Some Cognitive-Behavioral Techniques For OCD Patients and People in General

I have OCD, but I don’t talk about it much on here because no one wants to hear about it, understandably. If you want to know what it is, check out Wikipedia. I am a “pure O” obsessional. That is, I have no compulsions. Instead, my mind just goes around in idiotic circles a lot of the time, and I worry about all sorts of stupid shit. I also spend a lot of time trying not to think about various things, or trying to stop unwanted thoughts that keep popping into my head.
Personally, I have found that cognitive techniques don’t work very well unless I am good and medicated on a good OCD drug. I take an SSRI called Lexapro, but there are many others out there. In general, you need an SSRI. SSRI’s sort of suck, but so does OCD! Pick your poison. If x dose does not work, you may need to go higher.
Non-SSRI antidepressants, Lithium and Depakote, and antipsychotics are generally useless for OCD. I don’t think anti-anxiety drugs like Ativan and the Valium type benzodiazepines work very well either.
Many if not most psychiatrists and psychologists do not understand this illness very well. I have a number of patients who I work with online, and they are always getting misdiagnosed by docs. Typically misdiagnoses are anxiety and depression, or simply no diagnosis at all.
Many times they are given 3-4 different drugs all at once. Psych drugs are very nasty, and you need to be on the minimum number of drugs. The trend of polypharmacy so in vogue by psychiatrists nowadays is downright sick and almost evil. Furthermore, it’s stupid and pointless. These guys are nothing more than pill-pushers anymore, and it’s the more the merrier with them.
Many psychiatrists have a poor understanding of drug interactions. I have had to warn a number of patients of drug interactions due to the drugs that their moron doctors put them on. I really don’t understand why these docs are so stupid about this stuff.
You really need to be very aggressive with psychiatrists and psychologists. If you don’t like them, just pull up your tent and move along. Be assertive to the point of demanding with them, and don’t back down. Don’t treat them like they are Gods. I’m a horrible patient, but at least I know what I’m doing. You understand your body, and you understand your illness. Don’t let some silly clinician misdiagnose you on the grounds that “they are the experts and you are not.”
Read up on your illness, and read up on your meds. One fascinating thing about OCD patients is that most of them are intelligent, often highly intelligent. The illness seems to be directly related to intelligence. One interesting finding via MRI on OCD patients is that they have more brain cells and more connections than non-patients. Upshot is as we might expect. They think too much.
Anafranil remains the gold standard for OCD drugs, but it’s pretty nasty. It’s an old, dirty drug with lots of side effects. Nevertheless, nothing helped me like Anafranil. I could not have gotten my Master’s Degree without it.
Second line are the other SSRI’s which all seem to be about as good as each other.
It seems like cognitive stuff doesn’t work until you are on the drugs. Otherwise you’re too crazy with OCD to utilize cognitive stuff.
Cognitive-behavioral therapy is the therapy of choice, and there is much material online about this. I’m not going to bother going on about it.
However, I will say that it’s a good idea to confront the thing that you fear. In my case, there were a variety of situations that I feared, all revolving around a common fear, that, honestly, is ludicrous (And that I will not discuss.). I conquered the fear at at least one level by simply throwing myself into the situations that set off the fear (or the obsessive thoughts really).
I plunged into the deep end of the pool so to speak. For a while there, the thoughts just poured into my brain like a river so I could barely even think straight. The general tendency in situations like this is to run, to get out of there.
But the truth is, “You cannot run from your fears.” If you run from them, you will never get over them. Avoidance makes OCD worse. So you just throw yourself into the feared situation, and stay there while your mind is being overrun by horrible thoughts. Don’t leave, just stay and let the thoughts “flood” into your mind. I call this technique “flooding.” After a while, you simply get sick and tired of being anxious, and the anxiety starts to go down.
Your mind realizes it can’t run away from the feared object, so it just accommodates itself to the feared situation and learns to get used to it. This is how all of us overcame all of our fears in childhood and hopefully even in adulthood. You can’t stay anxious forever. After a while, the brain says, “I give up. Fuck it. We’re gonna stay here and handle this.” In behavioral terms, this is called “extinction.” The fear is “extinguished” through prolonged exposure.
If you get good and stabilized, there are some Kundalini Yoga* techniques you can do. One is alternate nostril breathing. Hold down one nostril and breathe through the other. First breathe through the left nostril and then breathe out through the right. Inhale as slowly as possible and exhale as slowly as possible. Cycles should be on the order of 45 seconds to 1 minute if you can. This is ok for OCD, but it’s mostly an anxiety reducer that works well for anyone.
