Wishing as an OCD obsession

I went to two undergraduate colleges. The first was a state university.

I left after two years because I told myself I was homesick and wanted to go to college closer to home.

I lived at home and attended a local college for two years and finished my degree.

The real reason I left the state university? I was suffering from deep, untreated depression and increasing symptoms of obsessive-compulsive disorder, and I thought going home would help alleviate my pain.

I have regretted the decision for the many years since I made the change after my second year at the university.

The university was more prestigious than the smaller college, and I have wished I had stayed. Perhaps I would have had more and better job opportunities, I’ve thought. Perhaps I would have done better in life. Perhaps I would be happier now. So goes my thinking.

I never attributed this type of thinking to obsessive-compulsive disorder until I read about wishing in Dr. Jonathan Grayson’s Freedom from Obsessive-Compulsive Disorder: A Personalized Recovery Program for Living with Uncertainty.

Grayson names several functions of rituals, one of which is wishing: “Everyone has dreams, hopes, and wishes; these lie at the core of our creativity and humanity’s greatest achievements. However, when we pursue an impossible wish, it can lead to our downfall” (p. 40).

He uses as an example a man who left college for a short time because of his OCD. “He constantly obsessed about the events of that year and how much better his life would have been if he hadn’t dropped out. In other words, he was constantly wishing he could undo his negative experience.” (p. 40).

That example struck a chord in me. I realized that my thoughts of regret—which I still had 27 years after graduating—were based on an obsession. I have been wishing that things could be different, haunted by my decisions, playing over in my mind how things might have been.

But I’ve been wishing for something impossible. I can’t go back and change the decision I made.

With the realization that my thinking was an OCD obsession, I’ve been working on ending the wishing.

Getting away from this type of wishing is giving me a new attitude. Instead of spending time regretting the past, I am slowly getting better at focusing on the present and what is in front of me. I am getting better at focusing on things that I do have control over.

  And I’m getting better at facing the fact that there’s no certainty involved here: I don’t know that my life would have been better if I had stayed at the state university. It might have been better. It might have been worse.

I’ll never know. And I don’t need to know.

Have you held on to wishes for too long?

Hit-and-run OCD

When I was in graduate school, when my OCD was at is worst, I drove certain streets in my college town a lot.

If I hit a bump in the road, or if I even thought I might have hit a bump, I turned the car around and drove back to look for bodies. Or I stopped in the road to look behind me and try to see if I had hit anyone.

I drove up and down some streets enough that I started to get worried that someone was going to call the police and report someone casing the neighborhood.

My long trips on visits home could turn into nightmares. I remember on one trip, while traveling around Columbus, Ohio, I frantically tried to find a local radio station, listening for any reports of an accident on the freeway that I may have caused.

In reality, I knew I hadn’t caused an accident, but I felt like I may have.

Over the years, the obsession lessened, but I still go through time periods when I obsess over whether or not I’ve hit something or someone with my car.

On my checking hierarchy, hit-and run-OCD is a 70. It causes me some distress, but not as much as numerous other things on my hierarchy.

Here are some recent driving experiences I’ve had:

·  I actually turned around my car to drive back over an area to make sure I hadn’t hit anyone or anything—even though I knew that I had hit rough spot in the road.

·  On a positive note, I drove for about 192 miles round trip recently to attend a church meeting out of town. I didn’t turn around and drive back at all, and I looked in my rear view mirror only occasionally to check the cars behind me.

·  I offered to drive a co-worker to a work related workshop in a nearby town.

·  I drove along a street crowded with trick-or-treaters rather than drive the long way around to avoid them.

The difference between the “bad” driving experience and the successful ones? My willingness to put up with the anxiety until it subsided.

Something that has helped me tremendously is something that Dr. Jonathan Grayson said in his book Freedom from Obsessive-Compulsive Disorder: A Personalized Recovery Program for Living with Uncertainty.

In laying out the rules for doing ERPs for hit-and-run OCD, he says the rules for not driving back and not looking stopping the car to check “may only be violated if you have no doubt that you hit someone—if you have the slightest doubt, continue driving” (p. 162).

This helped me tremendously. I have started applying it to other checking compulsions. I tell myself that if I’m not 100 percent sure that there’s a problem, if there’s any doubt of there being a problem, then I’m not checking.

