5 facts to know about OCD

I have obsessive-compulsive disorder, or OCD, as it’s commonly called. Some of my goals with this blog are to educate people about OCD and to be an advocate for others with OCD.

There are a lot of misconceptions about OCD in popular culture. I’m linking up with Nancy’s A Rural Journal again for Random 5 Friday. I thought I’d use my 5 random facts to go back to the basics about OCD.

1. OCD is an anxiety disorder. It is a mental illness. OCD causes intense, debilitating anxiety that can affect every aspect of a sufferer’s life.

For me, OCD changed the way I interacted with others, dictated what I did and did not do with my life, and caused me so much distress, I at one time contemplated suicide.

2. According to the website of the International OCD Foundation, 2 million to 3 million adults and about 500,000 children and teenagers in the United States have OCD.

I started having symptoms of OCD when I was a little girl. I was probably around 7 or 8 years old when I started my counting compulsions. I was around 11 or 12 years old when I started having symptoms of religious OCD and reading OCD. My symptoms were at their worst when I was in my mid-twenties, before I was diagnosed and started treatment at age 26.

3. OCD includes obsessions, or uncontrolled thoughts about specific things. The obsessions cause intense anxiety. Some obsessions that I’ve had center around harm to others, safety, religion, morality and contamination.

One example of an obsession that I suffered from for years was that I was completely responsible for the safety of my family.

Others with OCD may have different obsessions. For example, not everyone with OCD obsesses about contamination.

4. OCD also includes compulsions, which are actions taken to try to get rid of the anxiety caused by the obsessions. Some compulsions I’ve done include cleaning, checking, rereading texts, counting and praying.

For example, years ago, I compulsively prayed, believing that if I didn’t pray in a certain way and perfectly, harm would come to my family. I could spend hours praying the same prayer over and over, trying to get it “right.” I couldn’t define “right.” It only felt “right” when the anxiety receded for a while.

Compulsions may get rid of the anxiety, but it’s always temporary. The obsessions and anxiety come back. So OCD sufferers repeat the compulsions over and over and over, trying to rid themselves of the anxiety.

5. OCD is treatable. Medication and therapy can be very helpful to those suffering from OCD. Exposure and response prevention therapy is especially helpful.

I take medication and also do ERP, and I have come so far since the days when OCD controlled most of my life.

It’s important for people suffering from OCD to get treatment. Help is available, and sufferers can get better. I am living proof of that.

A good source for information about OCD is the International OCD Foundation.

If you’d like to share your own Random 5, link up with Nancy’s blog.

Is there a subject that you’d like the public to know more about, or that you believe is not treated fairly in popular culture?

OCD and the loss of dreams



The building at Bowling Green State University where I took many classes and taught many classes.



Obsessive-compulsive disorder, a debilitating anxiety disorder, can take a lot away from us. It can take time, money, peace of mind, self-esteem. And dreams.

The dream

When I was a senior in college, I began to worry about what I would do once I graduated.

I wanted to be a writer or a social worker. Those were my two interests. The desire to write had been with me since I was a child. The desire to be a social worker was ignited during one of several sociology classes I took in college.

Basically, I wanted to write, and I wanted to save the world. With a degree in English.

During my last semester, one of my professors talked with me about my future and suggested that I go to graduate school. I could teach and become a professor and write important literary papers and books.

I liked the idea, and I liked the thought of having a definite place to go after graduation from college.

So I applied and got accepted into Bowling Green State University in Ohio. They gave me a graduate assistantship, which meant they paid my tuition and gave me a stipend in exchange for teaching while I worked on my master’s degree in English.

I took classes and taught classes for two years, writing a thesis during my last semester (which is a story in itself that I will have to tell you one day). And I finished. I got my M.A. in English.

The next step, if I hoped to become a college professor, was to get a Ph.D. I chose to stay at BGSU for my doctoral work.

For the next two or so years, I took classes, put together a doctoral committee, chose a genre and time period to focus on, created a reading list for my doctoral exams, studied for my exams, took my written and oral exams, chose a dissertation topic, did preliminary research, put together a proposal for my dissertation, and gave a public presentation of that proposal.

I passed everything and ended up being in ABD status: All But Dissertation.

In other words, all I had left to do before receiving my doctorate was to write my dissertation. As my dissertation chair told me, “All you have left to do is to write a very long paper.”

