Should You Trust Your Therapist? Depends.

Got this excellent question from a blog reader:

I think I have HOCD but I’m not sure. My therapist is doing CBT but I don’t think it’s ERP and it’s making me anxious. Like what if this therapy goes know where and just becomes me talking about my problems.(what happened with my last therapist). Should I trust that she knows what she is doing? Her Website says she does CBT so by saying she does CBT does that mean she is also an expert on ERP?

It’s sad, but so many mental health professionals are not very educated on OCD or how to treat it. CBT (cognitive-behavioral therapy) is a pretty vague, blanket term, whereas ERP (exposure and response prevention) is a specific type of CBT.

Two things I’d suggest:

  1. Read up about ERP. As much as you can. It will help you recognize if it is being done correctly. Start with this article on the IOCDF website. Also read any/all of the CBT/ERP posts at www.jackieleasommers.com/OCD.
  2. Ask your therapist the following questions. These questions– and the answers you should listen for— are pulled from this page on the IOCDF website.
  • “What techniques do you use to treat OCD?”If the therapist is vague or does not mention cognitive behavior therapy (CBT) or Exposure and Response Prevention (ERP) use caution.
  • “Do you use Exposure and Response Prevention to treat OCD?”
    Be cautious of therapists who say they use CBT but won’t be more specific.
  • “What is your training and background in treating OCD?”
    If they say they went to a CBT psychology graduate program or did a post-doctoral fellowship in CBT, it is a good sign. Another positive is if a therapist says they are a member of the International OCD Foundation (IOCDF) or the Association of Behavioral and Cognitive Therapists (ABCT). Also look for therapists who say they have attended specialized workshops or trainings offered by the IOCDF like the Behavior Therapy Training Institute (BTTI) or Annual OCD Conference.
  • “How much of your practice currently involves anxiety disorders?”
    A good answer would be over 25%.
  • “Do you feel that you have been effective in your treatment of OCD?”
    This should be an unqualified “Yes.”
  • “What is your attitude towards medication in the treatment of OCD?”
    If they are negative about medication this is a bad sign. While not for everyone, medication can be a very effective treatment for OCD.
  • “Are you willing to leave your office if needed to do behavior therapy?”It is sometimes necessary to go out of the office to do effective ERP.

 

Question & Dancer: This & That

question-and-dancerI’m an artist not an expert, one who is learning to embrace questions more than answers.

These are some questions I got last month. Ask yours here.

I have hocd, and I’m a 17 year old girl. I was wondering, is it weird if I still get crushes on guys during this? sometimes I doubt if I even do like them and the feelings feel fake and forced. Other times, no. Since my hocd started I haven’t been able to really like a guy. If I do, my crush goes away quickly. This makes me worried and makes me think that I can never truly like a guy ever again. 

Dear one, not weird at all. HOCD will do whatever it can to confuse you. Please be sure to read about HOCD and ERP at http://www.jackieleasommers.com/OCD.

Hi Jackie! My question concerns telling my significant other about my HOCD. I have already told him a bit about my same sex attraction fears (around 1.5 yrs ago) but at the time, I didn’t realize it was HOCD. Now that I know HOCD is the culprit I am wondering if you have any advice as to how to explain… I am afraid he won’t believe its HOCD and indefinitely doubt my affection for him. 

This is definitely up to you. I think this is the one of the hugest fears for someone with OCD. I did write a letter you can give to your SO to try to explain things better. It’s available here: https://jackieleasommers.com/2015/07/29/hocd-a-letter-to-loved-ones.

I just want to say, a massive thank you. I´ve been on hell for the past six months, or maybe more. i even thought about killing myself. and i trully did search for so many blogs, but they are mostly about guys so i didnt feel like i found answers. But this is the first site that is from a girl. Made me feel like there is hope. I hope eventually i get to tell you how truly straight i feel i am.

Thank you for your sweet message. I promise you there is hope, and I look forward to hearing from you after you’ve undergone treatment. In the future, if you are feeling suicidal, don’t hesitate to call the National Suicide Prevention Lifeline at 1-800-273-8255 or chat with them here.

I feel like I have accidently made vows to give up things that i enjoy and i didnt want to give them up. I have OCD, but would the vows be binding? For example: “if i step on a crack, i have to stop doing this activity” but sometimes i feel like i mentally agree to it for a split second after the thought comes in my head. Like its 90% intrusive, but 10% my intentional.

I experienced this intrusive vow-making too, back when I was in high school, and it was a dark, dark time of my life. I don’t think that you are bound to these because it is OCD making the vow, not you. In any case, it is better not to focus on “solving” the vow-making but on treating OCD with exposure therapy. Best wishes!

Another vow question. I just feel so stressed because I really feel like I have to give up my two favorite activities according to the vows. After that I am left with no form of enjoyment. Even when I try ERP,  i feel like i am sinning by breaking promises to God and I dont even enjoy doing the activities anymore because of the anxiety.I feel like there is no hope. What do I do?

I also worried that my ERP might be sinful. I hope this post will help you: https://jackieleasommers.com/2014/08/03/ocd-scrupulosity-is-erp-sinful.

Hi Jackie, I have hocd. What worries me a lot is that I don’t have any attraction to guys (I’m a female). I want to like someone but I feel empty and don’t feel any attraction even though they might be perfect for me. What do you think?

Hello lovely, this is perfectly normal for someone with HOCD, and you can defeat it with exposure (ERP) therapy, which you can read about at http://www.jackieleasommers.com/OCD. There are resources there too in case you can’t afford therapy but would like to do it on your own.

Jackie, I’m a female with hocd. I know it is common for people to lose attraction to the opposite sex during this, but will I ever like another guy again?? It honestly feels like I won’t. 

Oh dear one, yes, I truly believe that you will. ERP therapy can help. You are not alone by any means, and I hope that as you read through the questions in this post, you will see that.

