OCD and Relapsing

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by tiverylucky freedigitalphotos.net

As most of us know, overcoming obsessive-compulsive disorder is no easy task. It takes hard work, enormous effort, courage, and dedication. When those with OCD regain control of their lives, it is reason to celebrate. It is an amazing accomplishment – which is why when a relapse occurs, it can be heartbreaking.

In this wonderful article written by Dr. James Claiborn, a relapse is defined “…as a return to the same level of symptoms as before treatment.” Basically, the person with OCD is back where he or she started. Relapsing should not be confused with a lapse, which is a temporary and/or partial return of some symptoms.

I am incredibly thankful that my son Dan has not relapsed since overcoming severe obsessive-compulsive disorder almost seven years ago. Has he lapsed? I’m sure he has. He still  has OCD and while he has the tools to fight and manage his disorder, I’m guessing there are times when anxiety takes over and it’s just too difficult to do what is necessary to keep OCD at bay. But it’s not the end of the world, and I think Dan realizes this. Similar to a dieter who has one piece of chocolate cake, it’s a lapse. You acknowledge it, accept it, don’t beat yourself up over it, and strive to fight harder tomorrow.

Interestingly enough, Dr. Claiborn discusses how the interpretation of a lapse can contribute to an actual relapse. Many people with OCD deal with cognitive distortions such as black and white thinking and catastrophizing. They also have a strong need for certainty, and often live with hyper-responsibility and perfectionism as well. These are all examples of absolute thinking which can affect how they view a lapse. Dr. Claiborn explains:

…If the person has a lot of distress and concludes they need to engage in some compulsive behaviors, then they have experienced a lapse. If they then engage in some absolute thinking, such as, “all my hard work in ERP is a waste because I still have obsessions and I have to do the compulsions,” they are on the path to a relapse.

Not surprisingly, part of a good relapse prevention plan involves addressing this absolute thinking. To put it simply, it’s all how you look at it. While lapses are bound to happen, Dr. Claiborn suggests they be looked at as learning experiences and not signs that a relapse is imminent. There is a lot of good information in his article, which I highly recommend reading.

Once again we see the importance of having a good therapist who really understands obsessive-compulsive disorder and how to treat it. While being skilled in exposure and response prevention (ERP) therapy is of the utmost importance, addressing relapse prevention is also a must. Because when you get right down to it, getting well is only half the battle. The other half is staying that way.

 

 

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OCD and Twins

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photostock freedigitalphotos.net

It is widely accepted that the causes of obsessive-compulsive disorder involve both genetic and environmental factors, and this theory has been supported by research. While OCD has been known to “run in families,” this doesn’t really tell us whether genes or environment plays a more prominent role in the development of the disorder. Studying twins who were separated at birth affords us the opportunity to separate these two factors. Unfortunately, as far as I know, OCD has never been studied in this manner.

There is no shortage, however, of twins with OCD who’ve been raised together, and I find their experiences fascinating. While their stories might not give us the answers we are looking for (in fact, I think they raise even more questions), they highlight the agony of OCD – times two. Continue reading

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What about Siblings?

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by sattva freedigitalphotos.net

Well, we’ve made it through the holidays, with so much focus on family and spending time together. We’ve read all the articles about how to get along with those difficult relatives that, thankfully, you only need to interact with once or twice a year. We do what we need to do, and then we’re good for another year!

But what if that “difficult relative” lives with you? What if he or she is someone you love dearly, someone you long to have a close relationship with? And what if you are too young to truly grasp the reasons why this closeness isn’t happening? Actually, there’s a lot you don’t understand. Why does he or she act oddly at times? Why (in some cases) does this person avoid you, or worse, not even allow you both to be in the same room?

I’m talking, of course, about being a sibling of someone with obsessive-compulsive disorder. I have previously written about my family’s situation and how we dealt with our daughters when our son Dan’s OCD was severe. I talk about what I think we did right, and what I think we did wrong. Of course each family’s story is unique, but for younger children who are living with a sibling with OCD, there are some questions I feel should always be considered:

Are they being teased about their brother or sister at school? Do they resent not getting as much attention as their sibling with OCD? Do they feel uncomfortable in their own home? Do they think their sibling’s OCD is somehow their fault? Do they feel frustrated because they want to help their sibling and don’t know how? Are they embarrassed, confused, jealous? Do they feel scared, or neglected? Do they think they might develop OCD also?

