Category Archives: OCD Strategies

Exposure and Response Prevention In A Pandemic: What’s Changed?

FAQs Regarding ERP During a Pandemic

My clients want to do the right thing. They beat their contamination fears before the pandemic and they don’t want to revive their OCD by following the CDC Guidelines.

The following is a list of questions often asked:

Q: Prior to the pandemic, for exposure, I skipped handwashing after leaving the grocery store. I’d say something like, “I’d rather catch a cold than be worried sick about catching a cold.” Since the pandemic, I don’t skip handwashing after going to the grocery store. Should I sanitize after the grocery store or is that feeding my OCD?

A: Skipping handwashing presents a real safety concern. So yeah, follow the Public Health guidelines and wash your hands after shopping at the grocery store. You can still do an exposure though. While washing your hands say, “I’d rather get COVID than worry sick about getting it.” 

The exposure is the grocery store and the response prevention is resisting the urge to follow any OCD-made up super-duper rules. Stick to the guidelines and don’t go overboard.

No guideline is telling you to hold your breath when you wash your hands, scrub your forearms, or wash for 20 minutes 50 times a day. All of those safety behaviors are rules according to OCD (aka your imagination.)

Resisting compulsions cannot be emphasized enough! You will get plenty of exposure opportunities just living your life in a pandemic. You won’t have any trouble hunting down triggers. They’re everywhere.

Your most important job is to resist the safety behaviors that go above and beyond the Public Health guidelines.

Q: It’s odd. I’m the one with OCD, but I seem to have fewer fears about COIVID than other people. Should I be more concerned? Is there something wrong with me? Should I be taking more precautions?

A: Well, you’ve trained for a moment like this. You’ve rehearsed a pandemic in your mind over and over. So it’s no wonder you’re doing better than the average person. Do your best to follow the guidelines but stay in touch with reality. Remember, you can be super-duper cautious and it will never be enough.  

Don’t lose sight of the truth. Hold fast to this truth: You can’t ensure the virus doesn’t find you. You can’t control everything. Imagine doing all the right things for months: distancing, wearing a mask, washing hands and then someone you haven’t seen in a while (who is visiting from Florida) approaches you from behind (wearing no mask) and gives you a big bear hug.

You can only fake perfection so it’s fair to predict that you and everyone else will be less than 100% compliant with the guidelines. For example, “don’t touch your face.” Yeah. Right. Every time I put a mask on, my nose is suddenly terribly itchy. CDC guidelines recommend washing hands after petting a dog. I have three dogs and that’s definitely not going to happen.

Q: I’m having the urge to wash my hands more often. I know I’m supposed to resist going above and beyond the CDC guidelines but that’s easier said than done.

A: Really? C’mon, are you telling me that it’s easier to feed OCD? Performing compulsions is an easy way to live? OCD has you doing backflips on dental floss and you find that to be easy? 

Maybe it’s easier to perform rather than resist compulsions because you live in a bubble? Perhaps you’ve practiced compulsions to the point of habituation and you’re settling for less.

Yes, it’s hard to resist compulsions. Good news! You can handle hard work. You can handle anxiety. It’s unpleasant but you can handle it.

Sort yourself out! You’re being pranked by OCD into thinking you can’t handle hard work and anxiety. Resisting compulsions and performing compulsions are both hard. Choose a remedy or a poison.

Q: My daughter overcame the need to constantly wash her hands. If she goes back to school the teachers are going to make her sanitize and disinfect all the time. She doesn’t want to do it because she thinks it will make her become compulsive again. What should she do?

A: She used to be compulsive and wash her hands excessively because she was trying to gain certainty. She wanted to know for sure that she was safe. As long as she doesn’t fall into that trap again it won’t matter how often the teacher makes her wash her hands.

She must not go over and above what the teacher tells her to do. If she thinks the teacher is over the top anxious and asking her to do more than what other teachers are asking, your daughter should tell you so that you can speak to the teacher or administration.

Most importantly your daughter, who has done a good job at this, must stay in touch with reality and continue to surrender to the possibility that anything can happen. “Whatever happens, happens.”

