Tuesday, July 26, 2011

OCD A to Z: U is For Unique Fears

breathing underwater

U was a hard one at first, but I remembered how many times I've encountered concern about having unique fears on the OCD Support Yahoo group, and in my own OCD support group, and in comments and emails from readers. OCD is as diverse as the people who suffer from it, with obsessions and compulsions that can be as unique as a fingerprint, but sharing the commonality of being human, and suffering from this disorder.
  • There is a despair that you are the only person who has a unique set of symptoms, and therefore maybe it's not really OCD, but something more dire.
  • There is fear that if no one else has these symptoms, no therapist will be able to help.
  • There is a visceral panic that the very bizarreness of your thoughts is a sign about you as a person, and your worth.
These fears are compounded by the lack of therapists trained in Exposure and Response Prevention Therapy, and who have sufficient experience treating OCD. For an inexperienced therapist, OCD symptoms may sound unique, but to someone who is familiar with OCD, they can see the underlying thread, the essence of the disorder underneath the permutations. This is not the same as finding a perfect therapist, and if you are like me and have perfectionist OCD, this can make it difficult to accept that all therapists are imperfect, even good ERP ones.

OCD is strangely unknown. Yes, there are whole reality TV shows devoted to it, but when faced with a patient in their office, it is all too easy for therapists to be distracted by the individual symptoms, trying to figure them out, trace their causes. This is what works in therapy for many other problems. I believe that recognizing OCD can be learned. My therapist didn't start out as an ERP therapist, but his OCD patients weren't getting better, and he wanted to learn more, and he educated himself, and now wants to go out and spread the word to his colleagues through continuing education and conferences.

It's like when someone mentions something and then you see it everywhere, but before then, you never noticed. Here is my prescription for therapists who want to learn more:

My prescription for someone suffering from a fear of having unique, untreatable symptoms would be much the same as for therapists, along with the knowledge that this is OCD's mode of operation to latch onto whatever is important to you, whatever your unique life experiences. For me, obsessing about obsessing is a struggle, so worrying that my OCD wasn't OCD, became one of my key themes, and I had to practice doing imaginal exposures, listening to scripts about how my OCD might really be something else, or untreatable, while going ahead with my treatment.


  1. Amen. I struggle with this a lot. One of the biggest things I have to constantly tell myself is that this is just my OCD latching onto what matters most to me. Significant other, mom, family, work, fun times, etc etc etc.

    I, too, have felt in the past and present, that my fears and OCD behaviors have been unique, that no one will be able to help me, that there is no hope for me. There have been times where I have felt so alone in these fears and felt like ruining everything in my life just to feel better.

    Bottom line, we have OCD, there are people out there like us, we are not alone, and we DO have hope.

    I love this thread you are doing about the A-Z. Do I have your permission to do it on my blog in a few months after you're done?

    I hope you're well, thank you for your educated, precise and personal blogging...

  2. When a psychologist first said to me "I think you have OCD" I only saw her once. Firstly - she was too expensive for me, and second - I thought "great - I know what it is now - I can handle it". Ha! I did go buy a book on OCD though. I think there was.....maybe one or two to select from. When I read it - none of my obsessions or compulsions were listed so I thought "there's no way I have OCD". I actually believed that for many, many years until I discovered Steven Phillipson's article about sexual and relationship obsessions.

  3. Sometimes I think that my obsessions and compulsions are too small and go too quickly. A minute on this issue, thirty seconds on that, a minute on an old issue, two minutes on three issues interwoven, etc. Maybe it didn't count. Maybe I should just get myself together. Maybe I don't need the help I'm getting (a contradictory supposition). And so on. Now on medication, one of my most disturbing obsessions with it's compulsions have grown small enough that I can usually behave like a "normal" person in that area of my life. But it still attacks, along with a bunch of other little tiny obsessions and compulsions that, added up, are annoying, exhausting, and depressing. I talked to my therapist about my scatterbrained OCD and how it was supposed to be different, and she said OCD isn't bound by my "supposed to"s; it can take many forms.

  4. This a great post, especially the part for the therapists. My OCD has always been SO textbook, that once I was diagnosed (at my first ever appt, within months of my first symptoms- I was rare and lucky), I've never doubted it.

    Doesn't really help cure it, but still, I'm glad not to have that extra layer of stress.

  5. Excellent post, but how sad is it that so many therapists still do not know the correct therapy for OCD (ERP Therapy). The International OCD Foundation has the BTTI (Behavior Therapy Training Institute) which trains professionals to treat OCD.....I'm sure there are other programs around as well.

  6. Lolly--I am thrilled to be of any service to others with OCD! I got the AtoZ idea from a challenge that some writers did in April--so I would love if you would do your own--I'd be curious which words you would pick!

  7. Pure O--This sounds like me, when I started subscribing to the OCF newsletter, and reading it for 5 years before actually finding an ERP therapist, because I assumed I *should* be able to fix myself. Self-help is definitely an option that can work, but sometimes outside help is necessary.

    Abigail--I am so with you on this scattered OCD. I'm sorry you have to deal with this exhausting thing, but it is possible to thrive.

  8. Ann--I would love if all OCD could be diagnosed so definitively! And I'm glad you don't have the additional stress on top of doing exposures.

    ocdtalk--thank you for mentioning the Behavioral Therapy Training Institute--sponsored by the IOCDF.