OCD is defined as: Obsessions are unwanted and repetitive thoughts, urges, or images that don’t go away. They cause a lot of anxiety. These obsessive thoughts can be uncomfortable. Obsessions aren’t thoughts that a person would normally focus on, and they are not about a person’s character. They are symptoms of an illness.
I wanted to shed light on mental images in OCD, a lot of times people who do know about OCD know about the intrusive thoughts or the compulsions. But what about the mental images? Many people who suffer with OCD are plagued by mental images that are often disturbing & distressing in nature. This makes the fears amplified to the point of the individual now picturing in detail their worst nightmares. Aaron Harvey describes it in an interview with Cosmopolitan.
“One of the things I have to deal with the most is harm OCD, and it’s really challenging. When I step into the shower and see the razor blade, it will automatically trigger [an image of] me, like, mutilating my genitalia. If I react to those images, they just get worse. It’s kind of like living in a nightmare. …I’ve struggled with sexual identity as a result of repeated, intrusive sexual thoughts about men, despite being straight. During sex, I may have dozens of intrusive thoughts spanning incest, violence, and other unwanted imagery that steals the beauty of the moment. I have graphic flashes of friends and strangers engaging in bizarre sexual acts” – Aaron Harvey (creator of instrusivethoughts.org)
The images are extremely debilitating, and getting to a point where you are okay with just allowing them to pop in and out is extremely painful and difficult. The images cause a lot of distress, so suffers gut reaction is to try their hardest to get rid of the thoughts. But as we know trying to push away and resist the thoughts fuels OCD and makes it worse.
ERP is a great tool against the images, exposing yourself to the images and not allowing yourself to engage in compulsions will allow the reaction subside. To really challenge yourself purposely try and think of the images and confront the discomfort.
Exposure Response Prevention, commonly referred to as ERP, is a therapy that encourages you to face your fears and let obsessive thoughts occur without ‘putting them right’ or ‘neutralising’ them with compulsions.
Exposure therapy starts with confronting items and situations that cause anxiety, but anxiety that you feel able to tolerate. After the first few times, you will find your anxiety does not climb as high and does not last as long. You will then move on to more difficult exposure exercises.
Being asked to face your fears is perhaps one of the bravest aspects of treatment, and is where the approach of the therapist is most valuable, helping a person understand the cognitive reasons behind an exercise and being there to help encourage and motivate them to face the challenges it involves. If the therapist actually participates in the exercises too, this helps build up trust and confidence in what they are asking the person with OCD to do.
I just came back from the annual OCD conference in Austin, TX and it was incredible! I encourage anyone who is suffering with OCD to attend the conference, not only are you around pioneers in the field like Doctor Johnathan Grayson and Jon Hershfield, but to meet like minded individuals is just so incredible. The conference was full of resources, talks, peer supports and so much more!
Here are a few key take aways:
The doctors from Bergen Norway came to present around the 4-Day Bergen Treatment
Brainsway TMS received FDA approval and will be getting approval in Canada most likely by the end of this year
ERP (Exposure Therapy) is the gold standard
ACT (Acceptance and Commitment Therapy) helps with pushing yourself past the thoughts and the pain by practicing mindfulness and radical acceptance
Suffers with OCD are the kindest, bravest and most compassionate people I have ever met I will hold on to these incredible interactions for ever.
Next years conference is hosted in Seattle!! See below for information:
I have been a huge fan of Rose Bretécher for years, she has been an incredible advocate for OCD, and has brought OCD into the mainstream media. She has been featured in several newspapers, magazines, documentaries and now she has been working on a miniseries based off her life and book Pure. Take a look at the trailer below!
I discovered Davind Goggins a few years ago, his passion and growth is inspirational. One of my favourite quotes of his that I use to tackle my OCD is “The path to success will leave you callused, bruised, and very tired. It will also leave you empowered.” – David Goggins
His mentally on facing fears and attacking things head on inspire me to continually do my exposures. When my intrusive thoughts are making me suffer I remind myself that sufferings is integral to growing because once I face the fear I become stronger, and more prepared to handle the ups and downs that are the reality of life.
