Three Types of Therapies That Have Helped Me - A Personal View

(Information for this essay comes from the following sources: the book “The Brain That Changes Itself” by Dr. Norman Doige, M.D., the website “ocduk.org/four-steps.”

 

Writer’s note: this essay is only my personal view. It is not meant as therapy. I have no right offering therapy. I recommend that the reader contact his/her doctor for therapy.

- Ken Munro)

 

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INTRODUCTION

 

Over the years, we feel the only way in bringing peace of mind to our OCD situations is by acting out our rituals and compulsions and by practising avoidance behaviours.

 

If we are to have any chance of recovery, we have to learn a whole new discipline in managing/conquering our OCD. As the saying goes: “old habits are hard to break.”  It’s a lot of work. It’s not easy. But it can be done.

 

We just have to be shown the way.

 

Secondly, I do not believe we are ever totally cured from our OCD. But we can to learn to manage it. If we have been cured, my first reaction is how sick was the individual originally?

 

Over the years, I have been taught several therapies. A lot of information was thrown my way. Often confusing. With this essay, I’ve tried to simply everything.

 

Here are 3 types of therapies that have helped me:

 

(1) cognitive behaviour therapy

(2) the concept that the brain is made of plastic or "plasticity" and

(3) "Brain lock" therapy.

 

First, cognitive behaviour therapy or CBT.

 

COGNITIVE BEHAVIOUR THERAPY

 

There are two parts to cognitive behaviour therapy:

 

Cognitive – the knowing part, the theory. The principle that giving in to our compulsions makes matters worse.

 

By giving in to our OCD, we may “win the battle but not the war.” We may get temporarily relief but the sources of our fears are still present. Original fears must be confronted. And we become prone to new fears.

 

In the long run, giving in makes matters worse.

 

The behaviour part – the practice of confronting one’s fears. And there are two parts to this known as “ERP” – “exposure” and “response prevention.”

 

Simply put: exposure is facing our fears, the triggers that cause our OCD and response prevention is NOT giving into our compulsions.

 

With CBT, we create a list of all our fears. We start with the easiest and work up to the more difficult fears.

 

We don’t want fears that are too easy. But fears that are challenging enough that won’t leave us devastated if we confront them.  We start off with the weakest fear and work up from there.

 

The intensity of the fears is measured by a scale: "S.U.D.S." which stands for "subjective units of distress scale" or "subjective units of disturbance scale." The greater the number, the greater the distress.

 

The plan is to build up confidence with each fear, to become accustomed to the fear so that the fear no longer holds terror in us. Once we gain confidence, we can move on to the next challenging fear.

 

It’s been said that CBT works in most cases. Few fail if they practice the principles.

 

Even if we gain confidence over our fears that once baffled us, we must constantly continue to confront them when they arise. Or they will control us as before.  

 

CBT is difficult. I have been in CBT therapy groups where people have dropped out.

 

CBT can be quite costly if we don’t have medical insurance. The wait list to take CBT is quite long. I have taken it twice having to wait over a year each time.

 

THE BRAIN and PLASTICITY

 

There is a new therapy that I find very helpful and its extension of CBT. It looks inside the brain and how certain parts of the brain work as it pertains to OCD.

 

OCD is connected to part of our brain that acts like a “sticky” gearshift. That is why we don’t respond to logic when it comes to our fears.

 

According to the book “The Brain That Changes Itself” by Canadian psychiatrist Dr. Norman Doige, M.D., the brain can heal itself. It is made up of plastic.

 

Studies have shown from brain scans that when we have an OCD attack, there are three parts of the brain that are involved - the “orbital frontal cortex”, the “cingulate gyrus” and the “caudate nucleus”. They are hyperactive in OCD sufferers.

 

The initial attack starts in the cortex which sends a signal to the cingular gyrus which triggers the dreadful anxiety causing the physical sensations we associate with dread.

 

Signals are, then, sent to the “caudate nucleus” or the “automatic gearshift” allowing our thoughts to flow from one to the next. Except in cases of OCD, where the caudate becomes extremely “sticky” and cannot process the information. Probably one of the reasons we don’t respond to logic and reasoning when it comes to our fears.

 

Because our OCD is caused by some faulty brain circuitry, the brain can heal itself if we confront our fears.

