So I've had a major up & down few weeks. After being relieved to get a suggested OCD diagnosis from my CBT therapist, in short the past few weeks have been about me mainly putting a fake positive/take action front on while desperately panicking about the fact I might have a chronic anxiety issue, and trying anything possible to 'fix' it while probably in quite a bit of denial.
I started to really do something useful the last time I blogged however; face up to the fact I need help, both medically and also from people around me including work. I've only today (7 days into my SSRIs kicking in) realised to what extent SHAME has been keeping my anxiety going as well as my lack of self-compassion.
I've been off work now for 10 days, starting at the beginning of last week when I was just too knackered to get out of bed. I emailed my boss saying it was a 'stiff neck' and then the next day 'stress' because I was too ashamed to admit what was really going on - I was exhausted and scared after 5-6 weeks of trying to deal with an anxiety relapse on my own, while being in no fit mind to do so.
Finally this week I owned up; said I had anxiety issues and explained my fear of flying, not being able to let my husband drive the car etc etc. I felt really weird telling him that and pretty ashamed at having to admit to my 'weakness'. Thing is I didn't HAVE to admit it but I think a part of me is working out that keeping this from people is also making it hard for ME to accept I have some form of anxiety disorder. Which means I do not treat it and once pills sort it I go back into denial.
For example I can see now that in the weeks running up to my holiday I was ripe for a crash. Not eating properly, working super-fast, worrying about my husband's illness in case we can't keep the house and what would than mean about how we were perceived in terms of 'success', making out I was looking forward to my holiday when in reality I was scared shitless, in case anyone thought I was weird. Not sure whether I can only start to see that now because my brain is getting flooded with serotonin but its true. It wasn't my holiday stress.
Shame is a big deal and is holding me back. So today I went into work and saw my boss and explained in more detail what I had. I also explained it to a few other people who had been worried about me. Almost all had their own tale to tell about depression or stress.
I think what will be important in my recovery is to accept that I have anxiety. This scares me as I worry for the future; can I cope alone, will I have another relapse etc? But if I don't face up to those fears I won't do anything about them eg learn to manage my anxiety properly, which makes future crashes all the more likely.
I've been feeling very depressed about the future you see. While my SSRIs have been kicking in I've had horrible feelings of doom and sadness, and my death fears have been slapping me over the head. I've been to some super dark places in the last week that will take me a little while to recover from.
It might be in part that I am coming up 40; but I think a lot of it is grief coming out that I have a limiting illness. I really do. I don't like it and don't want it in some ways, but even writing that makes me feel stressed. What is better is to try and accept it fully, and accept myself fully, which means feeling no more shame about my condition. Which means being open.
This I think is important to my recovery; to grieve and to rid myself of shame. Grieving the 'perfect' future I have always been certain I was due to have. Not to say I can't still have it, but I'll not get it by denying my limitations/problems, I'll only get it my managing it. Which makes me feel a little bit more positive as I try and learn new ways to deal with this. Maybe if I feel less ashamed of going 'mad' in a plane I will more easily be able to get back on a plane sometime.
I have an appointment with a psychiatrist next week to just see if I can get an official diagnosis of something; if nothing else to check we're not missing anything so I can then continue with my CBT therapy.
Wednesday 27 June 2012
Wednesday 20 June 2012
Learning real acceptance of who you are
As usual the past few days have thrown a lot at me and I've made quite a bit of progress, due to not a little bit of insight, and shit load of pain.
First and foremost a few days ago a came to the conclusion that, despite me having lasted around 5 weeks with my anxiety at pretty much full whack, the time had come to really engage with the NHS about it as, despite my doubts, I needed some more help and support (as despite me dealing well, an increased chance of recovery I think means accepting help).
I think this has come about as I searched around for the meaning of life while in the throes of my intrusive death thoughts. Although not great that I was ruminating, I came to the conclusion that the meaning of life is accepting things and handing over control, as well as accepting we are all part of a network and really REALLY need other people to be fully the people we can be, we can't do all this shit on our own. Its too lonely and too hard.
Although that conclusion didn't (surprise surprise!) stop the death thoughts, it, combined with a little more Rosen Method massage, made me realise that perhaps in trying to stay SO positive all the time and be SO adamant 'the real me' will deal with this problem, I am kind of missing the point.
Not to say meditation and so on will not help, as it has been, but I'm a human which means the 'real me' is just part of a network which is influenced by so many other people anyway I might as well just use all the tools available to me and not try and be so black and white about who 'me' is.
The only useful learning is that the 'real me' needs help, and has a chronic anxiety issues or issues that will probably wax & wane over my life, that to be honest I should stop trying to find an 'answer' for and accept there may not be an answer. It could be that I just have chemical imbalance and actually need to have pills and a planned support network to be happy. I might always need some pills in fact, as I think looking back over the past 5 years or so my anxiety has actually been creeping back up and affecting all kinds of things in my life.
EG I have been slowly avoiding doing more things, losing touch with friends, being more obsessive about achieving goals, doing my house up in record time in an almost manic way. Spending all my time in the future, planning, worrying, comparing, but not admitting, and often not actually noticing which I think shows the insidiousness of anxiety.
Anyway this morning I went to my local doctor and described my symptoms without trying to diagnose. I did say my CBT therapist suspected OCD but he suggested in all likelihood it was probably a range of anxieties that was the issue/issues. Either way by talking it through (and by me not being a pushover as frankly, GPs are generalists, so what do they know about mental health in detail) we agreed it was worthwhile me getting a psychologist referral to see if there was one stand-out issue, or whether the best diagnosis is 'Generalised Anxiety Disorder'.
