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.
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