Monthly Archives: February 2011
Patrick, I assume you read the post article here about obsessing about obsessing, so I will not repeat what was there. This form of OCD is a difficult one to help a sufferer understand what to do and I apologize if this doesn’t seem clear. In your post you ask if you should ruminate and I would re-word that to say exposure, since ruminating suggests ritualizing to me. You mention that you have a number of feared consequences (e.g. becoming poor) that you say may happen. This would not be enough. How would you attempt to cope with them in a positive way. How would you get on welfare and make the best of it. So part of the exposure would be very detailed that if these things happened what would I do. The reason for this is that if these things actually happened, life would go on and a person would have to continue. Though being poor would be very difficult, people in dire straits can still have enjoyment, even if it is less in their life.
Second, whenever you are doing something, we would like some attention paid to whatever good is actually going on. While learning to overcome this form OCD, it is important to learn how to notice whatever level of enjoyment is present, whether it be 80%, 50% or just 10%. It is learning to accept that this is my current best and so I might as well get something out of it.
The goal is learning to be able to have the thoughts in your head and feel anxious and learning how to cope with this while it is happening. This is very easy for me to say and it is lots of work to learn how to do. Obviously if it were easy enough to explain it all in a post, you would have figured it out on your own. But you can learn how to do this. Finally, it is true that OCD is both learned and biological. I have given you some advice for the learned part and an OCD specialist would be useful for you to be seeing. Medication would quite likely be a very helpful addition to your treatment and it is usually in the form of an SSRI for those who suffer from OCD. I hope this provides you with some help and hope.
Susan’s mental obsessions and religious concerns.
We actually have a sizable number of Orthodox Jews in our practice with a variety of religious concerns. You describe a few different problems with your OCD: words and images you have in your head that you don’t like; concerns about your own level of observance and how G-d may judge this; and finally how you will be judged by your peers. Each of these is a different feared consequence for the general concern about your religious practices. With mental obsessions, it is not the content of the thought that makes something an OCD problem — all thoughts, no matter how bizarre they may seem to you are normal. They become an OCD problem when you want to know what they mean or want to stop them. With you the goals would be twofold – helping you live with the thoughts (once you are able to live with them, they become less frequent and when they occur you would care less) and helping you to accept what you can’t know. In this second category, your neighbors say nothing about your level of observance, but it is true that some may be fine with it and some not. We can never please everyone. With regard to G-d, all of us could attempt to become saints and few do. Even the more observant in your neighborhood could always do more. Treatment would help you to accept that you can’t know the mind of G-d and that your goal would to trust in His judgement even if it went against you, because you’d like your faith to be strong enough to accept whatever He decides. Obviously this isn’t easy, but that is why treatment is necessary. It is likely that their are experienced OCD therapists where you live, especially in the major metropolitan areas (NYC, Washington, Chicago, LA). You can check with the International OCD Foundation to see if there are experienced OCD therapists in your area. Your other posts are thoughtful, but I wonder if they are a little bit compulsive in trying to assure/explain yourself to others.
Answer to Ed and his pursuit of the perfect looking princess girlfriend.
What you are describing could be described as reverse BDD (body dysmorphic dysorder). For anyone, if you stare at a face or body long enough, you will find imperfections and if your OCD attaches to this and you don’t do any treatment, then you will find this problem with anyone you date. If you want to overcome this, which would mean ultimately being able to be in a good relationship, be a good parent and have a partner you can love and depend upon for life, you will have to make a few decisions. And once you make these decisions, you will need to go through the difficult, but not impossible, process of learning to implement them. The decisions are deciding that you want to live with a person who will never look as perfect as you want. The two reasons for this are the one above – you will always find imperfections – and because whomever you are with will age. It may seem like you can’t get your mind off of the imperfections, but learning how to live with them is the process of therapy. You can check with the International OCD Foundation (www.ocfoundation.org) to see if there are experienced OCD therapists in your area.