Q: I have OCD. So I know my common sense isn’t always intact. You used to say that the way to tell what made common sense was to observe what the majority of people are doing. What most people are doing reflects common sense.

Nowadays following the majority is hard to do. It’s not clear who is the majority. How can I know that I am using common sense in my decision-making?

A: You’re right! It’s hard to know what makes common sense by watching people right now. Depending on what state or county you live in, what news channel you watch, the majority of people are either wearing masks or not. The majority are keeping 6 feet apart or not. The majority calls the virus a political hoax or the majority believes in medical and scientific information. 

Before the pandemic, you might have planned an exposure to touch doorknobs and shake people’s hands to “spread” whatever residue was on the doorknob.

The reason that was a safe and effective use of ERP is that’s what the majority of people did! Out of 100 people, the majority would touch doorknobs and shake hands without a second thought. Now out of 100 people, the majority do or don’t shake hands depending on the town or neighborhood you live in.

When I walk my puppy in my neighborhood, everybody keeps their distance. On the contrary, three hours away, I pull into my parent’s driveway to find a handyman and several neighbors hanging out on the front porch, sitting close to my elderly parents with no masks. Does my mask on my face show common sense or is it the majority of people on the porch with no mask who have common sense?

It seems like a no-brainer to me that at times like this, common sense is rooted in science and not based on what the majority of people are doing on the porch. Two out of three people trust science so that is the majority I ‘m following.

Common sense is in the eye of the beholder who is either influenced by a physician, Dr. Fauci, who has served as the Director of the National Institute of Allergy and Infectious Diseases since 1984 or a man who brags about sexually assaulting women, sidelines Dr. Fauci but praises a doctor who claims medication is made with alien DNA, and can barely recall the words, “person, woman, man, camera, TV.”

Ahh, I digress. The point is it’s hard to find common sense right now by watching other people. I vote for science, no matter how fluid it is. Dr. Fauci does not have a track record of lying. He has a track record of successfully fighting HIV/AIDS, Malaria, Ebola, and Zeka.

There is no way I trust a messenger with magical thinking (ahem), who claims COVID will disappear and is so jealous of Dr. Fauci, that he outright lies he too was invited to throw the first pitch at a major league baseball game. Good thing that wasn’t true. His bone spurs might have bothered him while winding up for the pitch. 

Ahh, I digress again. It’s hard not to these days.

Q: Before the pandemic, you would say the content of your obsession is irrelevant. We don’t need to focus on whether there is some kind of residue on the doorknob. We need to focus on the inability to ever know if that residue is there. Maybe it is. Maybe it isn’t. We can never know for sure.

Except now I feel like COVID is on the doorknob. For real. I look around and see people wearing gloves and masks and feel vindicated, “I was right to be super safe! I was ahead of the game. Welcome to my world. My fear was real!”

A: Okay, but wasn’t the last pandemic in 1918? You could live a lifetime in a bubble and never see another pandemic. I ask, “Who do you want to be and how do you want to spend your time?”

Besides, I highly doubt we’d (the United States) have this many COVID cases if we had had smarter political leadership and national response instead of a piecemeal one. So maybe the only reason “you were right” is because of a failed national response to containing the virus.

It’s difficult to do but it’s crucial, even in a pandemic, to shift your focus away from the theme of your obsessions, and instead focus on the relationship you are cultivating with your anxiety.

Are you wrestling with anxiety, trying to squirm your way out of it? OR, on the contrary, are you figuring out a way to live with anxiety?

What does anxiety make possible for you? In what way is OCD a strangely wrapped gift? Imagine what life would be like if you wanted to feel anxious? Are you willing to feel the fear and do it anyway? 

If you have a question I haven’t addressed please feel free to post one in the comment section.

Breaking Free From OCD’s Chokehold, Part One

Hi! My name is Azure. I want to pay it forward and share a few things I’ve learned about living with OCD. 

OCD chokehold

“Let everything happen to you: beauty and terror. Just keep going. No feeling is final.” —Rainer Maria Rilke

The End.