Hello! I believe that I have been suffering from HOCD for the past 8 years (this started when I was only 12, unfortunately). I’ve never been diagnosed or treated. However, my question is: is it normal/common for OCD compulsions to change over time?? 

Yes indeed! As obsessions and compulsions shift, we call this “theme hopping,” and you can read about it here: https://jackieleasommers.com/2014/01/19/theme-hopping.

I’ve been told I have HOCD. I have worried about this  on and off. My first time I was 12 & I remember crying to my parents & I think I said something along the lines “I’m staying straight & then I don’t have to be made fun of” now that scares me because that means I’m afraid of society & that’s what gay people go through. Now I feel like I want to be straight just for society reasons. Please help

It is very common for people with OCD to think back on old memories (even ones that have never bothered them before) and suddenly become fixated on them. Sounds like your experience is very consistent with OCD/HOCD. Have you explored ERP therapy? You can read about it at http://www.jackieleasommers.com/OCD!

Hi, I’m a 16 year old girl who has been suffering with HOCD for roughly 8 months now. I have come to the conclusion that the only way to overcome this is through therapy, but I’m scared to ask for help and recieve it. How do I ask my parents? I feel like if I sit them down to ask them for help, they will assume that I’m coming out or they’ll try to get too much information out of me. Help!

I hope that this will help, my dear: https://jackieleasommers.com/2015/07/29/hocd-a-letter-to-loved-ones.

How can I begin ERP for my HOCD by myself?

Hi friend, you can read about self-directed ERP therapy here: https://jackieleasommers.com/2014/10/05/self-directed-erp-therapy.

Should I open up to family & my boyfriend about my HOCD? It terrifies me to think about telling them about it. Can I deal with it alone?

You can choose to do whatever makes YOU feel most comfortable. Please don’t overthink this (I know that’s a silly think to say to someone with OCD, but I want to give you permission to do what you choose). The links in the answers to the two questions just above yours will be useful (I hope!) in choosing whether it is a better option for you to tell your family and boyfriend or whether to go after ERP therapy alone. Best wishes.

Jackie, I’m scared. I had a dream last night in which I married a female I know. (I’m a female with hocd). It was very detailed, including me being with her in bed. This is the second time this female has appeared in my dreams, I have no idea why. I was unhappy in my dream but I’m lost and terrified that this is a prediction to my future???

I know why: because you have HOCD and have been obsessing about this. It makes sense that it would carry over into your dreams. In this interview with a former HOCD sufferer, she talks about having the same experience: https://jackieleasommers.com/2013/10/20/interview-with-a-former-hocd-sufferer. It is not a prediction of your future, dear. It is natural for our waking concerns to sometimes leak into our dreams.

Can HOCD turn into straight OCD, i´ve spent many times on internet which made it worse. and since truly gay ppl have straight ocd, its now like i kinda have that. To be honest i am about to take sleep pills. Hope there is light

There is light. I promise. Firstly, if you are feeling suicidal, don’t hesitate to call the National Suicide Prevention Lifeline at 1-800-273-8255 or chat with them here. OCD can twist and morph through the weeks and years, so that is not unusual. It will do what it can to make you miserable until you learn to be comfortable with uncertainty. The best method for doing so is the evidence-based approach of ERP (exposure and response prevention) therapy, which you can learn about at http://www.jackieleasommers.com/OCD.

Where’s the best place to get diagnosed in the Twin Cities? I’m positive I have HOCD but I’ve never been diagnosed with any form of OCD and I’m worried I’m in denial.

Hi friend, here are a couple resources for you:
https://jackieleasommers.com/twin-cities-ocd
https://jackieleasommers.com/2017/07/24/qa-with-an-erp-therapist

If I’m struggling with hocd, do you think I should stay away from psych forums? I’m already getting help for therapy and medicine though. But do you think it’s my way of just reassuring myself? 

Yes, I really do think it is unhealthy for you to be on the psych forums. Part of your ERP should be avoiding compulsions, and I think this way of seeking reassurance is one. I’m so excited for you that you’re doing therapy and meds though! Are you doing ERP and not talk therapy, I hope?

Please read the following: https://jackieleasommers.com/2014/11/16/talk-therapy-vs-erp-therapy.

I have Hocd been going for 4 months.i always got aroused from girl and lez porn,but I did not wanted to do anything with girls.I once thought about kissing a girl and these things are fuelling my hocd.Yesterday I was horny.I decided to watch lesbian porn to check and I got really aroused i tried to think about having sex with a girl and I felt real arousal like i feel with men.Is my hocd or Im bi?

Does it feel intrusive and unwanted? This is part of how we define OCD.

What do you think of group therapy like DBT for OCD? Specifically hocd

I’ll admit that I’m not very familiar with DBT, though I have heard great things about it, especially in regard to treating things like borderline personality disorder. The evidence-based #1 treatment for OCD is exposure and response prevention (ERP) therapy, a type of cognitive-behavioral therapy (CBT).

Have you read, “All the light we cannot see” by Anthony Doerr? “Everything Everything” by Nicola yoon? And “Unbroken” by Laura Hillenbrand? Those are very good reads. Also, what’s your most favorite book of all time? 

I have read the first two, and I own the third book, but I haven’t had a moment to read it yet! My most favorite book of all time? Man, that’s difficult! I am going to go with Saving Francesca and its companion The Piper’s Son by Melina Marchetta. But everything Marchetta writes is magical. I also love The Chronicles of Narnia by C.S. Lewis, The Book Thief by Markus Zusak, The Scorpio Races by Maggie Stiefvater, The Last Unicorn by Peter S. Beagle, Peace Like a River by Leif Enger. (Sorry, it’s just so hard for me to only say one!!)

https://jackieleasommers.com/2014/08/04/read-these-10-novels-and-we-can-be-friends

Jackie I’m scared. I find myself constantly fearful because of my OCD. I have hocd, and I’m always terrified of the “what if..” although I have never questioned my sexuality, I feel as though nothing helps convince me I’m not gay. Some days I’m just depressed. My mind also wanders a lot. I’m not ready for ERP, but what should I do?

