Friday, May 28, 2010

Imperfection Is your Ally

I'm intrigued by this bit of graffiti. My default setting is "imperfection is my enemy." Part of why I am struggling with this triggering health anxiety is my compulsion to deal with it "perfectly." I want to be able to sort out what is OCD and what is not. I don't want to make any errors in the process, and in fact am terrified of making any errors. No wonder I felt so drained on Wednesday.

Today, I went down the path of "I'll just look up doctors who might specialize in interpreting my diagnosis." The next red flag was, "I'll stop at noon." Followed by, "I'll stop soon." I stopped searching at 1:30. Right now I'll take this as a victory, since in the past I would search for an entire day. My OCD perfectionism is jumping up and down and yelling about "You screwed up by doing research, therefore do more research to numb yourself to this abject failure," but I still stopped.

I have some anxiety surging through, knocking me around, but I want to learn how to tolerate this, because the difficulty of health anxiety is that something can go wrong with our bodies, and sooner or later I will have to deal with some sort of illness or pain. I'd like to be able to think clearly about what to do. I am sobered by the effect my OCD crisis had on me in 2006, and how the health problems that were intertwined with my anxiety scare me by sheer association with that suffering.

I remember the first time my therapist suggested I have compassion for myself and all I went through. I was baffled. I can sense such "all or nothing thinking" ingrained in me--either research all the time until I'm completely certain, or flee from all information and all problem solving. And no matter what I choose, I will be wrong according to the OCD and my old beliefs of my worthlessness.

Wednesday, May 26, 2010

What is different now?

I saw a headline about one of my health obsessions yesterday, and I felt forboding and fear, remembering the erosion of my functioning and my life in the summer of 2006, when my OCD went unchecked, went by leaps and bounds. What is different now? When I'm vulnerable it's hard to remember the changes. I don't want to ever go back to the pain I felt then. I'm afraid of even the memory of that year, afraid it will suck me back in, that I am the hopeless defective person the OCD told me I was.

We are vulnerable creatures. We can be hurt, and die. This makes my heart heavy, and the OCD is more than willing to rush in and tell me if I just try hard enough, I can make myself completely safe. The perfectionism is bearing down and taunting me, and demanding I resolve my confusion about this health issue, even if there isn't any definitive evidence or answer. There's a lot of discussion in the medical world about "evidence based medicine" but sometimes the evidence is lacking or not clear cut. I hate this. My urge is to start researching, but I would be taking my sanity into danger by doing that. Researching is part of what gave the storm of anxiety such power in 2006.

And the deeply stubborn beliefs bubble up. "If you hadn't started Exposure Therapy , you would've researched this definitively and known what to do, but no, you stopped researching. What kind of fool are you? Obviously worthless, negligent, defective." All the old stuff. I need the possibility of grace, the hope that I am loved, that even if I am a fool, I am forgiven. The uncertainty about how to proceed with my medical issues is painful enough without this sense of being on trial, obsessive interrogation of my every move.

Tuesday, May 25, 2010

Do I have to go? Bladder fears and OCD.

bathroom light 35mm

I've observed that my ocd obsessions can recombine with each other, and persist over many years. At age 8 or 9, I became hypersensitive to any sensation of pressure in my bladder. I'd get up multiple times to make sure there was not a drop left in me, because I had the obsessive thought that I wouldn't be able to fall asleep if I didn't. When I went away to college, I had a room mate who was swigging cranberry juice in hopes of warding off a bladder infection. I'd never heard of bladder infections, and my ocd was immediately hooked. My fear of a full bladder melded with fear of getting a bladder infection.

On my 21st birthday, I had a sudden heavy ache in my pelvis. Stress makes my ocd worse, as does having a lot of free time, and this was a very lonely and stressful summer. I went to an urgent care center and the doctor treated me empirically for a bladder infection, ie. he figured that's what it was, and didn't do a urine test.