Shortest blog post you ever read, huh? 

Kidding aside, my OCD has often put a sinister twist on those two words, “The End.” Because when OCD’s got me in a chokehold: it says, “This is it. This is The End. You will never have any other emotion besides this intense terror for the rest of your life.”

Everything is Temporary 

Life is a rollercoaster, life is a journey, life has ups and downs—all synonyms, you could say, for “no feeling is final”—these phrases are woven into our vernacular because we know the truth of them.

OCD says the exact opposite because it isn’t logical. It believes whatever it wants to believe—and wants you to believe it too.

When I was little, I would tap on stretchers underneath chairs with my feet. I didn’t know why I did it. I just knew that if I tapped on one side, I had to tap the other side with an equal amount of pressure.

One night, when I was about nine, I kept getting out of bed to tap the bathroom door against the wall. I’d get back in bed and have to do it again. After several trips, I started to cry. If I had to point to a distinct moment where I knew something was wrong, that would be it.

OCD: My Drunk Amateur Philosopher

My obsessions remained more in the physical realm at that stage, but after I hit puberty, they transitioned into an emotional one. I wasn’t as worried about symmetrical tapping anymore. Now I was worried about my words and thoughts and other people’s words and thoughts.

OCD chokehold

Living with my OCD was like living with a drunk amateur philosopher. It wanted to debate with me on the nature of humanity and the extent of one’s personal responsibility and other concepts that seemed to enter an insane, metaphysical realm. I couldn’t believe half the conversations I had with myself.

It’s Possible to Live Well With OCD

And that’s when I got in touch with an OCD therapist.

Thank you, Tammy, you definitely saved my life. OCD might not have killed me, but my quality of life had long been dead.

As soon as I started working with her, I noticed a remarkable improvement. A resurrection, you could say. Maybe I didn’t have to be trapped! Maybe I could actually live.

OCD chokehold

I’m sharing my story with you because if I can share what helped me, maybe it will help you.

Actually, helping you is what helped me. During the worst times, I always had this idea that one day, I’d talk about it, and it would help someone and give my suffering some purpose. This thought, combined with the fact that Tammy was giving me a new lease on life, is the first thing that helped me: Hope. Have hope that things will get better. You have no proof that they won’t.

OCD: Toddler-in-Chief

The second thing that helped was to start seeing OCD as a separate entity, not the voice in my head I must blindly obey. Tammy compared it to being a little girl inside of me, like the baby version of myself, uncertain and scared of the world, and not knowing anything about it.

I could now challenge what OCD told me: “You don’t know anything about life.” At the same time, it was no longer a monster to be vanquished; having a kinder viewpoint was really helpful.

I started talking to it like I would talk to a very young person. “That may or may not happen. In the meantime, we’ll do what I say.” (There are times, however, when the niceness approach won’t work and you have to be tough with OCD. Tammy’s also compared it to an overprotective security guard that won’t let you live life.)

I Am More Than OCD

OCD attacks your confidence. You doubt everything, you doubt yourself. Once I realized that about OCD, I started to question whether what I once thought was my personality— timid, passive—was the real me.

I took one of those personality quizzes and it said I was almost 50/50 introverted/extroverted. Me, 50% extroverted??? Imagine that! I’m determined to get to know this hidden, self-assured woman.

Having an inner dialogue where I gently take control away from OCD and into my own hands does more than treat faulty thinking; it’s making me a stronger person.

Over the years, I’ve had many ups and downs. Times when I thought I was “cured,” times when I thought I couldn’t get any worse. Each experience leaves me either a little stronger or a little scarred. (I still have a strange relationship with carbon monoxide detectors.)

One of the many things I’ve learned over time is to be aware of changes in your life and stress levels.

I lied to myself about that for a while. I’d say, “But this obsession isn’t resulting from stress! It’s because I told my friend to try Pilates without knowledge of her medical history and I have to remind her to check with her doctor before trying any new exercise regimen!”