A specific one for OCD is left-nostril breathing. Hold the right nostril down and breathe in and out through the left nostril. Once again, cycles should be on the order of 45 seconds to 1 minute if you can do it.
Another thing you can do is meditation. This works well if you are already pretty stabilized and want to get better. Focus your mind on one particular spot and just stay there. Think “nothing,” “nada”, “ommmm,” or whatever you want. Try to empty out your mind as much as possible from your obsessions.
If an obsession comes, mark it as an “irrelevant thought,” and just move back to your focus. This method enables you to keep most of the irrelevant thoughts (obsessions) out of your head. This method is best described as cognitive shifting. Research has shown that in OCD there is reduced ability to engage in cognitive shifting due to reduced activity of inhibitory activity in the frontal lobe. OCD patients are like a skipping record.
Instead of thinking “nothing”, you will only be thinking of important things or things you need to think about. It’s also very peaceful and helps you to think loving thoughts.
Most obsessions are pretty much “irrelevant thoughts.” I have one woman who worries about thinking racist thoughts or thinking bad thoughts about others (She’s nice and not a racist). A man and a woman I know worry that they are child molesters (They are not.). One man worries he might be in love with a little girl (He isn’t). I have a guy who worries that he hates people or that he feels superior to people (He doesn’t really hate people or feel superior to them).
They often try to overcome their thoughts with thought compulsions. The woman tries to think good things about minorities and nice thoughts about people instead, but then OCD pops up and contradicts her with racist stuff and nasty cracks about fat people, ugly people, etc.
I told her that really, it doesn’t matter if someone is fat or ugly or geeky or Black or Hispanic, and it doesn’t matter what she thinks of minorities, geeks, fatties or uglies. Who cares? The best way is to just avoid the issue altogether. Don’t think about how the person looks and don’t think about their race. Just focus on “ommmm” and keep that stuff out.
I told the guy that it doesn’t matter whether or not he’s in love with the little girl. He can’t think about this without turning into a rat on a wheel in his mind, so the only solution is to not think of those thoughts. Thoughts that send you onto the rat wheel are automatically “irrelevant thoughts” because you will never accomplish anything on the thought rat wheel. So best not to even go towards those thoughts at all.
With the people worried they are child molesters, I tell them that there is no way to think themselves to a solution of this issue. They just go round and round endlessly: “Maybe I’m a child molester. No I’m not. Yes I am. How do I know I’m not a child molester? I’m terrified I’m a child molester.” You can’t think your way to a right answer here! Best to just avoid the question altogether.
For the guy who worries he hates people or feels superior to them, I said it doesn’t matter whether he hates people or not or whether he feels superior to them or not. But since he can’t think about this stuff without going round and round in circles forever, I said to just avoid the subjects altogether and just think, “ommmm.” He does this and finds he’s nice to most people and doesn’t feel superior to most people either. In other words, meditation allows his true feeling to come out.
You can actually meditate anywhere. I meditate in supermarkets, driving down the street (You have to be a bit careful here), at coffeeshops, and the doctor’s office, etc. If you get good at it, most people will greet you with a smile and will give off good vibes towards you. There are some dangers with meditation, but I’m not really worried about them too much.
In conjunction with meditation, I would recommend studying Zen Buddhism. I studied it for many years, and for a while, I got very, very good at it. The ultimate book ever written on Zen is An Introduction to Zen Buddhism by D.T. Suzuki.
One thing that Zen teaches you is to only think about whatever you need to think about. There’s no need to think about 1000 things at once. When you clear your mind, you will only think of necessary or important things, and extraneous or irrelevant thoughts will become infrequent.
The person living in Zen simply lives his life with a clear mind and few thoughts. He doesn’t analyze his behavior. He just lives and acts naturally. He accepts his true feelings as they come to him. Once you start endlessly analyzing all of your thoughts and feelings, you’re on the road to nowhere. Just live and act naturally and don’t analyze. If you’re sweeping the floor, think about sweeping the floor. If you’re washing the dishes, think about washing the dishes.
These techniques work not only for OCD patients, but for anyone else as well. Meditation, Zen and yoga are great for anyone. Try them out!
*There are supposedly some risks with Kundalini, but I am not worried about them. I’ve been doing Kundalini for years, and nothing bad has happened yet. Sometimes it’s a bit weird though. You can get transported back in time to “previous selves” and “previous eras.” You have to be able to handle stuff like that.

