Sunday, November 5, 2017

The Questioner Tendency and OCD



I just finished reading The Four Tendencies by Gretchen Rubin, and her telltale sign of being a "Questioner" is that you dispute the validity of taking the quiz to find out what your tendency is. . .Yes, that would be me. In fact, it was an exposure for me to take the quiz, and tolerate the anxiety that the framework might not be valid. To be able to still learn from Rubin's observations is part of the flexibility that has come through doing Exposure and Response Prevention Therapy.  Rubin's quest has been to find the motivations for habit change, whether you meet inner and outer expectations.

Questioners question all expectations; they’ll meet an expectation if they think it makes sense--essentially, they make all expectations into inner expectations.

The desire to research can cause decision paralysis in Questioners, and I believe that OCD can take this to an extreme in the theme of indecision and perfectionism. As I've written on this blog, indecision was a struggle because of the fear of making the wrong decision and being haunted by anxiety. My research consumed much of my time. My librarian training only added to this desire for more and more information.

Rubin notes some ways to help overcome analysis-paralysis.


  • Setting an action deadline
  • Following the advice of someone you respect
  • Limiting information sources
These ideas echo what Leonard, my ERP therapist advised. Because he was willing to answer my questions initially about OCD treatment, and point to the research on the success of ERP, I learned to respect him, and be willing to follow his advice. He knew I was a Questioner, and in addition to providing that initial information, explained that a pattern of continual questioning becomes reassurance and makes the anxiety worse by reinforcing it.

Flipping a coin was one strategy for setting a deadline, which I practiced at the grocery store.

Leonard would ask me to imagine what someone without OCD would do in a particular situation, and take my best guess as to the action to take. Yes, it is scary, but OCD promises perfect knowledge and perfect results and never delivers. 

Others with OCD might not be Questioners, but Upholders, Obligers or Rebels, and need different strategies to motivate themselves.

For an Obliger who meets others expectations but struggles meeting their own inner expectations, treatment for OCD could be more effective with accountability: exposure homework from a therapist, or attending a support group and having an accountability partner to call when a task is done. 

For a Rebel, who has struggles meeting both outer and inner expectations, accountability can aggravate the "you can't make me" response. Appealing to values and identity can help free up the oppositional pattern, as can framing exposures as a choice, not a demand. Jeff Bell has written about how focusing on what you value can give the impetus needed to face uncertainty and move ahead in spite of anxiety.

For an Upholder, who readily meets both outer and inner expectations, reading a book like Jonathan Grayson's Freedom from OCD and following his suggestions for Exposure and Response Prevention Therapy could make more sense to them than support groups or even therapy. 



Four Tendencies Quiz

RELATED POSTS

I is for Indecision

N is for Need to Know

An Imaginal Exposure Script for Indecision OCD

Indecision at the Library

Just One More Search: Information Overload and OCD



Sunday, March 26, 2017

Compulsive Googling

In November, 2016, Amelia Tate interviewed me for an article on compulsively searching the web. It was moving to read the article, and feel like I had been heard and understood.

Here is a link to the article in theThe New Statesman, November 7th, 2016.
"It is like stepping into the storm: How OCD can affect your online life" by Amelia Tait

Tuesday, September 20, 2016

Fear of Noticing Floaters in the Eye: Update



One of the posts that gets a lot of response, even though it is from 2010, is Floaters in the Eye and OCD Vision. The post resonates with people who fear that the floaters will impede all enjoyment of vision. Part of my fear at first, in 1988, was that something was seriously wrong, but then after seeing an ophthalmologist, it became a fear of always noticing the floaters and having my life ruined by that, and yet now I don't notice them most of the time. 

I went to a museum this summer with a very bright white room, and it made me really notice my floaters. It was not pleasant, and I wanted to leave, but it didn't dog me after that. In the past, I would have kept trying to see if the the floaters were still there, ever increasing my brain's vigilance and anxiety. Because of all the ERP therapy in the past, I was able to let it go once I left the white room. Do I want to go back to that museum room? No, not really. Do I find it annoying that they advertised how fabulous the art looked in that room ~ yes!! But it didn't ruin my experience of the day, and that is real progress for me.

If you have been evaluated by an ophthalmologist, then I would next look to find an Exposure and Response Prevention therapist or check out the International OCD Foundation or read Jonathan Grayson's Freedom from OCD, to work on the obsessing about the floaters never going away.  You can work with an ERP therapist to find the most feared consequence of seeing the floaters in your eyes, and work on an exposure that deals with that, perhaps a script you listen to, or moving on with daily activities instead of stopping to focus on the floaters, and learning to habituate to the anxiety so it dissipates. 

I actually stopped noticing the floaters most of the time even before I went for treatment for other aspects of my health anxiety OCD.  If you contemplate your experience, you may remember symptoms that receded, even though at the time it seemed like they never would.  Sometimes it was a rotating worry from one thing to the next ~ ERP helps you get off the Merry-Go-Round.  Does hearing about other people's health issues still make me anxious? Yes.  I had a talk with someone last week which turned into her describing her retinal detachment, and I could feel an upsurge of anxiety, but again, I could let it go because I will never have 100% reassurance that nothing bad will happen, and yet I can still live my life.  

