Gathering of Good People

OCD- Most Difficult Mental Illness (2020)

Have you ever had a thought that just looped and looped?

Or maybe you found yourself doing something you didn’t want to do, but couldn’t stop yourself.

Repeating thoughts are called obsessive thinking patterns. And behaviors that you can’t stop are known as compulsions.  OCD or Obsessive Compulsive Disorder occurs when looping thoughts drive compulsive behaviors.

Most people think about OCD as excessive hand washing, and there is a kind of OCD that has to do with a fear around germs and health issues, but OCD is so much more.  Today, I want to share with you about OCD and particularly why I see it as one of the most difficult of all mental illnesses to treat.

I have a client, Kate, who worries all the time about keeping her house clear. Pretty classic, right? Everything has its place and is in its place.  But…wait a minute, does that mean everyone who has a clean house has OCD.  Well, people with more messy houses tend to think so.

I keep my house organized.  My closet is completely systematized, with my shirts organized by color and by style. Short sleeves are separated from the long sleeves.  I even have different colored hangers for the different types of shirts. Short sleeves are on dark hangers, while long sleeves are on medium tan hangers.

I organize my cupboards, with my glasses separated and also turned up right and then upside down, maximizing the space.  When my wife puts away glasses, she puts them every which way and it fills the bottom as well as the middle rows.

Do I have OCD? Love to hear your comments below.

I have had OCD, and I know all too well what it feels like.  So, I would tell you NO. Why, because my thoughts don’t loop about it, nor do I feel driven by anxiety to do it.  I don’t have the “O”, obsessiveness, nor the “C” compulsions.

Mental illness, or a disorder requires dysfunction.  For me to have OCD, I would need to feel bad, or be trapped in bad behaviors.  These negative feelings and actions would then disrupt my life in some way.

I used to be very anxious about particular behaviors, and I had to do them or the anxiety would spike off the charts.  Now, I am organized because I enjoy being organized.  My organization is functional, not dysfunctional.

Back to my client, Kate, now she had OCD.  When things were a mess, she was a mess.  And even when things were clean, she was hyper vigilant, on guard, for anything out of place.  Her excessive cleaning stopped her from interacting with her children. It prevented her from having people over, in fear something would be out of place and she may be judged.

To evaluate if you have OCD, or someone you love, you need to ask yourself the question, do I have thoughts and behaviors that control me through fear?  Am I robbed of joy because of my worries?  Do I find myself driven to act in ways that I don’t have control over?

With Kate both those conditions existed and she was a slave to her home.  She couldn’t go to bed until the house was put back together.  She never could sit still, and was forever focused on picking up and putting things away.

Out of all the mental illnesses I have treated OCD is the worst and most difficult. It is only beaten out by schizophrenia. And actually these two have a common issue that makes them resistant to treatment.

OCD is particularly problematic because you don’t see it as an illness, but a reality. Schizophrenics can’t tell the difference between truth and delusion. Hallucinations are perceived as real. With OCD a patient can’t distinguish between normal healthy thought, and their obsessive thinking.

With other forms of depression and anxiety there is an understanding that something is wrong. When I am crying all the time and can’t get out of bed, I know this is not normal and there’s a serious problem. Depressed people know their suicidal thoughts are not healthy.

In moments when I am flooded by my fears, I know there are no saber tooth tigers ready to eat me, but yet it feels like it. Those fears I know are disproportionate to the situation. I can tell the difference between rational and irrational thoughts.  I may not be good at controlling my thoughts but I know the difference.

With OCD, not only is your emotional mind out of calibration, but so is your thinking mind. OCD is an illness that affects that prefrontal cortex, and therefore causes a dysregulation of thought. People with OCD overthink. Their thoughts become tied to the core need for safety and survival.

Typically, the thinking around OCD is… “If I don’t (do whatever or worry about whatever) then bad things will happen.” The thought distortion centers around the ideas you are protecting yourself or others from harm by your worries and your compulsions. If you were to not worry or not act, then you would be bringing on horrible consequences, maybe even death, for you or someone you love.