One more step. One more task.

The OCD

What I haven’t told you yet is how OCD was a part of those years that I worked so hard.

I had reading OCD, which grew worse as I moved into the doctoral program. There were many books on my reading list that I was never able to finish because of OCD.

I had OCD about my writing, which made me obsessed with the possibility of plagiarizing, making it difficult for me to research and to then write a coherent paper.

I had contamination OCD, which made me clean my bathroom for hours, vacuum my apartment repeatedly, wipe down my kitchen counters. I spent literally hours doing these compulsions.

I had checking OCD. For example, I could spend huge chunks of time checking the stove in my apartment, making sure it was off, even if I hadn’t used it.

I had hit-and-run OCD. I drove the streets of Bowling Green looking for bodies that I imagined could be there.

The loss

The OCD affected my performance in graduate school from the beginning, but it got worse as time went by. It became especially difficult to cope as I faced what seemed to be the monumental task of writing a dissertation in spite of not being able to properly read, research and write.

Even though I started medication treatment during my third year in my doctoral program, it didn’t help enough, or help in time, for me to finish the dissertation by the time my fellowship ran out.

I moved back to Virginia, with vague hopes of finishing my dissertation there. But the OCD, though drastically improved, still fed into my academic work.

I never finished my dissertation. I never finished my Ph.D.

The vow

It may sound strange, but I don’t wish I was a college professor. The writing I wanted to do had nothing to do with the study of contemporary fiction. I don’t miss teaching.

I don’t believe I wasted the time leading up to the dissertation because education is never wasted.

I don’t dwell on it like I used to. I don’t know that my life would have been better or more productive with a Ph.D.

What I do regret, though, is not finishing a goal after coming so close.

I regret the fact that OCD was so strong then that it affected me reaching my goal, my dream.

But with all my tools to fight OCD that I’ve gained through treatment, with all my intent to live a full life, I won’t let OCD take away any more dreams.

What ways have you protected your dreams and reached your goals?

OCD and making decisions

“Are you sure you want to do this?”

As soon as he asked the question, I started doubting the decision that I thought I was satisfied with.

That’s all it took: a question, and I became uncertain about something I had been sure about for days.

I was faced with a decision recently that, depending on the route I took, could result in important changes in my life.

I came up with the idea for the change in the first place and pursued it, at first hesitantly, and then with more desire and confidence.

Then the doubt came.

I’ll write specifically about that decision in a post soon, but today, I’m focusing on the decision-making process and how obsessive-compulsive disorder can affect it.

Having OCD means having a lot of uncertainty about things that others don’t even think about. Those of us with OCD wonder about things like whether or not the stove is turned off, whether or not we hit someone with our car, whether or not we read a page in a book thoroughly, whether or not our hands are clean, whether or not we harmed someone.

The uncertainty about these things—the obsessions that trap us into thinking about these things—can lead to the compulsions that we do to try to alleviate the extreme anxiety we feel.

I have found that the same uncertainty that surrounds the obsessions and compulsions also filters into my decision-making process.

It isn’t always easy for me to make a decision, even about something as innocuous as what restaurant to eat in or whether or not to make a phone call.

I obsess over whether or not I’m making the right choice. I’m afraid of making a wrong choice. I’m afraid of hurting someone or otherwise adversely affecting someone with my decision. I’m afraid of ruining my life with one bad decision.

So I quite often practice avoidance. I leave decisions to others, or delay decisions until they’re made for me.

I also compulsively ask for reassurance from others. I want someone to say, “Tina, you are making the right decision. I have no doubt about it.”

What I’m really looking for is for someone else to take responsibility for the decision. And that’s not fair to others. Others deal with uncertainty—why shouldn’t I?

So after the setback by doubt, I did more research, asked more questions, thought more about the decision. And when I felt a great sense of devastation when it seemed things weren’t going to work out, I sensed that I may have been on the right path to begin with.

I had to let go of my fear of making a decision.

None of us can ever be 100 percent sure all the time that we’re making the right decisions. Uncertainty is a fact of life. Those of us with OCD may have more doubt than those who don’t, but we can still be responsible enough to make decisions. We just may have to try harder.

What goes into your decision-making process? What do you do when faced with a tough decision?

It’s worth saying again and again: You can get relief from OCD

If you have obsessive-compulsive disorder or think that you do, there’s something that I want you to know: you can get better. There are treatments available. You can get relief.