 

More specifically, the more we give in to our compulsions, they more we reinforce our fears, even though our fears are imaginative. We make matters worse.

 

But by letting go, those old circuits die making room for new circuits to grow. The brain can heal itself.

 

Or another way of looking at it: the more we give in to our compulsions, the more we want to do it; the less we do it, the less we want to do it.

 

But that principle is not easy for OCD sufferers. We do not want to confront anxiety. And we feel the only way in bringing relief is by acting out our compulsions.

 

But remember: we are being bluffed by sensations though painful. Fears are based on our imagination.

 

 

BRAIN LOCK THEORY

 

Taking it one step further, Dr. Jeffery Swartz, author of the book “Brain Lock” came up with a 4 step approach to managing one’s OCD. (The title: “Brain Lock” comes from the idea that with OCD, the first two parts of the brain are turned on and stay on as though locked in the “on position” together.)

 

His idea is to “manually shift” the gearshift with his 4 step approach.

 

The steps are as follows:

 

Step 1: Relabel

Step 2: Reattribute

Step 3: Refocus

Step 4: Revalue

 

With step 1 and 2, when one of our fears hits us, it is not an attack of germs or personal hygiene. But an attack of OCD.

 

In Step 3, we try to refocus on something positive. We try to get our minds onto something more constructive. That is difficult for many OCD sufferers. Our thoughts make us think inward. And many of us are loners.

 

The OCD doesn’t go right away due to faulty circuits in our brains. But by refocusing, (step 3,) we grow new circuits and old circuits die. This also triggers dopamine release which is very helpful.

 

Even with “Response Prevention” for a few minutes (not giving in to the compulsion) can be grounds for growing new circuits.

 

In step 4, we realize that our fears were really nothing of importance. We gain the confidence and start feeling normal.

Slogans about Pain

(We are more than happy to confront our fears – except for one little thing: if we didn’t have to confront pain. If we just could avoid pain, everything would be so simple.

As difficult as it sounds, we need pain in our lives. If we had everything going our way without struggles, I think that life would become an absolute bore.  

Unfortunately, the pain from our OCD (more like terror) can be overbearing at times.

Here are some words of wisdom encouraging us to confront our fears and bear the pain.

– Ken Munro)

 

 

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Pain is temporary. Quitting last forever.

 – Lance Armstrong

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Be fearless. Have the courage to take risks. Go where there are no guarantees. Get out of your comfort zone even if it means being uncomfortable. The road less traveled is sometimes fraught with barricades, bumps, and uncharted terrain. But it is on that road where your character is truly tested.  Have the courage to accept that you’re not perfect, nothing is and no one is — and that’s OK. 

- Katie Couric

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Facing your fears robs them of their power.

 – Mark Burnett

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You gain strength, courage and confidence by every experience in which you really stop to look fear in the face. You are able to say to yourself, ‘I have lived through this horror. I can take the next thing that comes along.’ You must do the thing you think you cannot do.

-  Eleanor Roosevelt

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Waiting to develop courage is just another form of procrastination. The most successful people take action while they’re afraid!

- Unknown‎

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Let me not pray to be sheltered from dangers, but to be fearless in facing them. Let me not beg for the stilling of my pain, but for the heart to conquer it.

- Tagore

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Each of us must confront our own fears, must come face to face with them. How we handle our fears will determine where we go with the rest of our lives. To experience adventure or to be limited by the fear of it.

-  Judy Blume

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A challenge only becomes an obstacle when you bow to it.

– Ray A. Davis

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Take chances, make mistakes. That's how you grow. Pain nourishes your courage. You have to fail in order to practice being brave.

– Mary Tyler Moore

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Never be afraid to try something new. Remember, amateurs built the ark, professionals built the Titanic.

 - Unknown

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Fear is the main source of superstition, and one of the main sources of cruelty. To conquer fear is the beginning of wisdom.

-  Bertrand Russell

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We must all suffer one of two things: the pain of discipline or the pain of regret or disappointment.

– Jim Rohn

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Doubt is a pain too lonely to know that faith is his twin brother.

-  Khalil Gibran

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We cannot learn without pain.

 – Aristotle

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It takes a lot more energy to bury pain than it does to confront it.

 – M.J. Abraham

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If you aren’t in over your head, how do you know how tall you are?