He was amazingly not trying to push pills down my throat, saying that the CBT therapy I was already having was probably the best course of treatment, but we did agree I was showing signs of stress and mild depression in dealing with it up to this point. I think that TBH I need a little bit of chemicals to help me do the exposure work I need so I did ask for them. I've lost a little of my enthusiasm for exposure work I guess, as am just so TIRED.
I used to be afraid that if I did ask for pills, that they would be doing the 'exposure' work, not me, but TBH having lasted 5 weeks feeling this bad, and managing to keep going to work etc I think I actually have the constitution of an ox. This week for the first time (I think due to acceptance of my issues) I struggled to go to work as just felt so physically tired and unengaged with work, which made me think long & hard about my 'do it alone' strategy more.
You see I think I deserve to be happy, and if that means being able to continue to go to work and keep TRYING to overcome my fears that is the main thing as the trying and the hope is what matters. I will accept any help necessary to do that. Especially as I know my anxiety is not 'me', my negative thoughts are not 'me'. None of that is a reflection of who I really am. I think I need the pills to help me build myself up, but I came to this conclusion myself not out of panic as I did before. I didn't run to the pills, I asked for them in full knowledge.
Of course I could just be kidding myself I'm in control?! Haha. But somehow I feel better for not doing a knee jerk and really thinking.
Linked into this is I think my acceptance of my anxiety now. Well, my ROAD to acceptance. I think some of my social issues in the past - eg avoiding making new friends etc - is because I never feel I can be free about who I really am with people. That I have 'dark secrets' I cannot share. I have now decided that I will be open about my mental health issues in future once I have decided a person is able to hear it. I don't think I do have 'dark secrets' or a particularly fucked-up past. I have a few dodgy genes and an overacting reptilian brain.
My friends think I am probably reasonably perfect and massively stable and don't need anyone. They have no idea how far that is from the truth and I really DO need them, and more of them, and actually get to know the ones I have properly. Equally, as I am always poised for action, I am EXCELLENT in an emergency myself should they need me as I have such finely tuned fight or flight reactions, and a brain as lithe and fast as an antelope due to my rumination practice. I'm not a victim. I might just need a lay down once in a while.
I'm not going to 'come out' just yet as would like to stablilise on my pills a little and make sure I am not adding too much pressure, but then I'm going to do something like run a 10k marathon and tell my friends about my problems. I think I will try and use my condition as a yardstick. If someone is freaked out and unable to deal with it, I imagine that deep down we are probably not really similar people. I always used to worry what people thought of me, TBH after facing the last 5 weeks I'm not sure I give much of a shit. I don't need people to know and care about an idealised version of me, I need them to care about me, just as I need to know and care about the real them. We all carry our armour and no-one has a clue who's really undeneath all that.
Rant over. I also called my mum for some help, she's coming to hang out with me this week as I wasn't feeling strong enough today to be on my own. Next week I might feel better, and enjoy a solo night in watching all kinds of trashy telly.
First and foremost a few days ago a came to the conclusion that, despite me having lasted around 5 weeks with my anxiety at pretty much full whack, the time had come to really engage with the NHS about it as, despite my doubts, I needed some more help and support (as despite me dealing well, an increased chance of recovery I think means accepting help).
I think this has come about as I searched around for the meaning of life while in the throes of my intrusive death thoughts. Although not great that I was ruminating, I came to the conclusion that the meaning of life is accepting things and handing over control, as well as accepting we are all part of a network and really REALLY need other people to be fully the people we can be, we can't do all this shit on our own. Its too lonely and too hard.
Although that conclusion didn't (surprise surprise!) stop the death thoughts, it, combined with a little more Rosen Method massage, made me realise that perhaps in trying to stay SO positive all the time and be SO adamant 'the real me' will deal with this problem, I am kind of missing the point.
Not to say meditation and so on will not help, as it has been, but I'm a human which means the 'real me' is just part of a network which is influenced by so many other people anyway I might as well just use all the tools available to me and not try and be so black and white about who 'me' is.
The only useful learning is that the 'real me' needs help, and has a chronic anxiety issues or issues that will probably wax & wane over my life, that to be honest I should stop trying to find an 'answer' for and accept there may not be an answer. It could be that I just have chemical imbalance and actually need to have pills and a planned support network to be happy. I might always need some pills in fact, as I think looking back over the past 5 years or so my anxiety has actually been creeping back up and affecting all kinds of things in my life.
EG I have been slowly avoiding doing more things, losing touch with friends, being more obsessive about achieving goals, doing my house up in record time in an almost manic way. Spending all my time in the future, planning, worrying, comparing, but not admitting, and often not actually noticing which I think shows the insidiousness of anxiety.
Anyway this morning I went to my local doctor and described my symptoms without trying to diagnose. I did say my CBT therapist suspected OCD but he suggested in all likelihood it was probably a range of anxieties that was the issue/issues. Either way by talking it through (and by me not being a pushover as frankly, GPs are generalists, so what do they know about mental health in detail) we agreed it was worthwhile me getting a psychologist referral to see if there was one stand-out issue, or whether the best diagnosis is 'Generalised Anxiety Disorder'.
He was amazingly not trying to push pills down my throat, saying that the CBT therapy I was already having was probably the best course of treatment, but we did agree I was showing signs of stress and mild depression in dealing with it up to this point. I think that TBH I need a little bit of chemicals to help me do the exposure work I need so I did ask for them. I've lost a little of my enthusiasm for exposure work I guess, as am just so TIRED.
