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.

Unhelpful Cognitions

Mental Filter: This thinking style involves a “filtering in” and “filtering out” process – a sort of “tunnel vision”, focusing on only one part of a situation and ignoring the rest. Usually this means looking at the negative parts of a situation and forgetting the positive parts, and the whole picture is coloured by what may be a single negative detail.

Jumping to Conclusions: We jump to conclusions when we assume that we know what someone else is thinking (mind reading) and when we make predictions about what is going to happen in the future (predictive thinking).

Mind reading: Is a habitual thinking pattern characterized by expecting others to know what you’re thinking without having to tell them or expecting to know what others are thinking without them telling you. This is very common, and most people can identify. Oftentimes, when we are telling someone a story about an interaction, we’ve had with someone else, we will make mind reading assumptions without actually having fact or evidence e.g., “They haven’t phoned me in two weeks so they must be angry with me for cancelling on them last week.”

Personalisation: This involves blaming yourself for everything that goes wrong or could go wrong, even when you may only be partly responsible or not responsible at all. You might be taking 100% responsibility for the occurrence of external events. It can also involve blaming someone else for something for which they have no responsibility. This can often occur when setting a boundary with someone and you take responsibility for their guilt or anger.

Catastrophising: Catastrophising occurs when we “blow things out of proportion” and we view the situation as terrible, awful, dreadful, and horrible, even though the reality is that the problem itself may be quite small.

Black & White Thinking: Also known as splitting, dichotomous thinking, and all-or-nothing thinking, involves seeing only one side or the other (the positives or the negatives, for example). You are either wrong or right, good or bad and so on. There are no in-betweens or shades of grey.

Should-ing and Must-ing: Sometimes by saying “I should…” or “I must…” you can put unreasonable demands or pressure on yourself and others. Although these statements are not always unhelpful (e.g., “I should not get drunk and drive home”), they can sometimes create unrealistic expectations.

Should-ing and must-ing can be a psychological distortion because it can “deny reality” e.g., I shouldn’t have had so much to drink last night. This is helpful in the sense that it communicates to us that we have exceeded our boundaries, however, saying “shouldn’t” about a past situation can be futile because it cannot be changed.

Overgeneralisation: When we overgeneralise, we take one instance in the past or present, and impose it on all current or future situations. If we say, “You always…” or “Everyone…”, or “I never…” then we are probably overgeneralising.

Labelling: We label ourselves and others when we make global statements based on behaviour in specific situations. We might use this label even though there are many more examples that are not consistent with that label. Labelling is a cognitive distortion whereby we take one characteristic of a person/group/situation and apply it to the whole person/group/situation. Example: “Because I failed a test, I am a failure” or “Because she is frequently late to work, she is irresponsible”.

Emotional Reasoning: This thinking style involves basing your view of situations or yourself on the way you are feeling. For example, the only evidence that something bad is going to happen is that you feel like something bad is going to happen. Emotions and feelings are real however they are not necessarily indicative of objective truth or fact.

Magnification and Minimisation: In this thinking style, you magnify the positive attributes of other people and minimise your own positive attributes. Also known as the binocular effect on thinking. Often it means that you enlarge (magnify) the positive attributes of other people and shrink (minimise) your own attributes, just like looking at the world through either end of the same pair of binoculars.

(CCI, 2008)

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