 – T.S. Eliot

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No pain, no palm; no thorns, no throne; no gall, no glory; no cross, no crown.

– William Penn

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The finest steel has to go through the hottest fire.

– Richard M. Nixon

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Those things that hurt, instruct

– Benjamin Franklin

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There is no success without hardships.

 – Sophocles

Why I Don't Take Medications - A Personal View

(Information for this essay comes from the following sources: books “The Brain That Changes Itself” by Dr. Norman Doige, M.D., “Freedom from Obsessive Compulsive Disorder” by Dr. Jonathan Grayson, PhD., and “Love, Medicine and Miracles” by Dr. Bernie Siegel. M.D. )

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I do not take medications for my OCD. That is my personal choice. They work for some but not for others. I’m just not a big fan of meds.

Medications do have a place in the recovery process. 

However, I’ve been to doctors who write me a prescription and simply send me home. You cannot cure anyone this way.

 

My experience with psychiatry is that meds are the first line of defense. Doctors say that OCD is bio-chemical. Therefore, meds must be used.

Let’s face facts. All emotions are bio chemical. Should we start popping pills for every human emotion? And meds are prescribed because much of the research in medicine is sponsored by the pharmaceutical companies.

Medications may quell our anxieties but often don’t eliminate the problem. The genesis of our fears must be confronted.

Medications have terrible side effects including leading to suicide thoughts. To find the right balance that works can take up to 6 – 8 weeks.

 

There are many factors why medications work for some and not for others.

Generally speaking, in medical research, a quarter to a third of patients will show improvement if they “merely believe” they are taking an effective medication even if the pill has no actual healing ingredient. This is called the “placebo” effect.

But the following must be present:

(1) meaning of illness experience for patient is altered in a positive manner

(2) patient is supported by caring group and

(3) patient sense of mastery and control over illness is enhanced.

 

Another factor to consider for meds to work: those patients who had a higher level of trust and rapport with their doctor. 

Why do meds work for some OCD sufferers and not others? Meds reduce symptoms in about 30% – 50% of patients. Patients still have to practice Cognitive Behaviour Therapy. As a matter of fact, meds are not that helpful unless accompanied by CBT.

We don't know why meds work for some OCD sufferers and not for others. There have never been any studies done to find commonalities among those who have succeeded. It is often a "hit and miss" or "trial and error" approach.

But medical researchers would be wise to ask if the patient truly wants to take meds and believes he is taking meds that he feels will work. This is called the “power of suggestion”. The patient is more likely to work at his recovery if he truly wants to take meds.

I also believe in a holistic approach in treating OCD. Medicine should treat the entire needs of the patient  - i.e. love, hope, faith, a sense of purpose, etc., and not just the illness. Personally, when I have a focus, a passion for something, my OCD symptoms are drastically reduced.

 

 

There is a problem on relying on meds exclusively. By saying that meds are mandatory for recovery allow patients not to accept any responsibility in their recovery. I have met patients, over the years, who refuse to accept this responsibility. They feel the only way for recovery is by taking meds.

Medications can help in bringing relief. It’s part of the healing package. 

But we must come to terms that much of our recovery is in our own hands. Confronting our fears that will pass if we allow them to expire, living with doubt, etc.

It’s a lot of work. And I never said it was easy.

Remember: we are being bluffed by sensations that lie to us!

It’s been said that the brain chemistry associated with OCD is capable of healing itself. We just have to be shown the way.

 

 

Finally, medications cannot do everything. They may relieve some of the suffering. But there are some things that they simply cannot do:

Medications don’t give me the wisdom to combat my fears. Only humans are capable of doing that.

Medications cannot feel my pain, show empathy and compassion towards me. Only humans can do that. Values that bring on healing.

And, finally, medications do not love me back to health. Only humans with caring hearts can do that. This, too, can ease my pain.

                                               - Ken Munro

 

 

A few Slogans About Doubt And Uncertainty

(Writer's note: if we are to have any chance of recovery, we have to learn to live with doubt and uncertainty.

If we fight for exactness, relief may be temporary. But the fears remain as well as we become prone to new fears. OCD has a mind of its own.

Remember: we are being bluffed by sensations that lie to us.