Right before my 27th birthday, my symptoms returned and I agonized about seeing a doctor, afraid I was weak, and wrong in my self-diagnosis. The nurse did a rapid test and said I had an infection. I felt a bit of relief, but then I got a headache, and feared it was from the antibiotic. I descended into health anxiety hell, into constant monitoring of how I felt, into fear of every sensation, every unknown, a dogged headache, and feeling dazed and overwhelmed when in the sun. I called the drug company hotline and they told me it wasn't the medication. I finally went back to the doctor, who diagnosed flu and gave me darvocet to help with the headache, but which only exacerbated my obsession about medication side effects. My infection symptoms went away, but my obsession with a bladder infection remained, and my fear of it spreading to my kidneys, of being condemned as negligent for not coming into the doctor sooner, and fear that I could bring on an infection by thinking about it.

On my 34th birthday, on vacation, I started worrying I had an infection. I went to the bathroom at a restaurant, and I felt a sensation of warmth, and panicked. I drank cranberry and water, with constant monitoring of my how my bladder felt which of course felt full. Later, I could look back and note that in a chilly air conditioned restaurant, chances are that the fluid in my bladder is going to feel warm. In the night, after getting up to drink water every 1/2 hr, I sat down with my journal and wrote about whether I really believed that I could cause an infection by thinking about it. I took a leap of faith and stopped drinking the water that night, and went back to bed. I was scared as I laid down, scared of the dizzy feeling of being on a precipice of anxiety, but I knew unless I took the risk of resting, rather than compulsively drinking fluid, I would be a captive.

OCD compulsions have an uncanny way of creating the very condition that you fear. Constantly checking my bladder made me hyperaware of every bit of pressure. Drinking constant fluids, in hopes of diluting any bacteria, created constant urgency to urinate. Trying to get rid of thoughts of getting a bladder infection made me focus on it even more.

OCD Squawking

Sunday, May 23, 2010

A Script for Fighting Health Anxiety OCD

I was reading one of my notebooks of scripts for doing imaginal exposure therapy, ie. listening to tapes of thoughts that cause me anxiety, until the anxiety starts to dissipate, and also including statements supportive to myself and who I want to be, what kind of woman I want to be. I thought I'd share one that I listened to for about a year, while walking at the gym, about 1/2 hour at a time, a few times a week. It really helped me clarify how corrosive the health anxiety compulsions were, and how much of my life was being consumed by them.

Health Anxiety Script 5-7-07

I'm not going to listen to your false promises anymore OCD. You tell me I can be absolutely certain what is going on with my body. No risk is acceptable to you, but to be alive is to be at risk. You always promise me that you will make my fears go away, if I listen to you. But whenever I listen I find myself deeper in hell, with you telling me you just want a little bit more. I am not a doctor. I can't definitively diagnose myself. Overcoming health anxiety is a scary process. I feel as though I am risking my life, but this is a chance I have to take to get better from OCD and get my life back. I've lost so much time already in fixating on my body. OCD, you truly torment me, suck up energy. I can't go on like this. I may get cancer and die a painful death, but OCD can't save me from this, only take away whatever enjoyment I have in my life. My rituals are useless anyway. I can't be vigilant about every body symptom. I don't know what is going in inside my body. Medical guidelines are imperfect but that is all humans have to go by. Maybe I'll get cancer, and my doctor will accuse me of being irresponsible, but I will have to learn to live with my regret at my negligence, so I can enjoy whatever time I have left. The alternative is to lose even more time than I already have to OCD.
Related Post:
OCD Toolbox: Listening to Scripts/Imaginal Exposure for OCD
Freedom from Obsessive Compulsive Disorder by Jonathan Grayson

Thursday, May 20, 2010

Wanting to Get Off my Medication: Part 7

I took my low dose of an SSRI antidepressant for 2 years. Doing the hard slogging of therapy with Molly, I began to discover that it was ok to do things because I wanted to do them, rather than what my parents wanted. I was driving again, going places by myself rather than always with my husband. I started making art. I emerged from years of depression and shyness, and started to believe that my life mattered.

