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Hi and welcome to my blog. I’m Jeff Aronson, TheFearMonsterSlayer. In this and future blogs I’ll share some simple, effective and fun tools for managing fear and anxiety. So, welcome aboard!

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BREAKING FREE FROM OCD (Part Two)

4/27/2015

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"You go back Jack, do it again, when turnin' round you go back Jack, do it again."
                                                                                                           --Steely Dan
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In my last post I talked about OCD, some of its characteristics and examples of it. I also mentioned that, while we really don't know exactly what causes it, we've developed some very effective ways to treat it. It's also true that we may never "cure" it but can manage it so that we're controlling it rather than it controlling us.

Sometimes OCD sufferers can develop ways on their own to overcome it, and that's great if they can, but it's usually most effective to seek professional help, either through medications (usually managed by a psychiatrist) or psychotherapy, or a combination of both.

Meds can be very effective but by themselves usually aren't enough to totally control the obsessions and compulsions. And besides, I believe it's always better to develop our own tools rather than relying on meds alone. It's like the old Chinese proverb: "Give a man a fish, he'll eat today. Teach him to fish, he'll eat every day."

So let's talk first about obsessions. Remember, obsessions are repetitive thoughts that are distressing, frightening or shame-producing. Compulsions are the actions taken to relieve or prevent the distress. Obsessive worry is a whirlpool that sucks us down the longer we stay in it. Some common obsessions are worries of hurting someone, having hurt someone, or ruminating guilt over something we did in the distance past.

Here's an example. A parent has ruminating thoughts about harming their child. They then make the assumption that because they have the thought it means they're going to harm their child. Needless to say, this is horribly disturbing and frightening. So I ask them: "Is it A), you intend to harm your child? Or is it B), you're disturbed by thoughts about harming your child?" Of course, they always answer: "It's B. I'd never harm my child. ABSOLUTELY NOT!" This at least helps reassure them that it's only a thought, not an intent. Learning to adapt an attitude of accepting the obsessions without judging ourselves when they occur versus fighting them. "It's OK to have these thoughts. They're just thoughts and, while disturbing, don't mean anything and will pass."

Now we have to get out of the whirlpool. Here are a few other suggestions:
1) Distraction--Get busy doing something else, especially involving physical and mental activity. Exercise,dancing, chores, etc.
2) Progressive muscle relaxation, tightening and releasing all the muscles in our body. Alone or combined with deep abdominal breathing.
3) Talk with someone about something other than the worry. Redecorating plans or last night's ball game.
Even though we often or usually know the thought is ridiculous, telling ourselves so is usually not enough to get out of it. Here are a few other ideas:
4) Postpone obsessing--Delay it for a short time, say, a minute, and then postpone it again, gradually increasing the postponing time. Use distraction during the postponing time and the thought may go away on its own. Postponing shows us that we do have some control and aren't powerless over our thoughts. (This technique also works for a lot of negative behaviors such as problem drinking).
5) Ready for this one? Set aside obsessing time. That's right! It may sound crazy but it helps. Rather than fighting or trying to escape the obsessing, schedule a time, say five minutes, to just obsess, several times a day. This dilutes the power and intensity of the thought, like repeating a word over and over until it loses its meaning. You'll find your mind wandering on its own as that's the nature of our minds. Bring the thought back until the time is up. You'll be surprised to learn that the thought isn't as powerful and entrapping as you thought it was.

These are just a few of many ideas and strategies that have been found to be helpful. They're some of the strategies that therapists use treating clients with OCD. Next time I'll talk more about managing and overcoming compulsions. See you then.

Next Time: BREAKING FREE FROM OCD (Part Three)    

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BREAKING FREE FROM OCD (Part One)

4/15/2015

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"It's deja vu all over again." "It's deja vu all over again. "It's deja vu all over again."--Yogi Berra
                                                                            As I'm backing out of my driveway to go to work and the garage door's closing, I think to myself, "Did I turn off all the burners on the gas stove? I'd better go back inside and check or the house could burn down." So I open the garage, disarm the alarm system and go check the stove. "Whew." All the burners are off and I feel a physical, emotional and mental relief flooding over me. 

But as I'm backing out of the garage again the thought returns to me, "What if I accidentally bumped one of the burners and the stove is back on?" And I feel the worry and tension rising again so I go back inside, repeating the same process. Of course, the burners are all off and relief washes over me again. But as I'm  backing my car out again...So you get the idea. Sometimes it can take OCD sufferers hours to get out of the house.

