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. 

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.'

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.