All that worry and anxiety sucks, but it’s not the worst part of the problem. What makes OCD difficult to treat is not the level of anxiety or it’s resistance to treatment. The true problem is that someone with OCD believes the lies their disorder is producing.

Kate knows her cleaning is obsessive, but any attempts to change her behavior, to relax or to stop her cleaning, produces intense fear.  These fears are what make OCD an anxiety disorder.  However, what’s different with OCD is then Kate begins to think and think. What comes up again and again is… “what if?”

“What if it’s all true? What if I stop and then something does go wrong? I can’t take that change.”  Kate’s own thinking talks her out of change.

Her over thinking goes on.  “What if Brett doesn’t understand? What if no one understands?”

Compulsive looping thoughts like those we see with OCD, have but one goal; to loop. Your looping thoughts will do or think anything in order to keep looping. Anything or anyone who tries to break the loop, even if it is you, will be questioned, challenged, and doubted so extensively and completely most cognitive interventions will fail.

OCD clients struggle with treatment because their thinking mind questions and doubts its effectiveness.  “This isn’t working. Nothing is going to work.”  “It’s all a bunch of BS.”

CBT or cognitive behavioral therapy, has been proven to be effective with OCD. However, there is an essential first step. A person with OCD must understand their thinking mind has been compromised by this disorder.

The term I like to use is called Discernment.  You have to learn to discern distorted thinking from healthy thinking.  You have to be able to listen closely to your own thoughts and be able to pull out the thoughts that are useful and those that continue the looping.

Culturally, we have talked about feelings as separate from thinking, and we have even believed emotions can be dangerous and misdirected.  There is a long cultural history of distrusting our feelings.

Most people identify themselves as the thoughts, or words, in our head.  We are always thinking, and we all tend to think of ourselves as our thoughts. This is what makes OCD so problematic.

OCD takes over the amygdala, as do most anxiety disorders, as well as the prefrontal cortex, or your thinking mind.  It’s easy to say my emotions are lying to me, but it becomes confusing to realize YOU ARE A LIE, or your thinking mind is lying to you.

A core principle used here in the Gathering of Good People is the idea you are NOT your thoughts.  In fact, you are not your feelings, or your behaviors.  This is a radical idea for psychology.

Yes, if you have OCD or any kind of mental illness you will have lots of negative thoughts, feelings, and actions.  If you believe these symptoms are YOU, then what happens when they stop?  What happens when you aren’t anxious, or you feel happy? Do you stop existing?

Well, this is exactly the lie that your OCD will tell you.  To stop thinking in a particular way means you are not being honest.  If you dispute your obsessive thoughts your anxiety will spike and it will feel like that saber tooth tiger is about to pounce.

If you have OCD, my heart goes out to you because I know the kind of torchure both your thoughts and feelings are producing.  You can’t get out of this trap alone, because you can’t tell what is true and what is a lie.  You need others.  Therapy and medication can be very helpful.

What I did with Kate, was to help her to start doubting her doubts.  She learned to step back and quiet your mind or at least learned to step back and observe her own thoughts.  The core skill she learned was to disassociate and discern her own OCD thoughts.

By learning her true state as the witness and the observer of her thoughts, feelings, and actions, she then could begin to interrupt and shift her thoughts, feelings and actions.

Don’t accept your thoughts as truth or reality, look at your own thinking and feelings as maybe a loop or a pattern that can only be seen from the outside.  Only by stepping outside your thoughts and feelings can you truly see your thoughts and feelings.

I don’t expect you can do this kind of mindfulness on your own.  We all need each other. When you are stuck, you need someone else to help pull you out.  The problem with OCD is that you don’t believe others, and you only believe the lies.

Please join the Gathering, GatheringofGoodPeople.com. By learning from the blogs and vlogs you will better understand yourself. But even more importantly, by shares with others on the forum you can begin to see yourself from outside your OCD thoughts. Only together can you step outside your feelings and your thoughts. Once you can see your patterns then you can interrupt the OCD thoughts that are destroying your life.

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