Webb Therapy Uncategorized OCD: tips for self-management

OCD: tips for self-management

People living with obsessive-compulsive disorder are encouraged to follow three general tips for effective self-management. They are: challenge the obsessive thoughts and compulsive behaviours (this includes use of distraction skills, and resisting the compulsion), maintain high self-care (you may need to put your needs first a lot – this is NOT selfishness or self-centredness), and reaching out for support. I want to clarify that I am not trained or qualified in OCD treatment – this is an extract from an article posted on the Australian Institute of Professional Counselling website.

The following information has been retrieved from AIPC Article Library | Self-help Strategies for OCD and OCPD. I think it’s also important to reinforce that if you have been living with OCD for years, you’re probably the expert on what is already most effective for you, and some of the following suggestions may make you roll your eyes. It can be very helpful/useful to talk to other people who live with OCD. They may understand your experience better than health workers, and this can be comforting, validating and healing.

Challenge the obsessive thoughts and compulsive behaviours. In addition to refocusing, the OCD client can learn to recognise and reduce stress. Some of the strategies here are counter-intuitive. You can urge clients to “go with the flow” by writing down obsessive thoughts, anticipating OCD urges, and creating “legitimate” worry periods. Tell them to:

Write down your obsessive thoughts or worries. Keep a pen and pad, laptop, tablet, or smartphone nearby. When the obsessive thoughts come, simply write them down. Keep writing as the urges continue, even if all you are doing is repeating the same phrases over and over. Writing helps you see how repetitive the obsessions are and also causes them to lose their power. As writing is harder than thinking, the obsessive thoughts will disappear sooner.

Anticipate OCD urges. You can help ease compulsive urges before they arise by anticipating them. For example, if you are a “checker” subtype, you can pay extra attention the first time you lock the window or turn off the jug, combining the action with creating a solid mental picture of yourself doing the action, and simultaneously telling yourself, “I can see that the window is now locked.” Later urges to check can then be more easily re-labelled as “just an obsessive thought”.

Create an OCD worry period. Rather than suppressing obsessions or compulsions, reschedule them. Give yourself one or two 10-minute “worry periods” each day, times you are allowed to freely devote to obsessing. During the periods, you are to focus only on negative thoughts or urges, without correcting them. At the end of the period, let the obsessive thoughts go and return to normal activities. The rest of the day is to be free of obsessions and compulsions. When the urges come during non-worry periods, write them down and agree to postpone dealing with them until the worry period. During the worry time, read the list and assess whether you still want to obsess on the items in it or not.

Create a tape of your OCD obsessions. Choose a specific worry or obsession and record it into a voice recorder, laptop or smartphone, recounting it exactly as it comes into your mind. Play the recording back to yourself over and over for a 45-minute period each day, until listening to it no longer causes you to feel highly distressed. This continuous confrontation of the obsession helps you to gradually become less anxious. When the anxiety of one worry has decreased significantly, you can repeat the exercise for a different obsession (Robinson et al, 2013).

Maintain good self-care. A healthy, balanced lifestyle plays an important role in managing OCD and the attendant anxiety (generally present with OCD, even though the disorder is no longer classified as an “anxiety disorder” per se), so the helpfulness of the following practices – truly not rocket science – cannot be underscored. Encourage OCD clients to:

  • Practice relaxation techniques, for at least 30 minutes a day, to avoid triggering symptoms.
  • Adopt healthy eating habits, beginning with a good breakfast followed by frequent small meals – with much whole grain, fruit and vegetable – throughout the day to avoid blood sugar lows and to boost serotonin.
  • Exercise regularly; it’s a natural anti-anxiety treatment. Get 30 minutes plus of aerobic activity most days.
  • Avoid alcohol and nicotine, as these increase anxiety after the initial effects wear off.
  • Get enough sleep; a lack of it exacerbates anxious thoughts and feelings (Robinson et al, 2013).

