All posts by tjlab32

Going Head-to-Head With OCD

Are You Willing to Go Head-to-Head With OCD?

Confront OCD

As a social worker, it is my ethical responsibility to employ evidence-based treatment for OCD. It seems like OCD is a moving target, and so for me, it’s essential to make sure I am current on cutting-edge, effective treatments.  

ERP is the gold standard treatment for OCD because it has been tweaked and improved upon over the years. Researchers and practitioners have given much attention to the best way to step outside of one’s comfort zone, and there have been significant discoveries concerning attitude.

Think of it like ERP with Attitude.

You Have to Be Willing to Feel Anxious

Exposure & Response Prevention

You have to do more than seek exposures and “put up” with the discomfort. It’s good to get up the courage and go toward whatever makes you anxious. But your attitude is crucial. You can’t drag yourself through it just to get through it.

ERP with Attitude: You have to WANT to feel anxious. Welcome the worry, the doubt, and all the what-ifs. Hit it hard. Eleanor Roosevelt once said, “Do one thing every day that scares you.” When going head-to-head with OCD, you’ve got to do more than one thing every day that scares you.

During a recent visit to North Carolina, I looked for ways to step outside of my comfort zone. I hunted for a lot of things that would make me uncomfortable.

Take a Scary Walk

I walked alone along the Cape Fear River, where I was assured of being eaten.

I was disappointed I never saw one. How can I practice without the trigger!

Let People Down

I went to the “House of Pickleball” where I didn’t know anyone. Mostly I was afraid of letting people down. I play a lot of Pickleball, but the receptionist warned me the competition would be fierce.

competitive

I was so nervous the first game I blew it—0 to 11. My partner, whom I just met, said: “Maybe you just have to get used to the new setting.” But in my mind, she was thinking, “What is she doing here? She doesn’t belong here. She’s going to drag us all down.”

It occurred to me to make things better for them; I should leave, but I didn’t. What could I possibly gain by leaving? And, what would they gain by my leaving? Maybe it was meant for them to play with a loser. I chose to be energized by the anxiety and we won 5 of the next 6 games.

Do Something New

When I called home and told my family what I was planning to do, they asked me not to do it. “Why not?” I asked. “Because you’ll fall and hurt yourself and you’re all alone, and you don’t even know where the hospital is.” So you can imagine that when I did this next thing, I had no confidence. I doubted my abilities.

Feel the fear and do it anyway
Life lessons learned on a segway…

I was pretty wobbly at first. Mostly my anxiety had me so revved up it was hard to balance. Every move I made caused the Segway to jerk. “Good,” I thought, “this is going to put me in the hospital, but at least it will make an interesting story.”

I reminded myself to use my bones to carry the anxiety, not my muscles. By loosening my muscles, my steering became smoother. (Well, for the most part, but there was that one time I almost ended up in the river with the alligators.) 

Life Lessons On a Segway

Before taking off through the city of Wilmington, the guide had me practice in the parking lot. He warned, “Initially, you’re going to think you’ll never figure out how to do this. But, I’ve never had anyone not figure it out. People of all ages learn how to do it in about 7-10 minutes.” Of course, I thought I’d be the first person not to be able to figure it out. He continued, “So if others learned how to do it—you can learn how to do it.” Should I trust common sense?

After a few minutes, my guide said, “You look comfortable. I think you’re ready for the tour.” I was still anxious but looked more relaxed because I used my tense body like biofeedback and switched my mindset to using my bones. I told my muscles I didn’t need them. I trusted my bones, and this relieved my muscles, which makes any task at hand so much easier.  

Lean In

Did you know the way to move forward on a Segway is to lean forward—and especially to go up a hill you have to lean WAY forward, I mean drastically forward? At first, it’s scary because it feels like if you lean too far ahead, you’ll topple over. Before the first hill, my guide advised me, “You are going to feel uncomfortable leaning into it. But, if you hesitate, you will only make it worse.” Leaning into a challenge gets us to the top faster.

Don’t Be Indecisive

If you’re not leaning forward on a Segway, you’re caught in a wobbly movement. The slightest shift from one knee to another is a sudden balancing act. You’re stuck in place trying to find balance but not really going anywhere. Not going forward feels like indecision—trying to feel just right but going nowhere.

Get Up and Move

To brake on a Segway, there is no seat but you act as if you’re going to sit down. There are no brakes. When you “sit down” the Segway comes to a halt. I think we can say the same about life. When you don’t get up-and-moving you’re only putting the brakes on life. 

Life Rewards Action

We were only supposed to tour for 60 minutes, but the guide could tell I was having fun taking on the challenge of maneuvering hills and curbs, so he added 30 free minutes! Living well with anxiety is challenging but also rewarding. 

Why Is a Therapist Anxious?

I felt anxious many times during this trip to North Carolina. Just before take-off, in front of passengers, the airline staff threatened to fine me $1,000 for something I didn’t even do! My mind told me this was a sign to get off the plane, but I didn’t.

In an email, the stranger who said he’d take me on a private Segway tour told me to meet him in the parking lot of an empty park and to look for his white van with no windows. My mind told me he was going to kill me, but I trusted common sense and went anyway.

On the way home the flight attendant said she wasn’t going to get up from her seat. “There’s going to be a lot of turbulence and last week a flight attendant passing out snacks fell and broke both her legs.” The pilot spoke through the intercom, “We’re in a holding pattern waiting to be given the okay to land.  It should be about 15 minutes and then we’ll give it a shot.” WHAT????????

A person reading this post might say to me, “I don’t understand. You’re a therapist. How can you not have any tools for your anxiety?” I use a lot of tools! But that doesn’t mean I won’t have anxiety. The goal is to embrace anxiety not to get rid of it.

ERP with Attitude

Remember what you’re fighting for. Let your values drive you forward. For me, I don’t want to waste time white-knuckling my way through anxiety. Time is precious and I can’t get it back. I have anxiety and I might as well figure out how to make the best of it.

Stay tuned for the next post to talk about being unthinkingly willing and eager to go head-to-head with OCD. While you’re waiting for the next post give some thought to the word, unthinkingly.

Are You White-Knuckling Your Way Through OCD?

ERP With a Clenched Jaw and White Knuckles

I’m on a mission to help you live well with OCD. And, I’ve got more than one idea of how to make it happen. In a series of posts over the next few weeks, I’ll share a variety of ways for you to manage OCD.