I used to be afraid that if I did ask for pills, that they would be doing the 'exposure' work, not me, but TBH having lasted 5 weeks feeling this bad, and managing to keep going to work etc I think I actually have the constitution of an ox. This week for the first time (I think due to acceptance of my issues) I struggled to go to work as just felt so physically tired and unengaged with work, which made me think long & hard about my 'do it alone' strategy more.
You see I think I deserve to be happy, and if that means being able to continue to go to work and keep TRYING to overcome my fears that is the main thing as the trying and the hope is what matters. I will accept any help necessary to do that. Especially as I know my anxiety is not 'me', my negative thoughts are not 'me'. None of that is a reflection of who I really am. I think I need the pills to help me build myself up, but I came to this conclusion myself not out of panic as I did before. I didn't run to the pills, I asked for them in full knowledge.
Of course I could just be kidding myself I'm in control?! Haha. But somehow I feel better for not doing a knee jerk and really thinking.
Linked into this is I think my acceptance of my anxiety now. Well, my ROAD to acceptance. I think some of my social issues in the past - eg avoiding making new friends etc - is because I never feel I can be free about who I really am with people. That I have 'dark secrets' I cannot share. I have now decided that I will be open about my mental health issues in future once I have decided a person is able to hear it. I don't think I do have 'dark secrets' or a particularly fucked-up past. I have a few dodgy genes and an overacting reptilian brain.
My friends think I am probably reasonably perfect and massively stable and don't need anyone. They have no idea how far that is from the truth and I really DO need them, and more of them, and actually get to know the ones I have properly. Equally, as I am always poised for action, I am EXCELLENT in an emergency myself should they need me as I have such finely tuned fight or flight reactions, and a brain as lithe and fast as an antelope due to my rumination practice. I'm not a victim. I might just need a lay down once in a while.
I'm not going to 'come out' just yet as would like to stablilise on my pills a little and make sure I am not adding too much pressure, but then I'm going to do something like run a 10k marathon and tell my friends about my problems. I think I will try and use my condition as a yardstick. If someone is freaked out and unable to deal with it, I imagine that deep down we are probably not really similar people. I always used to worry what people thought of me, TBH after facing the last 5 weeks I'm not sure I give much of a shit. I don't need people to know and care about an idealised version of me, I need them to care about me, just as I need to know and care about the real them. We all carry our armour and no-one has a clue who's really undeneath all that.
Rant over. I also called my mum for some help, she's coming to hang out with me this week as I wasn't feeling strong enough today to be on my own. Next week I might feel better, and enjoy a solo night in watching all kinds of trashy telly.
Thursday 14 June 2012
Compassion, meditation, and a bit of massage
I've spending a little time thinking about compassion recently. Partly because its a word that has been coming up a fair bit in my CBT - the need for me to not beat myself up when I perhaps do 'fall off the wagon' and ruminate, and also not to be angry with myself for having anxiety issues. But also because it comes up a lot when reading about meditation - not sure if I have mentioned but I have been learning to meditate recently as thought it might help me 'slow down' and start to be able to detach myself from my thoughts while at the same time becoming more aware of my feelings and my body as a whole. I've been using a mixture of the Headspace app and reading/using Jon Kabat Zinn's Mindful Way Through Depression book & CD.
I particularly like the Headspace videos.
I've found meditation to be pretty effective so far - I have noticed a sense of calm coming over me on occasion, and also I have noticed that by 'sitting with feelings' their power seems to be not quite as strong afterwards. I sat for a while with several layers of what felt like 'purple' fear a week or so ago and certainly felt that the fear had less power....though that's not totally correct.. how to describe it? It almost felt as if I became more aware of two of me; one who is calmer and more grounded (perhaps the real me? Hope so) and a second person who is, it feels, constantly on edge and in fear. After that meditation session it was weird as I could almost 'hear' the anxious person almost screaming away in the background, where as 'I' felt more calm.
Not sure if this just made me more aware of just how much anxious thinking/feeling is in reality surging through my body and mind, and for the first time I can actually see or hear it, though equally its power is slightly diminished.
So how to stop that person screaming? I think I might have figured something out, but its still a road I'm travelling. Compassion. I've become more aware of the relationship with mind and body as part of my meditation - when I think difficult thoughts that perhaps I am resisting, or am experiencing strong feelings, my body tightens. Its often around my shoulders and around my head and jaw especially - all around my brain basically! To help me to tap into that more I decided that I would treat myself, to the first time in my life, a massage. I didn't want to do any old massage but perhaps one that would complement my meditation and CBT work, so plumped to try the Rosen Method last night with a practitioner in London.
The Rosen Method is not really massage, a therapist 'reads' the tension in your body and then gently manipulates/touches the muscles and soft tissue around that area to try and help the body relax and in turn help the mind free up. Its not got the same clinical evidence base as CBT or meditation does, but also I do increasingly think that bodywork is important to maintain a healthy mind and emotions, and perhaps touch is more important than we realise. I mean, if you loved your car you wouldn't just spend all your money on keeping the engine in good condition, you'd also spend time ensuring the paint was polished and the lights worked!
I found the experience quite strange. At times I felt like it was 'hard to breathe' when the practitioner touched parts of my body, but as she worked them it felt as if my breathing improved. I also felt my body shudder on a few occasions and felt a pins & needles-y feeling in my legs.