Reach out for support. Staying connected to family and friends is the best defense an OCD client can muster against intrusive obsessions and compulsive urges, because social isolation exacerbates symptoms. Talking about worries and urges makes them seem less threatening. Also, involving others in one’s treatment can help maintain motivation and guard against setbacks. To help remind the client that s/he is not alone in the struggle with OCD, ask him or her to consider joining a support group, where personal experiences are shared and attendees also learn from others facing similar problems.

OCPD: Self-help strategies for survival

For both the person diagnosed with OCPD and also for his family and friends, dealing with this disorder requires patience, compassion, and fortitude. To start with, the ego-syntonic nature of OCPD means that the person does not necessarily agree that he has anything wrong at all. For those who staunchly continue to insist that their relational problems arise because of others’ faults, treatment is complicated. Given the OCPD’s general world view of “I am correct; you are wrong”, the prognosis for change is often poor. Transformation is likely to occur only when the OCPD’s relational skills and outlook are shifted. This is not a job for medication (at least not for long and not alone), and yet psychotherapy is not always available. When it is, the OCPD is not always willing to avail himself of it.

Regardless of this less-than-ideal context for managing OCPD, there are some things that the client himself and also friends and family can do to alleviate some of the tension and conflict that goes with living with the disorder. As a therapist, you can encourage the client and those around him to utilise some of these strategies.

Bibliotherapy. It’s a good idea to read up on OCPD, not only in order to know what to expect, but also for tips in dealing with it. Your client may also come upon writings that link some behaviours and lifestyle choices to the disorder in ways not understood before. When comprehension deepens, so, too, does the prospect of compassion.

Gentle confrontation (agreed beforehand). While we agree that OCPD clients have a mammoth need to be right, those clients who truly seek to feel better may be willing to make agreements with family and friends in which OCPD behaviours, when noticed, are gently challenged; the operative word here is gently.

Self-insight through journalling or tape-recording. We noted above that many OCPD clients are intelligent, sensitive people. Thus, keeping a diary or making voice recordings to note anything upsetting, anxiety-provoking, overwhelming, or depressing is a step toward the self-insight that will eventually help to manage the disorder. Too, family and friends may agree to note their observations and share them in a constructive, non-confrontational manner.

Good self-care. OCPD is a disorder about exaggerated need for control, so keeping on an emotional even keel can help reduce the unconscious need to micro-manage all of life. Strategies to achieve this are listed above under Tip 2 for maintaining self-care with OCD. They revolve around the basic life efforts of practicing relaxation techniques, adopting healthy eating and exercise regimens, getting decent sleep, and avoiding excessive alcohol/drug consumption (the last is not hard for the OCPD).

Reaching out for help. OCPD individuals tend to be loners, and relationships are hard for them to build and maintain. Nevertheless, it is helpful to the ultimate reduction of OCPD-engendered tension to go for support. This can be in the form of self-help groups, informal support from partner, family, and friends, or even from joining online communities of people dealing with the disorder. Whatever the form of the support, it may be helpful for OCPD clients to own their places of dysfunction when they see others owning their imperfect humanness – and surviving (Robinson et al, 2013)!

References

  • Long, P. (2011). Obsessive-Compulsive Personality Disorder. Internet mental health. Retrieved on 18 April, 2013, from: hyperlink.
  • Robinson, L., Smith, M., & Segal, J. (2013). Obsessive-Compulsive Disorder: Symptoms and treatment of compulsive behaviour and obsessive thoughts. Helpguide.org. Retrieved on 24 April, 2013, from: hyperlink.

Related Post

What does human development mean to you? How often are we thinking about our own development? Here is a start (“,)What does human development mean to you? How often are we thinking about our own development? Here is a start (“,)

Hello readers. I hope you are well. I imagine some of you are struggling and some of you are flourishing. Life consists of both. As humans, we relish pleasurable feelings and experiences and we tend to dislike uncomfortable emotions and experiences. I get it. I am just like you. We share this. I hope that provides some comfort.

What is human development?

Human development can be described as “systematic changes and continuities in the individual that occur between conception and death, or from “womb to tomb”” (Sigelman, De George, Cunial, & Rider, 2019, p. 3).