First, let me say that my clinical experience to date indicates there’s more to living with OCD than just white-knuckling your way through life.

A person with OCD often wishes out loud, “If only I could just trust myself again.” An Exposure & Response Prevention(ERP) therapist, such as myself, might say, “Well, OCD isn’t going to let you trust yourself. You have the doubting disease. There are things you will never know for sure.”

So, we discuss what must be done despite lacking faith in oneself. Employing ERP is at the top of the to-do list: Gradually confront what you avoid and do nothing to neutralize the anxiety. Endure the discomfort and resist compulsions. Accept the doubt.

And you know what? People with OCD can do it: They can go about their day, lacking confidence, having no sense of certainty or ease of mind. They are the least assured person walking the face of the earth, and yet people with OCD can accomplish anything. Anything. At. All. Including confronting their fears with little to no trust in who they are or what will happen.

But…is there more than tightening the jaw and fist, and pushing through the pain?

Does It Have To Be This Awful?

Exposure & Response Prevention continues to be the most widely regarded treatment for OCD. If I could wave a magic wand, every
client would use ERP to manage their OCD.

But, here’s a question: For those who do awful exposures, OCD Treatmentshould we say, “Congratulations! You forced yourself through that horrible exposure and tolerated all that discomfort! Good for you!”

White-Knuckling

Instinctively, these are the faces people make as they deal with obsessional thoughts and exposures:

ERP

People with OCD can white-knuckle their way through one trigger after another. But is that all there is? 

Is it enough to white-knuckle your way through triggers? Is there more to it than saying, “Whew, thank God that’s over with. I hope I never have to deal with that again.” Is it possible to feel better about going head-to-head with OCD?

YES!!! There’s more to ERP than forcing yourself to face your fears. Not only is there more to ERP, but there’s also more than ERP.

Come back soon for the next post!

What Most People Don’t Know About FFF

What is the Fight-Flight-Freeze (FFF) Response?

amygdalaFFF is an automatic response that prepares a human to fight, run or hide from a perceived attack, harm or threat to survival. The amygdala yells “danger,” and the body goes into survival mode.

Fight or Retreat

In the face of supposed danger, the body responds faster than the rational mind can react. Before your intellect can kick in, fascinating instantaneous changes take place in the body to prepare to fight or retreat such as: 

  • Muscles are prepared to fight or run. Blood is diverted from toes and fingers to core muscles in the arms, shoulders, and legs.
  • The skin acts like an air conditioner. Sweating occurs to prevent the body from overheating and getting sluggish. 
  • Adrenalin is released and the pancreas secretes sugar to give the body a jolt of energy. 
  • You need to be light on your feet, so there is a relaxation of abdominal muscles. The digestive and urinary system might need to empty, to ensure the body can be light and fast. 
  • Pupils dilate which shrinks peripheral vision and allows for straight-ahead vision to keep the focus in front.
  • The breath becomes quick and shallow to increase airflow and bring oxygen to the muscles and lungs.

looping

WHAT MOST PEOPLE DON’T KNOW

Freeze

There is more to the FFF Response than preparing the body to fight or run. When there is a perceived threat, the body might not FIGHT or FLEE but instead FREEZE. Perhaps the body comes to a literal halt, but another way of looking at this is the freezing of emotions. When a threat is perceived sometimes the response is to numb the anxiety.

Freezing is especially true in OCD. The purpose of performing compulsions, including mental acts is to numb anxiety. You might argue compulsions help stop thoughts, but we know that’s OCD talking. Compulsions provide temporary relief and numb the anxiety for a short time. But did you know you can’t isolate one emotion to anesthetize? When you numb anxiety you numb all feelings. 

Rusty at Being Human

Numbing becomes deadening to all emotions. You become flat and muted—perhaps depressed. Indifference sets in and you feel stripped of joy or pleasure. Motivation is practically nonexistent. When you spend time with friends and family, you feel detached. It feels like you are on the outside of life rather than “in” it. You become rusty at being human.

Numbing has helped you to survive awful thoughts and feelings, but it is after all, another word for avoidance. Numbing puts a wall between you and the life you want. Stop numbing, and yes, you’ll experience anxiety, but you’ll also feel other emotions like happiness and connectedness.

The Body Responds Faster Than the Rational Mind Can React

When triggered by an obsession, a client with OCD reports: “I’m having trouble breathing” or, “my heart is racing” or “I feel like running.” These are all signs that the body is responding to a perceived threat. 

If the client can ride it out, and do nothing to get rid of the anxiety the jolt of adrenalin will dissipate, and the rational mind will win. The brain will make a connection: Just because my body prepares for a threat doesn’t mean the danger is real. When the body goes into the fight-flight-freeze response, it doesn’t say there was actual evidence of risk. The body responds faster than the rational mind can react.

OCD is a fantastic storyteller. If it used facts to tell stories, you wouldn’t pay any attention. You’d be bored. So OCD does whatever it can to captivate you and set off adrenalin. It makes you feel fear and doubt not because it’s out to get you. OCD wants to save you from ruining whatever is precious and sacred to you.

The problem is you don’t need saving. It’s not the rational mind deciphering what needs saving. OCD can’t tell what is dangerous, so it takes a hard “just in case” stance. 

Summary
  1. The Fight-Flight-Freeze Response automatically kicks in when there is a perceived threat.
  2. The body responds to a perceived threat before the rational mind can react.
  3. Using avoidance or compulsions to numb anxiety suppresses good feelings too.
  4. OCD is nothing more than a talented storyteller that has no clue about what is or isn’t a true threat. OCD wants your body to live in a “just in case” fight-flight-freeze mode.
Ride the Wave

Notice your anxiety as a physiological response to a perceived threat. Get curious and determine whether your body is preparing to fight, flee or freeze. Is blood diverting from your fingers to your core muscles? Are you sweating? Do you feel like going to the bathroom. Are you feeling nothing? Did you numb?

Thank your body for being so fascinating. 

Keep it real. Just because your body goes into FFF it’s not evidence of true danger. Anxiety doesn’t mean something is actually wrong.

OCD prefers you to adopt a “just in case” way of life. So it’s going to use storytelling to get you to do it. Your best bet is to agree with OCD, “Maybe that’s true. Maybe it isn’t. I’m willing to find out.” Resist trying to figure out if the threat is real.