The strength of our mind and being able to will ourselves into transitioning from being debilitated to in control of how we react and feel towards OCD.
Goggins a previous navy seal speaks about his experience being beat, starved and forced to spend hours in extreme conditions during training. The leaders of the training got to go home relax with their wives and children, while him and the rest of the seals had to stay outside in the cold and suffer. Rather then wishing for the suffering to end he showed the leaders that they can’t get to him, and he smiled instead of wallowing in the pain. He had a paradigm shift and accepted his suffering, rose above it and shifted the power dynamic. This is exactly what is most effective with OCD, it will tell you that your a horrible person, you are disgusting, cruel or that everything should be feared but what if instead of listening and falling for its demands you smiled right at it and took away its power? Life is full of self hate, and external pressures and unfortunately bullies exist and all we can control is our reaction to them.
So, next time OCD tells us we are weak or that doubt creeps up again remind yourself you’ve been through this before and take away the power by building mental strength that it can no longer penetrate.
I highly recommend watching David Goggins and hope you feel inspired by his words!
I have been given the pleasure to post my friends personal story around how OCD has impacted his life.
My OCD struggles started at a very young age. I knew something wasn’t right, but I couldn’t put a finger on it. I remember chewing gum a certain way, and I had to chew it ten times on each side of my mouth at any given time. I also remember checking, and making sure doors, and windows were locked. I also checked over and over if the appliances were turned off completely. It literally became a chore, and it gave me extra anxiety and stress I didn’t need. What struck me the most was that during school, I never really had OCD pop up. I used to place my bag on the ground without the fear of contamination. I remember being able to use a public restroom without hesitation, or anxiety. Now, it’s literally an every day struggle. People don’t seem to realize the mental strain this illness has. It can be so overwhelming at times; you just wish you didn’t wake up the next day. It can get that bad!
Through my life experiences so far, a lot of my OCD stem’s from lack of serotonin (clinically speaking), but I noticed my OCD got worse from trauma I experienced in my life. Due to the constant stress my brain went through, it just made the mental illness worse. It came to a point where I couldn’t take it anymore and I tried to end my life. Stupid move, I know, but thankfully I survived my suicide attempt, and I am very thankful for it. The best way’s I find to deal with OCD is to tell yourself “Nothing bad is going to happen, if I don’t do the compulsion.” You just have to keep repeating this over and over in your head until it finally registers and you don’t do the ritual. Distraction is another great coping mechanism. When the compulsion pops up in your brain, just do push-ups, or put a cold towel on your face. Doing so will distract your brain, and in return the OCD will subside. Another way to cope is to join group therapy, which I did, and as a result made wonderful friends. Now we all struggle together! Also, it’s quite ok to make fun of yourself, and the illness. I find that laughter is the best way to cope, and it just takes the stress away! As they say, laughter is the best medicine.
Just remember, you aren’t alone. There are millions suffering with this illness, and don’t ever give up. Keep going, keep laughing, and in the end you’ll realize the illness makes you unique. And, it’s better to be different instead of generic. Keep fighting!
Three weeks after Chelsea Elker gave birth to her second baby, she was overwhelmed by a thought that also felt something like an urge: What if she smothered him?
Elker, who was peacefully nursing at the time, had never experienced anything like that when her eldest was born, and was horrified.
From that night on, however, the disturbing thoughts kept coming.
As she buckled her newborn into his car seat, Elker worried: “What if I touch him inappropriately?” As she washed dishes she’d think: “What if I stabbed him?” Elker reassured herself that of course she would never hurt her baby, only to immediately question why, then, she’d even entertain such ideas in the first place.
“It’s hard to explain,” Elker, now 29 and a mother of three, told HuffPost. “I felt like, ‘If I’m thinking it, it obviously means I want to do these things.’”