Human development involves the continuities (i.e., what remains consistent across time) and the systematic changes (i.e., patterns of change that are expected to come in order across time) that one experiences throughout the lifespan. Based on my education, there are three domains of continuity and change: 1. The physical and biological, 2. Cognitive (i.e., mind processes/thinking), and 3. Psychosocial and emotional. Let’s open these one at a time.

Physical development includes:

  • Physical and biological processes (e.g., genetic inheritance).
  • Growth of the body and its organs.
  • Functioning of physiological systems (e.g., brain).
  • Health and wellness.
  • Physical signs of ageing and changes in motor abilities.

Cognitive development includes:


Perception: the sensing of stimuli in our environment (internal and external), sending that information to the brain to be identified and interpreted in order to represent and understand our experience of the world and give it meaning. All perception involves signals that go through the nervous system.

Attention: the ability to actively (and often, involuntarily) process specific information in the environment while tuning out other details. Attention is a very interesting cognitive process because when we bring mindfulness to our thoughts we become open to the direction and attention of our mind. Remember this: where attention goes, energy flows.

Language: very broadly, Language is a communication system that involves using words (i.e., sounds arranged together) and systematic rules to organise those words into sentences and meaning, to transmit information from one individual to another. I was never very interested in language when I was studying at university however that has changed. We used language and concepts to talk to ourselves, about other people, and it is open to misinterpretation, error, and oftentimes language can be used as a means to hurt people or … bring us closer together.

Learning: very broadly defined as a relatively permanent change in behaviour, thinking, and understanding as a result of experience. Experience is everything from formal education to unique personal experience. We learn from each other, the world around us, books, movies, self-reflection and education etc. All of which are experiences.

Memory: Memory refers to the processes that are used to gather, organise, store, retain, and later retrieve information. I’m sure you’ve all seen a tv show or read a book about a person with Amnesia or Alzheimer’s disease. Imagine what your life would be like if you didn’t have the function of memory. I wouldn’t be able to type this very well, I don’t think. I wouldn’t remember my loved ones or what was dangerous in my environment. I know we all have unpleasant memories too and that may feel like a negative evolutionary by-product – however it is actually designed to protect us. Memory is finite – we actually forget a lot of stuff, or perhaps more accurately, we do not have the capacity to store and recall everything we experience.

Intelligence: I would like to reframe intelligence from what might be a common belief. Intelligence does not mean academically gifted as is considered valuable in Western society. I think Olympians and caregivers/parents have an intelligence that I do not because I haven’t learned their skills. Intelligence involves the ability to learn (i.e., sport, academics, the arts, swimming, survival, interpersonal skills), emotional knowledge, creativity, and adaptation to meet the demands of the environment effectively

Creativity: I consider creativity to be an evolutionary gift of our imagination, providing humans with the ability to generate and recognize ideas, consider alternatives, think of possibilities that may be useful in solving problems, communicating with others, and entertaining ourselves and others. Creativity can be stunted when we are struggling or caught in reactivity to external pressures or perceived stress.

Problem solving: is a process – yes, a cognitive one but also a behavioural process. It is the act of defining a problem; determining the cause of the problem; identifying, prioritizing, and selecting alternatives for a solution; and implementing a solution. Problem solving can be both creative or stress driven. I like to say whenever I am solving a problem I am also making a decision. A decision of mine is a choice. At university, our problem solving lessons were coincided with decision making which is why I think of it that way.

Psychosocial development involves:

Aspects of the self (i.e., your identity – which may change over time), and social and interpersonal interactions which include motives, emotions, personality traits, morality, social skills, and relationships, and roles played in the family and in the larger society. This is a huge area to be explored. I will endeavour to elaborate on our psychosocial development in later blogs.