Use your script:

“I notice I’m feeling ____________. I’m worried that:__________. Yes, it is possible that my fear will come true. I would not want this to happen but I can’t control what happens. I need to be in charge (not OCD) so I’m going to accept the risk that [this thing will or has happened]. I’m not going to check or use some magical wand (compulsion) to make sure all is well. I will never know if I do or don’t control outcome. I have to live with this uncertainty.”

Remind yourself to ride it out until the adrenalin fades. Don’t engage in compulsions and you’ll arrive in a non-aroused state quicker.

Maintain a growth-mindset. Never put yourself down as you practice these steps. You’re on this earth to learn. You’re not here to be perfect. Perfection can only be faked. Practice makes…progress.

Remember the Goal of Resisting Compulsions:
  1. Develop the ability to tolerate “hard” feelings like anxiety.
  2. Discover you’re stronger than you thought.
  3. Surrender to the fact you cannot control what happens.
  4. Accept uncertainty as a way of life.
  5. Let your guard down and allow feelings of vulnerability.

Why OCD Visits You In Your Sleep

It’s hard enough to have OCD during waking hours, but why does OCD infiltrate dreams too? Are you performing rituals even in your sleep? Do you obsess in the form of a nightmare? 

While you might feel alarmed about OCD visiting you during sleep, I’m here to tell you it’s a good sign. Your mind is looking out for you by using dreams to get your attention. 

Dreaming about OCD is signaling you to step up more than you have been. Perhaps there is a compulsion you need to resist or someone in your life you need to stand up to. The purpose of dreaming about OCD is to get you to stop doing what you’re doing and take a different action. You’re not listening while awake so now the message is being delivered at a subconscious level. 

Whatever you are avoiding, it must be having a negative impact on the quality of your life. So your dreams are here to help.

Stop Procrastinating

If you’re dreaming about OCD, ask yourself what you need to change. Your dreams about OCD means it’s time to take charge of a situation that has become serious. Consider the strong possibility that you need to stop procrastinating and confront an uncomfortable circumstance.

Take Better Care of Yourself

Has feeding OCD reached critical mass? Be honest, have you become severely impaired because of compulsive behavior? Is there a compulsion (including avoidance) that is detrimental to your health or making you unsafe? You might be dreaming about OCD because, at a deeper level, your mind is warning you. Your dreams might be saying the way you are feeding OCD is unhealthy if not dangerous.

Be Assertive

Sometimes when you dream about OCD it’s your mind’s way of saying you need to be more assertive. Clearly, with a diagnosis of OCD, you are constantly reminded that only one of you can be the boss. So when you start having dreams about OCD it might be your mind’s way of reminding you about the importance of being enduring not wary, decisive not hesitant, daring not fearful, and authoritative not bullied. 

Take Charge

Your dreams might be saying this is no time to be timid. Do you need to take charge of OCD or some other circumstance in your life? Perhaps there is a person who is taking advantage of you and needs to be confronted. Maybe there is a daunting task you keep putting off and it’s weighing on you heavily. Your unsettling dreams are telling you time is running out…take action…resolve this.

If you are performing compulsions it’s detrimental to your well-being. If you are avoiding conflict or necessary tasks, this will increase your level of stress and keep you from fulfilling your “dreams”–the ones that matter.

Don’t be surprised if the dreams about OCD persist. Never estimate the power of your brain and its ability to signal you to take action.

Every Day With OCD is April Fool’s Day

On April Fool’s Day, you will be pranked by only those who:

  1. catch you off guard
  2. sound convincing even if the prank is outlandish
  3. are privy to what riles you
Caught Off Guard

This morning I was barely awake and had no idea it was April Fool’s Day. I was caught by surprise when I was told “we need an exterminator. There were bugs coming out of the drain. It was so bad. We’re infested.” It was early in the morning and I fell for it and freaked out. 

Sounded Convincing

Yup, I believed it because we’ve had sugar ants crawling on the counter every morning. And even though it’s been getting better I fell for it. Bugs coming out of the drain? Sure. Why not. It happens. My family was hysterical about it so I thought, “It must be real.” I freaked out.

Privy to What Concerns You

My family knows I have a bug phobia so they know how to get my attention. If they had put poop or vomit in the middle of the living room I would have laughed. But bugs? Being free of infestation is precious and sacred to me, so my family knew exactly how to fool me. 

OCD is a prankster. Not just any prankster but a superior one. As an OCD therapist, I hear about OCD’s pranks day in and day out. 

Imagine for a moment all the pranks an OCD therapist hears about in one week: The next day other clients share a different set of OCD pranks: On another day of the week, the therapist hears about other OCD pranks: Still, in the same week more OCD hoaxes are shared by clients:

While these concerns represent what an OCD therapist is told in one week, there are even more ways OCD pranks people.

But honestly, while all the pranks sound different, at the end of the day, at the end of the week, they’re all the same. You can have five different flavors of ice cream, but they’re all made with the same basic ingredients. With eyes closed, you probably wouldn’t even be able to identify the flavor.

One obsession is no different than another. You’re feeding your OCD if you think otherwise. 

The details of the obsession complete a fantastic story. There is no better storyteller than OCD. The way to hijack your mind is not by facts. The way OCD captures your attention is by twisting the facts or telling outright lies.

How interested would you be if you were listening to a story over and over again about the number of times a car’s turning signal was used? “I went down route 9 and put my turning signal on. Then I drove for about 300 feet and put on my right turning signal. In about 300 feet I used my turning signal again.” Blah, blah, blah. You’d tune out in one minute if this factual story was told to you. 

However, you would maintain an interest in the story if it became more fantastical. Such as, “When I made a left turn, I realized my turning signal might not be working. Up ahead a truck seems to be blaring its horn at me. Something is clearly going to happen and it’s not going to be pretty.” Not one word of this story is factual and yet, you are captivated. You’ve been baited with lies.

OCD has a way of enticing you into paying attention. It avoids facts as much as possible. It prickles your nerve endings with lies, and like watching a horror film, you forget where you are and what is real. If OCD used facts to tell its stories, you’d be bored in no time and lose interest. So OCD knows it’s essential to make the story as real as possible.

OCD uses five essential elements to tell a tantalizing story:

Element One: Characters

OCD instills people in your story who are precious to you. According to OCD, you must protect these people. Sometimes OCD  claims you are a victim in the story and need protection. Other times you’re made out to be the villain. OCD pranks you into thinking you or others are at risk. OCD builds the story by creating villains and victims. Characters either seem vulnerable or possess supernatural powers. 