If you are not ready for ERP, the next best thing you can do is start to learn more about OCD and ERP. Education matters. It’s an incredible way to fight back. Track down some books and learn. You begin to steal back power this way.

I’m a female junior in high school, and I sometimes feel hopeless if I will ever get a guy. Every where I look people are in relationships. I’ve never had a boyfriend or even a first kiss. I know god always has a plan, but how can I trust him and know I won’t be alone forever?

Hi honey. I’m 35 and single. I completely get it, I promise. In fact, just this last week, I found myself asking my friends this same question, “will I be alone forever?” I guess that is where trust comes into play. We just don’t know, do we? BUT I do believe that when we love and honor God and follow him, he is the one who gives us our desires– in two ways. He gives us the actual desire– and then fulfills it too. I am being inarticulate. Let me try again. I think that God has given me the desire to be in love. I trust that he will also fulfill that God-given desire with a partner.

Is it normal for HOCD to play a part into ur relationship and make u question ur feelings for a person when u know in ur heart that you love/are attracted to them? Where when ur having guilt&questioning yourself about ur sexuality bc of HOCD u feel like maybe ur not in love w ur s/o or that ur not attracted to them when you know you are but ur intrusive thoughts try to make u think otherwise. 

HOCD and ROCD both cause havoc in relationships, yes. The best thing you can do is to treat the OCD itself with exposure therapy. You can do this, if not for yourself then for your relationship.

I have had HOCD it’s only getting worse. im starting to feel like I’m not in control of my mind. Sometimes Ill convince myself I want to be w a girl when really I just think they’re pretty! I feel like I have to accept being gay to get rid of these awful thoughts&everytime I try to I get so mad bc I know that isn’t me. I’ve always wanted to be with a man, never a woman. I’m scared of my own mind. 

Oh dear one, you are not alone. I promise there is help and hope and light. In exposure therapy (ERP), your brain gets rewired in a healthy way, a way that allows room for uncertainty. That might sound terrible, but it is one of the greatest gifts ever: to be able to let thoughts come and go without having to be sure about everything. It’s a new life. It’s freedom. Please read more at http://www.jackieleasommers.com/OCD.

Thanks for all the questions, folks! If you have questions for me about anything (but especially faith, creativity, and mental illness), add yours here.

As I said, I’m an artist not an expert. I will leave you with these, some of my favorite questions in one of my favorite poems, “Questions about Angels.” Click here to hear Billy Collins himself read it. (P.S. It starts with questions, ends with a dancer.

Q&A with an ERP Therapist

Erin VenkerMeet Erin Venker. I know her through the leadership team for OCD Twin Cities. Erin is lovely, thoughtful, and smart– and she has a unique experience of having OCD and being an ERP therapist. I’m so pleased to be interviewing her on my blog today!

Tell us a little about your background in regard to OCD, Erin.

I first had symptoms in 5th grade but I wasn’t officially diagnosed until 7th grade. At that time, my OCD was mostly rituals of “breathing in” and “swallowing on” the letter A so I would get A’s in my classes. I also did a lot of magical thinking, for example, having lucky and unlucky colors. It soon evolved to include repetitive praying and confessing to mom thoughts, worries, and “bad” things I did, or else I believed something bad would happen. I frequently had horrible intrusive thoughts, both sexual and violent. That period of my life is fuzzy; I just remember it was extremely painful. Daily life was exhausting. I thought I was a horrible person and in constant fear that something bad was going to happen to my family.  I was too embarrassed to talk about my intrusive thoughts, so I didn’t realize that was a part of my OCD until years later.

In college and post-college, my OCD evolved into primarily mental symptoms with rumination, trying to“figuring things out” by replaying scenarios over and over in my head, a constant fear of offending people, and reassurance seeking.

What led you to become a therapist? What are your educational credentials?

I didn’t receive the proper treatment for OCD until 14 years after I was diagnosed. It was at the OCD conference in Boston where I learned that exposure and response prevention therapy was the evidence based approach to successfully treat OCD. I also learned there how common taboo intrusive thoughts were, and that was a huge relief. I decided to become a therapist to help raise OCD awareness and expand the availability of treatment.

I received my master’s in counseling psychology at the University of Saint Thomas and have attended several workshops on exposure therapy. I currently work under the supervision of Dr. Vernon Devine who has 46 years experience treating individuals with anxiety disorders while I work toward my license as a professional clinical counselor.

What services do you offer, and what is payment like?

I specialize in OCD, agoraphobia, hoarding, body dysmorphic disorder, social anxiety disorder, phobias, panic disorder, basically all forms anxiety. I use exposure and response prevention therapy and integrate mindfulness and some dialectical behavioral therapy techniques.

Due to the rising costs of health care, insurance benefits have increasingly become more complex. Self pay ensures that the client’s records and diagnoses are entirely confidential documents as I will not have to submit them to insurance or a third party payer. The content of the sessions stays between myself, the client, and Dr. Devine.

Treatment often involves appointments that need to be longer than an hour, multiple sessions a week, at-home sessions, and public exposures. Self pay allows for treatment freedom as well as the time to get to the root of the problems the client is facing. It makes treatment much more effective. Typically treatment lasts no longer than three months before going to an as-needed appointment basis.

What are the benefits of exposure therapy? How does it work?

Exposure therapy works by essentially helping you confront what you fear the most. For example with contamination OCD, I’ll have clients work on touching and interacting with whatever they believe to be contaminated. If a client has a mental obsession fearing that they are attracted to a family member, we will make a script that they are in fact attracted to that family member. Basically whatever they avoid to protect themselves from their fears, we work up to doing that by creating a hierarchy. We start with whatever trigger the client finds the least distressing and expose them to that trigger until their anxiety decreases. We then gradually move up the hierarchy until the client is ready to confront the most difficult exposures.