The biggest difference came later though when I got home - I found that a feeling just kept returning and returning (one I had that was related to the 'screaming') but it was one up until then I had resisted engaging with. The feeling I guess was a mixture of fear and depression/sadness - fear I think that if I felt sad I would stay that way, and perhaps become a true 'depressive' and be 'out of control'. So I decided I would try and talk about it, but waited til my husband got home so I could talk about it safely and also 'feel' with a safe person nearby.
While trying to explain it I dissolved into a massive fit of tears which was scary but afterwards I felt so much better - certainly not totally okay, but almost as if I can reach parts of my lungs again, that I can breathe more deeply. I am aware now of a feeling of 'heaviness' in my chest but it sort of feelings like the screaming has in part moved out of my head into my lungs where perhaps now I can start breathing it out of my body. When I got up this morning I found it was practically impossible for me to walk quickly - I had to walk slowly - and I felt less on edge for sure.
Anyway I have no idea if it was the Rosen experience, or is a mixture of my CBT, meditation and that, but I do think that having a level of trust in myself where one did not exist before is helping. That trust has been grounded in the CBT work around 'thoughts are just that' and proving that to myself by some of my exposure work, but I think the really hard work is facing up to the feelings, and being compassionate with yourself in allowing you to admit you have those feelings, and feeling them, is essential to recovery.
I do feel better today there is no doubt; I also feel raw, uncertain of who I am in some ways or where this journey is taking me; but I feel as if I am living in my body not just being trapped in my mind.
Sunday 10 June 2012
Exposure Updates: Number 1 & 2
So this weekend I drove on the motorway, including joining the motorway at that point that I normally get very stressed. I also allowed my husband to drive all the way from my mum's (about 2 hours away) back home. Not to mention also visiting my ill relative in hospital which was stressful in itself, as she is not certain to recover.
So that is both Number 1 and Number 2 attempted on my exposure list. My immediate feedback is that I need to take some more time later today to be pleased with myself about these. I was happy about both at the time - I do tend however after the act to think to myself 'I might not be able to do that again' but that is my OCD, or doubt, talking. I suppose I do not like the idea that I need to keep doing these things until I have exposed myself enough to get over it.
I should remember though that for both of these I did not feel that much fear however save for the odd 'out of control' moment. Maybe this is why I don't feel as if I really tested myself? But I was very much 'in the moment' - eg when I was overtaking a car on the motorway I decided to take each second as it came and focused on the task, instead of my normal thought process which is 'I must overtake as soon as possible or I might go mad!'. As I wasn't thinking the latter, I didn't feel half as bad.
Perhaps there is a part of me that just thinks, 'It can't be that easy? It can't be just as easy as 'being in the moment. What if I fall out of being in the moment?'. But I suppose this is normal - these are both only the first times in a long time I have either done these things or approached them in a new way. That new way is still 'new' and not automatic, so I need to just keep doing them, be in the moment, and give myself a break as I make a transition in my life approach.
Afterall they weren't THAT BAD so what's the problem. And if I do fall back into old ways of thinking, the answer is I guess to just feel the fear and then try to get myself back in the moment.
I do, in an underlying way, feel as if somehow I have gained a little more 'control' by allowing myself to be 'out of control', especially with the latter - I don't think I've let my husband drive the car for more than a few minutes for the best part of a year. This is a success. Today I achieved, but I need to continue to try and do them as often as possible, as well as focus on the positive not the, 'Oh god, this is just a start, I've got so much more to do.'
So that is both Number 1 and Number 2 attempted on my exposure list. My immediate feedback is that I need to take some more time later today to be pleased with myself about these. I was happy about both at the time - I do tend however after the act to think to myself 'I might not be able to do that again' but that is my OCD, or doubt, talking. I suppose I do not like the idea that I need to keep doing these things until I have exposed myself enough to get over it.
I should remember though that for both of these I did not feel that much fear however save for the odd 'out of control' moment. Maybe this is why I don't feel as if I really tested myself? But I was very much 'in the moment' - eg when I was overtaking a car on the motorway I decided to take each second as it came and focused on the task, instead of my normal thought process which is 'I must overtake as soon as possible or I might go mad!'. As I wasn't thinking the latter, I didn't feel half as bad.
Perhaps there is a part of me that just thinks, 'It can't be that easy? It can't be just as easy as 'being in the moment. What if I fall out of being in the moment?'. But I suppose this is normal - these are both only the first times in a long time I have either done these things or approached them in a new way. That new way is still 'new' and not automatic, so I need to just keep doing them, be in the moment, and give myself a break as I make a transition in my life approach.
Afterall they weren't THAT BAD so what's the problem. And if I do fall back into old ways of thinking, the answer is I guess to just feel the fear and then try to get myself back in the moment.
I do, in an underlying way, feel as if somehow I have gained a little more 'control' by allowing myself to be 'out of control', especially with the latter - I don't think I've let my husband drive the car for more than a few minutes for the best part of a year. This is a success. Today I achieved, but I need to continue to try and do them as often as possible, as well as focus on the positive not the, 'Oh god, this is just a start, I've got so much more to do.'
Friday 8 June 2012
Facing my Obsessive Thoughts & Fears
There are three major steps to recovery from OCD, I understand from the
books I have read to date - most of which I will list at some point soon
down the side of the this blog. I thought it was worth mentioning early
on as these are the steps I need to take now and probably for the rest
of my life when I get new thoughts, as I do tend to get new ones
cropping up that try and 'grab' me. Fears in the past have included not
being able to breathe, and being trapped in the Tube (the latter I am
not quite over, but really its on the way down now not on the rise),
plus fear of it getting dark in the evening.