Element Two: Setting

Where is the “action” taking place? This is the place where the plot thickens. It could be in your home, at work, school or at the playground. It could be everywhere or it could be what takes place in your mind. Sometimes OCD contains the story to certain settings, but other times OCD is portable and goes wherever you go.

Element Three: The Plot

What is the plot? Where does the story begin? What is the trigger? Once triggered, what does OCD tell you happens next? And, how does this story end according to OCD? Will you be cast away, abandoned, imprisoned, annihilated, or left uncomfortable for the rest of your life? Or, is there no ending and that’s the problem. We don’t know how this story ends? Clarity cannot be found. Certainty isn’t obtainable?

Element Four: The Conflict

In any story, characters are either trying to solve the conflict or create a conflict. We usually witness conflict resolution at the end of a movie or a good book. When the movie ends without resolution we shake our heads in frustration.  We are socialized to believe every conflict can be resolved. Early in our childhood, we are taught conflict resolution by parents and educators. We’ve been trained to solve the conflict.

In OCD’s story, the conflict is the obsession. The resolution is the attempt to get resolution when there is none. 

Element Five: Resolution

The resolution solves the conflict. Every movie we watch or book we read resolution is expected. If there is no resolution we get frustrated. In OCD’s story, there is never a resolution but you’ve been tricked into thinking there is a way to get it.

By believing there is a resolution you are tricked into a life of compulsions or avoidance. In OCD’s stories, the resolution is nothing more than a hoax. Don’t fall for it. Your OCD story needs no resolution.

OCD is the greatest storyteller in the world. It uses five elements to create a realistic story that in reality is nothing more than a prank.

Every day with OCD is April Fool’s Day. How to cope?

  • Stop being surprised that OCD is going to try to prank you. Keep up your guard. Expect OCD to tell you stories. OCD never got the memo that April Fool’s Day occurs only on the first day of April. OCD is committed to prank you every day.
  • If you expect to be pranked you are less likely to be fooled.
  • Accept the fact that you have the greatest storyteller ever known to mankind, inside your brain. Its stories can bring highly intelligent people to their knees. It knows what is precious and sacred to you, and uses this information to captivate you and tug at your heartstrings.
  • OCD is masterful at using vulnerable characters, the perfect setting, a horrifying plot, and a neverending conflict to lead you to a life of compulsions.

OCD treatment

Don’t bother focusing on the OCD story. It’s a hoax. You know what isn’t a hoax? Your anxiety. That’s real. Besides treating every day like April Fool’s Day you also need to accept that you have anxiety. You just do. No story needed to explain it.

Commit to living your life with anxiety. Focus on your values. Live a priority-driven life. You can do anything with anxiety. You can do very little avoiding triggers or by engaging in compulsions.

I’m Falling in the big unknown

“I’m just trying to hold on. I’m falling in the dark below. I feel I’m falling in the big unknown.

I will rise. I will rise. I will rise again.”          

 ~Songwriters Ben Travers/ Helen Adu

I heard this song sung by Sade and immediately thought of OCD. I know it’s how it feels to have OCD. When you think you’ve figured out how to beat OCD, you find yourself falling back into the big unknown. It feels permanent. Every single time the threat feels like the real deal. But lo and behold, you rise again. Life feels like a Yo-Yo: downward—upward—downward—upward.

By changing just a few words of this lyric the remedy to living well with OCD is revealed:

“I’m just trying to let go. I’m jumping into the dark below. I feel I’m welcoming the big unknown.”

Living well with OCD means letting go and surrendering to not knowing. So rather than falling into the unknown, it’s better to jump right in. Any of these words will do: Leap, bound, hop, skip, jump, seize, grab on to…

Having a bug phobia, when I see a suitcase in the closet I immediately fear there are bugs in the suitcase from a recent trip. In the past, I would have thrown it into the garbage. But I’ve progressed and even though I’m anxious, and have thoughts of infestation, I grab the suitcase, embrace it, and say “come and get me. Whatever happens, happens.” I jump into the unknown.

A bee trap is successful because the bees fly into the plastic bottle for the honey, but then won’t fly back out because there is black tape wrapped around the outside of the bottle near the exit. Bees don’t like the dark. If only they’d agree to be uncomfortable and fly through the darkness they’d be free. But they won’t do it.

What do you wish you knew for sure? What is it that you’re trying to get to the bottom of? It’s at the center of your obsession. You won’t stop until you gain certainty. But certainty is unachievable. It’s like flying into a bee trap to find answers. You’ll do anything to get rid of the doubt. But now that you’ve been tricked and you’re in the trap how will you get out? You’re going to have to go into the big unknown. Will you do it? Or will you stay in the trap trying, and trying, and trying to answer the unanswerable?

The fact that you have OCD means there is going to be something you will never know for sure. You can gain clarity, but at some point, a question will surface that has the potential to pull you into the trap. 

How to Stay Out of the Trap?

I don’t know for sure. 

That statement might not be what you wanted to hear but it is the truth. There are many books about OCD and specialists who can tell you what to do to live well with OCD.

But all of those ideas can end up being a trap. 

When you apply a therapy principle and get relief, you’re going to expect that principle to save you every time. And when it doesn’t, it causes you to spin. You begin to compare and contrast, “What did I do then that I’m not doing now?” You analyze why the thoughts are back. You are utterly surprised the thought patterns are there. And suddenly you’re in the trap.

When you get a thought that disturbs you say, “good, there’s my thought. I want this.” Better yet, spend a lot of time trying to get disturbed on purpose. Create as much doubt as you can and tolerate it. Look for things, places, or people that trigger your thoughts and make you uncomfortable. 

Be willing to be uncomfortable and JUMP into the unknown! Jump! JUMP! JUMP!

But Ask Yourself This Question:

WHY ARE YOU JUMPING?

Why are you agreeing to jump into the unknown?

The reason you are jumping into the unknown cannot be, “So that I get relief.” This lacks commitment and your efforts will be half-hearted and superficial. The reason you are jumping must be, “because I’d rather live in doubt than try to figure stuff out.”

Do not try to control how you feel or think. You can’t heal what you won’t feel. Say, “I notice I’m feeling anxious. Good. I need the practice.” 