Because I was doing so well, and starting medication had been such a battle for me, I started thinking more and more about wanting to stop taking it. I'd read studies that if OCD is treated with medication alone, there is a higher chance of relapse after stopping it, as opposed to using Exposure and Response Prevention Therapy in combination or alone. I assumed I'd had so much therapy and changed so dramatically, that I would not relapse.

What I did not realize was that my therapy with Molly, as important as it was, left much of my OCD thinking and rituals intact. OCD is sneaky and evades much of regular talk-therapy, as if shielded in a cloak of invisibility. Some of what I did with Molly was the equivalent of Exposures--she often encouraged me to experience things rather than just research them, and I faced many things I feared out of a desire to fully live my life, but other aspects of my OCD thinking were not even conscious to myself.

I began to obsess about long term effects of taking SSRI's, and soon I was exhausting myself with searches on the internet. I didn't see the danger signal that I was reverting to the searching I did trying to decide whether to take the meds at all. The uncertainty about what the long term effects might be in my life was too hard for me to cope with, and I switched to compulsively searching about how to taper my dose to avoid discontinuation symptoms. I was fatigued from all the energy I was pouring into searching, but imagined that once I stopped the medication, the obsessing would stop. Oddly enough, although I know I talked to her, I don't remember anything about what Molly said about my going off medication.

I couldn't talk to psychiatrist about this because she was gone. One day a few months before, I'd gone to an appointment and there was a For Sale sign in the front yard. She apologized for not telling me sooner she was moving. This was disconcerting. I talked to my family doctor about stopping and she agreed that if my overall anxiety was improved, I could stop the meds once the long nights of winter were over. I reduced my dose slowly over a few months, and I had no withdrawal symptoms. I was ecstatic to be off the antidepressant. It's hard for me to think about how the next few months unraveled into a health anxiety crisis, but I will write about that next time.

Related Posts
Part 1: OCD and Medication Decisions
Part 2: Starting Medication while Struggling
Part 3: The Limits of Research in Medication Decisions
Part 4: My First Prescription for SSRI's
Part 5: Feeling it in the Jaw: Side Effects of Medication
Part 6: Being on Medication & OCD Weeping
Part 7.5: Built on Sinking Sand: OCD and Health Anxiety

Tuesday, May 18, 2010

Floaters in the Eye and OCD Vision

The eye floater grew some legs and ran off
In my post about OCD Hypervision, I was speaking metaphorically, but I've also had health anxiety about my eyes and my actual vision. In college, I suddenly noticed a couple gray squiggles floating across my field of vision. I went to the library in a panic, and starting pulling the medical reference books off the shelves(this was circa 1988, pre-internet) to look at the Eye chapter. I found all sorts of scary stuff in addition to the diagnosis that made most sense, floaters. To quote the Mayo Clinic,
Most eye floaters are caused by age-related changes that occur as the jelly-like substance (vitreous humor) inside your eyes becomes more liquid. When this happens, microscopic fibers within the vitreous humor tend to clump together and can cast tiny shadows on your retina, which you may see as eye floaters.
Sudden appearance of a flock of these can be a sign of retinal detachment, and my OCD latched onto this. It was already a hotspot, because a friend of mine actually had a detachment. I made an appointment with an ophthalmologist, after much angst because of my fear of making phone calls, and my perfectionistic self-loathing that somehow I should be able to diagnose myself perfectly before actually seeing a doctor.

The doctor was nice, and patiently explained that my retinas looked fine, and I had floaters, and that they weren't dangerous and if I rapidly flicked my eyelid, sometimes I might be able to shift the floater out of my field of vision if it was bugging me. I was convinced I would never see anything else but my floaters, that I was cursed, that my vision was ruined. I kept checking to see if I could still see the squiggles, and that of course made me more aware of them. I remember reading that eventually your brain adjusts and ignores the floaters, if you give it a chance. In spite of my OCD, I did finally get used to them.

Then in 1996, I had a job interview I was very anxious about, and suddenly a new squiggle floated by. At least I thought it was new, and I spent a lot of time compulsively trying to remember if I'd seen it before and wondering if I should see an ophthalmologist. Even worse was my critical self-analysis, trying to figure out if the stress was making me see the floater, and why the hell did I have to notice it right then, and what was wrong with me that I fixated on this, and if only I stopped fixating on it, it would go away. Was it there all the time? Was I hallucinating? Why was my memory so bad? An on and on.