“No one can be responsible for themselves,” OCD claims. “Policing everyone’s lives and regularly stating the obvious to them is the only way to guarantee their safety!”

No, I’ve learned you need to be extra diligent with OCD when you’re stressed and I know this from experience now.

I have had three majorly stressful events happen in my life since November of last year. I started a full-time job for the first time (I do enjoy my job—keep in mind that even “good” changes are still changes and can still affect you emotionally), my mother had a stroke (she’s okay now, but the effects and the trauma linger on), and we are now in the midst of a global pandemic. Yep. Heavy.

The week before my work shut down for COVID-19, I was under severe stress. Every day, the news brought in more reported cases. Contamination obsessions and weakened immunity made me feel so vulnerable and no amount of gloves and handwashing would cut it.

Once we began working from home, I was relieved, convinced that my anxiety would drain away. Wrong! It spiked to like a 12 out of 10!

It’s Easier to Be Tricked in Times of Stress

Why? I think that the past few months of stress, the new threat of becoming mortally ill, that long, intense week before closing, and the sudden change in routine came crashing down on me. And I fell, boy, did I fall, down what Tammy calls the rabbit hole.

I fell for some really basic tricks, too. And it was as if everything was magnified. I worry about people slipping on the stairs anyway, but this time around, I’d sit on the stairs for what felt like an eternity, carefully examining minuscule scratches and removing bits of fuzz. That’s just one example of the OCD things I did the first week of sheltering at home.

I’ve tried bargaining with OCD before, resisting a compulsion here, but giving in to another there. Surprise, that doesn’t work! And it especially wasn’t going to work this time. Tammy had laid the foundation, and I knew that the only way to bring myself down from anxiety that high was to do something drastic to combat it.

Two experiences helped in this regard. They worked in conjunction with each other, but I just don’t remember which one happened first. This month of sheltering in place has been a bit of a blur, and I know I’m not alone on that!

The first experience: I was taking a walk with my mom and wishing that I didn’t have this one obsession in my mind so that I could enjoy my walk. Then I had my lightbulb moment. I will always be anxious about something.

Let Anxiety and Joy Cohabitate

There’s no point in trying to pretend I don’t have this illness. Healing, we’re told, begins by feeling. I was just going to have to let the anxieties come, instead of desperately trying to fight them off (usually by giving in to compulsions—not a good strategy).

And instead of waiting until they’re all gone to enjoy myself, I was going to have to let anxiety and joy cohabitate, and hopefully, by focusing on the joy I wouldn’t focus on the anxiety. It’s not like I didn’t know this before, I just—didn’t realize it fully until that moment. And I was going to have to find a way to live my life despite it.

The second experience: I was going to bed one night with a sky-high list of accumulated anxieties. I was convinced that the house was either going to fall down or burn up. I had already gotten up and checked so many things. I’d kept checking and checking, and my anxiety kept growing and growing, and finally, I couldn’t check anymore. I knew I couldn’t.

I’d Rather Accept the Risk Than Live Like This

I crawled back in under the covers feeling like my body was made of lead. It was such an awful night. I’m quite a positive person, but there’s no other word for it, it was simply awful. I tossed and turned all night and at one point I think I was soaked in sweat (I probably should have been more worried that I had the virus!). But I just had to ride it out. I had to let myself feel all that crushing anxiety without trying to do anything else to make it go away.

After that, I noticed a shocking change. Sweating through it was like weathering a storm. And the clouds broke and suddenly my anxiety dropped! Who knew!

The Only Way Out Is In

So I’ve learned a few things from these experiences. First of all, whether you’re looking down into the rabbit hole or already well along in it, whether you’ve checked something once or one hundred times, whether your anxiety is at a 2 or a 10—wherever you’re at, stop. Let the anxiety come, let yourself experience it in all its fierceness. The longer you try to paddle around the storm, the more it will suck you back in and the more energy you will waste. Sweat right through the centre of the storm. It’s the quickest way to get to the other side.