Can you briefly describe how you guide a patient through ERP, especially what the first couple sessions might look like?

In the first session, I get to know the client, gather some background information, and go over an assessment I have them fill out before the appointment. We go over details about their presenting symptoms and explore their triggers.  We then begin to build a hierarchy of ways to expose the client to the thoughts, images, objects, and situations that they find distressing and provoke obsessions/compulsions. ERP is no walk in the park, but it is an evidence-based approach that has shown to be incredibly effective.

Many of my blog readers are very concerned about being judged by a therapist who doesn’t truly understand OCD. What advice would you give to them?

Know that whatever intrusive thoughts or rituals you have, no matter how embarrassing, weird, or perverted you believe they are, I guarantee they are extremely common in OCD, and thousands of individuals have similar if not the same thoughts and compulsions. Everyone has intrusive thoughts– people with OCD just get them stuck in their head and distressed. Whatever you find most upsetting, OCD will latch onto it and continuously project it in your head like a song stuck on repeat.

Find a therapist who truly understands OCD. It breaks my heart when I hear about individuals who saw a therapist, tell them about sexual or violent intrusive thoughts they are experiencing, and the therapist does not recognize these symptoms as OCD. This can create further isolation, shame, and hinder the therapeutic process.

Erin Venker 2One last question: reassurance is often a compulsion for OCD sufferers. How can a therapist practice compassion without reassurance? What is your approach to this?

I use a lot of humor in treatment. I try to help clients notice when there OCD is sneaking up on them. Depending on the context and the individual, I will push the exact opposite of the reassurance they are seeking.

I have a rule of thumb that in the appropriate moment, I will only reassure once. I know you are not a pedophile, this is the one and only time I reassure you. After that, it’s all about accepting uncertainty. Well, maybe that thought does mean you want to kill someone, let’s make a script of it happening. At the same time, I validate the client that ERP is extremely difficult, and what they are doing is brave and hard work.

Thank you so much to Erin Venker for a great interview! If you are in the Twin Cities and think you could benefit from working with Erin, click here for her contact information. 

nOCD, an ERP App/Hero

If you’ve spent time around this blog, you know that I wrestled my life and freedom back from the clutches of obsessive-compulsive disorder in 2008. (Read more about my story at jackieleasommers.com/OCD).

From the onset of my symptoms to my diagnosis: 15 years.
From my diagnosis to appropriate treatment (ERP): 5 years.
From treatment to freedom: 12 weeks. (<–Read that again please.)

Exposure and response prevention (ERP) therapy is powerful, friends.

On average, it takes OCD sufferers 14-17 years to get the correct diagnosis and treatment. This is not okay. 

So many OCD sufferers cannot afford treatment. In some countries, ERP therapy is simply not available. In fact, in some countries, the stigma associated with having a brain disorder like OCD is so strong that sufferers would not dare admit to needing help. This is not okay. 

The creators of the nOCD app felt the same way. One contacted me and said, “Our goal is to reduce the time it takes for people with OCD to get effective treatment (from decades to minutes).” He said, “One thing advocacy has shown me is the need for OCD treatment in other countries! There are people in Bangladesh, India, etc that have literally nobody! My team is actually building a 24/7 support community within nOCD to combat this issue.”

The app is FREE and, I-hope-I-hope-I-hope, going to change the world.

Some of the very best things about this app:

nocd.jpg

Right now it’s available for iPhones, but this fall, the Android version will come out. Please check it out here. And be sure to tell me what you think!

xoxo Jackie

Question & Dancer: What is “Normal” with OCD?

question-and-dancerI’m an artist not an expert, one who is learning to embrace questions more than answers.

These are some questions I got last month. Ask yours here.

My question is this.. I have hocd but whatever I do it just seems like I get afraid or concerned when a guy comes around me.. it’s like sometimes I look just to check if im attracted to them.. and it’s annoying because the action is becoming involuntary and it’s scary because people read what you send them .. and people are starting to think that I’m gay! And thats very false! What should I do to combat that?

Exposure and response prevention (ERP) therapy, which I’ve written about extensively on this blog: check out http://www.jackieleasommers.com/OCD, friend. Educate yourself on ERP; then seek out an ERP specialist or track down one of the books I recommend so that you can do ERP on your own. Either way, ERP is the solution.

Please read here about Self-Directed ERP.

i’ve met we a psychologist- but she doest seem to have any experience with HOCD and thus has not really been catching it’s symptoms/mentioned it, she does think i have an anxiety disorder and excessive worry- but not specifically anything on OCD. Note she is relatively inexperienced psychologist, as i’m a student and needed to find someone low cost. Not the psychologist has little experience as i’m a student and need a low cost specialist. She has mentioned CBT and ERP as helping methods though. so, what i wanted to ask is form what i have described do i sound like i have HOCD or an i in denial. I am not trying to seek reassurance but guidance, I don’t have anyone to turn to (from a very backwards society in asia) – should i be looking for an OCD specialist or a general psychologist to help me come to term with who i am?

Hi dear! You need an OCD specialist, specifically an ERP specialist. If you can’t afford to meet with one in person, then definitely track down a book (I list four on my website) that will guide you through doing ERP on your own! And kudos to you for being ultra-aware of seeking reassurance. That is one of the primary compulsions for many who suffer from HOCD– the more you are aware of it and resist it, the better! Click here to read more about the Problem with Reassurance.

