Tuesday, July 27, 2010

Just One More Search: OCD and Information Overload

information overload
There's a discussion that threads through the OCD-Support group on Yahoo about providing information and changing beliefs as a way to treat OCD rather than doing exposures. When someone asks about a particular feared consequence in the OCD-Support group, there is almost always several people writing to reassure the person that what they fear won't happen, and sometimes a defensiveness about the basic human need for accurate information and compassion. What unfolds in many cases is that the person already knows the information(ie. how HIV is contracted), has had repeated tests, and asked the same questions many times.

A compulsion is usually the tip of the iceberg, with a lot of suffering underneath, and there are always people who will say, "That's not a compulsion, that's a good idea." At age 27, I once told a doctor I was anxious about skin cancer, and she said "Good, you should be." She didn't know that I was checking my moles constantly, researching skin cancer, and that none of this actually made me any better and identifying moles that might be abnormal. It's not compassion to encourage life eroding rituals.

In my experience, I could never get enough information. I've earned my living doing research, and I'm good at it. I read 12 books on OCD the first month I started treatment with Leonard, but it wasn't helping me since I was trying assuage the part of me that was afraid I didn't have the perfect treatment, and that I wouldn't get better.

Fortunately, I was able to be honest with my therapist about all the reading I was doing. He didn't fit the authoritarian stereotype of an Exposure Therapist, and he did give me some information, but it was information about the nature of the disorder, about the constant desire to have 100% certainty, and that his clients get better, but he couldn't give me an absolute guarantee, and asked me to consider taking the risk and doing the treatment, and not reading more books. He wasn't asking me to follow him unquestioned, or demanding I do what he wanted. He was appealing to the healthy observant part of myself that wanted to get better. We all have this part, no matter how buried under OCD.

7 comments:

  1. When you write about the doctor who told you, good, you should be worried about skin cancer, I am immediately riled up by recent memories of similar experiences.

    When I first started falling apart almost a year ago now, I sought help at my employer's free counseling service because I felt like I just couldn't do my job anymore without constantly being overwhelmed by anxiety. The mental health professional to whom I explained my fears basically recommended that I do reassurance research! I look back and am extremely frustrated by this, since, as a mental health professional, I feel he should have been trained to recognize that my fears might be OCD-related and that further research (which I had already been doing) might cause me more harm than good. For a month I continued to see this guy as my OCD just became more and more debilitating. In the end, I was the one who brought up the possibility of OCD, and I spent the rest of the month waiting for him to give me appropriate referrals for treatment. When he did give me these referrals he admitted to me that he wasn't necessarily sure if any of them had experience treating OCD but I could call and ask! So frustrating! I ended up searching on on my own when his referrals seemed shaky at best. I'm glad I did, and I'm glad, that by chance really, I ended up with my therapist!

    Sorry for the rant - I guess I am just bothered by the fact that medical professionals, especially mental health professionals, are sometimes unaware of the detrimental toll their well-meaning advice can take.

    I really like your last two paragraphs, as well. I feel like I need to copy them down somewhere and reference them when I begin to question whether my therapist, who specializes in treating OCD, is really providing me with the 100% "correct" treatment. I have become so accustomed to resisting my therapist's advice sometimes because I am convinced that there must be a missing piece to the puzzle that he just hasn't found yet that would make it all click - that would make the ERP process feel as I imagine it is supposed to feel. I am put off by the fact that, when treatment does work, when situations that would have previously caused me anxiety do not, I am not relieved as I feel I should be. Rather I get mad at myself and tell myself that I am becoming careless for not feeling that it's necessary to perform the compulsions I once felt were absolutely necessary. Oh my!

    Life gets easier because I am not constantly avoiding things or performing elaborate rituals, but lack of that sort of anxiety and freedom from rituals does not seem to equal the relief that all the books and resources out there suggest will come. Instead of being able to appreciate my increasing liberation from one form of anxiety, I am berating myself for not being more careful to maintain my old, restricting OCD ways!

    This is where I think what you mentioned could come into play...I need to just KEEP trusting my therapist even if the CBT doesn't seem to be working as it is supposed to...even if I fear there is something he is missing. I need to move forward and try to follow his recommendations even if it doesn't seem to immediately provide the relief I was hoping to feel! As long as I evade his recommendations or pick and choose which ones I want to follow, I will not ever have the opportunity to find out whether his suggestions really do work or not! I believe that ERP and CBT work, but of course I begin to wonder if they can work for me. I wonder if there is still something more that is needed, something else about my OCD that needs to be identified and understood for the process to work for me! But to see if the process does work, I need to trust it enough to carry it out properly. I have made substantial improvement but still have a ways to go!

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  2. Fellow Sufferer--I'm sorry you had to deal with cluelessness--I've experienced that with mental health professionals as well, and it sucks. Your experience with wanting ERP to feel a certain way is similar to mine--I actually did exposures related to this, recording a script about I might be making a mistake doing this therapy, but I was going to take the chance, and deal with the consequences later if they happen. It really helped to tell my therapist I was obsessing about doing therapy "right" and feeling "right" after doing it--hopefully you can talk to yours and address it directly with exposures.

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  3. I have, in the past, fallen into the trap of the "reassurance ritual". Now, I do let myself get some perspective by sharing my concerns with someone I trust to get their view and feedback - ie - is this food ok? do you think this is worrisome? I can only ask ONCE - that's my rule. It helps me see if I am being OCDish, when I can't tell. It can also help me garner strength to push through an exposure when I am teetering on avoiding.

    I also realize now, after reading your post, that if I have reassurance to offer (something I recently did on one blogger's post) it might not be desired. Maybe I should just "listen" without "teaching" or giving facts.

    The good news is that I did not obsess about having done 'the wrong thing' with the blog.

    I appreciate your writing. Thanks for being part of the OCD Blogging community.

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  4. All I can do is nod as I read this post. I'm going to link to it in an upcoming post on my blog because it's such a good point! Someone with OCD wants certainty and we have to learn to deal with uncertainty. It drives me crazy when I talk to someone about my OCD symptoms and they start to rattle off facts and statistics to what? Make me stop being afraid of (fill in the blank)? I don't understand people who think that they can talk me out of OCD. It is so not that simple!

    I ask for reassurance a lot when doing really hard exposures. I need to tell my boyfriend that he should stop reassuring me in the middle of exposures. It's not helping me.

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  5. Kinder Brain--Yes, the "asking once" rule of thumb is something I thought about mentioning in my post--the gray area really is a struggle for me, when my OCD is demanding I know for certain I'm not asking for reassurance. . .and it's trial and error. And also, not knowing if I am giving reassurance when I post on other blogs, or if I am causing harm in some way--definitely an exposure! It is indeed good news that you didn't obsess about the comment you left--and thank you for your kind words about my writing!

    Ely--I'm glad you could take something from this post! Be sure to let me know when you write your post. It definitely helps me to tell my husband that I'm doing something as an exposure--then he knows not to reassure me, but he is supportive, which for a long time I thought was the same thing as reassurance, but I discovered it's not. He'll tell me he's sorry it's so hard for me, or encourage me to complete my exposure.

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  6. I just wanted to say that the picture of the strainer for this post is PERFECT! When I write posts, I always try to search for an image that expresses what I am trying to say in words. Love your blog!

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  7. Hi Beth,
    Thanks for the kind words! When I trust my visual sense, I find some really cool photos. When I get stuck in the ocd, I end up not posting anything--so I'm working on picking a photo even if I'm not "sure" it's the right one.

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