Simmering with self-hatred, I went to my job interview, and once that stress lifted, I did indeed stop fixating on the spot as much, which made me hate myself even more. I felt defective in my hypersensitivity to stress and to body symptoms and sensations. I knew I had anxiety, but I didn't know it was OCD, and I had a lifetime of believing that it was all due to my personal flaws, my inadequacies. But even people without OCD find a first appearance of floaters freaky, and there's nothing inappropriate about having your eyes checked. The key is what happens after you get checked--if the diagnosis is a harmless floater, but it consumes your attention with ceasing, treatment for OCD could help.

My last entanglement with eye symptoms occurred in 2006, when I started seeing a dark spot float by when I woke up first thing in the morning. It didn't look like my other floaters, and I panicked. I went to the ophthalmologist who said I had fabulous retinas, and said that some visual phenomena cannot be explained. Just what someone with an OCD fear of uncertainty wants to hear! Fortunately, I started with an OCD specialist, doing Exposure and Response Prevention therapy a few months later.

Related Post:
OCD Hypervision
Telephone Phobia: Fear of Making Phone Calls

Being on Medication for OCD & Weeping : Part 6

weeping willow

It was April of 2002, and finally, I was on medication for my OCD. I was at the point I never imagined I could be at. My OCD had demanded that I know I wouldn't be a different person, unalterably changed, or plagued with side effects, and somehow I had persisted and taken the antidepressant anyway, and tolerated the achy jaw, and after a few weeks, my jaw felt better, and I was in a routine of taking a blue pill at breakfast. My perfectionism guaranteed that I took it every single day. And again, anticlimatic as it was, I still felt like myself, and didn't have any other physical symptoms.

I was in the thick of dealing with some very painful memories with Molly, my therapist, and the medication did settle the anxiety long enough for me to actually face the pain, grieve and come out the other side over the course of the next couple years. I suspect the antidepressant was indeed helping my depression lift, and allowing me some room to grow. OCD is often intertwined with whatever else is going on in our lives, an is often comorbid with despression. As much as I advocate for Exposure Therapy for OCD, that doesn't mean everything else will be solved by it, and these other issues can make the OCD worse or treatment harder to do.

For me, just about any strong emotion would trigger my obsessing. I was scared of feelings, and before I could let myself experience them, my OCD was all over it, analyzing and debating and getting me stuck in the middle of the pain, which is what I had been trying to avoid in the first place. The low dose of a SSRI allowed me to go deeper into the pain, which on the face of it hardly sounds like a reward for taking it! But I had become numbed with fleeing from anything sad, and then overwhelmed by a compulsive desire to "solve it all now" by ruminating on every sad thing, and the medication seemed to make it possible to let the pain ebb and flow, and let in the possibility of joy as well.

While in the midst of this waking up to feelings and to my own life, the obsessing about SSRI's took on a new form. I started obsessing about the long term effects of being on medication. My health anxiety was still operating in the background. It wasn't a roar, more like a dull hum. Molly wasn't treating my health anxiety. We had enough going on with just my depression and grief, and she didn't really understand the extent of my obsessive thinking. I'd been that way for so long, it seemed an intrinsic part of me, and unchangeable. I feel extremely grateful that Molly persevered with me and all the painful history I brought with me, my distrust of just about anyone's love, my fear of being worthless and abandoned. This gratitude coexists with anger that she wasn't competent to deal with OCD as well. The ability to let these two feelings be there at the same time was hard won.

Related Posts:
Part 1: OCD and Medication Decisions
Part 2: Starting Medication while Struggling
Part 3: The Limits of Research in Medication Decisions
Part 4: My First Prescription for SSRI's
Part 5: Feeling it in the Jaw: Side Effects of Medication
Part 7: Wanting to Get off my Medication
Part 7.5: Built on Sinking Sand: OCD and Health Anxiety
Talking to OCD: The Hazards of Talk Therapy

Monday, May 17, 2010

Am I still anxious? Does this still bother me? And other querulous questions.