Sometimes I’m more successful than others, but that mindset is helping me be successful more often. I feel the anxiety of not checking, but I have discovered that it dissipates fairly rapidly once a few minutes have passed and I become focused on something else.

  Do you have anxiety about driving? How have you dealt with it?

My fear hierarchies

In last Friday’s post about my obsessions and compulsions, I mentioned the fear hierarchy.

In his Freedom from Obsessive-Compulsive Disorder: A Personalized Recovery Program for Living with Uncertainty, Dr. Jonathan Grayson defines what that is: “A fear hierarchy is a ranked order of the situations that cause you anxiety, ranked from most to least anxiety-provoking. This hierarchy will be the blueprint for your exposure and response prevention program, guiding your decisions about what to expose yourself to and when” (p. 67-68).

He suggests using a rating of subjective units of discomfort (SUDs) to rank the anxieties (p. 68). Sunny at 71 & Sunny wrote an excellent post about SUDs, and I urge you to check it out.

I’m using a SUDs scale of 1 to 100, with 100 being the worst anxiety, 1 being the least.

I created a fear hierarchy for every type of OCD I experience. The hierarchies help me organize what I want to work on. I am trying to work on exposures from more than one hierarchy each day.

Grayson suggests starting with the lower ranked items, the ones with the lower SUDs (p. 68).

Here are some of my fear hierarchies, which reflect what I'm working on:

Contamination Hierarchy

Toilet in public bathroom 95

Shower walls and floor 90

Rinsing dishes 90

Washing dishes 80

Home bathroom door open 80

Rinsing recyclables 80

Cleaning off stove 80

Floor in public bathroom 70

Toilet seat in own bathroom 70

Sticky substances 70

Greasy substances 70

Kitchen floor 70

Walking in house with no shoes or socks 70

Walking in house with just socks 70

Cleaning off kitchen counter 60

Eating utensils in restaurants 60

Water faucets in public bathroom 50

Brushing teeth 50

Door handles in public places 40

Checking Hierarchy

Cooking on stove 98

Leaving office without checking lamps 90

Leaving home bathroom without checking lights 90

Checking for sharp objects, contaminated objects on floor at home 90

Checking coffeemaker after using 90

Writing without checking/reviewing 90

Reading without going back and rereading 80

Making sure others know of potential dangers 80

Going upstairs without checking basement lights 80

Checking area around dryer for lint 80

Using bath soap/shampoo bottles without rinsing them afterwards 80

Checking dryer vent 80

Checking between washer and dryer 70

Water taps in laundry room 70

Paperwork 70

Checking to be sure razor is on medicine cabinet shelf 70

Making sure others know of recalls 60

Driving 70

Checking food bags to make sure properly sealed 60

Car brake set 50

Mail slot at post office 50

Car doors locked 40

Perfection, Movement and Magic Hierarchy

Nodding my head 90

Being perfectly understood in written words 85

Saying things perfectly 80

Being perfectly understood in spoken words 80

Rewriting words or letters to make them perfect 50

Only buying items that are perfect 40

Counting steps 30

Mental Compulsions Hierarchy

Praying 90

Knowing or learning everything about a subject 80

Checking memory to determine if harmed in past 80

Doubting religious beliefs 80

Analyzing thoughts for appropriateness 70

Past actions, possible sins 70

  Do you think using something like the fear hierarchy would help you make changes?  Have you ever used anything like this before?

Obsessions and compulsions: The worst ones

As I’ve previously written about, I am doing exposure and response prevention therapy on my own through Dr. Jonathan Grayson’s book Freedom from Obsessive-Compulsive Disorder: A Personalized Recovery Program for Living with Uncertainty.

Part of this work in fighting my OCD involves completing checklists to arrive at a list of the obsessions and compulsions that are most troublesome to me.

I like having such a list because it provides me with an idea of what I need to work on the most. And it was eye opening to realize how much OCD affects my daily life.

This list is not a fear hierarchy. As Grayson writes, “A fear hierarchy is a ranked order of the situations that cause you anxiety, ranked from most to least anxiety-provoking” (p. 67).

