Supporting OCD and Anxiety: What Your Loved One Wishes You Understood
OCD and anxiety don't just affect the individuals living with them; their loved ones are equally impacted. Family members often grapple with frustration and uncertainty, not knowing how to best support their loved one in their struggle.
In this article, you'll hear insights shared by OCD sufferers about what they find most helpful from their loved ones and what their loved ones should avoid.
Understand Their Unique Experience with OCD
First and foremost, it's essential to acknowledge that OCD and anxiety aren't one-size-fits-all experiences. Some people experience physical compulsions, while others are experiencing mental compulsions (often referred to as Pure O).
Internally, individuals with OCD experience a significant mental burden, even if it's not apparent to others, making their daily lives mentally exhausting.
It’s important to resist the urge to normalize their experience. Even if you can relate or have OCD yourself, remember that you can never fully understand their experience. Instead, be a good listener and validate their feelings. For example, say, "That sounds like it's painful for you to live with."
OCD is often misunderstood, and its impact goes beyond common stereotypes like contamination-related OCD. Just because you don’t see them doing compulsions, doesn’t mean they aren’t experiencing OCD. Learn about the various sub-types of OCD here.
Action Steps:
If your loved one mentions their struggles, trust them, even if you can't see any outward signs of distress.
Respect their word and ask them how you can support them.
Always be willing to correct any mistaken assumptions about their state of mind.
If you don’t feel like you understand OCD, take the time to fully educate yourself by reading reputable books or visiting trustworthy websites.
Be a Safe Haven for Your Loved One with OCD
Having safe people in their lives to share the raw truth of their OCD journey can be a game-changer.
Clients of mine have shared that they felt most supported when they were encouraged to be completely authentic and not have to always pretend that everything is "fine." Just letting them be themselves can lift a significant weight from their shoulders.
OCD should not be downplayed. Even if the person with OCD knows their thinking doesn’t make sense, it still feels very real to them and difficult to handle, so take them seriously and treat them with compassion.
Action Steps:
Do not laugh at them or tease them about it having OCD.
When your loved one opens up to you, try to maintain a calm demeanor. A strong reaction may discourage them from sharing their thoughts, as they may feel like they're causing you distress or can't trust you with their concerns.
Thank your loved one for opening up to you.
Validate their experience by saying “this sounds really painful” or “I can see how this is confusing to you. You don’t want to do this but feel like you can’t stop.”
What to Do When Your Loved One is Engaging in Compulsions
It's natural to feel frustrated when your loved one engages in compulsions, but getting angry won't help. Remember, they don't want to perform these rituals; they feel compelled to do them.
Action Steps:
Acknowledge their struggle and ask if they would like help or if they prefer some space.
If they want help, see if you can help them through a distraction or see if they are willing to delay the ritual, even if it’s just for a few moments. For more tips on reducing compulsions, read here.
If you are having difficulty with your emotions, it’s ok to remove yourself from the situation.
Remember: It’s not your responsibility to stop their compulsions.
Don’t Accommodate or Enable Your Loved One with OCD
Loved ones often feel the need to make changes in their own behavior to accommodate the person with OCD.
You don’t want to see them in pain and so you want to do what you can to make them feel better. Or perhaps they are insisting on you reassuring them and feel you need to.
Although you may not agree or want to do these things, it can make you feel trapped.
If you experience these feelings, then you may be unintentionally feeding your loved one’s OCD by making accommodations for them. This occurs in nearly every family when someone has OCD.
Accommodating behaviors are normal. So don’t beat yourself up.
However, recognize that this is only feeding your loved one’s OCD and not actually helping in the long-run.
This is the part of the OCD cycle that you can ACTUALLY control.
Action Steps:
You have the right to say no when they ask you to do something (like change your clothes or give them reassurance).
Removing every and all accommodations at once is unrealistic and likely going to be unhelpful. Learn more about handling family accommodation here.
It’s important to be intentional, have a plan, and work towards it over time. It won’t happen overnight.
You Don't Need to Fix Your Loved One’s OCD
You might want to swoop in and solve everything, but sometimes, that's not what they need.
Remind them that what they're going through sounds incredibly challenging. Acknowledge their courage and resilience in living with OCD.
People with OCD need to know they're not alone on this path, and your validation can be their lifeline.
Action Steps:
NEVER force your loved one to face their fear or do an exposure. Instead, encourage them, but let them decide their boundaries and pace.