First of all, accepting that thoughts are just that; thoughts, and that they don't mean anything at all, they are like your brain mindlessly trying to give you messages based on past experiences and reactions to thoughts, to see if you still think they are worth bothering with. Rather like someone asking 'do you want to wear white or black socks today?'. I mean you might have a thought, like I have occasionally, that if you walk under a tall building something might drop from it on your head. That's a perfectly normal 'musing' thought. My OCD would like me to spend more time thinking about that to the point of obsession, and eventually avoiding walking under tall buildings. But on the face of it, its just a thought, and I don't need to do anything with it at all. It is my choice how I respond to it. Some people say, "It's not me, its my OCD' about these kinds of thoughts. I don't want to separate it from me though as it kind of makes me think of OCD in a schizophrenic way. Anyway, I can kind of tell though as I get tension in my body and a sort of 'out of control' feeling when it is trying to 'grab'. But in summary, if I do avoid tall buildings, I am giving into my OCD, but worse, creating more problems further down the line.
Which brings me onto exposure. Say for example that I did spend time thinking about something dropping on my head, and I did start to avoid walking under tall buildings. An important part of my recovery would be me systematically seeking out tall buildings and walking under them. Better still, find some with window cleaners on pulleys who might drop something and walk underneath them! Sounds weird but the exposure is there to show you the risk of something falling on your head is small. There is still a risk, but it's small, not massive, and certainly not enough to warrant not walking under buildings. There's a trend here of short term pain for longer term gain....
This video from the BMJ explains this quite well in terms of how CBT therapy can help. The lady featured had to expose herself to all kinds of germs to get over her contamination OCD.
Thirdly, there is stress management. If you have OCD it is likely your OCD will flare up when you are going through a stressful time. For me, I had flare ups of 'anxiety' as I thought it just was then, when I started work and fairly soon after went on a family holiday where my dad was acting in a very stressed manner. This brought up a lot of old memories and led to a flare up when I got home. I'm not sure what caused this flare up this time; it could have been the stress of going on holiday to France but strangely I think its more positive this time....that somehow my inner self thinks it is time to 'deal' with my issues and that perhaps the way I was dealing on holiday wasn't appropriate. Either way, knowing that stress can make OCD thoughts more frequent is worth planning for - for example I would like children at some point, but I need to be aware that my OCD might flare up.
My issue with number 2 is that some of my concerns are about places that I can't expose myself to in short bursts to 'prove' nothing will happen. Take flying; I need to get into a plane, take off and be in it for probably at least 45 minutes, and then keep doing that time after time after time until I am shown that the risk is small that anything will happen to me. Still, that's probably my very top exposure challenge so there are probably some things I can do to help recreate the feelings and start to prep for it. I also do have at the moment a fear of being on my own for too long; I think that is pretty normal while I feel wobbly, but the obsession is that if I am on my own, I will have thoughts and feelings that will send me mad.
Anyway following on from that I am going to start pulling together a list of things that I need to expose myself to from now on whenever I can, and deal with the fear or other emotions that come. This is not exhaustive but is a start.
1. Driving on the motorway - I have a worry about being in the fast lane especially, and crossing over from lanes. What I need to do is try and do this as much as possible from now on, I am starting this weekend by driving up to my mums.
2. Allowing my husband to drive the car - I almost never let him do this as worry that I am not in control and may crash. In retrospect he is as good a driver as me and in all honesty at the moment probably safer than me.
3. Being on my own - my husband is away for two days in the next few weeks. I do expect to be wobbly but will push on through. I am alone today, but am okay as a rule with during the day, its evenings which cause unhelpful thoughts. I was fine with this until a month ago, but its common for it to return when I get wobbly; maybe now I know the real cause of my problems I might deal with it forever.
4. Going into small places that I might get trapped in - I will carry on using the train, tube and elevators wherever possible, in fact seek them out...maybe I should go caving...!
5. Going up tall buildings and looking down from them. I do not like heights as I feel trapped and sometimes get an urge to jump....I realise this is linked to my major major fear (which I will mention in a few imminently). Tall buildings make me feel overwhelmed, small, vulnerable.
6. Going on plane-like experiences whereever possible - I think I need to go on the London Eye soon, and will be looking at flight simulators, and maybe a rollercoaster. I think an important element of these will be to also try and 'humiliate' myself as part of my concern with these is going mad in front of other people.....so I think there is a social anxiety there too. I admit I do not like to think I am 'weak'' but in reality I think I am super strong with a anxiety condition...I am not sure how to do this but maybe actively allowing myself to cry and physically move about.
7. Going on a plane. EEEK.
8. Travelling further and further away from home and allowing myself to feel the fear
9. Now this is weird I know but....I have a fear that my fears and thoughts will get so overwhelming that I will try and kill myself, which if you look at the pattern of all my other thoughts which are about trying to protect me from harm at whatever cost, seems to be at cross purposes. But two weeks ago I was starting to believe that perhaps I had had enough of OCD and might want to kill myself. I am already exposing myself to this one as I kind of had to, it was making it very hard to function.....yesterday for example I stood in front of a Tube train and said, 'Go on then!'. I know that sounds super extreme, but when I said that, another part of me said, "No F*cking WAY!".
Clearly I do not want to hurt myself and it just goes to show how powerful OCD can be sometimes if you take the thoughts seriously. Already in a way I am dealing with my worst fear, but in some ways I think its is just my 'meltdown' fear I get when my brain just can't cope with any others. It is, I am sure you agree, a pretty horrible one to think that perhaps you no longer want to live.