Ideally, you want to stop at the entrance of the rabbit hole before falling down it, right? For years, I struggled with that. I would dip my toe into the rabbit hole, thinking that if I did “just one compulsion” I would “satisfy” my OCD and get rid of enough anxiety to let go of whatever I was obsessing about. I’d think, “It doesn’t have to get rid of my anxiety perfectly. Just enough so I can ignore it.” What do you think would happen? That’s right, I was well on my way to another Alice in Wonderland experience!

OCD will trick you into believing that if you just perform the compulsion, you’ll feel better. If I tell myself that isn’t true, it doesn’t work. OCD says, “No, it’s true.” And that’s because you do feel better.

Even though that relief is temporary, maybe only lasting a second, OCD will convince you that the compulsion is worth that second of relief. So instead of saying, ‘that isn’t true,’ I’ve started telling myself, ‘yes, that’s true, but then it will get so much worse.’ Not, ‘it may get worse.’ I have to be very strict. ‘It WILL get worse.’

OCD Chokehold

I know from experience that as soon as I perform that compulsion after the initial relief passes, another compulsion is right on its heels, and it will suck me in deeper. Hello, rabbit hole.

Tammy once gave me a business card that said: “This compulsion is a hoax. The relief from this compulsion will not last.” Repeat it until you believe it.

Breaking Free From OCD’s Chokehold, Part Two

Hi! My name is Azure. I want to pay it forward and share a few things I’ve learned about living with OCD. This is Part Two of my guest blog post: Breaking Free from OCD’s Chokehold.

Don’t Try to Fix the Anxiety

Lately, I’ve been telling myself to live each day as if I were a normal person, haha, but seriously, one of the things my OCD therapist has told me is to ask myself what a reasonable person would do in a given situation, or how many people out of 100 would be sharing my current worry.

Because I’m under stress, I have to remember to be stronger than usual by letting the anxiety wash over me and resisting those compulsions.

Another helpful thing to do is reach out to others. I’m trying to think of people besides myself and share any mental health pointers I can with them.

Be Willing to Find Out What Happens Next

So maybe you’ve read Part One and Part Two of this blog post, and you think, “she sounds like she’s all good now.” I know, I never like it when personal experiences are too clean, too tied-up-with-a-bow. ‘Things were bad but I’ve found my happily ever after!’ doesn’t ring true for me. It’s the stuff of fairy tales.

So, will I just keep improving from here on out? I don’t know. I write all these words now, but tomorrow I may be down another anxiety spiral. I sure hope not, but I have to accept that uncertainty—and that doesn’t mean I have to fear it. “Let everything happen to you.” Because even if I land in a bad place tomorrow, that is not my final destination. Ups and downs. Downs and ups.

OCD chokehold

I don’t want to end this blog post without a couple thoughts on the current, highly unusual time we’re in. Everyone in the world is grieving something, even though it’s something different for each of us.

I’ve Trained For This Moment

Obviously, this is a hard time for OCD sufferers. If you have a lot of experience tackling OCD and you’ve been faced with this sudden change in your routine, OCD might get innovative like it did with me. It’s something to watch for. But Tammy has referred to OCD as a strangely-wrapped present for a reason. What opportunities does having OCD give you?

What do I mean by opportunities? Well, I might react to the news more sensitively than people who don’t have anxiety, yes. However, I might be better able to deal with it than people who’ve never had to learn coping skills. Interestingly, there are quite a number of people who have reported a decrease in their anxiety and depression, because of this new sense of solidarity with the outside world.

For the first time, everyone’s getting a taste of what it feels like to be scared and isolated. For those of us already with anxiety, the current state of fear doesn’t feel novel to us. In fact, we may be skilled in having an inner world to escape to and may already have calming, solitary activities we enjoy while others are trying to find theirs.

I hope you feel empowered— not that your OCD is a ‘superpower,’ but that the mental strength you have in dealing with OCD has given you an edge. You have something to offer to people experiencing uncertainty for the first time.