The terror from our fears will subside. I have seen this too many times. Once this happens, we are left with doubt and uncertainty. These feelings are manageable.

We have to give up the desire for exactness and perfectionism. We can live with doubt and uncertainty.

Here are a few slogans addressing doubt and uncertainty. - Ken Munro)

                                                       
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Security is mostly a superstition. It does not exist in nature, nor do the children of men as a whole experience it. Avoiding danger is no safer in the long run than outright exposure. Life is either a daring adventure or nothing.
                                                                                                     - Helen Keller

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Maturity of the mind is the capacity to endure uncertainty.       - John Finley

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If you are scared to go to the brink, you are lost.                   - John Foster Dulles

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To believe is very dull. To doubt is intensely engrossing. To be on alert is to live, to be lulled into security is to die.
                                                                                                 - Oscar Wilde

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Faith means living with uncertainty - feeling your way through life, letting your heart guide you like a lantern in the dark.
                                                                                                  - Dan Millman

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Exploring the unknown requires tolerating uncertainty.        - Brian Greene

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Security is a kind of death.                                                    - Tennessee Williams

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I spent a lot of years trying to outrun or outsmart vulnerability by making things certain and definite, black and white, good and bad. My inability to lean into the discomfort of vulnerability limited the fullness of those important experiences that are wrought with uncertainty: Love, belonging, trust, joy and creativity to name a few.
                                                                                                   - Brene Brown

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Uncertainty is a permanent part of the leadership landscape. It never goes away.
                                                                                              - Andy Stanley

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I have devoted my life to uncertainty. Certainty is the death of wisdom, thought, creativity.
                                                                                                 - Shekhar Kapur

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Uncertainty and expectation are the joys of life. Security is an insipid (lifeless) thing.
                                                                                                  - William Congreve

Compassion, Understanding and other Traits That We Need To Practice To Help Others In Their Recovery

 If we want to help our fellow OCD sufferers recover, we would be wise to cultivate certain qualities that will help in their healing……Compassion…. Understanding….. Empathy….And love.  The last thing that we need is someone who does not understand our pain. Nor wants to understand. It can be frustrating.

Years ago, I went to a support group for those suffering from mental illnesses. The group briefly touched on the symptoms of OCD. They offered me advice which came from the group’s literature. The members thought it was great wisdom. But they were not OCD sufferers. The members were totally clueless about my OCD. I was hurting even more. I was not only fighting my OCD, I was also fighting the members.

 

When it comes to recovery, it is not just the help one receives, it is often how it is said that can make the difference. Many people who try to help us will convey their advice/help using “sarcasm” in their tone of voice. Their advice, though "maybe" helpful, is delivered with such distain, it can hurt more than the actual emotional wounds. 

And it’s no wonder sarcasm hurts. The word “sarcasm” comes from the Greek word  ”sarco” which means “to tear flesh.”

 

We also must be aware and deter those individuals who want to play “rescuer” or “hero” to the hurting. They become amateur psychologists.

Members try to box other members into their way of thinking, their values, their philosophy. Because it has worked for them, it must work for others. We see this with the fundamental religious and life coaches. They are not aware that one man’s medicine is another man’s poison.

I believe that they are doing more harm giving such advice.

 

Things like love and empathy can work on a professional level. In his classic bestseller “The Road Less Traveled,” American psychiatrist Dr. M. Scott Peck suggests when it comes to therapy, a lay person like a plumber has a better success rate offering therapy if he offers it with love and empathy versus traditional therapy by a psychotherapist.

 

If we are in the position of helping an OCD sufferer, we can start by being a good listener. A person with a sensitive ear, a caring heart, a non judgment mind can soothe more heartaches, more emotional wounds by being that listener. Those listeners are a rare breed.

According to the book “Peace Is Every Step” by Thich Nhat Hanh,  a Zen monk, who was nominated for a Noble Peace Prize by Dr. Martin Luther King Jr., “the essence of love and compassion is understanding, the ability to recognize the physical, material and psychological sufferings of others, to put ourselves "inside the skin" of the other." According to his book, "compassion means, literally, '"to suffer with.""

And, again, according to his book, if we want to understand a person, we have to “feel his feelings” and “suffer his sufferings.” The word “comprehend” is made up of the Latin roots “cum” which means “with” and “prehendere” which means “to grasp it” or “pick it up.” To comprehend something means “to pick it up and be one with it.”