Rather, this list is a general overview of what my OCD looks like.

But I did use the list to help me come up with my fear hierarchies.

Below is a partial list of my obsessions and compulsions from the checklists that rated a five (highest rating) and a four. In other words, they are the obsessions and compulsions that take up more of my time and attention than others.

I’m providing this information for two reasons. If you have OCD, maybe you’ll see your own obsessions and/or compulsions here, and you will be reminded that you are not alone.

If you don’t have OCD, you will get a sense of some of the obsessions and compulsions that can occupy the life of someone with the disorder.

Obsessions rated at 5

• An accident, illness or injury happening to someone else
• Causing harm to others through my own negligence or carelessness
• Doubt about whether or not I have harmed or injured others in the past
• Bodily waste or secretions
• Perfectly understanding what I have read
• Perfectly communicating my thoughts through writing
• Questioning whether I have told the truth perfectly
• Questioning whether others perfectly understand what I have said
• Doubting my faith or beliefs
• Fears of having acted sinfully or unethically
• Wanting to do, think or say everything (or certain things) perfectly
• Wanting to know everything about a specific subject or topic

Obsessions rated at 4

• Dirt or grime
• Grease or greasy items
• Sticky substances
• Repetitive questions which are unimportant or for which there are no answers
• Excessive awareness of normal bodily functioning (breathing, eyes blinking, heartbeat, etc.)
• Being rejected by a loved one
• Being deliberately sinful or blasphemous

Compulsions rated at 5

• Handling or cooking food
• Using public restrooms
• Electrical appliances
• Stoves
• Light switches
• My paperwork or writing for errors
• Reading or rereading every word in a document to avoid missing anything
• Rewriting or writing over numbers or letters to make them perfect
• Questioning others, or my own memory, to determine if I have harmed or insulted someone (recently or in the past)
• Collecting or removing objects from the environment that could harm others
• Having difficulty using sharp objects
• Checking on the whereabouts of others to be certain that harm has not come to them
• Trying to limit the activities of others to prevent harm from happening to them
• Repeatedly warning others of potential harm or danger
• Saving excessive quantities of informational matter (newspapers, old lists, magazines, junk mail, etc.)

Compulsions rated at 4

• Bathing or showering ritually and/or excessively
• Avoiding specific people, places or objects that may be contaminated
• Excessively questioning others about contamination
• Washing dishes
• Washing clothing
• Driving situations (to verify that I did not hit someone or something with a vehicle)
• Objects dropped accidentally
• Container tops or lids for closure
• Remaking decisions to ensure picking the perfect one
• Moving my body or gesturing in a special way
• Asking others if they will be safe or if things will turn out well for them

Why am I doing this?

One of the tasks assigned in Jonathan Grayson’s Freedom from Obsessive-Compulsive Disorder: A Personalized Recovery Program for Living with Uncertainty is to create a cost-benefit analysis of why we are choosing to go through treatment for OCD versus not going through treatment.

This exercise has been valuable for me. I have been experiencing a lot of anxiety and discomfort from just reading about what I will have to do to get better.

Plus I have had the anxiety that goes with exposing myself to some of my fears and preventing myself from ritualizing in response.

It has been helpful to me to pull out my cost-benefit analysis and remind myself why I’m doing this.

Basically the cost-benefit analysis gets you to examine the advantages and disadvantages of going through treatment and not going through treatment.

Here’s mine:

Accepting Treatment

Advantages

• I won’t have the near-constant anxiety of OCD.
• I will learn to live with uncertainty.
• I will have more time to do the things I’m meant to do, like write.
• I won’t have to spend time doing rituals.
• I’ll feel better about myself.
• I’ll be stronger emotionally.

Disadvantages

• It will take time.
• It will be difficult.
• It will make me uncomfortable.
• If I take it to formal therapy, I’ll have to continue therapy and continue that cost.
• It might not work.

Refusing Treatment

Advantages

• I won’t have to take the time to do the work.
• I won’t have to go through the difficulty of trying to change.
• I won’t be disappointed if it doesn’t work.

Disadvantages

• I’ll spend time doing the rituals.
• I’ll have less time to do the things I want and need to do.
• I’ll have the anxiety of OCD.
• I’ll struggle with living with uncertainty.

