Game Plan

Here’s another great article by Dr. Steven Phillipson, entitled “Strategies for Managing OCD’s Anxious Moments (Dance with the Devil)”. It’s the same old “OCD-as-the-Devil” analogy which actually works quite well.

It actually says “By L. Potter and the Friday Night Group — Adapted from Speak of the Devil by Dr. Steven Phillipson” so, um, I’m not sure how to correctly attribute an author here. But there’s the information; you figure it out.

The piece first goes into OCD’s “game plan,” then suggests what ours should be in dealing with it. One thing that particularly resonated me was that OCD tends “To exploit moments of weakness that come at the worst possible times in your life, i.e., when you perceive that it will be disastrous to become anxious.” That’s definitely true for me! Just like when I’m eating or expected to give a speech or sometimes even finish a sentence my breathing tic will creep in, at the worst possible times my OCD fears pop up, too. It’s not coincidental — those are moments I am more vulnerable to all my fears, especially my worst ones. Most of the time it simply means I have to watch out at the end of the day when I’m tired, because my OCD is bound to cause me to start worrying about something then. Which is funny, because normal people are like “I’m too tired to worry about little things right now” whereas my brain is like “I’m tired — that means I might’ve missed something important that I should be worried about!” But it also means I have to be wary of important times in my life — the loss of a loved one, happy occasions such as weddings, or anything terribly affecting whether negative or positive. It’s these times that I feel the need most to protect myself, and my OCD is trying to do that, but doesn’t realize it’s doing a horrible job. That’s why it ends up being called “Devil” in articles like this — it’s not a bad guy or an enemy, really, it’s just our brain, and our brain wants to protect us, but sometimes its logic is all wrong.

Also from the article: “Consider not rationalizing with the devil: do not attempt to treat the OCD by logically disputing the irrational nature of the spikes.” This is important because when you engage the OCD thought directly, you won’t win. This is probably why I have a knee-jerk reaction when people tell me “Don’t worry” which actually makes me worry even more. The thing you want to do when dealing with someone with OCD is not to tell them not to worry, but instead encourage them to objectively examine their thoughts and fears. A great way to do this is by asking questions instead of making assumptions or giving advice. Instead of saying “That’s a silly thing to worry about” or “You can’t change that” ask questions like, “What are you feeling right now? Why does this make you so upset? Is there anything you can do to affect this situation?” Or, try taking the fears at face value and see what happens. “OK, maybe all those dishes really are still dirty. But — are you sure the napkins are really clean too? What about the table? What about the cleaner you used on the table — how do you know that’s not poison?” If you can eventually get the person to realize there is some degree of uncertainty in all aspects of life, they will either A) Become motivated to accept uncertainty and begin doing so or B) Break down, shut themselves in and do as little as possible. Now of course B is a bad thing, but sometimes things have to get worse before they get better and you can’t overcome OCD without learning to accept uncertainty. That’s why reassurance doesn’t help. Don’t tell me “Everything’s OK” because I know it’s not. Not only that, but I know you don’t know, and no one really knows. The only correct answer is “Things are probably OK and for now we just have to assume that and accept that we can’t be prepared for everything that happens in life.”

If reassurance works, it’s temporary. And you’ll most likely find the time-frame that it works becomes shorter, and shorter, and shorter.

One last quote from the page: “This management is not a cure: if you choose to take the leap, this will require consistent effort for as long as the devil decides to deal it out.”

“Don’t Feed the Reassurance Monster”

…Or No Doubt II: Some Doubt.

I’m quoting from the following article, which is officially extremely awesome:

It discusses dealing with OCD in children, and ways parents and other caregivers can help. Your time will be best spent reading the article in its entirety, but I will give a few of my favorite points:

“OCD is based on intolerance of doubt and uncertainty.”

“One example of an exposure-based strategy might be eating dinner while intentionally making statements related to contamination.  These might include, ‘Pass me the germy mashed potatoes’ or ‘I hope the roast beef has extra e.coli tonight.’  Although many people (with or without OCD) might be uncomfortable thinking about germs while eating, this strategy allows us to directly challenge OCD-related cognitions.”

“All primary caregivers (and all household members, if possible), should adopt consistent policies for responding to OCD.”

“Understand why kids do rituals.”

“Recognize the many forms that OCD takes.”

and of course:

“Don’t feed the ‘reassurance monster.’ In most cases, regardless of the form it takes, OCD is about wanting certainty in situations that are fundamentally uncertain. [. . .] When we, as parents, repeatedly provide OCD-related reassurance, we make it more difficult for our children to learn to be content in an uncertain world. Examples of ‘Feeding the Reassurance Monster’ include:

  • ‘You won’t get sick–you’ve gotten all the germs off.’
  • ‘Don’t worry.  We live in a safe neighborhood, so no one is going to break into the house.’

When you avoid these types of statements, you help your child learn to better coexist with uncertainty.”

This article is by the same guy (Steven Seay) I linked to in my No Doubt post, and covers some of the same points — but I thought it was worth posting for the extra info about kids specifically.

Title of This Blog

Why is this weblog entitled, “Will It Be OK?”

When I was a child, that’s what I used to ask — over and over. Whenever I got worried I would catch some disease, get poisoned, or eat a food that had gone bad — that’s what I would ask. “Will it be OK? Yes? Are you sure? Are you positive? Are you sure you’re positive?” Finally, I’d realize the inevitable — that the person I was asking wasn’t really sure, because I was old enough to know it’s impossible to be sure of these kinds of things. So I’d feel anger, and distrust, but still want to know and be reassured.

As a new adult, I used to think my reassurance cycle had gone away and I’d gotten over these sorts of things. In truth, my fears hadn’t so much gone away, but changed into different kinds of fears as I grew older. I still feel that need for reassurance very often, but I try to keep reminding myself that it’s just an obsession, and that no matter how much reassurance I get, I’ll never truly feel better — which is true. The only way to feel better is to accept the way things are and not ask for something I know I can’t get.