping tremendously!!

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    1. HA! Patience is not one of my virtues either! Anyone who knows me can tell you that. It's a genetic thing and runs in the family. Learning that often times I need to take time to process things was one of the most difficult lessons I've had to learn through therapy. Many of us "stuffers" have those issues. We've learned to stuff immediately rather than feel or process, for whatever reason has led us to feel it's necessary for safety and security. So, our processing doesn't come until later, after things have passed and we feel secure. Then we're often smacked with multiple things we haven't processed, but eventually, our minds are able to catch up. It just takes time and helps to have an understanding of what's going on.

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    2. Kat, I hadn't thought of it in that respect--that "stuffers" push the anger/hurt/fear under the rug and DON'T process the feelings. But apparently they have to be processed at some point in order to be free from them. And we're stuffing for what we think will be safety and security.

      Good points and things to ponder!

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  7. Tina,
    I totally agree that stress and anxiety bring on the OCD...OCD is about control and when we feel as if parts of our lives our OUT of control, well, what can we control? Yep, the straightening and the cleaning and all the other things we become compulsive about.
    Remind yourself that only so much can be changed at any given time...don't try to tackle it all at once or you will run yourself ragged. Prioritize what is going on in your life and address that...and One Day at a Time. Try not to look too far ahead but take it moment by moment...and the depression is speaking to you...listen to it.
    hugs to you...

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  8. Tracy, Thanks so much for commenting. I do tend to try to tackle too much at one time. I don't know what it is. I seem to think if I'm not fixing everything at once, I'm not doing everything I can. Not a very healthy way to think! Maybe it's more of that control I crave--I want to fix everything now and control it now.

    Thanks for the reminder that I need to prioritize what to work on. And take it one day at a time.

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    1. I do that, too. I think it's part of the Perfectionism. : (

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    2. Yeah, a little is never enough, somehow. If I'm not running myself ragged, then I'm lazy. Ugh!

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  9. Very Good Source of info. about OCD
    ocfoundation.org

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    Replies
    1. Thanks for the reminder, Vinnie. Yes, the foundation is a very good source.

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