My Go-To Coping Skills

Here’s a method I like to use when COVID-19 worries or other anxieties hit:

  1. Identify what you’re feeling, breathe and centre yourself.
  2. See if there’s just one thing you can do that will help. For example, if you’re dealing with uncertainty, make space for being okay with not knowing. It’s okay not to know or have all the answers. I don’t know what the future holds, I’m scared—and that’s okay. There’s a space for that.
  3. If you are overwhelmed, what can you be in control of right now? Doesn’t have to be anything fancy. (Example, I can control how my nails look so I like to self-manicure.) If you’re feeling lost, what’s one thing you can do right now? A definite action, like cooking something.
  4. If the day is sad, what’s one thing within it that brought you some joy? I try to look for that moment every day. A new song I like, or noticing that the daffodils have just come up. Things that make you laugh are always a plus!
  5. Remember to take extra good care of yourself. We’re all just doing our best.

In conclusion, I am on this journey with you. OCD has hurt me. But in facing it, I’m developing valuable life skills. Patience. Resilience. Endurance. So keep going.

Keep going and The End will have new meaning. It will mean The End of a particular obsession. The End of a painful feeling you’ve been holding on to for too long. And if you look at it long enough, you may see a different pair of words start to emerge.

The Beginning.

People With OCD Respond to COVID-19

COVID-19: It’s Surreal Isn’t It?

This is the moment you’ve trained for. You’ve spent a lifetime imagining all kinds of catastrophes. And now that the real catastrophe is here…you’re like, what’s sup?

bugs bunny horses GIF by BasketsFX

You’re thinking it shouldn’t be this easy. Everybody’s freakin’ out and you’re not. WHY AM I NOT FREAKIN’ OUT??? 

Because you’ve trained for moments like this.

ERP Before COVID-19

With the pedal to the metal, you touched all kinds of crap without washing your hands. You learned to watch people touch stuff that was “contaminated” and shrug it off. “That’s your problem OCD, not mine.”

You stopped washing excessively. Fabric and surfaces no longer bothered you. Showers got down to less than 15 minutes. You freely moved around without scanning and monitoring. Sure, you still had pop up thoughts about contamination but you were wise to it. “Nope, not going down that rabbit hole.”

OMG, you did it!!!

You got your life back!!! You learned to “Boss it Back.”

And then…

Enter COVID-19

It’s surreal, isn’t it?

As an OCD therapist, I’m asked a lot about how clients are holding up with what’s happening. Many are thriving–some are struggling.

I’m Okay:

“You might think this pandemic would make anxious people way more anxious. But for those of us who’ve been catastrophizing our entire lives…We can be surprisingly calm in a crisis and many of us are right now.”

“I’m personally more anxious when things are typical. My brain is always trying to find what’s going to blow up in my life and fall completely apart. When there’s a real crisis happening it’s stressful, but not in the way I see it stressing other people out.”

“I feel like it’s helped me focus my anxiety–instead of worrying about hundreds of things, I just have to worry about one big thing.”

“My planning for the worst and hoping for the best finally comes in handy. And it feels good.”

“I’m like, FINALLY EVERYONE FEELS LIKE I DO ALLLLLLL THE TIME!”

“I’m an expert in crisis management because I’m an expert in crisis creation.”

“I’ve been training my whole life for this.”

“I actually feel some kind of release. It’s like I’ve been waiting for “something” to crash, and now that it finally does, it seems emotionally easier…”

“…kinda just a “well I’ve been expecting this to happen” feeling.”

For some people, they feel worse. Not so much because of the virus itself but because of the change in daily routine and the way other people are behaving. Being cut off from a purposeful day or from being around support systems can be stressful.

I’m Not Okay:

“I acclimated quickly to the restrictions and changes and felt surprisingly okay, feeling like I had what I could under control, but this week I’ve just been a mess.” I think many people are experiencing the second or third week as more stressful. So what you’re feeling is reasonable. It’s okay to fall apart. Put yourself back together though.

“Reality checks and distraction normally help me but when the world confirms my obsessive fears of germs, disease and loved ones at risk, that doesn’t help so much.” It’s hard taking the recommended precautions because it might seem like you’re agreeing with OCD. But you’re not. You’re agreeing with the experts who tell us to take these precautions. Your fears are no different than the rest of the world right now. Don’t give OCD credit.