  Have you ever used the cost-benefit analysis method, or some other method, to make decisions? How does it work for you?

OCD treatment: Living with uncertainty

“Are you willing to learn to live with uncertainty?”

That is the key question OCD sufferers must answer before embarking on the program in Dr. Jonathan Grayson’s Freedom from Obsessive-Compulsive Disorder: A Personalized Recovery Program for Living with Uncertainty.

Grayson holds the premise that there is no certainty in life. Even things that we think we can be certain about, we can’t.

One example Grayson uses is the belief we have that our car is in the driveway. But unless we’re looking at it, we can’t guarantee that it’s there. It could have been stolen and no longer be in the driveway.

  In addition, unless our loved ones are right in the room with us, we can’t be sure that they are safe and unharmed.

He says, “The inability to feel or be certain is reasonable. . . . Improbable is not impossible” (p. 9).

Grayson says that those with OCD already know that uncertainty is a given in life. No matter how hard we try with some of our rituals, we can’t arrive at absolute certainty in those things.

I can relate to that. My need for certainty tends to revolve around the safety of my loved ones, and even of people I don’t know. I want assurances that they will be safe and well, and a lot of my OCD ritualizing has to do with efforts to make that happen.

But keeping others 100 percent safe and well is an impossible task for me. I cannot guarantee their safety, and all of us are going to die eventually.

Grayson says that just knowing that uncertainty exists is not enough. We have to be willing to live with uncertainty.

“It is quite likely that you agree with the premise that you can never be certain. Indeed, the persistence of your OCD symptoms and its constant attendant doubt have shown you that certainty is unattainable. Yet you persist in trying to achieve the impossible. Why? Why won’t you accept what you know?

Answering the question with a ‘yes’ means choosing acceptance of what you already know instead of denial” (p. 52).

A way that we hold on to denial is through “fantasy and wishing. In the case of death, denial is not a delusional fantasy of believing the dead are alive; it is comparing the present with how much better life would be if the deceased were still alive” (p. 52).

There is a price to pay for living in denial, according to Grayson: “However, when we compare reality with fantasy, we also destroy and demean the moment” (p. 52).

That statement hit me like the proverbial ton of bricks. I had never thought of denying uncertainty as denying reality. I had never thought of denying reality as disrespecting the very moment we’re in.

Acceptance of reality means acceptance of uncertainty. Acceptance of uncertainty, living with uncertainty, means living with the uncertainty of whether the lights in the office are off, whether or not my hands are contaminated, whether or not the stove is off, and so many other uncertainties in life, including the big ones, like whether or not my loved ones are safe and well.

My answer to the question? Yes.

  How important do you think it is to accept uncertainty?

Fighting OCD: Making a commitment

I have decided to make a bigger commitment to fighting my OCD.

I am going to use Freedom from Obsessive-Compulsive Disorder: A Personalized Recovery Program for Living with Uncertainty, by Jonathan Grayson Ph.D., as my chief guide.

I am going to follow the program as closely as I can.

This decision has been a while in the making. I started cognitive behavioral therapy for my OCD earlier this year, but my therapist and I decided to concentrate instead on my chronic depression.

We’re still working on that. But I want to work on my OCD, too.

Here are my reasons:

1. I’m tired of feeling the constant anxiety related to OCD.
2. My scattered approach to fighting the disorder has not been effective.
3. I’ve read about and heard about people who have had success with an intensive program of therapy, specifically exposure and response therapy.
4. I want to be free of the control of OCD.

Though it’s usually best to work with a therapist on this program, the book does provide guidance for those wishing to work on their OCD on their own.

I’ve been working hard—and I don’t say that lightly—in preparation for beginning. I have completed an extensive assessment checklist for both my obsessions and my compulsions, so I can group together those that cause the most anxiety.

I’ve been thinking about and noting my daily routines, so I can be sure I include as many of the OCD symptoms as I can in my work.

And I’ve been working on my fear hierarchies, which will provide me with the basis for the exposure and response therapy.

I’ll be writing scripts to help me get through the exposures and to help me avoid doing rituals.

And I’m making a commitment to live with uncertainty.

I was taking a shower this morning and became aware of how much tension and anxiety my body was holding because of the rituals that I go through during my routine.