I’ve said that before. I hope it’s a belief that permeates my blog.

But it’s worth saying again. And again. As many times as it takes to make sure you know, deep down: you can get better.

Earlier this week, I wrote a post describing a day with OCD and other anxiety. The day I wrote about was stressful and full of anxiety, but it wasn’t the worst day I’ve ever had.

I started to think about those of you who have worse days than that quite often. And I felt compelled to write this post.

Before I got any treatment, before I even told anyone about my symptoms, OCD had come to rule my life.

I was in my 20s when I first got treatment for OCD.

Before then, I spent hours at a time scrubbing my bathroom over and over.

I checked my stove until the early morning hours to make sure it was turned off.

I couldn’t read a book because of reading OCD, which made life as a student very difficult.

Every time I walked anywhere outside, I slowed myself down by checking every stick and stone that looked like it might harm someone else.

I prayed compulsively for God’s forgiveness and worried about my eternal salvation.

My hands were dark red and incredibly dry from excessive hand washing.

My life was hell. I had no hope that I would get better. I didn’t want to live.

But a friend encouraged me to see a therapist by revealing to me that she was in therapy.

I started seeing a therapist who I learned to trust. She referred me to a psychiatrist, who diagnosed me with OCD and depression and started me on medication.

Through the years after that, I also learned new ways of dealing with OCD and my thoughts and actions by reading and researching OCD, from cognitive behavior therapy, from exposure and response prevention, by reaching out to others with OCD, from writing about OCD, from meditation and from learning more about myself.

I am better today, so much better than I was when I was first diagnosed more than 20 years ago. And I have hope that I will continue to get better and learn to live a life at peace with OCD.

Here are some resources to help you learn more about OCD and the treatments available:

*The International OCD Foundation

*National Institute of Mental Health

*Beyond OCD

*National Alliance on Mental Health

*Anxiety and Depression Association of America

Here are two books that especially helped me:

Brain Lock: Free Yourself from Obsessive-Compulsive Behavior. By Jeffrey M. Schwartz, MD, with Beverly Beyette.

Freedom from Obsessive-Compulsive Disorder: A Personalized Recovery Program for Living with Uncertainty. By Jonathan Grayson, Ph.D.

Remember that you are not alone.

I encourage you to reach out and get help if you haven’t. I encourage you to keep on fighting to get better.

I encourage you to get some relief.

What are some things we can all do to encourage others who have mental illnesses?

Vision board for fighting my OCD

I created a vision board for inspiration in my ongoing efforts to improve my obsessive-compulsive disorder.

I got the idea from Lisa at Two Bears Farm. She created a wonderful board when she was trying to get back into shape after the birth of her twins.

I already had some corkboards, so I used one of them. I covered it with scrap paper and then began taping up words and photos that inspire me.

I didn’t allow myself to be a perfectionist about it. There are uneven edges to the design.

I included photos of my husband and cats and photos representing things that I want to do with my time instead of spending it on obsessions and compulsions.

I also included copies of my fear hierarchies so I can see at a glance what I intend to tackle.

I set it up in the bedroom and look at it mostly in the morning as I’m getting ready for my day. I like having a visual reminder of what I’m working on.

However, I have discovered that the more I look at it, the more it tends to fade into the background—kind of like the chair that’s always there that you don’t notice anymore.

So I will need to add and change things as I go along, to keep it fresh.

What I have is a board to remind me that I’m on a journey to win over OCD, to live with it on my terms.

Have you ever made something like a vision board? Do you have any suggestions on how to make it more effective?

OCD and Christmas Day

I hope everyone is well and at peace, and if you celebrate Christmas, I hope you had a wonderful day.

Christmas Eve and Christmas Day were both busy and fun for Larry and me. We visited with his mother and my mother, attended the candlelight service at church on Christmas Eve and enjoyed time together. It was a wonderful holiday.

Obsessive-compulsive disorder didn’t ruin the holiday, but I found it sneaking in a few times to remind me that it’s still there, Christmas or not.

I felt it Christmas morning, when Larry and I opened our gifts to each other.

We keep our wrapped gifts on the dining room table until Christmas morning because our cat Sam likes to chew on boxes, wrapping paper and ribbons. She can’t climb up on the table anymore, so it’s the safest place we can keep them.