Hi Jackie. I was wondering if you have any strategies to just letting the thoughts be thoughts in your head. On the web (when I looking for reassurance yes I know its sooooo bad but I can’t help it), people say to let those intrusive thoughts wonder in your mind, but do I just sit there and think nothing as those thoughts wreak havoc on my emotions? Do I just try to calmly breathe through it when my heart is beating super hard? It’s also so hard to not check for reassurance online! How did you have the strength to not reassure yourself? What did you say or think to yourself to prevent it? (I can’t afford a diagnosis, much less ERP so I’m scared that my HOCD may be actually be in denial, but I do know that I’ve had many obessions and compulsions in the past and when the professor talked about OCD, my first thought was THATS ME but then it’s also never been severe to the point where it has disrupted too much of my life. I would just cry myself to sleep most of the time when I’m obsessing)

When I read questions like this, it takes me back to specific memories– horrible, manic ones where I could not calm down, could not do much of anything except to cry and ask for reassurance. It feels so helpless and hopeless in those moments, but I promise it’s not! First of all, since you can’t afford an ERP therapist, please track down one of the books I recommend on my site so that it can guide you through ERP at home. For me, I had a set amount of time when I was intentionally practicing ERP– for me, it was about 40 minutes, twice a day (total of 80 minutes). In the grand scheme of the day, that’s under an hour and a half of putting myself through these exercises (which sometimes felt like torture). Although I did try to avoid compulsions throughout the day, it was only during these 80 minutes that I was specifically triggering myself (exposure) and resisting compulsions (response prevention). It is hard. Don’t let anyone tell you differently. It’s hard and exhausting and feels masochistic. But for me– and for many others– it worked. And it was worth 80 minutes a day for 12 weeks in order to experience this freedom– I’m coming up on nine years of it.

Hi! I’ve been having what I (hope)think is HOCD for two months now and it’s been an intense hell for me. I’ve always been confident that I’m straight and I’ve even intensely championed for gay rights and everything. I used to read articles about gay people and watch videos about people coming out and be fine. But now I avoid all of those and even romance novels because I’m basically terrified of being aroused for the wrong reasons (like if I read a love scene from a guy’s point of view that means I want to do that to a woman when I dont!??!?!?!?). I’ve been trying to do self-ERP and I’ve read that I’m suppose to embrace those “you are gay” “you are turned on because you actually want to do that to a woman” thoughts and the arousal that comes with it. My question is, if I embrace these thoughts for 10-12 weeks, will I really be healed? I JUST WANT THIS HOCD THING TO END.

I don’t think I or anyone can guarantee that 12 weeks of ERP will work for you. But it is an evidence-based treatment, meaning that the statistics of ERP working are in your favor. One thing I can almost for sure guarantee is that if you don’t do ERP, then your OCD will not go away on its own. I suppose it’s possible; miracles do happen. But, for 99% of us in the OCD community, we had to do the hard work of ERP.

Hi Jackie! I’m doing self-ERP for my HOCD right now and although I feel like it would be best with a therapist, I can’t afford it 😦 (maybe one day!) But anyways, my question is that I know when I’m doing ERP, I’m suppose to accept and AGREE with those thoughts of “Yes, you’re probably a lesbian” (gosh it was hard to even type that), but when I’m not doing ERP, do I still have to agree with my intrusive thoughts or should I just let it float around in my head? I know for my past OCD fears (earthquake, breast cancer, blackholes, intersex, death, etc) I would just stop checking and doing my compulsions and would let the thought float around in my head (never did ERP for those things) and a couple hellish months later it would disappear, but HOCD is taking my anxiety to another level (especially since I’m 20 and never been in a relationship with a guy because I’m soooooo shy so now my HOCD is using it as ammunition). Also when I have those OCD-free moments, can I go back to thinking about my crush and the imaginary life we may have one day (wow I’m so weird, I can’t believe I confessed this on the internet) or is that counter-productive to my ERP?

No, I don’t think that’s counter-productive to your ERP. That’s the goal! But during the moments where you are doing your ERP exercises, then yes– you will want to be all in: experiencing the anxiety completely, resisting the compulsions as completely as you’re able. One thing that you wrote specifically interests me: “I would just stop checking and doing my compulsions and would let the thought float around in my head (never did ERP for those things)” … this sounds like it was ERP, friend. Letting thoughts come and not doing compulsions to alleviate the anxiety … that is what ERP is. You can do this.

Hi Jackie, I’ve recently stumbled upon your blog because I am suffering from hocd. I’ve been dealing with it for around 9 months now. I feel so lost because it’s the worst time to really be dealing with all of this. I am a sophomore in high school and all around me people are questioning their sexualites or coming out etc. I line up with all hocd symptoms and anxiety runs in my family. The intrusive thoughts just popped out of no where one afternoon. All my life I’ve liked boys! I talked to my therapist about ERP but she’s not a specialist and I’m scared to even try it. My psychiatrist prescribed medicine that ended up making me worse. Like you I am an avid Christian, but I have always been doubtful and indecisive with everything. I FEEL SO LOST. I’ve lost my hope and feel like nothing is gonna work. I have a hard time believing this could be a disorder. I feel like I should just accept my intrusive thoughts are real but that just depresses me further. What do you think?

Hi honey. If your intrusive thoughts were real, I don’t think they would be intrusive or cause this intense anxiety. For a short time, just suspend your concern that you are dealing with anything other than OCD and tell yourself, “Yes, it IS OCD, and I will treat it.” There is no harm to doing ERP even if you didn’t actually have OCD. Be kind to yourself: accept your self-diagnosis at least for three months while you do ERP on your own with a book to guide you. “Doubtful,” “indecisive,” “so lost,” “lost my hope and feel like nothing is gonna work” … all of these described ME. For nearly 20 years, this is how I would have categorized myself. And, for whatever it’s worth, my sophomore year of high school was HELL, one of the worst and hardest years of my entire life, as I dealt with all of this while undiagnosed. When I was your age, I still faced another 12 years of clawing my way through this alone before I found and did ERP. Please don’t wait as long as I did.