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19 thoughts on “Some Cognitive-Behavioral Techniques For OCD Patients and People in General”

  1. RL:”I have OCD, but I don’t talk about it much on here because no one wants to hear about it, understandably.”
    Yeah, some of us regulars do indeed want to hear about your experience with OCD, Robert. So if you feel like it, tell us about it.

  2. Hi. I have been prescribed 25 mg of Anafranil for OCD and Anxiety. Kind of aprehensive to try it because of the side effects I have read about. Please let me know your thoughts.

    1. Anafranil, to me, has been the most kickass drug of all for OCD. I have also suggested it to 2 people with very serious OCD issues, and it worked great for both of them. One guy was suicidal and Anafranil saved his life. It has some side effects. I no longer take it due to the side effects. If you don’t like the side effects, just go off, it’s no problem.

  3. I actually found your old blog a while back from the posts about POCD, that’s my major obsession but i have had lots rotate around that now…racism,murder,rape you name it i have obsessed about it.
    I am kind of stuck atm, i have done some CBT and other therapies (which werent really tailored to anxiety disorders) but i feel jammed. Feel like i am self pitying a bit so i’ll end here.I am glad meditation has worked well for you, i am thinking of trying it myself. This post fills me with some hope.

  4. did you ever write an article on POCD? I have suffered from it. It has really messed up my life and made given me a lot of anxiety to be in public to the point of causing panic attacks. I discored your blog reaserching POCD and heard that you coined the term. When I first had the symtoms I was really freaked out and thought I was the only person in the world to have it but than I discored many other people suffer from it.

    1. Actually, it’s very common. I talk to people with POCD all the time, usually younger folks, often guys, but a few women too. Typical sufferer is about 18-25 or so, highly intelligent, etc.
      POCD is just OCD, that’s all. The problem is that therapists do not understand it at all, and they often think you’re a pedophile. That’s about the worst therapy I can think of for this problem.
      Let me republish some of my old stuff from the old site that I wrote on POCD.

  5. I stumbled on this page by accident.
    But after reading the first few sentences i couldnt stop. You have a very nice way of writing, and it’s so refreshing to read that someone is so nice and helps other people. In a light but still serious way, so it doenst come in like a dark cloud.
    Bless you.

  6. I really liked this write up and I’ve also heard that we OCD folks are quite intelligent. My son and daughter have it as well. My daughter worse so. She tried prozac which helped but basically doesn’t like to talk about the OCD. I think it was triggered initially by a traumatic event that we went through and mine was also triggered by what happened to me when I was young.

  7. “I have OCD, but I don’t talk about it much on here because no one wants to hear about it, understandably.”
    I could tell. I can also tell you have other issues going on.
    OM? Really? That’s horrible Hindu upper caste Brahmin dogma there Bobby Ji. Really I’m disappointed in you.

  8. “In my case, there were a variety of situations that I feared, all revolving around a common fear, that, honestly, is ludicrous (And that I will not discuss.)”
    You’re POCD, aren’t you?

    1. I have had all the major themes at various points in the past: Schiz OCD, gay OCD (HOCD), POCD, Harm OCD, racist OCD, fear of various illnesses and lots of others. That is all I am going to say at the moment.

      1. I could tell you had a lot of issues just from your photo alone, and the way you write confirmed it. I’m expert in faceology.

  9. Hi , I have senserorimetor obsessions , these are particularly around my face area , I am very aware of my eye movements , jaw movements , blinking etc and very often feel that this normal face structure there is something not right , 10 years I have been suffering , am on Daxid 150 mg . Need help , unfortunately my country India does not have qualified exposure and response therapists , any inputs would be appreciated . Really struggling !!

    1. Hello Hema, I just want to express my support. It sounds as if you have been professionally diagnosed, is that correct? If so, has a certain type of therapy, beyond the drugs you mention, been recommended? I would not want to suggest anything that goes against a professional diagnosis. My own disorder is usually facially-related (obsession with left side of my face) and linked to Pure O. I have had some really helpful therapy in the past though, which greatly improved everything. Best wishes.

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