In the last decade, awareness about postpartum depression has exploded as research has revealed it affects anywhere between 10 and 20 percent of moms. Likewise, knowledge about postpartum anxiety — which could affect up to 17 percent of new moms, according to some estimates — has also begun to spread among women and health care providers. Mothers struggling with anxiety and depression now at least have some kind of name and explanation for the things they are feeling.
For the smaller subset of mothers who have postpartum obsessive compulsive disorder, that kind of broad — or even broadening — recognition of their circumstances simply does not exist. “OCD” has become a watered-down term, an acronym thrown around in conversations about that friend who’s just a bit too fastidious or who is especially germaphobic.
But for mothers tormented by the condition, it signifies something much darker — a cycle of fears and behaviors that grabs hold of them and threatens to upend their sense of who they are in one of the most grueling, vulnerable moments of their lives. And many find it impossible to open up, gripped by fears that someone will take their baby away.
“It became 100 percent of my day and 100 percent of my nights,” Elker said. “I could be having a conversation with you and inside I’m thinking 1,000 different, terrible things.”
Inescapable ‘Intrusive Thoughts’
In many ways, OCD — perinatal or otherwise — is simple to identify. Its signature symptoms are intrusive thoughts and fears (i.e. “obsessions”) and often rituals (“compulsions”) aimed at making those thoughts disappear.
Under the DSM-5 — the most recent version of the “bible” of psychiatry — OCD was given its own chapter and moved out from under the broader umbrella of anxiety disorders. There is no diagnostic distinction between OCD that begins during the postpartum period and at other times in a person’s life, though women who have experienced anxiety and OCD in the past are at higher risk of dealing with it again postpartum.
In new moms with OCD, however, the intrusive thoughts that are a hallmark of the disorder tend to center around one thing: their babies. Suddenly, a woman who longed for motherhood may be utterly convinced that something or someone — perhaps even herself — is going to hurt her child in ways she’d never considered before, either deliberately or through carelessness.
“I had a patient who presented at five or six weeks postpartum with her fourth baby, and she had a precipitous onset belief that she couldn’t be near knives,” Dr. Catherine Birndorf, co-founder of The Motherhood Center of New York, a clinic that specializes in perinatal mood disorders, told HuffPost. “She couldn’t be in the kitchen. She had visions of taking a knife and cutting her infant’s throat — and she was absolutely freaked out by these intrusive, violent images. That’s super common in perinatal OCD.”
Moms who experience those thoughts are almost immediately overcome by shame and horror, which is the primary way experts distinguish between OCD and postpartum psychosis, a rare, severe psychiatric emergency in which new moms can absolutely pose a threat to themselves and their babies.
“OCD is what we call ‘egodystonic’ in so much as it is upsetting and exhausting to have the thoughts and do the actions you do to try and make yourself feel better,” Birndorf explained. In postpartum psychosis, delusions and hallucinations take over.
Loretta Notareschi, 40, gave birth to her daughter in 2013 and had her first intrusive thoughts — about throwing her down the spiral staircase in her home— while she and her baby were recovering in the hospital. It wasn’t a hallucination or a desire, but it gripped her imagination nonetheless. She told a nurse who reassured her that she was probably just exhausted, but before she was discharged she had to meet with a social worker.
“I was triggered by all kinds of things, especially the spiral staircase or knives,” Notareschi told HuffPost. “Bathtubs. Being in the car. I would think, ‘What if I hurt her with that?’ Or, ‘What if I hurt myself with that?’”
Over time, she began to develop what she thought of as coping mechanisms, though later she learned they were simply the hallmark compulsions of her illness.
“To the OCD mind, they seem like brilliant ways to deal with your anxiety,” Notareschi said, laughing ruefully. “I decided in the first couple of days after my daughter was born that every time I had a scary thought I would have to repeat to myself a certain phrase, which was ‘Baby face, hairbrush, duckie.’ In my mind, it was going to neutralize the thought or magically make it OK.”
An Adaptive Behavior … Gone Wrong?