These three questions all reminded me of each other:

1. I have been diagnosed with OCD (HOCD) and have been doing CBT and ERP. I feel as though I am getting better and the intensity of my obsessions and compulsions has reduced but I have this strange feeling of sowmhing not being right and as whole as it use to be? My attraction and desire for relationships and such seems very reduced. It just doesn’t seem to feel or come authentically – is that normal?

2. Is it normal to feel no attraction or interest in romantic relationships when suffering with HOCD, even when recovering (reduced obsessions and compulsions, but the feeling of not knowing your sexuality and not being attracted to the gender you always have been attracted to?

3. Is it normal to become hypersensitive to the looks of your same sex with the onset of HOCD? even if you’ve known and seen the person before they just appear a lot more attractive now? Is that a symptom of a change in sexuality or another Possible HOCD Symptom?

Yes, my dear ones, all of this is normal for someone with HOCD. Please don’t give up. ERP can help.

Hi Jackie, Did you ever feel like your hocd would never end? As a current hocd sufferer, I feel a lot that it’s never going to be over. I question and doubt even the most logic of facts I’ve been told to use in order to help cope with the intrusive thoughts. Everyday it’s a new “what if” question and it makes me terrified and sad.

Hello sweetie, YES. I felt that way about all of my OCD themes … that things would always be this way and that, to me, was probably the scariest thing about it. We can go through any pain so long as we see an end in sight, don’t you think? But OCD lies to us, makes us believe there is no end in sight, and that robs us of hope and joy. Please read this blog post I wrote back in 2014: THINGS WILL NEVER BE OKAY AGAIN [& other lies I sometimes still believe].

I am 54 years old recently my ocd has become worse for last 6 months since i changed my job and because of ocd anxiety i am not able to work at present. My ocd is mostly god related i have to pray and touch god photos everytime i pass through them and think i have not prayed properly and become anxious. Also there are lots of thoughts coming and going in my head always about touching god photos etc and i am not satisfied with my praying i tried medicines and they made my condition worst,Please help me Sir

Hello friend, have you heard of ERP therapy? My OCD was also based primarily around religious obsessions; I battled this for 20 years before undergoing ERP, and just 12 weeks of ERP therapy snapped my OCD in half. The last nine years have been so peaceful, so free. Here are a few posts that might help:

OCD & Christianity
(or other religious scrupulosity)
OCD, ERP, and Christianity
I’m a Christian and Take Meds!
Unashamed of my OCD
Is the thought from OCD … or God?

God’s Sovereignty, OCD, the Cross, & His Purposes
Is Mental Illness a Spiritual Issue?
Is ERP Sinful?
OCD & Faith (or Lack Thereof): a Double Interview

Hi Jackie, I have been suffering from hocd for a while now. One of my biggest problems besides the intrusive thoughts and fear I can’t shake off is the EXTREME SADNESS I have. I feel like I get sucked into this dark hole where I can’t get rid of feeling hopeless and sad. I lose all motivation to do my homework and just feel angry at god. Have you ever felt this way? If so, what did you do to help yourself?

My gosh, YES. 100% yes. I am guessing that you have depression comorbid (alongside) OCD, as I did. For me, the OCD was the root issue and what was causing the depression, so when I treated the OCD, the depression alleviated as well. I talk about my anger at God a little bit in this post. Ultimately, I got so sad and felt so lost that I hit rock bottom– and God was there. He looked like a Korean psychiatrist who gave me hope, a prescription, and a phone number for a local ERP therapist.

Hi Jackie, I finally realized my problem is OCD. My question is, do people with this “doubting disease” have the capacity to have faith? I’m so worried I might lose faith altogether, because of what’s wrong with me.

Yes, absolutely! In Yes Novel (my work in progress that has been temporarily set aside), the main character has this interaction with his professor:

He nodded, headed toward the door. But before he left, he turned around and asked, “What you teach us in class, do you really believe it?”

Dr. Morgant pursed his lips thoughtfully. “On my worst days and my best days, yes. But not every day. There’s only one thing in I believe every day.”

“Doubt,” said Asa, as his teacher said, “Faith.”

“Same thing,” said Dr. Morgant with a smile.

Anne Lamott has said it best:

I have a lot of faith. But I am also afraid a lot, and have no real certainty about anything. I remembered something Father Tom had told me–that the opposite of faith is not doubt, but certainty. Certainty is missing the point entirely. Faith includes noticing the mess, the emptiness and discomfort, and letting it be there until some light returns.

Thanks for all the questions, folks! If you have questions for me about anything (but especially faith, creativity, and mental illness), add yours here.

As I said, I’m an artist not an expert. I will leave you with these, some of my favorite questions in one of my favorite poems, “Questions about Angels.” Click here to hear Billy Collins himself read it. (P.S. It starts with questions, ends with a dancer.)

Question & Dancer: OCD & Family, Romanticizing Mental Illness, and What to Expect in OCD Remission

question-and-dancerI’m an artist not an expert, one who is learning to embrace questions more than answers.

These are some questions I got last month. Ask yours here.

How do you explain OCD to your family? Especially when you’re not sure whether or not your family has mental illness?

First I’ll say that I think that it’s up to each individual to determine whether or not they’d like to share– and how much. With OCD, many of our obsessions are taboo, which– quite honestly– makes the idea of sharing seem terrifying. I hear from a lot of younger sufferers too, who are under their parents’ roof and parents’ health insurance, which complicates treatment.

I heard from so many teens with HOCD that I wrote this post in 2015 so that they could share it with their parents and not have to say a word themselves. I’d be happy to write a general OCD one, if you guys think that would help.

As for me? I gave my mother a copy of Kissing Doorknobs by Terry Spencer Hesser– a copy in which I had underlined all the quotes that resonated with me. At that time, it was the best I could do to explain what I was experiencing. These days, I’m more articulate– but I have lived for longer with my diagnosis, been through treatment, and come out shame-free. I know many aren’t there yet.

Is HOCD a physical illness as well as mental?

Briefly, yes.