Qualities like empathy and understanding are skills that we all need to hone - be it by medical professionals or by lay people. They have to be taught just like learning any discipline. I do not believe these qualities come natural.

These qualities are not absent only in the outside world. Sadly, I have met, over the years, fellow OCD sufferers who lack them as well.

The core of the Golden Rule states: treat others as you would like to be treated.” We all want compassion and understanding. But how many people are willing to practice them?

What Is it Like To Have OCD?....Help For Family And Friends

I’ve heard it so many times….From family…..From friends…..Even fellow OCD sufferers.

My OCD has been acting up and people all around me say….Why can’t you just forget this nonsense?....Stop worrying!!....Just think positive!! People give me advice that hurt me even more.

So, what is it like to have OCD?

First, what is OCD?

OCD stands for Obsessive Compulsive Disorder and is diagnosed as repetitious thoughts and/or actions motivated by fear and anxiety. To reduce the anxiety, we “ritualize” - acting out our compulsions by repeating certain things until it feels right.

Most of us know that our fears are “irrational.” They are based on our imagination. They logically make no sense. We may have these fears but, in reality, we are being bluffed by a sensation that deceive and emotionally cripple us.

And according to the website “Theguardian.com”, the World Health Organization (WHO) lists OCD as one of the top 10 most debilitating illnesses.

 

Let me put you in the mind of an OCD sufferer and what we have to confront. I believe that we all have the following feelings. OCD sufferers have them more.

Have you ever felt the following: you have left your home, you get half way down the road and you have a sudden thought that causes anxiety: …….Did I turn off the stove? …..Did I turn off the faucets? ……Did I put out my cigarette in the ashtray? Etc…etc.,...Something is troubling you and you cannot get in it out of your mind.

You try to reason with your anxiety. You go over and over in your mind, replaying what you did and what you might not have done. No amount of thinking it through brings peace of mind.

You just cannot get this “thing” out of your mind.

Somebody tells you just to forget it. But this is futile. You want to forget it. And get it out of your mind. And get on with your life.

Now multiple those feelings about 100, 200, even 1000 times a day. And that’s what many OCD sufferers go through.

We’ve all had these feelings. Fortunately, for most, it is fairly rare. But OCD sufferers have them on a consistent basis.

You wouldn’t tell an alcoholic wanting a drink to forget it. You wouldn’t tell someone suffering with the flu to stop feeling this way. Then why should an OCD sufferer plagued by his anxiety be treated any differently? To tell him to forget his problem is telling him to forget his pain.

For recovery, pain must run its course.

Another feeling we confront: have you ever handed anything in – a report, an essay, sent out a letter – you know is right. But something doesn’t “feel right.”You keep checking and checking.

Or you’re about to leave your house, you’ve checked half a dozen times. Again, something doesn’t “feel right.”  And you keep checking.

We’ve all done this. OCD sufferers just do more of it.

We keep giving into our compulsion until it feels right. We have trouble living with uncertainty and doubt. That is why OCD is called “The Doubting Disease.”

The more that the OCD sufferer gives into his fears, the more anxiety he creates and more fears become prey to his OCD. It’s been said that if you give your OCD an inch, it takes a mile.

We all have one or two obsessions/compulsions. Medical officials feel when obsessions/compulsions control one’s life, consuming much of a person’s time, then there is a medical problem.

What’s the difference between obsessions and compulsions? Obsessions are the thoughts or ideas that the sufferer cannot get rid of. They cause anxiety. Compulsions are the physical acts or rituals to neutralize his anxiety.

What I have mentioned here is one small facet of OCD – checking things. There is a host of other behaviors that plague OCD sufferers – hand washing, doing things in a specific order, avoiding words/phrases to name a few.

 

What causes OCD? Were we born this way? Is it caused by some brain chemical imbalance? Or is there something “broken” in our brains? There are many prevailing theories.

One of the theories that I find comforting comes from the book “The Brain That Changes Itself” by Canadian psychiatrist Dr. Norman Doige, M.D.

Studies have shown from brain scans that when we have an OCD attack, there are three parts of the brain that are involved - the “orbital frontal cortex”, the “cingulate gyrus” and the “caudate nucleus”. They are hyperactive in OCD sufferers.