There are no guarantees that you’re doing the right thing by surrendering to the unknown. There is no such thing as knowing anything for certain. No decision guarantees a specific outcome. No action guarantees a particular result.

You have to be willing to find out what happens and deal with whatever happens. “I’d rather live with uncertainty than waste time trying to answer the unanswerable.”

Who do you want to be and how do you want to spend your time?

If you’re not answering this question when you wake up and throughout the day, you’re drifting aimlessly with no sense of purpose or self. You must commit to spending your time being the person you want to be, no matter what you are thinking or how you are feeling. Don’t drift. Jump. And don’t plug your nose when you do it!

A Special Gift For You

I use a lot of catch phrases with my clients so they can stay focused on the mission. If you would like access to some of these phrases, just click BELOW and you’ll be able to print out these free posters.

If you like these posters then you might also like my book, Gratitude, the Great OCD Sanitizer.

[pdf-embedder url=”https://blog.bossitback.com/wp-content/uploads/2019/02/inspirational-posters.pdf” title=”inspirational posters”]

How to Engage in ERP by focusing on your strengths

Grappling with OCD is no easy task. There is a continuous need to “boss it back” and face fears without compulsions. The best way to live well with OCD is to accept obsessions and resist compulsions—through the use of Exposure & Response Prevention (ERP.) 

It’s true, ERP is not for the faint of heart. Committing to ERP requires a willingness to experience emotional pain. I’m not saying the pain will definitely occur. To one’s surprise, sometimes it doesn’t—the anticipation of confronting a fear can be worse than facing it!

In comparison, avoidance causes more pain than confronting. But, if facing a fear does cause discomfort, it’s usually short-lived. 

When I give advice to face a fear, a client almost always says, “easier said than done.” Listen, I know it’s scary to give up trying to prevent bad things from happening. But, you’ve got your head in the sand if you think it’s easier to live a life of compulsions! No matter what you do (Feed OCD or Boss it Back), it ain’t going to be easy! 

No matter what you do, it’s going to be hard. But you have strengths to help you face any challenge. By tapping into your strengths you will feel stronger and more daring.

After you answer those questions you’ll hopefully make the right choice and boss it back through Exposure & Response Prevention (ERP).

Once you take the plunge and immerse yourself in ERP, the reward of freedom and independence is well-worth the hard work of saying “no” to OCD. Besides, most people admit that feeding OCD only turns fear into terror, and pain into long-lasting agony.

It’s best to confront and not avoid; accept uncertainty, and not seek reassurance. BE DARING. You’re stronger than you think. You can endure the difficult times. You can defy OCD.

Focus on your strengths and not your shortcomings and you will be able to confront OCD. Theodore Roosevelt, (yes, the man who once gave a 90-minute speech just after being shot, with the bullet still lodged in his chest) said it best:

The credit belongs to the one who is actually in the arena, whose face is marred by dust and sweat and blood; who strived valiantly; who errs, who comes again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly.

What’s interesting about this quote is that Teddy Roosevelt is bringing into focus the need to emphasize strengths, not shortcomings. He displays a growth mindset and highlights the importance of being daring.

Daring people believe everything will be okay in the end, and if it’s not okay, it’s not the end.

If there’s one thing I’ve learned about people with OCD, it’s this: being daring is your superpower. But, I’ve also noticed that your superpower vanishes quickly when you get down on yourself.

Every person is unique and has the potential to change. You can live well with OCD. The key is to capitalize on your strengths and pay no mind to your shortcomings. You reinforce your shortcomings by focusing on them!

The secret to being daring is to focus on your strengths, not weaknesses or deficits. Imagine what is possible when you take advantage of your strengths! Did you know that by focusing on your strengths your shortcomings will spontaneously combust? Focus your efforts on developing your strengths and the rest will take care of itself. 

Here’s an interesting article about focusing on strengths: What are your strengths and why you should list them.

You’re an over thinker and this is a shortcoming. But it’s not a good idea to try and improve by thinking less. We know where that takes you. Trying not to think makes you think more! But perhaps one of your strengths is that you are known for your high level of energy. Focus on your strength of being more action-oriented, and you won’t have time to overthink.

Spend your time nurturing your strengths and not your shortcomings. This will make you more daring. Focusing on your weaknesses makes it harder to confront fear because your shortcomings make you feel weak. Whereas, developing and improving upon your strengths increases brain activity, releases happy juices (serotonin/dopamine) and makes you feel strong.

Think about who you want to be and how you want to spend your time. Do you want to be the person in the arena that Teddy Roosevelt is describing or, do you want to be like this person:

At the moment, I’m feeling like a victim. I’m having bad thoughts one right after the other. This is depressing. I thought I was done having intrusive thoughts. I feel like I’m being attacked from all sides. My family refuses to acknowledge how hard my life is. Yes, I have a victim mentality, but I don’t think I always have this. I’m trying really hard, and no one is giving me any credit. Having OCD is frustrating.

What’s interesting about this person is that s/he is focused on the problem, not the solution. There is no mention of this person’s strengths. We are not responsible for being down but we are responsible for getting up.

Focus on Strengths and Be More Daring

When an exposure exercise starts to get easy ask, “How can I be even more daring?” Dare to feel uncomfortable and life changes. Your strengths can help you be more daring.

Conduct a personal inventory NOW of all your strengths—these might include: 

  • Personality traits
  • Favorite activities/hobbies
  • Special interests passions/desires
  • Skills/abilities talents
  • Work/education accomplishments
  • Cultural/spiritual/ethnic ties
  • Interpersonal relationships
  • Community resources
  • Knowledge/experience
  • Environmental assets/tools/equipment/aids
  • Sensory awarenes

If you have trouble describing your strengths:

  • Imagine being 60+ years old. What would you tell your younger self to focus on? Would you tell your younger self to self-loathe and hopelessly concentrate on weaknesses?
  • What if you could be someone else for 30 minutes. What would your other self be like?
  • Try identifying your strengths from someone else’s point of view. “My best friend says that I am willing to be vulnerable (yes that’s a strength) and that I’m thoughtful.” 
  • Recalling one of your own strategies from a past success of risk-taking, what advice would you give to a friend who doesn’t feel very daring.
  • What personality traits help you to keep going even when times are hard?
  • Think about something you’re good at. Now, ask yourself, “why?” Why are you good at it? Next ask if you can get even better at it. How?