Hi, does OCD make you want to confess something even when it’s not true?

I have Pure-O, and confession was one of my biggest compulsions. I would confess to bad thoughts, things I thought might be sinful, anything that my OCD took and throttled me with. And yes, sometimes those were things that I didn’t even need to apologize for. But the anxiety would grow so intense that the only “release” was to confess. I got a lot of weird looks in those days.

Here is the thing: if you (like most people with OCD) can understand when you’re thinking or doing something off (you know it is not quite logical, even if you have created a weird sort of logic for it; or if you know it is something that the general public would not care about or confess), then don’t. This is fighting back against your OCD with the tools of exposure therapy. It will, for a time, feel like the anxiety will go so high that things will never be okay again, but that is the lie of OCD. The anxiety will diminish, and you will be okay. Stay in the cold pool long enough to adjust, and eventually the water will not feel cold anymore. But this can only happen by staying in the pool.

I read your post about OCD and creativity. Could those two ideas be linked to intelligence?

Great question. You’re likely referring either to this post or to this one.

Research has shown that high IQ is correlated with anxiety. Anecdotally, many people with OCD are also very creative (did you know popular YA authors John Green and Maggie Stiefvater both have OCD, along with unpopular YA author Jackie Lea Sommers? ;-))

HOWEVER, OCD is not something to be embraced. I know that in the past, I thought if I didn’t have OCD, I wouldn’t be as funny or quirky or creative. John Green, in a talk I once heard, shared that he also had that false understanding for a time– that his OCD was what fueled his creativity. He’s written about that here. Please read it; it’s very good.

The point is that– whether or not there is a link between OCD (bad, awful thing) and creativity and/or intelligence (good, excellent things)– we need to be careful not to romanticize mental illness or to give props to it. If you are smart or intelligent, kudos go to you, not to the disorder.

I treated my OCD in 2008, and now I am more creative, more me, more productive, more intelligent. So it wasn’t OCD that made me what I am at all. In fact, OCD was holding me back. Don’t romanticize mental illness. Treat it.

Hi…this is a weird question, but I’m worried ERP won’t work on one of my particular obsessions. I made some account on a website and now feel the compulsive urge to delete it because maybe I don’t like the username and it’s “contaminated.” But at the same time, I don’t want to delete it because I’ve invested some time into building it up (it’s a writing website, more articles you write higher rating you get)…but I’m worried if I don’t delete it, this anxious feeling will never go away!

That is a lie: the anxious feeling will go away … and possibly sooner than you’d think. ERP works great for situations such as these. You can do this.

With OCD, can it be possible that you don’t know the difference between what thoughts are even yours anymore or the OCD’s?

That is possible– and sometimes happens to me when I’m in sort of a manic state.

Most often, I can tell the difference. I know that one thing feels a bit ridiculous. And this is a hallmark of OCD (except in very young children): that people with OCD usually have some understanding that what they are obsessing about is not something that most people would worry over.

My ERP therapist taught me to look at these things through the lens of the “community standard.” That is, how would most people react in this situation? Because if my reaction is way off from that, then for ERP, I need to go with the community standard instead, even if it’s scary or hard.

When I am in the throes of an obsession, I sometimes can’t tell what the community standard is. I have literally sat down my friends or coworkers, explained the situation, asked for the standard response, and then BELIEVED IT and DONE IT, no matter how difficult. Because this too is part of exposure therapy, the very best treatment for OCD. (If you’re not familiar, you can read up on ERP at http://www.jackieleasommers.com/OCD.)

I have thoughts about death and how we will all disappear after this…and if life is meaningless or not I’m diagnosed with OCD and i had HOCD , harm ocd , etc… Is that a new theme or is that something new ?

This sounds like an existential theme of your diagnosed OCD. This was a huge part of my own experience, and what my first novel is about! See http://www.jackieleasommers.com/truest.

With your OCD, do you ever feel that you’re wearing a mask everyday?

Not anymore– but before, YES YES YES.

I used to talk about this with high school students in the midwest, and I would read this poem aloud.

I’ve been struggling with ‘Pure-O OCD’ for a while and because my compulsions are almost exclusively mental, I’m afraid I’ve been automatically engaging the negative sensations associated with the thoughts I get. Although I know the thoughts are very irrational, I can’t seem to be mindful enough to sit with the negative emotions and not have them affect my mood. Little by little, over the years the thoughts are triggered by almost any activity I’m involved in and I feel like I’m running around in a circle and not making much progress. Activities and events that are supposed to be enjoyable are viewed by my brain as hurdles and obstacles to overcome. As far as CBT goes, I tried following the 4-step method by Dr. Schwarz which help a little to put me in the right mind set but I haven’t had much sustainable success. Being a Christian, I feel like I’m wasting time giving in to the negative pull the thoughts I get have on my behavior, which in turn, rob me of valuable time spent acting as a true follower of Christ. Based on your experience with Pure O, what would you say is the best CBT method to effectively manage it? Is it ERP or mindfulness, or a combination of both? Thank you

While I know a lot of OCD sufferers who practice mindfulness, the #1 treatment recommended by all OCD experts is ERP (exposure and response prevention) therapy. Your story sounds so, so, so, so similar to my own. I went around in circles for 20 years before doing ERP. After just 12 weeks of ERP, I have had tremendous freedom, peace, joy, and spiritual growth for the last 9 years. You can do this!

I hope you’ll take the time to read my post about Post-ERP Spiritual Growth. It really summarizes all the healthy changes that came about in my life and faith after treatment. Blessings!