The initial OCD attack starts in the cortex which sends a signal to the cingulate gyrus which triggers the dreadful anxiety causing the physical sensations we associate with dread.

Signals are, then, sent to the “caudate nucleus” or the “automatic gearshift” allowing our thoughts to flow from one to the next. Except in cases of OCD, where the caudate becomes extremely “sticky”.

Probably one of the reasons we don’t respond to logic and reasoning when it comes to our fears. And why comments like “just snap out of it” by those around us are so futile and insulting. And why unresolved fears often torment us. And why we cannot wrestle our negative feelings into submission in an instant.

 

The main treatments for OCD are medications and CBT or Cognitive Behavior Therapy.


The cornerstone of CBT is “ERP” – “E” is for “exposure therapy” where the sufferer faces his fears and “RP” for “response prevention” where he is prevented giving into his rituals to neutralize his anxiety. To say it is difficult is an understatement.

And the wait to take CBT is torturous long. I’ve taken it twice. I had to wait over a year each time.

If the sufferer has no medical insurance to cover treatment, CBT can be extremely expensive.

As for medications, research says that meds work for only 30% - 50% of patients and only accompanied with CBT. There are also the negative side effects including suicidal thoughts.

 

There is no instant cure for OCD. Many of us have to work on our recovery for a life time. The road to getting better is long, painful and difficult.

When our OCD acts up, please do NOT tell us to just forget this nonsense!…. Or just stop worrying!....Or just think positive!.  We’d love to be able to do this.

If you want to be helpful, understanding and empathy with our pain and frustrations without being judgmental can go a long way.

                                                                       - Ken Munro

 

Quotes Addressing Slips and Setbacks

(Writer’s note: We’ve just had a slip or a setback. Our first reaction is to give into the compulsions(s) until it feels right in order to bring peace of mind….WRONG!!!!

Slips and setbacks are part of the recovery process. It’s what we do AFTER the setback that matters.

Here are some quotes that have helped me when I have had a slip. There are two parts to it: “TO ERR IS HUMAN” and “TO FORGIVE (ONESELF) IS DIVINE.” – Ken Munro)

 

 

                                                          TO ERR IS HUMAN                                                                                 

Experience is the name everyone gives to their mistakes. 

– Oscar Wilde

 

Mistakes are the portals of discovery.

– James Joyce

 

The greatest mistake you can make in life is to continually fear you will make one.

                                                                                                           – Elbert Hubbard

 

Some of the best lessons we ever learn, we learn from our mistakes and failures…. The error of the past is the wisdom and success of the future.

– Tryon Edwards

 

What we do AFTER we make a mistake is more important than the original error.

– from the book, “A New Day”

 

He who never made a mistake never made a discovery.

– Samuel Smiles

 

One must be a god to be able to tell success from failures without making a mistake.

– Anton Pavlovich Chekhov

 

Wisdom is learned from failures much more than from success.

– Author unknown

                                              

If we were brought to trial for the crimes we had committed against ourselves, few would escape the gallows.

– Paul Eldridge

 

 

 TO FORGIVE (ONESELF) IS DIVINE

All the things you think you should have done that you didn’t do and all things you did that you think you shouldn’t have done, accept them. You did (or didn’t) do them. That’s reality. That’s what happened. No changing the past. You can struggle with the past or pretend it didn’t happen or you can accept it. We suggest the latter. A life of guilt, fear and unconsciousness is, to say the least, not much fun.

-from the book “Life 101”

 

There is no witness so terrible – no accuser so powerful – as conscience which dwells within us. – Sphocles

 

He forgives all my sins. He heals me.

– Psalm 103:3

 

Perfectionism does not exist; to understand it is the triumph of human intelligence; to expect to possess it is the most dangerous kind of madness.

– Alfred de Musset

 

The desire of perfection is the worst disease that ever afflicted the human mind. 

– Louis de Fontanes

 

Reforms always come from below. No man with four aces asks for a new deal.

– The Irish Digest

                 

Why art thou troubled because things do not succeed with thee according to thy desire? Who is there who hath all things according to his will? Neither I, nor thou, nor any man upon earth.

 – Thomas A’ Kempis

 

How unhappy is he who can not forgive himself.                                     – Publilius Sy