That is in reality my greatest, most awful fear. So I fully expect to have to get myself to do very weird things like this some more, around death. Its worth saying my therapist thinks I am super brave for this one, as death fear is a pretty primal one. NO SHIT.
10. Being bored. A strange fear but this is related to being on my own. If I am bored I feel I will turn in on myself and my OCD will come and destroy me, as I fear I do not have the capabilities to see it off. This is something I am not sure if I will deal with just by being alone....it feels like I need to also create times when I am unable to do anything useful and must just sit with myself and my thoughts and feelings and prove to myself nothing will happen as long as I gently push the thoughts away, but allow myself to feel anything including panic and fear and hopelessness and sadness. I am trying to learn to meditate to help with this practically....but more on that later.
First of all, accepting that thoughts are just that; thoughts, and that they don't mean anything at all, they are like your brain mindlessly trying to give you messages based on past experiences and reactions to thoughts, to see if you still think they are worth bothering with. Rather like someone asking 'do you want to wear white or black socks today?'. I mean you might have a thought, like I have occasionally, that if you walk under a tall building something might drop from it on your head. That's a perfectly normal 'musing' thought. My OCD would like me to spend more time thinking about that to the point of obsession, and eventually avoiding walking under tall buildings. But on the face of it, its just a thought, and I don't need to do anything with it at all. It is my choice how I respond to it. Some people say, "It's not me, its my OCD' about these kinds of thoughts. I don't want to separate it from me though as it kind of makes me think of OCD in a schizophrenic way. Anyway, I can kind of tell though as I get tension in my body and a sort of 'out of control' feeling when it is trying to 'grab'. But in summary, if I do avoid tall buildings, I am giving into my OCD, but worse, creating more problems further down the line.
Which brings me onto exposure. Say for example that I did spend time thinking about something dropping on my head, and I did start to avoid walking under tall buildings. An important part of my recovery would be me systematically seeking out tall buildings and walking under them. Better still, find some with window cleaners on pulleys who might drop something and walk underneath them! Sounds weird but the exposure is there to show you the risk of something falling on your head is small. There is still a risk, but it's small, not massive, and certainly not enough to warrant not walking under buildings. There's a trend here of short term pain for longer term gain....
This video from the BMJ explains this quite well in terms of how CBT therapy can help. The lady featured had to expose herself to all kinds of germs to get over her contamination OCD.
Thirdly, there is stress management. If you have OCD it is likely your OCD will flare up when you are going through a stressful time. For me, I had flare ups of 'anxiety' as I thought it just was then, when I started work and fairly soon after went on a family holiday where my dad was acting in a very stressed manner. This brought up a lot of old memories and led to a flare up when I got home. I'm not sure what caused this flare up this time; it could have been the stress of going on holiday to France but strangely I think its more positive this time....that somehow my inner self thinks it is time to 'deal' with my issues and that perhaps the way I was dealing on holiday wasn't appropriate. Either way, knowing that stress can make OCD thoughts more frequent is worth planning for - for example I would like children at some point, but I need to be aware that my OCD might flare up.
My issue with number 2 is that some of my concerns are about places that I can't expose myself to in short bursts to 'prove' nothing will happen. Take flying; I need to get into a plane, take off and be in it for probably at least 45 minutes, and then keep doing that time after time after time until I am shown that the risk is small that anything will happen to me. Still, that's probably my very top exposure challenge so there are probably some things I can do to help recreate the feelings and start to prep for it. I also do have at the moment a fear of being on my own for too long; I think that is pretty normal while I feel wobbly, but the obsession is that if I am on my own, I will have thoughts and feelings that will send me mad.
Anyway following on from that I am going to start pulling together a list of things that I need to expose myself to from now on whenever I can, and deal with the fear or other emotions that come. This is not exhaustive but is a start.
1. Driving on the motorway - I have a worry about being in the fast lane especially, and crossing over from lanes. What I need to do is try and do this as much as possible from now on, I am starting this weekend by driving up to my mums.
2. Allowing my husband to drive the car - I almost never let him do this as worry that I am not in control and may crash. In retrospect he is as good a driver as me and in all honesty at the moment probably safer than me.
3. Being on my own - my husband is away for two days in the next few weeks. I do expect to be wobbly but will push on through. I am alone today, but am okay as a rule with during the day, its evenings which cause unhelpful thoughts. I was fine with this until a month ago, but its common for it to return when I get wobbly; maybe now I know the real cause of my problems I might deal with it forever.
4. Going into small places that I might get trapped in - I will carry on using the train, tube and elevators wherever possible, in fact seek them out...maybe I should go caving...!
5. Going up tall buildings and looking down from them. I do not like heights as I feel trapped and sometimes get an urge to jump....I realise this is linked to my major major fear (which I will mention in a few imminently). Tall buildings make me feel overwhelmed, small, vulnerable.
6. Going on plane-like experiences whereever possible - I think I need to go on the London Eye soon, and will be looking at flight simulators, and maybe a rollercoaster. I think an important element of these will be to also try and 'humiliate' myself as part of my concern with these is going mad in front of other people.....so I think there is a social anxiety there too. I admit I do not like to think I am 'weak'' but in reality I think I am super strong with a anxiety condition...I am not sure how to do this but maybe actively allowing myself to cry and physically move about.
7. Going on a plane. EEEK.
8. Travelling further and further away from home and allowing myself to feel the fear
9. Now this is weird I know but....I have a fear that my fears and thoughts will get so overwhelming that I will try and kill myself, which if you look at the pattern of all my other thoughts which are about trying to protect me from harm at whatever cost, seems to be at cross purposes. But two weeks ago I was starting to believe that perhaps I had had enough of OCD and might want to kill myself. I am already exposing myself to this one as I kind of had to, it was making it very hard to function.....yesterday for example I stood in front of a Tube train and said, 'Go on then!'. I know that sounds super extreme, but when I said that, another part of me said, "No F*cking WAY!".