Another way to identify your strengths is to take an online assessment:

  1. Find out more about yourself here: personalitydescribed.com/knowyourself 

There is a $15 fee but the results are worth it. Just make sure you rate yourself fairly. No self-loathing allowed! Use plenty of positive adjectives. Be comprehensive. The more adjectives you use, the better your report will be.

2. Here’s an assessment to find out about your hidden strengths: https://portal.howtofascinate.com/you

Use this free code (YOU-bossitback) to discover what’s fascinating about you. (This code can only be used a limited number of times—so 1st come 1st serve!) Go to HowToFascinate.com/YOU  Enter the code (YOU-bossitback) + your information. Click the “Start Now” button.

3. This is a more costly assessment but highly informative and popular.

NOW WHAT?

Once you have identified some of your strengths, it’s time to take advantage of them! 

Nurture Your Strength

Take one of your strengths and on a scale of 1-10 how high would you score this strength? For example, let’s say you think you are a 7 when it comes to being kind/loving. Now think about steps you could take to raise the score to an 8 or 9. Perhaps one of the steps would be to set Alexis to start your day with a daily affirmation. (Developing self-compassion.)

Communicate Your Strength When Talking Back to OCD

“I know you are afraid right now OCD. You’re leaning toward being stuck. Afraid to be daring. But daring is my superpower. So hold on…it’s going to be a bumpy ride. I’m a mover and a shaker. I got this.”

Use Your Strengths to Take Risks

Always, always, always pat yourself on the back for initiative and effort regardless of the outcome. Better to take risks than be paralyzed.

Find Your Hidden Strengths

We all have strengths we don’t even know exist. We use them every day but we haven’t identified them because they run in the background of our consciousness. Taking one of the online assessments can be helpful with finding hidden strengths, but asking friends and family is often even more enlightening.

Keep Track of Your Strengths As They Improve

It’s beneficial to have a visible way to keep track of your progress. Download an app (e.g. habitbull) on your phone or keep a diary. I like apps because they provide graphs which are rewarding to look at and see the progress.

Share Your Strength with Others

Maybe someone else isn’t as organized and as good at planning as you. Offer your services. Design a planner and sell it on Amazon.

Collect More Knowledge About Your Strength

Instead of reading a self-help book to improve upon a weakness, read a self-help book or listen to a podcast or Ted Talk about one of your strengths. Reinforce your strengths by learning more about them.

Use your strengths to be daring. Dare to be uncomfortable and you’ll leave OCD crippled by your superpower. By sharpening your skills and reinforcing your strengths, you’ll be more motivated to engage in ERP.

In summary:

Get Rid of Your Fear of Anxiety

Do you think it’s possible to get rid of anxiety? Read the title of this post again. It doesn’t say to get rid of anxiety. It says to get rid of your fear of anxiety. And, yes. It is possible to accept anxiety as an annoyance but nothing to be feared.

Get rid of your fear of how it feels to be anxious. If anxiety makes you feel lightheaded, stretch your arms out like an airplane and start spinning round and round. Make yourself lightheaded. If anxiety makes your heart pound faster, get up and do 50 jumping jacks. Get your heart pounding faster. Go ahead and drum up the feeling of anxiety. Give yourself a good dose of it.

Get rid of your paranoia about being anxious. If you’re worried that people will think less of you because you have a panic attack or act ditsy, then by golly, act more anxious! Get it over with. Don’t complete sentences during conversation. Bite your nails. Jiggle your legs. Wet your armpits with a sponge. Stutter. Make sure people know that you are super duper anxious. If someone thinks badly of you it’s because they’re miserable. Only a person who is hurting will judge you.

Get rid of your fear of the anxiety never ending. Maybe it won’t end. Maybe it will. Time will tell. Anxiety isn’t dangerous. It’s your reaction to anxiety that can make life chaotic. You can do anything anxious. You can do nothing by avoiding. Set your intentions. As an anxious person, who do you want to be? If the anxiety never lessens you can choose to acclimate. Become accustomed to feeling anxious and come to terms with having a thorn in your side.

Get rid of your fear of anxiety as a signal of bad things to come. Someone once said of me, “You don’t understand that we actually experience this stuff as real.” No one can know what it feels like to be in anyone’s shoes. But I certainly have been afraid of something terrible happening. And it sure felt real to me: “This time it’s really going to happen.” The truth is, if it’s not happening now, it’s not happening. If something bad does happen in real time, so be it. Bad things happen to everyone and we deal with them as they occur.

I’d rather be anxious than afraid of being anxious. How about you?

ERP With a Different Twist

Compulsions Are Nothing More Than a Coping Skill Gone Rogue

If you use avoidance behaviors or mental neutralizing rituals to manage anxiety and obsessional thoughts, then you’ve selected compulsions as a coping mechanism. You believe compulsions have value. Naturally, if a coping skill seems useful, you’ll use it often. The more you use a coping skill, the more mindless or automatic the use of it becomes.

Bossy-Pants OCD
A Compulsion Is a Coping Skill in Excess

Your brain perceives a threat or senses something unpleasant, your body reacts, and your brain selects a coping mechanism—and in your case, it’s often a compulsion. You employ a repetitive and well-oiled skill that has helped you cope in the past. You can employ this skill mindlessly—with no concern for consequences.

Ta-Da…You’ve mastered a coping skill!

Just because you’ve mastered a coping skill doesn’t mean it’s right for you.

Even when you think it’s a healthy coping skill because an authority or role model told you to do it—it can be a compulsion.

Have you ever been taught this coping skill: “A thought is just a thought.”

If you’ve read Brain Lock or talked with a therapist who doesn’t use ERP, then no doubt you’ve been reassured, “Just because you think it doesn’t mean you want it.” Many people have become proficient at repeating, “It’s just OCD, it’s not me. I am not my thoughts.” 

Yeesh! It’s a coping skill gone compulsive!

Compulsions aren’t spontaneous. They’re learned. Through trial and error, and reinforcement a compulsion is born.

It’s true; you are not your thoughts. You are your compulsions.

Compulsions form your loss of identity—and your lack of sense of self. I wish I had a nickel every time a client said to me, “I don’t know who I am without my compulsions.”

You and your compulsions are joined at the hip. Two peas in a pod. But, let’s get this straight…if you are engaging in compulsions you CAN’T know who you are. Drop the compulsions, and you WILL find yourself again!