Question marks on the wall

It's as if I am poking someone who is sleeping, and saying "Are you sleeping?" poke, poke, poke, and then they wake up. The mental ritual of checking on my anxiety level or sensations is one of the hardest to deal with. I'm sure that some of those reading this blog have had the experience of being consumed by anxiety about a particular obsession or topic and then getting up the next day and the anxiety is gone. I assumed that once anxiety set in, only sleep could fix it, and I would long for it to be the next day.

Even more frustrating is waking up calm, and then remembering my anxiety from the day before and having it all kick up again. My immediate response when remembering an old worry is "Damn, there it is again. Why can't I get it to go away?" It's like a staticky bit of plastic that you try to flick into the trash, and it just clings to your fingers. This is followed by having the urge to check if I am still anxious or if a certain symptom or thought still bothers me, and the more I check, the more entrenched it gets.

I would recogzine anxieties that would probably fade the next day, like fear that I'd chosen the wrong dish off a menu, and I'd be frustrated by my inability to step away from it sooner armed with this knowledge. Knowledge alone is not a match for the anxiety created by OCD. My theory is that sleeping would give me a break from poking at the anxiety, waking it up, and increasing its noisy dominating behavior. It wasn't a magical cure.

My therapist has encouraged me to let my anxiety producing thoughts into my mental space, letting the noise happen, in fact practicing introducing the noise into my mind, which is an exposure. I usually feel snarly when he suggests this, but I also recognize that the vigilant checking to make sure the intrusive thoughts aren't there repeatedly reminds me of them. And every "Damn there it is again," highlights the thought, magnifies it, makes me exquisitely sensitive to even the threat of a particularly despised thought.

I know this sounds crazy. If you are desperate to avoid a scary thought, and you forget it for a few hours, the last thing you want to hear is the idea of purposely seeking it out, and disrupting that bit of peace. But the peace is fleeting and leads to long term anxiety--I have never been able to force a thought out and make it stay out for good. I have learned that it is possible to enjoy life even with those thoughts making noise.

Update on Gravity Legs

My doctor called today to say that my bloodwork was good, so my gravity legs may indeed be due to gravity. . .she also said my hemoglobin and iron have rebounded! She wants me to switch to taking the iron every other day, which did give my anxiety a tweak, "But what if I need more than that?" but I am hanging in there with the idea that she's going to test me in 3 months and if my iron goes down, I can re-up my dose, and OCD may stomp around grumpily, but this is how a human life of trial and error works.

Related Post:
I need iron

Thursday, May 13, 2010

Gravity Legs

So here's what my ocd was up to on Tuesday:

OCD: What's that on your legs?
Me: Kind of looks like broken blood vessels.
OCD: There were some last week on one leg, but now they are on both. This must be serious. You need to know what they are.
Me: Maybe the marks have been there awhile and I didn't notice until I start wearing summer clothes. It doesn't hurt or itch.
OCD: It could be connected to your low iron count. It could be really bad. What if you don't go to the doctor and then it turns out that you missed a major sign of a serious illness? Look it up.
Me: When I look things up, I deteriorate quickly. I find something scary, and then keep searching and searching.
Me: I could go to see my doctor.
OCD: But in the meantime, look things up. You can't wait. You will implode with anxiety, and you'll start obsessing about this constantly.
Me: This uncertainty is very uncomfortable. I would like it to go away. Given a choice between websearching and going to the doctor, in spite of potential humiliation of it being nothing, I'd rather see the doctor. I'll call.
OCD: Oh, man. The receptionist offered you an appointment at 4:00--it must be serious.
Me: I won't know until I get there.
OCD: What if it is really nothing? The receptionist asked if it hurt and you said no. You led her astray by calling in the first place. You are just obsessing again, and deficient as a human being. This is just like your past--seeing the doctor for reassurance.
Me: Yes, it might be nothing. Part of me really suspects it's just the effects of age. You aren't very flexible OCD--you are demanding I know ahead of time what is wrong or not wrong with my skin. That's not humanly possible.
OCD: You suck. You'll never get this right.
Me: Yeah, you could be correct, but there is no universal law that if you guess wrong before seeing the doctor, you qualify as a failure.
At the doctor's office:
Dr: Let's see what's going on with your legs. (Leans in to look.)
Hmmm. I certainly didn't think, "Oh, my goodness. What happened to your legs??" (Gets down on floor to take a closer look.) I don't think it's clinically significant. Kind of looks like broken blood vessels. Maybe it's just gravity. I can do some blood work, but I would be very surprised if something bad was going on.
So here I am. I survived this visit. The biggest difference now is that I could joke about my "Gravity Legs Syndrome," with my husband. I had my blood taken today and now I wait for the results. Part of what got to me so quickly was the fear of obsessing. What if I start obsessing about this? What if the fear never dissipates? This combined with the old crap about being a failure and worthless makes for a powerful cocktail of anxiety. I felt fatigued by my OCD hypervision, but relieved that I didn't feel my value as a person was on the line when visiting the doctor, in spite watching her crawl around on the floor trying to see what I can see.