What happens is that OCD, or Obsessive Compulsive Disorder, is an anxiety disorder and by checking the burners and finding them all off I get relief or reward. And any behavior, such as checking, that's rewarded is reinforced. It's like teaching a dog to do a trick by giving it a treat each time it does what you want. 

A couple of simple definitions: Obsessions are repetitive thoughts or images that are distressing, frightening and often shame producing; they're almost never, if ever, pleasant. Attempts to dismiss them are usually unsuccessful. Compulsions on the other hand are actions, behaviors or rituals that are hard to resist and attempts to control the worry. Such as checking the burners.

We're all a little OCD (I won't tell you mine) and sometimes we even laugh them off as funny little quirks. But it's when they become disruptive or interfere with normal functioning that there's a problem and we need to learn how to manage or overcome the thoughts or behaviors. And once symptoms begin they usually become more persistent over time. Interestingly, as a therapist I often see clients who come in with a different problem and in the course of therapy will mention, almost as an afterthought, some OCD behavior they do. "Oh yeah, it drives me crazy if my socks aren't lined up from light to dark colors in the drawer and stacked exactly six inches high."

So what causes OCD and who gets it? Well, even though we know a lot about treating it, we really don't know much about its causes with any certainty. Some studies suggest that OCD has a biological basis possibly caused by abnormalities in brain neurotransmitters. Maybe it's genetic and runs in families. If a parent and offspring both have OCD there's no conclusive way to determine if it's truly genetic or learned behavior by a child imitating the parent.

Studies of life histories are not revealing as no particular childhood events distinguish OCD sufferers from others. A person's psychological makeup can often influence the persistence of obsessions or compulsions but is not their cause.

It's often the case in medicine and psychology that we know more about how to treat a problem than what causes it. And that's OK. We can come up with better tools and strategies to manage and diminish OCD symptoms (as well as a lot of other problems too)  and never figure out the cause. But as long as things get better that's what's important. Next time I'll talk about some of these powerful and effective techniques. See you then.

Next Time: BREAKING FREE FROM OCD (Part Two)  


  

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COUNTERATTACK!*

4/14/2015

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"My mind's got a mind of its own."--Jimmie Dale Gilmore
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The "WhatIfMonster" has launched its attack. It might be an "Ohmygod!" full-scale assault or a guerrilla infiltration that starts with a quiet niggling thought that grows into a full-blown panic attack (I'll talk more about panic attacks in future blogs). So we need to take the offensive and counterattack.

The "WIM" plants this little land mine in our head and, since what we focus on expands, the next thing you know we're out the door down the street around the corner on the freeway going 100 mph and we haven't even gotten out of bed yet. It's called catastrophizing, the proverbial making a mountain out of a molehill. So now what?

The first thing is to realize we're having the thought before we can stop it. Seems obvious, right? But not always that easy, especially if our default setting is to go straight into crisis mode. Some people shout "Stop!" or make a loud noise. Others may snap a rubber band around their wrist. Whatever works. Of course, if we can think to do this we're already three-quarters of the way to stopping the attack.

Now we need to stay calm and assess the situation. Easier said than done when all the danger neurons in our brain are firing in a nano second. This is why taking a few deep breaths is helpful as it increases needed oxygen to the brain for clear thinking (it also prevents hyperventilation and lessens the likelihood of a panic attack). And to deep breathe we have to focus on breathing so our attention shifts away from the "What if?" thought.

So now we can more calmly and objectively analyze and challenge the irrational thought. Think of ourselves as a lawyer in court questioning a hostile witness. "Where's the proof? Who says it's true? What's the likelihood it will happen? If it does happen how bad could it be? How would I deal with it? What can I do to prevent it?"

Now we're controlling the thought, not it controlling us. Time to move forward.

Next time: Thought Shifting.

(Here's a great resource: The Anxiety and Phobia Workbook by Edmund J. Bourne, PhD. About $18)



*Note: This post first published 5/7/2014


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    Jeff Aronson

    Hi and welcome to my blog. I’m Jeff Aronson, TheFearMonsterSlayer. In this and future blogs I’ll share some simple, effective and fun tools for managing fear and anxiety. So, welcome aboard!

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