Christmas morning we took the wrapped presents to the big tree and sat in front of it to open our gifts. We had Celtic Christmas music playing, and it was a peaceful and fun time as we discovered what we had picked out for each other.

We were prepared. We had a trash bag to put the used wrapping paper in, and a box to put the ribbons in.

But I still found myself anxious about leaving a piece of paper, a bit of tape or a sliver of ribbon on the carpet for the cats to eat.

So I grabbed the paper and tape from Larry’s hands as soon as he tore it from a package and stuffed it down in the trash bag. Then I scanned the carpet for any pieces I might have missed.

It was not a big deal, compared to some other compulsions I have and have had in the past, but it was enough to take my mind momentarily off the festivities.

The real anxiety-producing obsession came later, when we visited my mother and had dinner with her.

She lives in an assisted living home, and has a large bedroom and bath, plus a lovely living room and dining room that she shares with the other ladies that live there.

My brother and his wife were also visiting, so we had to get an extra chair out in mother’s room where we talked with each other after dinner. Mother had a folder chair stored behind her bathroom door, so I got that out to sit in.

When it came time for Larry and I to leave, I refolded the chair and put it back behind the door.

That’s when the self-questioning started.

What if I didn’t set it firmly enough against the wall? What if I didn’t balance it well enough? If it fell, it might cause my mother to fall.

I turned the chair both ways and leaned it against the wall. I couldn’t tell which way made the chair more balanced, so I asked Larry to look at it.

My mother heard me and said, “There’s a certain a way you put it so it won’t fall.”

I asked, “Which way?”

My mother just said, “There’s one way to put it so it won’t fall.”

I was really anxious then. She apparently didn’t know how it should be set up, just that it had to be a certain way.

Larry looked at it and moved it around a little. We did our best to set it right.

He told me later that he thought he understood what my mother meant and put the heaviest part of the chair against the wall.

But as we said our goodbyes and left, it stayed on my mind. What if the chair fell? What if my mother fell?

Outside, my brother was taking a smoke break. I knew he was going back in, so I asked him to check the chair again for us to make sure it wouldn’t fall. He agreed to.

Looking back on it now, I should have just let it go. The chair was fine the way Larry and I had it. But I wanted the extra “checking” that my brother would give it.

Small things in the grand scheme of OCD, but they were enough to give me pause during the day.

Did OCD or anxiety sneak into your holiday activities?

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?

The lights at work: Are they really off?

The lights at work—specifically, the two lamps I use in my office—have been a checking nightmare for me.

My ritual has been to turn off the floor lamp first, then unplug it. I then stare at the lampshade, trying to convince myself that it’s dark, that the light is off.

Then I stare at the electric receptacle, trying to convince myself that there’s nothing plugged in.

Then I turn off the desk lamp and stare at that lampshade, again trying to convince myself that the light is off.

I don’t unplug that lamp, which shows just how inconsistent OCD can be: I feel the need to unplug one lamp but not the other. If it’s dangerous to leave one lamp plugged in, why not the other, you might ask.

I have stayed behind while the others left work, to be alone to check the lamps and make sure they were out.

On my checking fear hierarchy, leaving the office without checking the lamps is a 90. That means that I have extreme anxiety over these lamps.

I’ve been working on this checking dilemma for weeks, with mixed results. I could turn them off and leave fairly quickly, but I was first trying to convince myself that the lamps were off before leaving. I couldn’t figure out how to get past that.

Then I had a talk with my therapist last week about OCD and logic.

He reminded me that there is no logic in OCD and that I can’t use it when trying to combat an obsession or a compulsion.

According to what my therapist told me, when I turn off the lamps, it’s time for me to leave the office and focus on something else.

  I’ll have anxiety, he said. But I need to be actively engaged in whatever I do next, like driving. Don’t engage with the thoughts about the lamps, he said.

  And it’s helping. I turn off the lamps, and though I’m still glancing at them, I’m no longer spending time convincing myself that they’re off. I’m packing up and leaving the office. I feel the anxiety, but it dissipates quickly as I focus on other things.

Now I want to get to the place where I’m not even glancing at the lamps, where I’m not even thinking about them after I turn them off. I hope I can build on the success I’m having.

  If anyone has advice on how to do that, I’m all ears!