Monday, May 10, 2010

Being Mentally Ill: On Stigma and Soundbites

A recent presentation, by Dr. Mairwen Jones at The Royal Australian and New Zealand College of Psychiatrists' Congress, notes that global warming fears were found in 28% of a sample of obsessive compulsive disorder patients. Yeah?

I'm wondering what the original purpose of Dr. Jones' study was? Headlines could also read:

Fear of Terrorists after 9/11 Found in Patients with Obsessive Compulsive Disorder

Fear of Hurricanes Found in Patients with Obsessive Compulsive Disorder

Fear of Going to Hell Found in Patients with Obsessive Compulsive Disorder

OCD latches onto anything, but often related to something important to the sufferer. The content of OCD fears is nothing less than the fears of humanity. Media often focuses on bad news, scary things, attention grabbers, and yes, that will show up in the content of OCD fears, but the scary stuff comes from many other sources as well in the classroom(private and public schools), in the family, on the street, and from the pulpit.

There are Christians who suffer from scrupulosity, a religious-moral form of OCD, and fear they are going to hell, no matter what their faith tells them. I've struggled with that. Global warming fears in OCD could be scrupulosity--the fear of causing harm to our world, and being a bad person.

Dr. Jones' study provided a tantalizing soundbite taken advantage of by Washington Examiner online opinion editor, David Freddoso, with a comment that psychologists are concerned that media coverage of global warming may cause people to go nuts literally.

Wesley J. Smith's Second Hand Smoke goes with Global Warming Hysteria: Scaring the Mentally Ill, and ends with a snarky,
Panic mongering, as we have seen, has thankfully not convinced the world to destroy economies and keep developing nations mired in low emissions destitution. But it has disturbed children and worried the mentally ill. Nice going.

I'm still trying to wrap my head around this idea of being mentally ill, and as a member of that category, being subject to scaring. I have OCD, so that would make me mentally ill according to Smith, and I don't appreciate this community being used as an object lesson or illustration to make a point. It's patronizing and disrespectful of real human pain.

Many people with OCD hide it as much as possible(hence my anonymous blog), in part because the disorder seems to be mainly fodder for jokes. Many of the people I've met who have OCD are finding ways to function, in spite of the exhaustion that comes with trying to keep the fears at bay by performing actions meant to undo the fear.

I knew a young man who was concerned about the environment, and his OCD glommed onto this, demanding he know for certain that his recyclables were actually being recycled, so he kept a growing stack of bottles and papers in his house, paralyzed with fear that he'd be culpable for any misdirection. He knew that ultimately, this meant he wasn't recycling, he was hoarding, but the fear was too intense. Does this make him any crazier than the young woman, a faithful church member, who has an OCD fear that someone at her church will think she's a lesbian, and goes to great lengths to never be seen with female friends, and speaks with her hand over her mouth in case she says something blasphemous?

