Answer to Patrick’s Obsessing about Obsessing Post

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.


  • I think this is an easy to understand explanation as to what should be involved in the therapy for someone with this type of OCD. Of course it’s so much harder than it sounds, but sticking with the ERP Therapy is so worth it, as the positive results can be dramatic. Good Luck Patrick!

  • doc …your are by far the best doctor, my ohter therapist wouldnt tell me anything like that he would just say face it .. feel the anxiety ..and im like but how i cant im miserable … he wouldnt tell me this .. thas why i just left him i was paying 100 a visit and i still felt like crap by the 10 session ..

  • I need more help. I have read the book. Gone to a few OCD meetings in Downtown Philly and bala Cynwyd. Obsessing about obsessing. Wishing rituals. Ruminating about past arguments for months, I need to see a specialist to help me sort out the main obsession and then do exposures for them. My thing used to be violent intrusive thoughts. Then it seemed to go away after a few experimental exposures with a trusted friend and his pocket knife, and Harold and him having me hold a car key up to his eye. That violent obsession seemed to have faded but I couldn’t figure out what was bothering me and worrying me so badly til I read this a month ago. I was pusuaded to get off klonapin by by AA sponsor and a dr at University of Penn board certified in addictions meds. He knows a lot about OCD and anxiety it seems. I am doing yoga like he suggested but it seems a far cry from a solution. I never really abused my klonapin my ritual seems to be wishing I was on them again and not being able to be present very much at all and repeatedly arguing with my sponsor and the dr in my head searching for a way to have it be alright to take the pills that worked in the first place, I will have four years sober from alc on feb 19 th. I know they have the potential for abuse and I am more at risk than others but it’s been almost three months and I have never been so depressed and afraid all day and night. I am told I will feel depressed for 6 to 9 months while I am going through the psychological withdraw but I know it’s more than that. I am depressed cause fear is stealing Everything worthwhile in life from me and I am watching it happen helplessly. I feel trapped. People are gonna think I just want to get high and I don’t. I feel like this is a life sentence of fear and depression. I don’t wanna become suicidal. I have never felt this bad for so long. I fear most of all that I won’t be able to sort out the main Obsessions and be able to treat the w ERP and therefor feel like this and waste my life. Any insight would be great, cause I am lost.

  • Neutral obsessions. I forgot to mention that’s what I have identified them as. And also, carrying ,y own pocket knife around helped a lot as a constant exposure

  • Dear Dr. Grayson,
    I have worked with you before. Thank you. Kelly is not my real name, it is a manifestation of one of my obsessions. I can lick a toilet perfectly fine, it’s the pure obsessions that get me. I am getting old, and am uncertain (lol) about burdening any potential partner with my constant need for reassurance. It seems like as soon as one thought is conquered, another one pops up, and I don’t even know it until someone asks. They just think I’m annoying them, or am needy. I feel I have a need to hide my obsessions from others so I can continue to seek the reasurrance, and I know this is wrong and not helpful. Then I end up being angry at them for not helping. My question is: In a romantic relationship, if I start obsessing over if they really love me and won’t ever leave, how can I keep that a secret since in the very nature of it’s insidiousness, it causes severe damage? Then, the balance of control is tilted and resentment begins. Then the cycle completes. It’s very complicated. I don’t want to be alone, and that is my fear: so is seeking a partner not normal then? Or merely a compulsion? I mean, how can you go into this, knowing how hard it will be for your partner?

  • Hi! I have two questions. When thinking about how you’d cope with being poor in a positive way, how do you prevent this from turning into a problem-solving ritual (i.e. I must figure out a plan for how I’d cope with every possible disaster)? And what about obsessing about doing ERP correctly (i.e. obsessing about whether each little thing you do/think is a ritual or whether you are following ERP guidelines to the letter)? Would you deliberately do ERP imperfectly and live with the possibility that you might not fully eliminate rituals? (Or am I making excuses here??)

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