OCD and ringing the bells

Sometimes obsessive-compulsive disorder gives me tunnel vision. I become self-centered. I focus on what I’m feeling and what I want or don’t want instead of other people.

OCD never completely goes away, and it can appear in any part of my life. It even showed up when I was trying to do a good deed.

The past two years, Larry and I volunteered to ring the Salvation Army bells outside a big box store here in town.

For just an hour, once the first year and twice the second, we stood outside the store and rang the small red bells and thanked people who put donations in the red bucket.

It was fun, and it really put us in the holiday spirit.

So we decided to do it again this year. I signed us up for two stints, and we did our first last week.

The bell ringers wear red aprons, the type with the bib and the string that goes around the neck.

When Larry and I relieved the people ringing before our shift, the man took off his apron and handed it to me.

I didn’t want it to touch me.

I had a coat on because it was cold, so I just put the apron over my coat, and then put the neck string under the collar of my coat to keep it from touching my skin.

Funny things was, Larry felt the same way. His apron had been lying folded up on the sidewalk beside the bucket. I helped him put the neck string under his coat collar, too.

Even with the string under my collar, I still felt anxious about it. I had to put my hand in the pocket to get the bell out, and I cringed.

I couldn’t wait to get that apron off.

I felt small and petty for worrying about such things when my real purpose was to thank the kind people who donated to the Salvation Army.

I try not to be selfish, but I’m not perfect. I have to accept that of myself.

But OCD has more than selfish moments. It has its funny moments, too.

Last year, while ringing the bells, Larry’s bell broke. The little piece of metal inside the bell flew off.

At first we couldn’t find it. I kept ringing my bell, and we kept thanking people, but the whole time, we were scanning the area for that little piece of metal.

And all I could think of was that the next people to ring would have only one bell.

My scrupulosity made me feel like I needed to “confess,” so I called and left a message for the coordinator, telling him we’d broken one of the bells and there was only one left.

Then we found the little piece of metal lying on the pavement in front of us, and Larry was able to fix the bell.

So I was soon back on the phone and leaving another message for the coordinator, telling him we’d fixed the bell and not to worry about it.

He probably thought I was strange.

But he called me again this year to see if we’d volunteer and didn’t mention it, so I guess that’s a good sign.

Do you ever get tunnel vision when dealing with OCD or other anxiety?

Memoir: The jug of water

She set the jug of water on top of the toilet.

It was a plastic milk carton being re-purposed for a lesson.

She said something like, “This is all the water you can use today. You can’t run the water. You’ll have to use what’s in the jug.”

There was no convincing her to do otherwise.

And I thought I was going to die.

I was about 13 at the time, which would make it 1976. We were living in the country, in the house my parents built after they sold most of our farm and the farmhouse.

I understand now where my mother’s anger came from. I ran water long and fast, washing and rewashing my hands, trying to get them clean.

I usually used the bathroom just off her and my father’s bathroom, instead of the larger one in the hallway, because it seemed more private and less contaminated. So they could hear the amount of water I was running.

“You’re going to run the well dry,” she warned me.

My parents had told me to stop running “so much water.” But I had disobeyed, something that wasn’t done lightly in my home.

I didn’t understand why I felt compelled to wet my hands, soap them up, rub them together for a certain time, then rinse, and then do it all over again, again and again. All while running the water.

My hands and wrists were red and raw looking. But I thought I was just doing what everyone should be doing, washing my hands thoroughly.

I hadn’t heard of obsessive-compulsive disorder, and I don’t think my parents had either.

With the jug of water, I had to pour water out, just enough to wet my hands, then lather up with soap, then pour water on my hands again.

I hated getting soap on the jug when I lifted it to pour out the rinse water.

I worried about so many things: was I getting all of the soap residue off? If not, and I touched a plate or something that someone else might touch and then eat from, then that person could get diarrhea, because I had learned from my mother that eating from dishes not properly rinsed could give people diarrhea.

What if my hands didn’t get clean from the cold water? What if I had germs on them and spread them to others and made them sick?

What if I used all the water in the jug and there was none left, and I still had to wash my hands?

Oh, I hated the jug.

  My mother made me use the jug for a few days, but gradually, I started running the water again, warm water, hot water, to get my hands cleaned well and rinsed well.

  And the jug went away. But nothing else did.

  If you were reading more about this 13-year-old girl, what would you like to know about her?

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