This is only the tip of the iceberg. So much to consider!

The Washington Post recently published a wonderful article titled “Eight things siblings of children with special needs struggle with.” While it doesn’t specifically focus on OCD, each struggle mentioned rings true for families dealing with obsessive-compulsive disorder. I highly recommend checking it out.

While it is quite possible that siblings of those with OCD will grow up to be more empathetic, responsible, and understanding than many of their peers, we must realize they are also often burdened. As are we parents. It can be heartbreaking to witness the toll OCD takes on everyone in the household. And while it is a monumental task to do right by each child in the family when obsessive-compulsive disorder is involved, it is necessary. Parents should seek support and professional advice whenever possible.

And we need to remember that children themselves can be extremely helpful as well. Asking all of our children what they feel and what they need from us is so important. Open communication among everyone in the family can go a long way. With a lot of hard work, love, and proper treatment for OCD, there’s a good chance that close sibling relationship can become a reality.

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2017 Here We Come!

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by krishna arts freedigitalphotos.net

For many people, with or without OCD, the onset of a new year stirs up a wide range of emotions……hope, trepidation, excitement, fear. Basically, a little bit of everything as we look ahead.

I find myself looking back as well. As I reflect upon this past year, both personally, professionally, and globally, I realize that as with every other year, there were ups and there were downs. I feel lucky to have so many blessings in my own life; at the top of the list are my wonderful family and friends. But I’ve also had my challenges in 2016. Haven’t we all? Isn’t this in fact, LIFE? The highs, the lows, and everything in between. Continue reading

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Relationship OCD (R-OCD)

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by sira anamwong freedigitalphotos.net

This post originally appeared April 2011. I’d like to wish all of my readers who celebrate Christmas and Hanukkah a very happy holiday…….

I am continually learning about OCD, and the more I learn, the more I hate this disorder. I had never even heard of  Relationship OCD (or R-OCD), but it’s not new, and all of a sudden I seem to be reading about it everywhere.

Basically, those with R-OCD believe that they should no longer be with their spouses (or significant others) either because they do not love them anymore, aren’t compatible, or whatever. I’m not talking about  those fleeting thoughts that we all have once in a while (sorry Gary). I’m talking about unrelenting, strong obsessive thoughts that tell the sufferer to get out of the relationship. These feelings are so overpowering that some people even become physically ill because of them.

One of the reasons why these thoughts are so distressing is because, as with other OCD thoughts, the sufferer knows his or her thoughts are not rational. But these thoughts torment nonetheless. They incite doubt. So it is upsetting and  confusing to not only the person with OCD, but to his or her partner as well.

From everything I read, R-OCD can come on quite suddenly. It is most common in those with other OCD traits, though there do seem to be cases of those with just R-OCD. And it often goes misdiagnosed or even undiagnosed. The treatment is the same for OCD in general: Cognitive Behavioral Therapy (specifically ERP) and/or medication. And finding the right therapist is paramount.

Left untreated, sufferers commonly will either be in an on-again off-again relationship with the same person, or be in a series of failed relationships. How sad is that? That even one of the most basic human desires, to love and be loved, can be shattered by OCD.

Like I said, the more I learn about OCD, the more I hate it.

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OCD and The Holiday Season

Image result for happy holidays sign

 

 

This post first appeared November 2015…..

With the holiday season upon us, many of us are firmly entrenched in the excitement, anticipation, and busyness of this time of year. Maybe we will visit friends or relatives. Perhaps a small army of loved ones will descend upon us in our own homes, or maybe we will be part of smaller, more intimate gatherings.