Interestingly, research suggests that some elements of postpartum OCD may be adaptive. A 2013 study of roughly 400 women found that 11 percent of new moms were experiencing some obsessive-compulsive symptoms two weeks after giving birth. Six months later, nearly half of those women still had symptoms, while another 5 percent of moms had developed symptoms at that point.
That study asked if women were having any symptoms of OCD, not if they met the criteria for an actual diagnosis. But it raises the possibility that the prevalence of the disorder is much higher than the 2 percent that is often cited — and raises tricky questions about what’s normal (and what is not) in the minds of new mothers faced with the daunting task of keeping a helpless newborn alive.
“One of the most common obsessions is fear about germs, and some of the most common compulsions are checking behaviors and washing behaviors,” Dr. Dana Gossett, a professor of obstetrics and gynecology at the University of San Francisco California and the author of that 2013 study, told HuffPost.
“It’s not crazy to think that if a woman has a newborn, she might want the house to be clean and for people’s hands to be clean,” she continued. “It’s not unreasonable that she would want to check on her baby frequently to make sure he or she is OK. What happens in OCD is that is carried to a point where it is no longer logical or productive.”
And when those thoughts become intrusive and frightening, mothers become understandably fearful to come forward to share what they’re going through — and to be counted.
“We know depression is common. It’s well studied and there’s a lot less stigma now than there was 15 years ago around articulating feelings of sadness,” Gossett said. “Whereas if a mom says, ‘I’m terrified I’m going to burn down the house’ or ‘I’m terrified I’m going to shake my baby to death,’ there’s so much more shame and fear.”
And it is not unreasonable for women to worry that their babies could be taken from them, she added.
“One of the challenges about OCD is that it is less broadly known, so even OBs and pediatricians who are good about screening for depression are going to be less familiar and less comfortable with these diagnoses — and how to make that distinction between psychosis — so women get the help they need,” Gossett said. Postpartum Support International, an advocacy and education group, says that postpartum OCD is the most misunderstood and most commonly misdiagnosed of the perinatal mood disorders.
That is what makes postpartum OCD so heartbreaking. Like so many other mental health issues that crop up during the tumultuous postpartum period, experts say it is highly treatable with some combination of therapy, support, medication and time. But in a culture that demands moms cherish every exhausting moment of raising young children, admitting to frightening obsessions can feel impossible.
“I didn’t want to tell anyone, because all the media tells you with stories about women who hurt their babies is that if you think a thought, you want to act on it,” said Elker, who took more than a year to recover from postpartum OCD through a combination of intensive therapy and medication and has written extensively about her experience.
“But I didn’t want to hurt them,” she said. “I was so fiercely trying to protect them that I drove myself insane.”
It is hard to put in words the distress that OCD causes; it is this weight that follows you around everywhere you go. You can’t escape it, and you can’t run away from it. Throughout the day and night these echoes of thoughts, images and sensations are there with you, the story line so vivid and crippling we fall surrender to its demands. All moments are slightly stolen because your there but your OCD is also there with you.
There has been so much I have lost to OCD, so much I fear because of OCD. I try to beat it and overcome it, but there are days where you are overwhelmed. It is important to remember that OCD does not define you, and even though our minds have turned on us we can live with this monster.
The struggle is real and ongoing; it is hard to explain how your mind can become your biggest hurdle in life. The dark lens of OCD alters reality, and forces us to want to maintain control.
It is so scary to take risks, and to feel brave enough to trust yourself and that this is just OCD. For me my OCD has manifested in a few different forms, but the best way to describe it is imagine watching a horror film over and over again in your mind, but this isn’t any normal horror film all the characters in this story are the people you love and care dearest for. You can’t do anything to stop it, and are forced to be subjected to this torture. The people you would do anything for you would sacrifice anything for you have to live with being bombarded by never ending thoughts and ideas that you can’t protect them and if you don’t engage in certain behaviour they won’t be safe. Even when you are told this is a disorder this is what the disorder does a part of you still is afraid that what if it isn’t? What if they are wrong and there is real danger? You have to ask yourself has what I have been doing worked so far? Am I happy? Maybe I should take the chance that nothing bad will happen and this is just OCD, and every doubt I have is also OCD? It is so hard to take that leap of faith but it is worth a shot to try, I still every morning have that struggle between doubt vs taking a risk. The days when I chose risk always turn out more fulfilling but it is hard to remember that when doubt feels so strong.