Many people with OCD never get treatment, in part because some therapists get fixated on the content of the fears, rather than on the mechanism by which OCD demands more and more ritualizing. Others never share their OCD fears with anyone because of shame or embarrassment or fear of ridicule.

Tuesday, May 4, 2010

Stuck in my Head

Kei - Principles of Anxiety

Yesterday I was driving with a couple bowling balls in my trunk, and every so often they would give a lurching jolt as they clanked together. It made me think of Jeff Bell's account of his "hit and run" anxiety--a constant fear that he had hit someone with his car and going back to check the road--and how the bowling balls could provide an Exposure to that fear, with their unannounced thumping, and practicing driving on without turning back to check the scene.

Until I read about this OCD theme, I didn't realize it existed. That is the challenge with OCD. It's a shapeshifter, and can take an infinite variety of forms. Sometimes in my support group it was difficult for people to relate to obsessions that weren't like their own. It's so much easier to come up with Exposures for anyone but ourselves!

But there are more commonalities than appear on the surface. When I have an unexplained body sensation or symptom, I immediately fear something is wrong. I want to know what caused it and why it's there, just as someone might hear an unexplained noise while driving, and be afraid they hit someone, and want to know what the noise was, and that it's not dangerous.

I think about potential contamination scenarios quite frequently since I work in a hospital, but the thoughts don't stick. My OCD doesn't latch onto this very often. It's not one of my major themes, and the temptation is to assume that my health fears are more realistic or more painful, or more likely to happen, and that's why I'm worried about them. Some people get a song stuck in their head and can't focus on anything else, and fear going crazy. The OCD amplifies something that happens all the time, and sticks tenaciously.

Monday, May 3, 2010

Does your therapist treat OCD? Have they heard of ERP? Do their patients get better?

yes and no
Most therapists say yes, they treat OCD. As I've observed on several anxiety forums though, and in my own experience, most therapists say, no, I don't practice Exposure and Response Prevention Therapy. I feel distressed by the lack of education about Obsessive Compulsive Disorder and how to treat it, and the unrelieved suffering of many of those in some sort of therapy. The International OCD Foundation offers the Behavior Therapy Training Institute for therapists to learn ERP skills, as well as CE credit at the IOCDF Conference, but it's still hard to find someone who does ERP.

A couple years ago I went to the annual IOCDF Conference and over and over again I witnessed people realizing they weren't alone, and seeing the evidence of others who had done ERP treatment and were getting better. I get frustrated at how slowly this knowledge seems to flow out into the wider world of therapy.

If you are interviewing a potential therapist, and they've never heard of ERP and you have limited access to providers of therapy, ask if they are willing to learn about it. My previous therapist would have been willing. Not every therapist is open to something they are unfamiliar with, or they might have a stereotype of what Behavior Therapy is about.

I do take heart from discovering that Time Magazine has selected Edna Foa, researcher of OCD and PTSD at University of Pennsylvania, for their list of the 100 most influential people in the world.

If you've read about Exposure and Response Prevention treatment for OCD, you've most likely come across Edna Foa. She co-wrote Stop Obsessing! with Reid Wilson in 2001.

She is the director of U/Penn's Center for the Treatment and Study of Anxiety.

Participate in Health Anxiety Research by Taking this Survey

I came across this request from a psychology student asking people with health anxiety to fill out this survey for a study she's doing. I am glad to see that there is research being done.
You are invited to participate in a study about Health Anxiety and Cognitive Processes in a Community Sample (Protocol Number H7880).

Who is conducting this study?
Researchers from the University of Western Sydney, listed below.

Background to the study
Health anxiety is anxiety about your health and includes the way you think, feel and behave. It can range from mild to severe. Everybody can be anxious about their health from time to time, but when someone worries about their health continuously it can get in the way of everyday life. This study is aiming to learn more about how people who are health anxious think. This will help to understand how to conceptualise health anxiety better, which may help to work out better ways of providing support and assistance.

How to Participate
Please click on the following link to be taken to the online study:

Principal Researcher:
Name: Ms Kristy Bale

Name: Dr James Malcolm
Phone: +61 2 9772 7466