OCD self-help
December 24, 2020 9:19 AM   Subscribe

I have some behaviors that are consistent with OCD. I have all sorts of self-help stuff I do for anxiety already, including meditation, but I really struggle in the moment to not get stuck in a compulsive head space in a particular situation. I'm wondering if there are tools and techniques that I don't already know about.

Compulsions include reassurance seeking, fixation on a specific outcome, obsession with a specific emotional experience and a very rigid expectation for what it should look like. I end up getting variations on the communication I am seeking but I am so fixated on a particular package for the message that I literally *can't stop talking about it*, or saying the same thing many different ways thinking somehow what I'm asking for isn't clear, but the whole time it was basically clear enough and the person is doing their best to deliver what I am asking for. But I'm unable to hear it and I perseverate. And it can last literally hours sometimes and I hate that so much.

If there isn't active communication then I am obsessively googling about the issue or seeking reassurance from other people online.

(I have other situations that manifest obsessions, intrusive thoughts, compulsions etc but this particular one is the one causing the most pain for others so that's what I want to prioritize changing.)

I guess I'm looking for strategies to increase mindfulness of getting stuck in this head space. Once there I really can't get out of it for a long time and it's exhausting.

Unfortunately the medication used for this problem is a type that I don't tolerate so I need behavioral solutions. I want to take responsibility for managing this pattern better than I have been. And most descriptions of OCD don't talk about this type of issue so my obsessive googling isn't leading to any actionable information. I suppose maybe I'm using the wrong search terms. If you're familiar with the type of dynamic I am describing and have found self help through researching a different topic please share.
posted by crunchy potato to Health & Fitness (16 answers total) 11 users marked this as a favorite
 
Best answer: Can I ask what the specific outcome you're looking for is?

Otherwise, I'd suggest you need to revisit how you're using meditation. Because, you're very articulate and you know that being stuck in the headspace (intrusive thoughts, rumination) is really your brain trying to HELP you by trying to problem solve a possibly unsolvable problem.

And you seem to be having trouble processing that your distress is caused by what you think the other person should be doing.... and you have no control over them. There is no magical spell that others can (or indeed should--in the case of reassurance) say to release you. In fact, reassurance will engender the need for more reassurance.

So I'd try to meditate when you feel triggered, and using that time to become mindful that 1. your brain's rumination is its ineffective way of trying to help you.. so say "thanks brain, but we got this" and 2. when you feel panged with not receiving communication you feel you should receive.... sift through the implications of not meeting your rigid expectations by meditating, naming them, and releasing them.... maybe you need to recalibrate without judgment. Practice every time you feel panged.
posted by Dressed to Kill at 9:34 AM on December 24, 2020 [4 favorites]


Response by poster: Can I ask what the specific outcome you're looking for is?

Typically some form of the perfect expression of empathy and understanding for my position, or a genuine/heartfelt apology that is thorough while also not being contaminated by defensiveness or irritation on the level of nonverbal communication. I get some version of these, but they aren't the perfect vision I had in my head of what these things should look like, so I continue to perseverate.
posted by crunchy potato at 9:46 AM on December 24, 2020 [2 favorites]


Best answer: A couple of things...

Are you sure these people are actually treating you well? Is there a consistent need for apologies that go this poorly? I can see how this might be some element of codependency where your needs aren’t being met but you insist to yourself that you’re the problem, or that it’s your responsibility. Fixation on the problem is a result of thinking you can solve something outside of your own control. Are you in a denial/anger stage with this person? It sounds a lot like you want respect or care from someone incapable of giving it to you.

When I sought OCD treatment there was a lot of emphasis on the new method of discovering what core fears are driving the OCD. Poke around at that link, might help. I am not quite sure that I actually had OCD but that site helped me consider what I was really running away from with rumination.
posted by stoneandstar at 9:58 AM on December 24, 2020 [8 favorites]


Have you tried sitting down and literally writing it out, all of it? The entire story of what happened, and the dialogue that want to have happened, and a discussion of why you feel the way you do, and all of your grievances, any other material that is floating around in your head attached to it?