“I was starting to get better before the pandemic, but now I fell back into a hole and my anxiety is off the charts. In times of peace, I’ll be anxious. In times of crisis, I’m more anxious.” Anxiety is uncomfortable but don’t let it keep you from being who you want to be. You can do anything no matter how anxious you are. You can do nothing by avoiding anxiety. How do you want to spend your time and who do you want to be?

“How am I supposed to tell OCD no when everyone in my house is bonkers? They keep telling me to wash my hands! So I’m back to square one.” It might feel like you’re back to square one but that doesn’t make it true. Once you’ve confronted OCD and faced your fears you don’t forget how to do it. Remember, you just have to start somewhere and build momentum. You’ve got muscle memory on your side.

This situation we’re in is fluid and ever-evolving. We’re all in it together. Remember it is crucial that you:

  1. Maintain a routine. 
  2. If you’re not living alone find some “me” time.
  3. Follow the recommendations of physical distance but find ways to stay socially connected.
  4. Find something better to do than perseverate and ruminate.

Courage is not the absence of fear but rather the assessment that something else is more important than fear” ~Franklin Roosevelt

Over 20 Ways to Combat Boredom and Isolation During COVID-19

How to Manage OCD While Your World Shrinks Because of the Coronavirus

Coronavirus and OCD

Schools and colleges are closed. Businesses are having employees work from home. Sports and entertainment activities are canceled. People are isolated at home or worse quarantined to a room. 

For people with OCD, you’re probably handling the anxiety better than most people. After all, you’ve trained for catastrophic events most of your life. And if your anxiety has increased, you know all you can do is follow the CDC guidelines like everyone else and say, “Whatever happens I’ll deal with it. This isn’t my first rodeo.”

You also know you have to have something better to do than worry and perform compulsions.

Even if you are managing your anxiety there is still the problem of isolation.

Not by choice but your world is temporarily changing and shrinking. We all know the smaller your world the more agitated OCD becomes. If you don’t have something better to do rituals and mental compulsions can increase. Harassing or awful thoughts can seem more intense, frequent and real.

So what will you do? You have a choice. Listen up! Right now you have a choice. You can make it easy for OCD to hijack your brain or be assertive and come up with a plan to take care of your mental health while your world shrinks.

Stuck in your home you are at risk for leaning into mental and physical stagnation. Without a normal routine of getting out of bed and following a regular daily schedule, OCD can become obnoxiously loud. To confront OCD you need “happy juices.”

Being quarantined or isolated can prevent your body from manufacturing happy chemicals like oxytocin, dopamine, endorphins, and serotonin. These happy chemicals help maintain: 

  • Muscle function
  • Attentional focus
  • Healthy nutritional habits
  • Arousal and alertness
  • Sleep-wake cycle
  • Pain control
  • Positive emotions
  • Stress reduction
  • Clarity

You can’t maintain the above when you’re bored and inactive. It’s crucial to get out of bed and follow a schedule but you also need stimulation. Take steps to protect your mental health while coping with a widespread virus that is restricting your movements and activities.

Here are over 20 ways to fire up your neurons and keep your brain a lean mean fighting machine:

  1. It’s about keeping physical distance while maintaining social closeness. Think of ways to be close and yet keep your distance from people. How about twenty cars driving by someone’s house to sing happy birthday. Or, check out this beautiful way people are connecting with one another by hunting for rainbows. Click HERE.
  2. Instead of saying, “you can get through this” or “I can get through this” say, MWE can get through this.” Me + We…if we work together it will be our finest moment.
  3. Get fresh air. Open windows. Step outside. Take a walk if you’re up for it.
  4. Hug a tree—you need the oxytocin from touch.
  5. Listen to loving-kindness meditations. Jack Kornfield is one of the best: https://jackkornfield.com/loving-kindness-meditation/
  6. Diffusing essential oils may increase oxytocin levels. I prefer Puriclean by Young Living because it is an Animal Scents product—which when diluted is safe for most pets.
  7. Undertake a challenge that requires planning and designing. The satisfaction of completing a house or other projects will be rewarding.
  8. Solve puzzles: Sudoku, Words with Friends, Crosswords, Jigsaw—an excellent dopamine producer.
  9. Listen to podcasts. To find podcasts related to your specific interests download the app: “Player FM—Podcast App” and choose your favorite categories.
  10. Pump up the music and dance!!! I highly recommend adding Dive in the Pool by Barry Harris to your playlist! Make playlists for other people. Check out D-Nice on Instagram for Virtual Dance Parties.
  11. When you’re finished dancing go soak in a hot tub—warm temperatures produce oxytocin!
  12. Make small gifts for people. Here are some ideas: Paint rocks, whip up some specialty butter, make stuff with popsicle sticks, knit/crochet dishcloths. Giving gifts will increase happy chemicals in your brain!
  13. Boost your brainpower by memorizing: Flags for each country, the periodic table, the roulette wheel, all 206 bones of the body, words of kindness in other languages, or practice drawing a map of the U.S. by memory.
  14. Practice saying the alphabet backward.
  15. How about making materials for exposure exercises? (e.,g.,Trigger word coasters, T-Shirts with triggering images.)
  16. Stay in touch with people through video chats: Watch a movie together while on Zoom or Facetime.
  17. Have competitions with friends/family on Zoom: Cook-offs, Knot-tying or quickest to fold sheets.
  18. Practice magic tricks, drumming with your hands.
  19. Research sports you’ve never observed or played. For example, do you know what a Snooker table is or how Pickleball got its name?
  20. Do your brain a huge favor and juggle.
  21. Get curious and learn new stuff! Do you know the history of fingernails? Solve the over vs. under debate about toilet paper.
  22. Give an author a hug and improve her 😉 rankings by writing a review of a book you purchased on Amazon. 
  23. Learn yoga poses but if you want yoga to be fun, try laughter yoga.
  24. Have you always wanted to learn tai chi? Dr. Lam has an excellent self-directed program.

In the comment section feel free to add what you’re doing to stay mentally and physically active during the coronavirus.

The Best You Ever Felt

The best you ever felt can be traced to a time when you trusted the following:

  1. A thought is not an action.
  2. Thinking about thinking is nothing but space junk.
  3. What you already know cannot become unknown.
  4. Facts and evidence are a reality—imagination is not.
  5. You are capable of handling whatever happens. 
  6. What you see, hear, smell, taste, and touch are real—not what you think you saw, heard, smelled, tasted or touched.
  7. You deserve self-care.
  8. You are worthy of love and praise.
  9. Not all hurt is bad.
  10. Common-sense measures are all that is needed.

Remember the day when the same thoughts that haunt you now had little to no effect on you? Or, maybe once upon a time, you didn’t even have so much junk between the ears—your mind was clear and decisive.

No matter the theme or content of the thought, or how uncomfortable you felt—you maintained your trust—that’s when you felt the best. 

There was a time you weren’t always terrified by your thoughts, and you didn’t ever question your true identity or safety. And then the time came when you stopped trusting.

The best you ever felt is when you trusted that thought is not action.

looping

The best you ever felt is when you trusted that it’s not what you think, but how you act upon what you think, that matters.

looping

The best you ever felt is when you trusted what you know and lived your life based on facts and evidence; not opinions and possibilities.

looping

The best you ever felt is when you believed in yourself.

looping

The best you ever felt is when you trusted what you saw, heard, smelled, tasted and touched.

looping

The best you ever felt is when you trusted you were worthy and deserving of love and happiness.

looping

The best you ever felt is when you trusted that not all hurt is bad.

OCD

The best you ever felt is when you trusted common-sense measures.

looping

Now I want to ask you something. If you trusted again would you even have OCD? Sure, you’d still have thoughts. We don’t choose our thoughts, they choose us. But if you trusted again, would you have the need to perform repetitive mental acts or any more compulsions?

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.