I have decided that life will be filled with challenges, uncertainties and pain. But along the twists and turns there will be these beautiful moments, connections and experiences that make it all worth it. We can either let OCD rob us of those moments or accept that it is going to be painful and filled with uncertainty but it is better then letting OCD win.
“In order to write about life first you must live it” – Ernest Hemingway
Dr. Steven Phillipson is a leading expert on OCD his work with patients has provided an immense amount of progression for OCD treatment. His website https://www.ocdonline.com is full of a wealth of knowledge for suffers. I have provided below an excerpt from his article “Choice”, I encourage you to visit his website and read through the articles posted.
In both the treatment of OCD and in living a disciplined life, there is no word more important than “Choice”
by Steven J. Phillipson, Ph.D. Center for Cognitive-Behavioral Psychotherapy
It is unfortunate that our schools do not teach us that our brains are comprised of many systems, some of which operate with considerable independence from the others. The independence of these systems is reflected in the way individuals suffering from OCD respond to episodes of extreme anxiety. Like all human beings, those with OCD have a strong basic survival instinct and are likely to experience great distress at the prospect of leaving a perceived threat unresolved. However, when what they experience as a threat is actually a function of their OCD (and therefore, is essentially the product of misfiring brain circuitry), they still react to this perceived threat as if their very lives were in danger. A conflict of independent systems also can affect those who do not have OCD. For example, a person may have the goal of exercising, but when the opportunity to do so presents itself, she may find herself thinking, “I’ll begin tomorrow.” Similarly, when tempted, someone whose goal is to save money may find himself thinking, “Yes, but this sale is so tremendous! Look at all the money I’d be saving!” The point is that we can only make disciplined and values-based choices that challenge instinctive or self-defeating urges when we are mindful of the contradictory agendas presented to us by our brains.
To date, the focus of my writing has been on educating sufferers and professionals alike about the various forms of OCD and the methods of behavioral treatment I have found to be effective. In contrast, this article attempts to identify the essential qualities within the patient that contribute to the success or failure of treatment. In my discussion of this subject, I will give considerable attention to such concepts as agency, mindfulness, and autonomy. Agency can be defined as the faith we have in our capacity to respond effectively to challenges in our lives. Mindfulness is the non-judgmental awareness of an experience in real time – that is, as that experience is unfolding – and an acknowledgement of our responsibility for the choices we make and/or the beliefs or perspectives we endorse in relation to that experience. The willingness of patients to be accountable for the choices they make has a profound effect both on the recovery process and the achievement of their goals in life. And finally the term autonomy refers to the choices and actions of the “Gatekeeper,” the “I” or “me” who, based upon his or her goals and values, makes the final decisions on matters of importance to the individual.
The conscious, independent behavior (physical or mental) of selecting, making and or acting upon a decision when faced with two or more possibilities: the choice between good and evil, skilled and unskilled as well as, fight or flight.
• A range of possibilities from which one or more may be selected.
• A course of action (mental or physical), object, or person that is selected or decided upon and summarily put into effect.
This writing is a call to arms! Its purpose is to inspire readers to come to terms more honestly with the choices that will be required if they are to achieve their goals in life.
nOCD is a great app to use during treatment with or without a therapist. I have been using it for over 6 months now and have really felt the impact the app has. It allows you to input your triggers, track your progress, do exposures and even share it with your therapist. I would really recommend this app to anyone who is suffering with OCD, it also gives you the encouragement to get through those tough exposures and delay the compulsion. What I also like most about the app is that you can look back and truly see your progress and if things have become less triggering for you.