It takes a significant amount of thought and energy to write all that stuff down, in clear narrative form. If you haven't tried it, I'd strongly suggest it. It should help a lot. You will be so done with whole topic by the time you're done that your brain will be far less inclined to return to it.
posted by fingersandtoes at 10:05 AM on December 24, 2020


Best answer: I've been going through similar things lately. I'm obsessed with situations where I want specific emotions and my thoughts directly get in the way of experiencing those emotions. You clearly have enough self awareness to understand the problem, so here's some thoughts that might help:

It sounds like you have a very detailed expectation for what you want, and you have a very detailed analysis of what you think is happening. You also seem to have an emotional feeling of anxiety or conflict between what you want and what you have. That combination means your brain is trying extremely hard to figure out what is wrong about the reaction you are getting and it is going to find every possible fault in the way the other person is behaving. And of course you will find some because the other person's behavior is not perfect. Most people will accept a "good enough" reaction but those of us with anxiety and obsessions don't really do that.

There's at least two ways to deal with this: The first is to address the emotional/visceral feeling of wrongness that is happening in these situations. For me, I am unable to address any of my obsessions if I have a strong body anxiety reaction, so before I try to change my thought I need to relax my body. For me I use Beta Blockers for anxiety if I know it's coming, or use CBD oil to relax myself. But you could take a bath, listen to music, meditate, etc.

That makes me receptive to change but does not stop my obsessions. For simple ones I've found that writing them down is enough for me to resolve them. But for complicated and entrenched ones I have found I need to directly address the conflict at the heart and resolve it somehow. The technique I've been using lately is an adaptation of the Coherence Therapy method for self practice. Roughly the idea is to try and emotionally engage with both sides of a conflicting thought (ie "I must get this exact reaction" vs "They are trying their best and this reaction is good enough"), then work through emotions to come up with a unifying statement that feels authentically true (which is unique to each individual and situation), then reinforce that statement with affirmations. This is what works for me personally (msg me if you're curious about this specific technique), but there are other techniques for resolving mental conflicts that may work better for you.

I am not a therapist and am not advocating anything specific, but I think any method that gives you a legitimate sense of "resolution" about this conflict can help you move forward. I did my own research to look for techniques that might work, and just focusing on that helped me a lot with my obsessions and makes them feel like something I actually can address.
posted by JZig at 10:10 AM on December 24, 2020 [4 favorites]


I literally have the same exact experience as you do. I also would think it was "OCD tendencies", but know that I definitely didn't have OCD.

It wasn't until I got a hold of a DSM-5 and my wife and I decided to "for fun" go through and see if we had any of the personality disorders (a bad idea in hindsight...). Turns out I fit the bill for "Obsessive Compulsive Personality Disorder" to a goddamn T.

I'd start researching OCPD and see if that is what you might have. I personally have only gotten that far and it has helped SO MUCH just to be able to identify these things. If you ever wanna talk about struggles, just send me a message. I'd also not mind someone to relate to!

Good luck!
posted by midnightyen at 10:17 AM on December 24, 2020 [1 favorite]


Maybe reading up about attachment theory might help? What you said about seeking reassurance sounds like it could be connected to an anxious attachment style, so looking for strategies related to that might help.
posted by diffuse at 10:33 AM on December 24, 2020 [1 favorite]


Dialectical Behavioral Therapy is standard treatment for managing certain damaging interpersonal behaviors, including harmful reassurance seeking. Exposure and response prevention is standard treatment for compulsive behavior.

These are not self-help issues, unfortunately.
posted by Rock 'em Sock 'em at 10:38 AM on December 24, 2020 [1 favorite]


IANAD/IANYD, but I have similar experiences as you, including having at least some flavor of OCD tendencies that manifest in the ways that aren't necessarily what is thought of as "typical" OCD symptoms.

You mentioned meditation... I've found mindfulness is incredibly helpful for this. You recognize the pattern, so it sounds like the first step may be to find a way to stop this in the moment before it becomes this drawn out hours long process.