In the late 1950’s, a German-American developmental psychologist named Erik Erikson created a theory for human psychosocial development across the lifespan. His theory suggests that human personality develops in a predetermined order through 8 stages of psychosocial development. See the table below:

Age or StageConflictExampleResolution or “virtue”Key Question to be answered
Infancy (0 to 18 months)Trust vs. MistrustBeing feed and cared for by caregiver.HopeIs my world safe? Will I be cared for?
Early Childhood (2 to 3 years)Autonomy (personal control) vs. Shame and DoubtToilet training and getting dressed.Will I would add self-efficacy here too.Can I do things for myself, or will I always rely on others?
Preschool (3 to 5 years)Initiative vs. GuiltInteracting with other children and asserting themselves in their environment e.g., during play.Purpose Taking initiative, leading others, asserting ideas produces a sense of purpose.Am I liked by others or do I experience disapproval by others?
School Age (6 to 11 years)Industry (competence) vs. InferiorityStarting formal education and participating in activities.CompetenceHow can I do well and be accepted by others?
Adolescence (12 to 18 years)Identity vs. Role Confusion (uncertainty of self and role in society)Developing social relationships with peers and sense of identity.Fidelity (loyalty) The ability to maintain loyalty to others based on accepting others despite differences.Who am I and where am I going in my life? What are my personal beliefs, values and goals?
Young Adult (19 to 40 years)Intimacy vs. IsolationDeveloping intimate relationships.LoveAm I loved and desired by another? Will I be loved long-term?
Mature Adult (40 to 65 years)Generativity vs. StagnationVocation and parenting, typically.Care Contributing to the world to demonstrate that you care.Will I provide something to this world of real value? E.g., children or valuable work, art, a legacy etc.
Maturity (65 year to death)Ego Identity vs. DespairReflection of your life. Feelings of satisfaction and wholeness.WisdomWas I productive with my life? Can I accept my life and have a sense of closure and completeness?

Cognitive (thinking) ErrorsCognitive (thinking) Errors

Well, hello and good morning, afternoon, and evening readers. I truly hope you’re swimming in the pleasantries of life rather than keeping your head above water in the unpleasant swamp. HOPE = Hold On Pain Ends. And there’s generally a learning or personal growth that comes after the storm of every painful experience, even if it’s simply greater empathy and compassion for others.

Today’s the day to learn or remember the fallacies of the human mind. I am not as smart as I look, haha. Have you heard of heuristics before? In cognitive psychology, a heuristic is a mental “shortcut” that allows people to solve problems and make judgments quickly and efficiently. They can be very helpful in many situations, but they can also lead to cognitive biases, errors in thinking, and even perhaps without the mental shortcut, our thinking is often filled to the brim with cognitive distortions, assumptions and fallacies (faults). Awareness raising is probably the first step to identify our own cognitive traps and also identify them in others. Cognitive errors are natural – we all have them. Below are some cognitive distortions/errors to be aware of when we reflect on our interactions with people, during personal reflection, and when making meaningful decisions or judgements.

  • ALL-OR-NOTHING THINKING (aka. POLARISED THINKING, SPLITTING, and BLACK-AND-WHITE THINKING: is extreme thinking i.e., the error in a person’s thinking to bring together the dichotomy of both positive and negative qualities of the self and others into a cohesive, realistic whole. It is a common defense mechanism. Before you think “I must have really shitty thinking because I do this ALL the time”, give yourself a break. If you’re thinking in black and white, you probably internalised this from social media, television and movies, your family of origin and the broader society. Be mindful of using extreme, dichotomist terms, such as “failure”, “success”, “best”, “worst”, “freezing”, “boiling”, “everything”, and “nothing”. If you think “I’m a terrible person”, that is bullshit and inaccurate. You may have behaved terribly for a period of time towards yourself, to someone else, or towards some “thing”, but we cannot discount all the NON-terrible qualities about you. We must THINK in DIALECTICS i.e., the ability to view issues from multiple perspectives with reason and wisdom or in other words being able to have two contradictory viewpoints, where a greater truth emerges from their interplay. The truth is, if you think you’re a terrible person, there’s also virtuous person in there too.
  • OVERGENERALISTION: The words “always”, “every” and “never” come into play here, and you have an unshakable “rule” or “conviction” about yourself, something, or someone, based on one or two incidences. Overgeneralising is “a cognitive distortion in which an individual views a single event as an invariable RULE, so that, for example, failure at accomplishing one task will predict an endless pattern of defeat in all tasks.” Coming into the present moment and being specific can be helpful if you are someone who overgeneralises. You may also want to ask yourself if what your saying is the really the truth. Is it really accurate or correct. There’s an assumption that because something has happened once or a few times that it’s like going to happen every time. Remember, the words “always”, “every”, and “never” frequently appear in this cognitive “trap”. I encourage you to look at the big picture and ask yourself if what you’re saying or thinking is accurate. Overgeneralisations tend to be vague and board statements e.g., “I always get every red light”. Perhaps this is part of our evolutionary negativity bias. We tend to notice the so-called “bad” and overlook the so-called “good”. If you find yourself using overgeneralisations that suggest a future prediction (e.g., “I’ll never get a partner) … use some humour – you may have big balls but neither one of them are crystal – VEEP. If there is some truth to unusually frequent and specific situations that are making your life unpleasant, validate them, talk to someone, and brainstorm some solutions. We humans have plenty of blind spots that others can see sometimes.