Whatever our holiday plans involve, there are bound to be changes in our routines. While this can be unsettling for many people, those suffering from obsessive-compulsive disorder might have a particularly tough time, especially when dealing with vacationing and traveling. It’s not hard to see why these situations might trigger all kinds of concerns for those with OCD. No matter what type of OCD they suffer from, there’s always lots to worry about when stepping out of their comfort zone. Some concerns might include:

Will I be able to use the public or hotel restroom?

What if I hit someone while driving on the highway?

What if I get sick while I’m away?

The questions are endless and will be different for each person with the disorder. As you can see, however, all these concerns revolve around one thing: the uncertainty of what will be. Those with obsessive-compulsive disorder have the need to know, for sure, that all will be okay.

Friends and family also are affected when traveling and vacationing with someone with OCD. Having to alter plans, not being able to be spontaneous, and dealing with high levels of anxiety are just some of the many examples of how OCD can impinge upon a vacation. Before actually leaving home, anticipatory anxiety with all of its “what ifs” and doubt can be particularly distressing. Interestingly, anticipatory anxiety is often worse than the actual event being agonized over. So what should those with OCD do when faced with all these holiday events fraught with doubt and uncertainty?

The answer is clear. They should push through their anxiety and embrace the doubt and uncertainty that is holding them hostage. Yes, there is uncertainty that comes with traveling or vacationing or entertaining. Indeed, there is uncertainty in every aspect of our lives, and we all need to learn to accept, not fear, it.

I know it’s not easy. But it is possible.

If you have obsessive-compulsive disorder, I propose that you give yourself a gift this holiday season and make the commitment to stand up to your OCD. Embrace exposure and response prevention (ERP) therapy and reclaim your life. You deserve to enjoy the holidays, and every day, with your family and friends instead of being controlled by obsessions and compulsions. It will not only be a gift to yourself, but just might be the best gift you could ever give to those who love you.

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OCD and Mental Imagery

brainIn this article published in Frontiers in Psychiatry, mental imagery is defined as:

…the experience of conscious contents that possesses sensory properties and therefore resembles actual perceptual experience. The perceptual properties can be visual but can also cover other sensory modalities such as tactile, acoustic, or somatic experience. In contrast to cognitions, mental images are not purely verbal or abstract.

In other words, we see, hear, or feel something without the presence of the corresponding external stimuli.

Not surprisingly, people with obsessive-compulsive disorder deal with mental imagery a lot. Some examples include vivid intrusive thoughts, inner voices warning you of some impending danger, or actually feeling dirty when you’re not. Because OCD manifests itself differently in each person, there is no limit to the types of mental imagery that might be experienced.

Because I write about OCD, a disorder that I don’t have, I’m always trying to understand it. What does it really feel like? I’ve learned that the thoughts of those who have OCD are typically no different from the thoughts we all have at times. What differs is the intensity of the thoughts as well as the weight given to them. But what about mental imagery? How can I possibly relate to that?

Well, after reading the article referenced above, I now realize that most of us, whether we have a brain disorder or not, experience mental imagery. Again, it is likely the intensity and vividness of the imagery that varies. In fact, the article states that intrusive mental images lie on a continuum with hallucinations on the far end. Also, it is important to note that mental imagery can either be unwanted or voluntary. So while someone with hit-and-run OCD might clearly envision hitting someone when they haven’t, the same person could possibly conjure up a clear mental image of something that brings them joy, such as the birth of their child. I’m not talking about just “remembering,” but rather vivid mental imagery that evokes our senses. While the first example is an involuntary mental image which likely leads to feeling anxious, the second example might bring about feelings of warmth and love. I think many of us, whether we have OCD or not, can relate to this in the context of our own experiences. I know I can. The article says:

…if we remember how we met our loved one, we sometimes see a visual image of how we first met them and this visual image can be accompanied by intense positive emotions. Similarly, we may vividly remember how it hurt when we were beat up in the school yard and again this tactile image may come with intense negative emotions.

If you’re interested in learning more about mental imagery and how it relates to brain disorders, I recommend reading the article, which goes into more detail and also discusses a couple of studies. Once again, I’m thankful for researchers who work so hard to uncover the mysteries of OCD and other brain disorders.

 

 

 

 

 

 

 

 

 

 

 

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