I knew then that I had made the right decision in committing to focus on my OCD with Grayson’s book, and other sources, helping me.

Here’s my first script, one where I talk to OCD:

   OCD, I am going to win this. You’ve influenced me for most of my life—for over 40 years. I know you’ll still influence me. But you’re going to have a very small influence. You are not going to win. I don’t want to think of myself as at war with you. But we’re going to make peace, and it’s going to be on my terms. I am going to stop giving you my time, my effort, my tears, my feelings, my life. I will give you nothing. I will not feed you with rituals. I am going to have time on my hands, and I’m going to fill it up with helping others, with doing things I want to do, and with the life God made for me. OCD, I am going to win this.

This is a sentence from Grayson’s book that gives me hope and something to look forward to as I fight my OCD: “Your ultimate goal is to be less conscious of your environment so you can be free to enjoy the flow of life, to take all your creative and imaginative energy and have your thoughts dominated by things that you actually want to think about” (p. 125).

   When you have made a change in your life, what helped you to stay committed? Any tips to share?

Have OCD? You have something to be proud of

Trees: symbols of strength to me.

I’ve been reading Freedom From Obsessive-Compulsive Disorder: A Personalized Recovery Program for Living with Uncertainty, by Jonathan Grayson, Ph.D., and though I’ve experienced OCD for most of my life, and I’ve read a lot about it over the years, this book is reminding me that I still have much to learn.

I like how Grayson specifically addresses people with OCD. Anytime he addresses “you,” he’s talking to OCD sufferers.

And his writing starts off with a bang by raising our awareness that those of us with OCD have a lot to be proud of.

Proud?

  I’ve written before about my first psychiatrist called me “high functioning” and how disconcerting that was to me. I didn’t feel like I was functioning very well on any level because obsessions and compulsions filled all of my time.

What I had been able to do, though, was to stay in school, complete a master’s degree and make good headway into a doctoral program. I was able to teach writing and literature classes. I had my own apartment and paid my bills.

What I may be have been displaying is something Grayson referred to in his book: “You [people with OCD] function in the world, and you don’t appear to be in obvious distress. Unlike the extreme cases publicized in the press and on talk shows, your OCD doesn’t seem to be much of a difficulty to live with” (p. 4).

In 1990, I managed to live an outwardly “normal” life while struggling with OCD.

To OCD sufferers, Grayson said, “This ability of yours to successfully function under stress has a special name: competence” (p. 5).

Grayson said all people who are successful have this ability to perform well under stress, but they have to rely on the ability less than people with OCD.

Think about it

If you have OCD, have you ever been able to go to school, go to work, work at home, volunteer, take care of children, or do anything at all even while feeling extreme anxiety from your obsessions and compulsions? Then you were displaying competence.

Of course, there are times when none of us can be competent in this sense of the word. Hard times come and it’s all we can do to get through the day and have time to do anything other than rituals.

But look back over your life and consider how much you have accomplished, despite having OCD.

Competence: helpful and not helpful

Grayson said competence could be a positive thing and a negative thing.

“On the one hand, it allows you to function in the world. . . . It is important for you to recognize this strength in yourself” (p. 5).

Reading that made me feel proud of not only myself but of all of you dealing with OCD. I agree with this statement of Grayson’s: “Bravery is not a feeling; bravery is how you behave when you are scared. You are among the bravest people I know. The strength and competence you are accustomed to using in order to get through your daily life can help you succeed in treatment” (p. 5).

Competence has a negative side, too, according to Grayson: “It has led many of you to delay seeking treatment. After all, if you are trying to hide your problem, seeking treatment might be a flag to others that something is wrong” (p. 5).

And just because we are able to function doesn’t mean we’re not suffering: “Though you may succeed in appearing ‘normal’ to the outside world, you know something that non-sufferers don’t: You know how anxious you feel” (p. 6).

People with OCD are not better or stronger than the general population. But we display strength that is worthy of mention.

So take a minute to delight in your strength, and make plans to use it for the good.

  If you have OCD, have you ever considered yourself brave and strong? If you know someone with OCD, have you ever witnessed those qualities in him or her? For all of you, how do you define strength?