Clearly I do not want to hurt myself and it just goes to show how powerful OCD can be sometimes if you take the thoughts seriously. Already in a way I am dealing with my worst fear, but in some ways I think its is just my 'meltdown' fear I get when my brain just can't cope with any others. It is, I am sure you agree, a pretty horrible one to think that perhaps you no longer want to live.
That is in reality my greatest, most awful fear. So I fully expect to have to get myself to do very weird things like this some more, around death. Its worth saying my therapist thinks I am super brave for this one, as death fear is a pretty primal one. NO SHIT.
10. Being bored. A strange fear but this is related to being on my own. If I am bored I feel I will turn in on myself and my OCD will come and destroy me, as I fear I do not have the capabilities to see it off. This is something I am not sure if I will deal with just by being alone....it feels like I need to also create times when I am unable to do anything useful and must just sit with myself and my thoughts and feelings and prove to myself nothing will happen as long as I gently push the thoughts away, but allow myself to feel anything including panic and fear and hopelessness and sadness. I am trying to learn to meditate to help with this practically....but more on that later.
Coming to terms with Pure or Rumination OCD
I've always been a 'nervous' person in that I have fears and obsessions, though you'd not necessarily know this by talking to me. I don't appear nervous, anxious most of the time. I probably just appear a little more 'driven' than most people, as if I'm pushing through life a little faster than most, and have some things to prove. In short, I probably appear pretty normal.
In reality I am pretty normal. I hold down a really good job, have my own house, am happily married with interests such as playing music and interior decor. But I also have the ability to think myself into such a tense, anxious, frantic state, and I wonder how I will manage the next 30 minutes of living, let alone anything else.
Hang on, you might think, how can thinking hurt a person that much? Let me explain. As someone who has very recently been told I am probably suffering from the 'thinking' kind of Obsessive Compulsive Disorder, 'thinking' is not just noticing a passing thought and maybe engaging with it for a few minutes like someone without OCD.
It means I think that with many thoughts that I have, however nuts or weird or random, must have a hidden and urgent meaning that I must immediately analyse and find the 'solution' to. Not finding the solution feels like a horrible, dreadful outcome in which I will, in my case, go mad, or perhaps decide life is worthless and I will jump in front of a train or suchlike.
I would like to say here that I realise now that do not believe either of these things, but my OCD makes me feel as if I very much do believe it. It is like having a Big Fat Liar living in your head alongside your rational brain. The liar tells you things such as 'you must solve this problem or THIS bad thing will happen' or 'you must not feel like that or THAT bad thing will happen'. It's hard to explain as unless you have experienced it, it seems amazing that such minor things such as thoughts could do that to a person. But they can, if a person reacts to those thoughts in an unhelpful way.
This blog is intended to be a journal of what I hope to be a successful story of how I will learn to manage my Pure OCD better. (Note, there's a very good slideshow on Pure OCD on the OCD-UK website that this slide comes from)
So how did I get here, to this day, this blog? To be fair I have had until recently pretty much 10 years of low-anxiety living, where my OCD has been targeted mainly at specific things which I avoid as, though perhaps I've only recently recognised this, they bring on feelings and thoughts which are too strong for me to manage. Flying for example, which I have successfully avoided now for nigh on 5 years.
Up until a month ago, I thought I just had a flying fear, with some other related fears such as claustrophobia. About a year ago I went to see a Cognitive Behavioural Therapist to start to deal with this, and deal with it we began, starting with helping me deal with my fear of tube trains stopping in tunnels, and to begin to stretch my limits in terms of travel.
But while trying to assess this, it turns out fear of flying etc was just a cover for what's really been going on. I successfully went on a trip to the south of France, the furthest I've been for a good few years - by high speed train, but all the same it was stretching my 'limits' in terms of what I considered 'safe'.
I did pretty well, with some rumination (the term used for obsessive thinking) but generally without having a full on panic. But then I got home. Instead of feeling relaxed and happy with myself, I felt on edge, as if I had upset some kind of balance in my life. Very quickly mentally I went downhill as I started to think the worst, with some 'old' thoughts and fears I'd not had for a while coming back very strongly. That I might want to hurt myself as I couldn't control my thoughts and feelings, that I might go mad, and 'fail' as a person. Beating yourself up is quite a big part of OCD as well.
I quite like this example of what Pure OCD can be like - around a normal fear like weeing yourself in public.
Anyway after I got home I went straight to see my CBT therapist, who quickly suggested that actually what has been the problem all along is that I have 'Pure' or 'Rumination' OCD which is quite hard to spot, as its the OCD type that doesn't come with rituals such as hand washing or door closing. Certainly I wasn't aware of it!
My 'obsession' or greatest fear is, at its heart, that I can't trust my thoughts and feelings, and my compulsion is to try and solve my 'lacking' by working through it in my mind to try and 'solve' this problem, to resist the thought and the feelings that come with it. It's trying to use rational processes to solve irrational problems. Using the head to calm the heart.
As you fail to 'solve' the problem - ie above, that you cannot reassure yourself you definitely won't wee yourself - you get increasingly and increasingly panicky and desperate, which in turn feeds back into your inner fear that you can't manage, you can't deal with your thoughts and feelings. Its a very slippery slope and before you know it you've gone from balanced individual to seemingly a total mess in the space of a few days. As I did just a month ago.