  • MENTAL FILTER: is considered to be the opposite to OVERGENERALISATION the mental filter takes one small event and focuses on it exclusively, filtering out anything else that’s relevant. Filtering out the positive and focusing on the negative can have a detrimental impact on your mental well-being. Filtering out the so-called “negative” can also make one a bit hubris (excessive pride or self-confidence), arrogant, vain and conceited – and then you’re just a stone’s throw away from narcissism.

  • PERSONALISATION AND BLAME: Personalization and blame is a cognitive distortion whereby you entirely blame yourself, or someone else, for a situation that in reality involved many factors that were out of your control. I think this is a symptom of our wounded ego, or simply just the ego. As human’s we are egocentric, like children, and we often think that circumstances in our environment are solely because of our influence. For example, your friend isn’t behaving like they usually do, so it must be because you have done something.

Again, personalisation is an egocentric error in cognition. “Of course it has to do with me”, we think. It makes sense that we personalise things. We are the star of our own show, our own narrative. If you personalise something, it means we’ve directly influenced it – we are the primary cause. This may elicit internal pain, shame or guilt, so what’s the pay-off? Personalisation is a cognitive error that offers us the illusion of control e.g., “If we caused it then we will learn how to not cause it again, and maybe even undo what we have caused”. If you think about it, personalising something is something children do. Remember, there are infinite variables in any situation to take full credit of the outcome. That being said, it is responsible and mature to reflect objectively on the influence of our behaviour and what we can learn about our shortcomings.

Blame deserves it’s own blog post but in short, it can be defined as a defence mechanism to protect the self from feeling some unwanted emotion or thinking something unacceptable in relation to the “self”. Blaming provides a way of devaluing others, an the pay-off or reinforcement the blamer receives is a sense of superiority. It protects our ego from feeling responsible for something, and protects us from feeling guilt or shame. Perfectionists are very good at blaming others, and themselves. Even if you genuinely think faulting someone or something is valid, remember that no one is perfect. Recognise that you are human and others are fallible humans. As they say in recovery, “there is a bit of bad in the best of us and a bit of good in the worst of us“. We may have internalised from society and culture that we couldn’t make mistakes (because we receive “punishment” for making mistakes) but we must move beyond that now. As adults, we need to get real. Validate your experience because it may be very disappointing when we don’t meet others or our own expectations. We must nurture and care for the wounded child. Lets attend and befriend to our shortcomings and accept we are not superhuman. Learn to expect you will make mistakes. Failure is kind of an illusion, isn’t it? Or maybe a social construct? “Failure” is really learning – replace ‘failure’ with the word ‘feedback’. Would a cat or dog blame them self for a “mistake”? In the minds of animals, there’s no such concept as failure or a mistake.

Here’s a link to website “simplypsychology” that discusses a theory called Attribution Theory, an idea about how people explain the causes of behaviour and events: Attribution Theory – Situational vs Dispositional | Simply Psychology