I feel like I might have OCD..maybe ROCD for a while, but that cleared up so I’m unsure about that. I’m 13 years old (a girl) and I think I have been dealing with hocd since the end of 6th grade (11 years old). I have been with my boyfriend for 7, almost 8 months. This hocd is getting better…I think. I always feel like there is another person in my mind telling me that I’m gay. I sometimes don’t feel as disgusted as I usually do when that happens, and that scares me even more. I wish I could tell my boyfriend, but I feel like he would think I actually am gay. Also, Recently i have the tendency to look at girls’ butts and boobs! Is this normal? Is it not hocd? It bugs me so much, and I feel so disgusted and guilty. I’ve never wanted to kiss, date, or do anything sexual with a girl. Whenever I see a girl, I think “she’s pretty.” And then I start questioning myself. And I think “is she attractive? Do u want to do stuff with her?” And soon it calms down. But it comes back as quickly as it goes. It’s so scary. I want it to go away for good. I told my dad two years ago when it wasn’t as bad. So he doesn’t know the full story. My mom knows and I told her recently. She doesn’t understand how horrible it is. I don’t want to tel her everything I question and feel because I don’t want her thinking that I am gay. Even though she would be fine with it. But I’m not. I want that therapy. I’m on medication for anxiety, but it’s not helping too much. This hocd causes me anxiety and depression. I went through a really bad period of this about a month ago, for two weeks. I wanted to die, and I’d use my nails to scratch myself. I don’t know what to do. I wish I could tell my parents, friends and boyfriend, but I don’t know what they would think. Please help me. I want an OCD free life.

Oh sweetheart, please read my answer to the first question above. I think it will help you. Consider sharing this post with your parents. ERP works; it truly does. You are thirteen and have so many exciting things ahead of you– your whole life! The earlier you treat OCD, the sooner you can get to enjoying things again. If you really feel like you can’t tell your parents about your OCD, and if you’re driven, you can treat it yourself at home, using one of the books listed in this post. Don’t give up, honey. Gosh, I can remember being in the same hell that you’ve been living in when I was your age. It feels so horrible and hopeless and exhausting. But you won’t be there forever. ERP will help. Hang in there.

Want to know more about consequences of years of compulsive behavior and thinking haunting life…even after ocd is gone

This is a really good question, one I’ve not been asked much before.

First things first, OCD is very rarely ever gone. Except in the case of a miracle, OCD is a chronic disorder that a sufferer has until death. That said, ERP therapy can subdue it to the point where it feels gone, which is just about as good as the real thing, right?

I’ve written a pretty detailed post about remission and relapses here. While I think it will answer an aspect of your question, the spirit of your question seems to be: what lingers?

For me, not much. (Thank God!) OCD has little to do with my daily life anymore. That said, there are seasons (and in fact, I’m in one right now) when it is like opening a rarely used door in my life only to find that OCD has actually been chilling out there for years, just waiting for you to reenter that old room. (For me, it’s dating. I haven’t dated in a while, and so I haven’t had to deal with the whole ROCD thing. It’s okay. I’m battling it, and I have all the confidence in the world that I can subdue it because I’ve done it successfully now for nine years.) For me, the 12 weeks of ERP therapy I underwent had a far longer-lasting influence on my thought patterns than the 20 years of obsessions and compulsions that came before. It is that powerful. Learn more about ERP at http://www.jackieleasommers.com/OCD.

Thanks for all the questions, folks! If you have questions for me about anything (but especially faith, creativity, and mental illness), add yours here.

As I said, I’m an artist not an expert. I will leave you with these, some of my favorite questions in one of my favorite poems, “Questions about Angels.” Click here to hear Billy Collins himself read it. (P.S. It starts with questions, ends with a dancer.)

 

Dear Diary: Salt, Sickness, & NOT YOU AGAIN

A (not so) little update for you:

Salt Novel

Oh my gosh, I finally finished revising my synopsis and am ready to dive into revisions! This took me a lot longer than I expected, but that was foolish of me: why would completely reorganizing/restructuring a novel, reconfiguring motives, and solving problems of fictional people be considered a weekend project? Ha! While I still have a few things to iron out, the majority of it is sorted out, on paper, color-coded. It looks gorgeous. (Okay, only to me.) I feel so excited about these changes– especially because I haven’t started trying them and failing yet. 🙂

Sickness

I’m getting better! I was down for the count for a stretch, but I’m bouncing back finally. Has anyone else been sick? Sounds like it’s been going around. I got so much extra sleep this past week, and it felt incredible. I even had some of those naps where it feels like you were out for about three years. Mmm!!

Online Dating

… is so weird. And I think, in general, a lot of men are pretty confident (and wrong) about what they think women want. That’s all. For now.

ROCD

One thing that really surprised me with the whole online dating thing: my OCD has come out to play again. Ugh. I have lived as close to OCD-free as is possible since 2008, when I went through exposure therapy to treat it. In a lot of ways, OCD has felt like a part of my past, something I experienced a lifetime ago. Then, guys started talking to me.

It’s crazy how fast OCD/ROCD symptoms blasted back into my life. I was not prepared for it.

But, and maybe this is a little embarrassing to admit … I haven’t really been in the world of dating during my remission. ROCD hasn’t come up because, well, it hasn’t come up. You know? So, now I’m talking to this cute guy, and I’m a WRECK. Thankfully, I was able to recognize it as OCD, and now I’m re-learning how to love the uncertainty. Again.

Sigh.

🙂

Wrists

Months ago, I posted a cry for help in regard to my RSI. One reader (thank you, Ash!!) commented with the name of a book by Pete Egoscue, Pain Free at Your PC.

This is changing everything for me. I’m sooooo grateful. Right away, in reading the book it became apparent that I needed to be symmetrical, and I knew that I wasn’t. (My left leg has been shorter than my right since I was in middle school.) I got a heel lift from my chiropractor, and that was the beginning of the changes. I’ve also been doing Egoscue’s exercises a couple times a week. I feel better than I have in years.

Creative Goals

Salt Novel, coming together.
Book a week, check!
Blog every week, done.
Learn something new every day? I am, but I have sadly not been recording everything.
Yes Novel … it’ll come.

And you?

Drop me a line– I’d love to hear from you!