Coping skills are employed for a reason—to achieve a goal. When you employ a compulsion, what is your goal?

Maybe you’re saying, “Tammy, I use compulsions to stop something bad from happening.” ~or~ “I use compulsions to try and figure out something important. I’m trying to answer a question that is gnawing at me.”

Ummmm, nope. That’s nothing but a hoax. Compulsions have no effect on anything but the quality of your life. Trick. deception. Fraud. Scam. I know you won’t argue that compulsions are all of that and more. Nevertheless, it’s how you cope.

Peel off the many layers of why you profess to engage in compulsions. You will discover you perform compulsions as a way to cope. You use compulsions to fire up or extinguish a feeling.

If you were willing to experience any feeling—all feelings—what would life be like for you? You’d be compulsion-free!

If you agreed to coexist with your feelings and obsessional thoughts, there would be no need to neutralize an intrusive thought. No more mental acts. No more trying to get to the bottom of who you are. No more rewinding, replaying, or forecasting. No more fixing. No more controlling what you can’t. No more hypervigilance. 

If you were willing to experience uneasiness the quality of your life would significantly improve. I’m not saying you have to enjoy anxiety or fear. I’m just saying you’d be compulsion-free if you agreed to coexist with your thoughts and feelings.

Tired of compulsions? Then apply the principles of Exposure & Response Prevention (ERP).

But hold on!!! If you decide to engage in ERP, the reason you’re doing it is critical. What is your goal? What do you hope to achieve through confronting OCD and resisting compulsions?

Are you engaging in ERP to stop thoughts? Bzzzzz. Wrong. Are you participating in ERP to avoid feeling unsettled or anxious? Bzzzzz. Wrong. Are you employing ERP to get rid of OCD? Wrong! Are you engaging in ERP to fire up anxiety or an uneasy uncertain feeling? Ding ding ding. RIGHT!

How else can you learn to tolerate an unpleasant emotion unless you hunt down ways to feel it?

You can’t heal what you won’t feel!

Now I want to give you, the reader, a peek at a therapy session:

Let’s say that for an exposure exercise you put a big piece of spinach in your teeth and talk to people all day.

ERP With a Different Twist

Predicting what will happen if you do this exposure is not new to the practice of ERP. The different twist is to make sure you lay it on thick. Don’t make little of what could happen. Be vivid. Go beyond saying you’ll “be laughed at” or people “will stare.” 

What do you predict will happen? Think about your worst fears. Go for it! Don’t just predict someone will think “less” of you. Use your words! Use foul distasteful adjectives! Amplify, magnify, go into detail and elaborate what you fear could happen.

Okay, I predict this will happen: People will be disgusted with my poor hygiene. They’ll accuse me of not bathing too. They’ll think I’m of low intelligence. I’ll be accused of never brushing my teeth. Someone will hand me floss and say, “Here, floss. Your teeth are disgusting.” Because of that spinach in my teeth, people will call me, a big fat pig! Oink Oink.

Now that we have gone hog wild and been thoroughly descriptive with your predictions, it’s time to put the spinach in your teeth.

ERP With a Different Twist

Make sure it’s noticeable. You might think, “Maybe we should start with a small piece.” Not really. You can if you want. That’s traditional ERP; slowly working your way up to a higher level of anxiety. But then you’re not fairly testing out your hypothesis. We need to see if your predictions come true!

We need to make sure the spinach is in plain sight! We need to find out what happens! Uh-oh…you’re losing your nerve, aren’t you? What are you having a hard time believing? Are you worried you can’t handle this experiment?

I’m worried I will be looked down upon. I’m going to fret all day long if that spinach is in my teeth. I’ll be demoralized and just want to die.

Do you feel like the anxiety is too much to tolerate?

YES!!! A thousand times yes! This is a horrible idea!

Okay, so that’s another prediction you’re making…”I can’t handle the anxiety if I do this.”

Let’s regroup for a minute. Do you want to live well with OCD?

Yes.

Well, then we need to test out your hypothesis! 

Be willing to find out what happens, and you can live well with OCD.

Before you put the spinach in your teeth, I just want to point out that it’s important to engage in ERP for the experience, not the outcome.

Be willing to find out what happens when you put your hypothesis to the test. In summary, what is your hypothesis?

I predict

People will think I’m a disgusting pig. I’ll be cast aside. I’ll be alone for the rest of my life.

I predict 

I can’t handle all of this anxiety. I’ll have a panic attack and never recover.

It’s been two weeks since our appointment. How’d you do?

Surprisingly, great!

Awesome! Despite your predictions, you feel great about your efforts! 

So, did your prediction turn out to be factual?

No one even seemed to care about the spinach in my teeth. There’s no way they missed it, but nobody seemed grossed out. Eventually, somebody pointed out I had spinach in my teeth, but it was no big deal. We laughed.

Your predictions were false. There was no catastrophe. Nothing bad happened. Nobody called you a pig or accused you of not bathing. And, you’re happy about your discovery!

The purpose of the exercise was to poke holes in your prediction. Did it work?

Yes.

But, if someone had called you a pig, would that be factual or an opinion?

An opinion. I can’t be a pig. I’m a human.

And by the way, only a person who is in pain would call you a name for having spinach in your teeth. A happy or caring person would have no need to bring you down. If someone calls you a name, we must have compassion for that person who must be hurting.

Alright, but there’s more to ERP than trying to disprove a hypothesis.

What if your fear cannot be readily disproven? Maybe you fear something that could happen months or even years from now. Or, what if you fear something where the outcome can never be known? Lesson #1 will be of little help to you.

ERP With a Different Twist

When does the exposure end? Hint: It doesn’t end when your anxiety comes down.

It’s not so bad to look foolish, be stared at, ignored, or called names. It’s unpleasant but not dangerous. The purpose of exposure exercises is to discover you’re more capable of tolerating anxiety and unpleasant events than you thought.

I didn’t think I could walk around with spinach in my teeth, but I did it! I didn’t panic! 

Did you keep the spinach in your teeth until your anxiety came down, or did you stay in the situation until your brain got an update about your ability to cope with the discomfort?

I ended the exposure when my anxiety came down. It came down when I realized my predictions were false.

How will this help you for obsessions that can’t be disproven? 