Four weeks on now I have finally realised that my thoughts are, although they don't feel like that, just thoughts. Also, that my mind will carry on thinking them, as my mind is, in part, a wild creature that creates thoughts from all kinds of bits and pieces, some based on memory and experience, some of which is no longer relevant, and that I have a choice in how I react to them.
What I need to try and learn to deal with is, just because I have a thought, I don't need to 'do' anything with that thought, and the feeling that comes with it is best experienced, and not fought against. The more I allow myself to think and feel, the more likely that the most extreme thoughts and feelings will start to dissipate and leave me in greater peace. Much much easier said that done, as I have 30-odd years practice of resisting unwanted thoughts and feelings, and only a month now of recognising my whole 'coping' strategy has actually been part of the problem.
This is enough for now, things to do.
In reality I am pretty normal. I hold down a really good job, have my own house, am happily married with interests such as playing music and interior decor. But I also have the ability to think myself into such a tense, anxious, frantic state, and I wonder how I will manage the next 30 minutes of living, let alone anything else.
Hang on, you might think, how can thinking hurt a person that much? Let me explain. As someone who has very recently been told I am probably suffering from the 'thinking' kind of Obsessive Compulsive Disorder, 'thinking' is not just noticing a passing thought and maybe engaging with it for a few minutes like someone without OCD.
It means I think that with many thoughts that I have, however nuts or weird or random, must have a hidden and urgent meaning that I must immediately analyse and find the 'solution' to. Not finding the solution feels like a horrible, dreadful outcome in which I will, in my case, go mad, or perhaps decide life is worthless and I will jump in front of a train or suchlike.
I would like to say here that I realise now that do not believe either of these things, but my OCD makes me feel as if I very much do believe it. It is like having a Big Fat Liar living in your head alongside your rational brain. The liar tells you things such as 'you must solve this problem or THIS bad thing will happen' or 'you must not feel like that or THAT bad thing will happen'. It's hard to explain as unless you have experienced it, it seems amazing that such minor things such as thoughts could do that to a person. But they can, if a person reacts to those thoughts in an unhelpful way.
This blog is intended to be a journal of what I hope to be a successful story of how I will learn to manage my Pure OCD better. (Note, there's a very good slideshow on Pure OCD on the OCD-UK website that this slide comes from)
So how did I get here, to this day, this blog? To be fair I have had until recently pretty much 10 years of low-anxiety living, where my OCD has been targeted mainly at specific things which I avoid as, though perhaps I've only recently recognised this, they bring on feelings and thoughts which are too strong for me to manage. Flying for example, which I have successfully avoided now for nigh on 5 years.
Up until a month ago, I thought I just had a flying fear, with some other related fears such as claustrophobia. About a year ago I went to see a Cognitive Behavioural Therapist to start to deal with this, and deal with it we began, starting with helping me deal with my fear of tube trains stopping in tunnels, and to begin to stretch my limits in terms of travel.
But while trying to assess this, it turns out fear of flying etc was just a cover for what's really been going on. I successfully went on a trip to the south of France, the furthest I've been for a good few years - by high speed train, but all the same it was stretching my 'limits' in terms of what I considered 'safe'.
I did pretty well, with some rumination (the term used for obsessive thinking) but generally without having a full on panic. But then I got home. Instead of feeling relaxed and happy with myself, I felt on edge, as if I had upset some kind of balance in my life. Very quickly mentally I went downhill as I started to think the worst, with some 'old' thoughts and fears I'd not had for a while coming back very strongly. That I might want to hurt myself as I couldn't control my thoughts and feelings, that I might go mad, and 'fail' as a person. Beating yourself up is quite a big part of OCD as well.
I quite like this example of what Pure OCD can be like - around a normal fear like weeing yourself in public.
Anyway after I got home I went straight to see my CBT therapist, who quickly suggested that actually what has been the problem all along is that I have 'Pure' or 'Rumination' OCD which is quite hard to spot, as its the OCD type that doesn't come with rituals such as hand washing or door closing. Certainly I wasn't aware of it!
My 'obsession' or greatest fear is, at its heart, that I can't trust my thoughts and feelings, and my compulsion is to try and solve my 'lacking' by working through it in my mind to try and 'solve' this problem, to resist the thought and the feelings that come with it. It's trying to use rational processes to solve irrational problems. Using the head to calm the heart.
As you fail to 'solve' the problem - ie above, that you cannot reassure yourself you definitely won't wee yourself - you get increasingly and increasingly panicky and desperate, which in turn feeds back into your inner fear that you can't manage, you can't deal with your thoughts and feelings. Its a very slippery slope and before you know it you've gone from balanced individual to seemingly a total mess in the space of a few days. As I did just a month ago.
Four weeks on now I have finally realised that my thoughts are, although they don't feel like that, just thoughts. Also, that my mind will carry on thinking them, as my mind is, in part, a wild creature that creates thoughts from all kinds of bits and pieces, some based on memory and experience, some of which is no longer relevant, and that I have a choice in how I react to them.
What I need to try and learn to deal with is, just because I have a thought, I don't need to 'do' anything with that thought, and the feeling that comes with it is best experienced, and not fought against. The more I allow myself to think and feel, the more likely that the most extreme thoughts and feelings will start to dissipate and leave me in greater peace. Much much easier said that done, as I have 30-odd years practice of resisting unwanted thoughts and feelings, and only a month now of recognising my whole 'coping' strategy has actually been part of the problem.
This is enough for now, things to do.
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