I recently did a Mindfulness Based Stress Reduction course online, which is worth looking into. One of the techniques we learned is STOP which stands for: "

Stop
Take a breath
Observe and process
Proceed

You'll want to practice this in less stressful moments. For me, I started by setting a timer to go off every so often, and when the timer went off, I practiced these "STOP" skills. Eventually, the idea is you get to a point where when you start to spin out into these obsessive ruminations, you can stop yourself, breath, observe what's happening, and then try to go in a different direction.

There's obviously a lot more to unpack here, but I have found STOP to be a helpful, easy to remember skill I can use for something like this.
posted by litera scripta manet at 10:41 AM on December 24, 2020 [1 favorite]


Best answer: As a therapist and a person who lives with OCD, I would *really* not suggest writing it all out. Emotion-focused coping such as this tends to exacerbate ruminative thoughts, and research suggests that it's more harmful than helpful for most people, and tends to prolong and intensify feeling states. Also would not suggest reading the DSM and self-diagnosing; your own cognitive biases prevent your from being a good diagnostician for yourself.

Exposure Response Prevention is the gold standard treatment for OCD right now. If you do not have access to therapy for financial or logistical reasons, it is kind of possible to ERP yourself. I'm not giving you advice as a therapist here, but as a person who believes that it's okay for you to take charge of your mental health and try things on your own if it feels okay to you. It would require you to put together your own exposure exercises, treating reassurance seeking as a ritual and gradually eliminating it. If you Memail me I can send you more info/resources about this.

I'm in pediatric mental health, but I sometimes work with families where kids have OCD, and will need parents, for example, to say "I love you" ten times or they will be consumed with terror/panic. We coach the parents not to say "I love you" ten times, no matter how scared, angry, or dysregulated the child does. If they do this, they become part of the cycle of the disorder, and reinforce the pattern. Instead, we ask the parent to externalize the feelings, so they aren't part of the child, but part of the disorder. We may give the parent a script that is something like "This is the OCD playing tricks on you. I know it feels real and terrifying, but it's just part of the OCD." Parents often feel reassured to have a script, because they have been feeling like no matter what they do, they can never adequately reassure their child. I wonder if people in your life would benefit from a script like this.

When I read your Ask, I get the sense that you struggle with attachment wounds or attachment trauma. These are tricky obsessions/compulsions to work with, because it may not actually be super realistic to completely stop reassurance seeking. Some level of reassurance seeking is pretty normal and healthy in relationships. It's the rigidity about what kind of reassurance you need that's the problem, not wanting reassurance itself.

I wonder if it is possible for you to identify some of the repetitive thoughts that come up when you are in this state, and then when you notice them, say to yourself "This is an intrusive thought. It is part of my attachment trauma/OCD." (only if that feels like a true statement to you)

How able to self-soothe are you? If you could adequately bring yourself down to a calm, regulated, okay state, would you need these interactions from others? It sounds like you want some of this behavior from others as a replacement for self-soothing. Do you think this was a skill you didn't get growing up, possibly due to environmental factors like an unavailable caregiver? Could you channel some of your research about the situation into research "how to self-soothe" and put energy into trying some of those strategies? I can send you some DBT resources about self-regulation and distress tolerance if you're interested, but highly recommend TIP skills and a 1-2-3-4-5 exercise to activate your cortex and get your out of your fight/flight lizard brain. There's not necessarily an evidence base for DBT skills used independently from true DBT, but if you are open to DIY-ing mental health interventions for yourself, I think it is okay to give them a try, with the caveat that YMMV, and take what works for you and leave the rest.
posted by unstrungharp at 10:45 AM on December 24, 2020 [20 favorites]


Oops - just wanted to add: IANYT.
posted by unstrungharp at 10:50 AM on December 24, 2020 [2 favorites]


Best answer: It sounds like you are specifically experiencing the neuro-chemical brain cocktail that we experience as loneliness. Loneliness is one of those natural feelings, like hunger, designed to make us go get the need filled for the sake of our survival, and like hunger it is impossible to permanently fill. Your OCD tendencies may be making it worse, but it may be pretty strong on its own.