The lessening of anxiety because you recognized a discrepancy between what is predicted and what occurs is nice and all…but it’s not enough. There are many obsessional thoughts you can’t disprove. And many obsessions consist of questions that simply can’t be answered.

But, I could probably do that spinach experiment again now that I know my anxiety will lessen.

Yes, but will that be true at a later time or in a different context? Let’s not care so much about your anxiety lessening. If we place emphasis on reducing the anxiety, what kind of mixed message is that? That’s teaching you that you should be able to control your anxiety. And isn’t that what compulsions do?

Anxiety is inevitable, a part of life and it can be tolerable. Accepting this as the truth is how you can live well with OCD.

It’s important to stay with an exposure until you discover it’s okay to be anxious and have weird thoughts. Instead of trying to fix your anxiety through exposures, learn to be with or experience your anxiety.

If I ask you, “what surprised you about this experiment” and you answer, “I was surprised by how well I tolerated the fear” then hurray mission accomplished! But, if you answered, “I was surprised nothing bad happened,” that’s probably not going to translate into long-term benefits. Nor will it be applicable for every obsessional thought.

It’s about the lesson, not the lessening.

It doesn’t matter if your anxiety comes down. It’s all about the experience, tolerating it and discovering it’s okay to step out of your comfort zone. 

ERP With a Different Twist

The exposure ends not when your anxiety comes down, but when these objectives are met:

  • You realize anxiety is unpleasant, not dangerous.
  • You’re surprised by how well you handled the anxiety without a compulsion.
  • You accept it’s important to coexist with unpleasant feelings and obsessional thoughts.
  • You exceed your expectations about being able to continue an exposure even while feeling anxious and having obsessions.

If you’ve achieved those objectives even though your anxiety is still high, the exposure is considered completed.

Focus on the anxiety being tolerable; not the anxiety being fixed or controlled.

ERP With a Different Twist

You don’t even have to rate your anxiety. Instead, pay attention to your ability to withstand and tolerate anxiety and obsessional thoughts.

I end the exposure when I learn that I can stand uncertainty and anxiety. I tolerate experiencing these feelings and admit the feelings are unpleasant, not dangerous. And third, I must reinforce my strength and courage by admitting how surprised I am. Only then do I stop the exposure?

Exactly. 

Wait, that last objective . . . How do I exceed my expectations about being able to continue an exposure?

Step outside your comfort zone even more. Demand the anxiety become worse.

Not only put spinach in your teeth but also part your hair differently. Talk to someone really important with spinach in your teeth. Adding a bit more discomfort to the situation, and the fact that you survived it, would have even surprised you more! You would have exceeded your expectations.

One more time, what do you mean by “coexist” with my anxiety and obsessional thinking?

Be a person not willing to be overcome by anxiety or obsessions. Accept that anxiety and weird thoughts will be a part of your life and that you must live with this fact and tolerate it. Do not try to eradicate or influence thoughts or anxiety. Despite your anxiety and obsessions, agree to live together.

Remember, the practice of ERP is about the lessons, not the lessening!

ERP is more effective than any other intervention. AND, research continues to find ways to improve the short and long-term benefits of stepping outside of the comfort zone. Incorporate all three lessons into your daily life and you can live well with OCD.

“My Therapist’s Crazy Science Experiments”

The following post is from a Guest Blogger who is new to living with OCD. He’s confronting three whopping obsessions, all at the same time and is using ERP to do it. Here’s his triumphant story:

At 27 there were many things I expected to be happening at this point in my life… engagement, getting a dog, planning the next vacation, enjoying life in a brand-new city… the list goes on.

The reality of it has been much different, thanks to my OCD diagnosis. Instead of what I had envisioned, I found myself doing things I never would’ve imagined to confront my fears and obsessive thinking.

Growing up with two older sisters I was used to being dressed up. However, that was over 20 years ago. I didn’t think I’d be playing dress up at 27, trying on my mom’s dresses and jewelry while “I am woman” plays on YouTube. I wish I was kidding but my therapist focuses on Exposure and Response Prevention therapy (E&RP) and this was one of the first exercises she assigned to me.

At first, it was terrifying but it ended up being very entertaining and my parents got a good laugh and some pictures to blackmail me with for the rest of my life. At least I know if I end up trans I can rock the s%&t out of a nice dress.

living with OCD
Another exposure exercise my therapist has me do is a bit more intense… Imagine having to hold a knife to your wrist and gut while having thoughts of killing/stabbing yourself play in your head.

When completing an exposure you’re not allowed to self-talk or re-assure that nothing is going to happen. To make the exposure even more intense my therapist has me say bloody and dark statements as I hold the knife… this definitely gets the anxiety pumping.

I’ve also had to hold the knife to strangers throats in group therapy and also to my parents. If you ever are looking for a way to spice up your weekday nights give it a try… but in all seriousness confronting these fears has been incredibly difficult.

Finally, in a group therapy setting, I came out as “gay” to a bunch of strangers who don’t know anything about me… hitting all three of my fears.

To others reading this post it may not seem like a big deal but to me all of these experiences were terrifying. I always get self-conscious when completing exposures because on top of the anxiety I feel ridiculous and embarrassed I’m having these obsessive thoughts.

But in the end, I can’t worry about it… I must continue to face my fears and continue to be a guinea pig to my therapist’s crazy science experiments because, in the end, it does appear to be working.

My anxiety and compulsions are improving… I still have thoughts but they don’t have the same amount of power over me as they used to and they aren’t as frequent. A lot of trust goes into my relationship with my therapist… I wouldn’t dress up as a woman for just anyone.

In the end, maybe one of these fears/obsessive thoughts will become reality but I can’t continue to live in fear and not attain my hopes and dreams. I will continue to embrace any exposure exercise that comes my way and hope that one day I can look back at it and have a good laugh. In a weird way, this is helping me become more comfortable in my own skin… an unforeseen perk of OCD.

Living With OCD

This young man’s account of the lengths he must take to break free from OCD is astounding. He is brave and strong, with a huge funny bone and an ever-growing mindset. He is determined not to be held hostage by fear. There is nothing he won’t do to #bossitback.

He is a blogger and openly shares his journey at Millennials for Mental Health. He’s candid about the many twists and turns he has encountered along the way. It’s not been easy for him and there are times he still gets tricked by OCD. Visit his blog and he’ll tell you how he stays strong and focused.

You can leave a comment here to help celebrate his victories!