Wednesday, September 14, 2016

Participate in an Online Survey about Childhood Experiences and OCD

Graduate Student Jenna Feldman is working on another research project at Yeshiva University.  She asked me to post the link to her survey about childhood experiences and OCD, and invite you to participate.


Online Survey about Childhood Experiences and OCD

If you are an adult (age >18) and suffer from the symptoms of OCD you are invited to complete an online survey about your symptoms as well as certain childhood experiences that some people have. This study is being conducted by the Ferkauf Graduate School of Psychology at Yeshiva University. If you consent to participate in this study you will complete a series of anonymous questionnaires that ask you questions about your childhood experiences and emotions. The survey should take approximately 45 minutes to complete. If you elect to participate you will have the option to be entered into a raffle for one of four $50 gift cards. To learn more about the study please follow the link below:

Saturday, September 10, 2016

Anxiety in Creative Business: Tara Swiger and Encouragement that You Can Move Forward

This podcast on Depression and Anxiety in Creative Business from Tara Swiger caught my attention, and I wanted to write about it. Tara also sent this introduction to a follow up webinar:
Studies show that 1 in 5 adults deal with mental health issues at least once in their life.
And yet, there's so much shame and stigma about talking about this.And still, in the last few months dozens of students and friends have told me about their depression, anxiety, or struggles with their kids health.
I understand not everyone is called to talk about their experience publicly...but when we ALL stay quiet, the stigma grows strength. So today on the podcast, I'm getting honest.
You’re not alone in this.
You are NOT alone in struggling with this. And as I share, I want you to remember – whatever you’re struggling with, not only are you not alone, but you can also move forward WITH IT. Exactly as you are. People are doing it. You don’t have to be different, better, or “more together” to make a business thrive.
I have a creative business, and when I have anxiety, sometimes I come to a halt in the belief that I can't move forward WITH IT.  But the truth is I started creating art in the depths of my anxiety, and went on to start my Etsy shop in 2007 just a few months after I began Exposure and Response Prevention Therapy for my OCD.  The Exposure for me was to create the shop without knowing if it was "perfect" or the right photos, or the right descriptions, or whether anyone would ever want to buy anything. 

Tara describes how reading about intolerance of uncertainty resonated with her when thinking about her own anxiety, and this is a key theme of mine as well.  All those What If questions, the desire to know how things will turn out before they happen.

Struggling with manually creating Wordpress website for my business was the next step to realize I was compulsively researching how to do it, when in fact, I needed something simpler, and the anxiety of letting go of the idea that I needed to know how to do things before I knew how to do them.  

A turning point was at a craft show, when a woman spent a long time checking each of my items for the most "perfect" one.  The piece that the craft show customer liked the best wasn't the most flawless in her eyes, so she told me she was choosing another one that had no visible defect.  Talking with my ERP therapist, I recognized myself in this woman.  Shopping for anything would drag on because I couldn't decide if a "flaw" would mesmerize me forever or eventually fade, and I would get angry at myself for latching onto such tiny things.  

It was huge to know I was making imperfect art, but that I wanted to do it anyway.  That I did not want to walk away from something I truly loved, because it was flawed.  I now work full time in my creative business, and yes, when anxiety flares up it is difficult, but part of the difficulty is in believing that I must entirely banish the anxiety to accomplish anything, and that it is a sign that I am a "bad person" if I feel anxious. The underlying premise of Exposure Therapy is that you can move forward through the anxiety, that it is possible, and for this encouragement, I am grateful. 

 

Saturday, January 23, 2016

Online Survey on Beliefs about OCD Treatment is Still Looking for Participants

Online Survey of Beliefs about OCD Treatment
Please help Jenna Feldman with a research survey about OCD treatment and enter a raffle for a $50 giftcard!

She is a graduate student working toward her doctorate in Clinical Psychology at Yeshiva University, and collaborating on a research project about OCD.  If you are an adult age >18) please participate in the online survey about your beliefs about treatments that exist for OCD.  The survey should take around 40 minutes to complete.  The study was reviewed and approved by the Institutional Review Board at the Albert Einstein College of Medicine.

If you elect to participate you will be entered into a raffle for a $50 giftcard!  We are now about a quarter-way done with our data collection, and have already awarded one $50 giftcard to a participant.  However, we still have three remaining giftcards to give out, so please consider filling out our survey. We really appreciate your help!

To learn more about the study please follow the link below:

https://yeshiva.co1.qualtrics.com/jfe/form/SV_6GxEWgbMJcx1ZaJ
Thank you for participating!

Wednesday, October 28, 2015

Participate in an Online Survey of Beliefs about OCD Treatment

Online Survey of Beliefs about OCD Treatment

Jenna Feldman, graduate student working toward her doctorate in Clinical Psychology at Yeshiva University, is collaborating on a research project about OCD. She is looking for (adults over age 18) who would be interested in participating in an online survey about your beliefs about treatments that exist for OCD.  The survey should take around 40 minutes to complete.  If you elect to participate you will be entered into a raffle for one of four $50 gift cards.  To learn more about the study please follow the link below:

https://yeshiva.co1.qualtrics.com/jfe/form/SV_6GxEWgbMJcx1ZaJ