You could try seeing if oxytocin helps - triggering more oxytocin production is done by skin to skin contact or holding babies or another living creatures.

it is much harder to get the feeling of meeting-of-two minds and recognition, appreciation met. One way people do this is by staring into the eyes of their beloved. It's part of the pattern of falling in love. You can stimulate some of this by staring into your own eyes, in the mirror, as long as you look into your eyes and not as much at your face and do not run a bad mental track while you do it. Your own eyes and a mirror is not as effective as staring into the eyes of a lover/child/parent.

Endless circular conversations where you try to break down a shade of meaning for emotional verity are sometimes partially kept going by anxiety, where you relieve anxiety by talking compulsively. An exercise where you stop talking and play a game like making the other person smile can help, as can setting a timer for two minutes and not talking for those two minutes, taking turns and then try setting the timer for five. This helps train you to tolerate delaying the core dump of exactly the feelings/thoughts you have.

Training yourself to tolerate feelings of loneliness and not obsess over them might help. If you can work on accepting that you will never be truly loved or understood or accepted due to the inability of language, human nature, and need, then you may be able to turn of the racing thoughts. It is work trying to get to a point where you think, "Yes, he doesn't understand me, but he never will completely." Having the other love or accept or understand you 100% is impossible - that is only impossible in science fiction and religion. So consider what percentage are you okay with.

Maybe it is okay if the store clerk undertands/likes/meets you 30% of the way, but for your significant other 95% would be acceptable. You can change your goals.

Also take note of how you feel when your partner in this conversation gives you a validating statement. It is possible that there is nothing wrong with what they are saying, but instead that what they are saying can never provide that feeling. If your partner says, "I love you, I trust you, I am sorry I hurt you, I will try never to hurt you that way again," there is not much point in increasing what they say to include assurances that they "...know you are sensitive about your education, and that your education was adequate and you had good reasons why you never got that post graduate degree..." Because if you want that level of reassurance it's not them you need to have convinced that you are worth loving despite the little educational glitch, it's you.
posted by Jane the Brown at 10:54 AM on December 24, 2020 [3 favorites]


Best answer: One exercise to break compulsive thoughts is to sing something really upbeat with physical motions at the same time, at a speed and tempo that leaves you breathless. It is hard to actually think while you are stepping and singing, "One of these days these boots are gunna walk all over you!" or "Staying Alive" with suitable fist pumps. Pick a song you don't know well that makes you want to move your feet and belt it out. Complex is better, as is something you have to really concentrate on because you don't know it well. Something like "This is the song that never ends" is not going to work as well because you can still have shallow thoughts while you chant it on automatic.

Just don't go with a song that reinforces your unhappy feelings.
posted by Jane the Brown at 11:12 AM on December 24, 2020 [4 favorites]


Hi, I have been getting treatment for OCD since 2004.
Here's what has worked well for me:
-Cognitive Behavioral Therapy (be careful searching for CBT online, it is also a sex thing)
-Medication (anafranil)
-taking time to meditate every day
-forgiving yourself

best of luck with your journey.
posted by evilmonk at 12:25 PM on December 24, 2020 [2 favorites]


you might want to get into DBT - the focus is very much on distress tolerance techniques
posted by megan_magnolia at 3:55 AM on December 25, 2020 [1 favorite]


This has been said above better. But the only thing I have found for noticing "I am about to try the exact same thing I already tried twice, I am perseverating, I need to stop," is practice. Something like the STOP technique above.

And then, how do you stop? You just do. Throw your phone onto a sofa across the room. Shut your mouth even though you are mid explanation - you don't have to finish to stop. Don't go through the word processing part of your brain, just push your lips together. It's hard to talk with your mouth closed. Wait and watch the other person and see what THEY say. Respond to them rather than responding to yourself.

Actually, the last one helps a lot with the obsession over getting the perfect outcome / feeling / mood / emotion. "I am distressed about ___ who can I call about it?" has started to flow, with practice, into "hey, what else was that friend struggling with last time we talked? Can I follow up with them about that, either also or instead?"

Taking the spotlight off myself and my own feelings helps me a LOT with the perfectionist compulsion in the moment.
posted by Lady Li at 10:00 AM on December 25, 2020 [2 favorites]


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