Remember, it's essential to validate their feelings rather than trying to fix everything.
It’s ok to admit to them “ I wish I had the answers” or “I wish I could take this pain away from you.”
This allows your loved one to feel heard without you having to provide a solution.
OCD Recovery Is a Lifelong Journey
Recovery from OCD is not linear. There may be times that your loved one is doing really well but then they have a setback. It’s important to expect a setback and encourage your loved one to get back on track.
A setback is not the end of the world. If they have been through treatment and had good progress, they will be able to regain that progress again. No knowledge has been lost. Check out this article for more helpful information on handling setbacks.
Action Steps:
Do not be panicked or upset with your loved one. It will not help your loved one if you start to freak out. Stay calm and express confidence in them that they know exactly what they need to do to get back on their feet
Remind them of the things that were helping them before whether that was medication, therapy, exposures, etc.
Ask them if there is anything that you can do to help them feel less overwhelmed with getting back on track with their treatment plan. Perhaps a few sessions with their previous therapist as a refresher will be useful.
Avoiding Caregiver Burnout
Make sure you are not forgetting about your own needs during this time. Remember what the flight attendants say at the start of an airplane ride, they say to put on your mask before you help other people.
Why do they say this? It's because if you are not taking care of yourself you will not have the strength, energy, or skills to be able to help somebody else. You will end up burning out before you can be helpful.
Action Steps:
Have activities and hobbies that you are engaging in
Seek your own therapy
Be sure you are taking your medications (if applicable)
Be sure you are taking care of yourself by eating and sleeping well
Conclusion
Remember that OCD is lifelong. It’s not your job to solve it for your loved one. But you play a critical role in your loved one’s recovery. If your loved one is in need of treatment, be sure they are working with a therapist that specializes in treating OCD using effective and evidence-based treatments available for OCD (such as ERP or ICBT).
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What is Pure O?
Pure O is a subtype of OCD that is not often recognized. In this video, Bryan Piatt shares more about how to identify Pure O.
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Deep Breathing in Action [Video]
In this video, Bryan Piatt discusses how to use your breath effectively to manage anxiety symptoms.
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Traveling with Anxious Flyer? Sidestep These 5 Common Pitfalls
If you are traveling with someone who is nervous about flying, it can be hard to know what to say or do. Most people have good intentions when attempting to alleviate another person’s anxiety. But sometimes those good intentions can lead to your travel partner feeling upset and unsupported.
5 mistakes to avoid when traveling with an anxious traveler:
Do not encourage the anxious flyer to drink alcohol or use drugs to handle their anxiety. Although alcohol can help people relax, it isn’t effective for everyone. It can cause additional problems for anxious traveler. For example, getting dehydrated from alcohol can increase their anxiety symptoms. If your travel partner gets intoxicated on the flight, it could cause other problems like saying something embarrassing or passing out and unable to wake in the event of an actual emergency. And some people are on medications that could be dangerous to take with alcohol, so it’s important not to suggest it if you don’t know the impact it could have on them.
Do not tell them to calm down. Rarely is this ever effective. If it was that simple then they would do this on their own. it is never helpful to hear that when you are anxious. Instead try offering something specific like a back rub or “lets take some deep breaths together” or “I’m here with you, you’re safe.”
Remember that there is nothing you can say to "talk them out of their fear." Most anxious flyers know that they are safe but their brain tricks them in the moment. Validate their feelings and let them know you understand how hard this for them. If you try to “fix their thinking” then you will only cause them to shut down and feel frustrated.
Don’t be late. A person who is nervous to fly does not need added stress on top of their worry. Allowing for plenty of time will allow them to keep their stress low so they keep their worry at bay.
Be aware of your behavior. Someone who is anxious is going to be easily irritable. So if you have any habits that they other person finds annoying (like chewing with your mouth open or talking loudly) then that may add to their stress. Try not to take it personally and realize that their tolerance for anything bothersome is really low. Do your best to mitigate the behavior to help them feel more relaxed.
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Guided Meditation for Intrusive Thoughts
Created by Bryan Piatt
Bryan Piatt is a practicum provider that helps people get untangled from obsessive thoughts and worries so they can find freedom and joy in their life. Interested in working with Bryan? Schedule a free 15 minute phone consultation below to get started.
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How To Stop Playing Whack a Mole with Worry
Do your worries change topics? Maybe you have spent tons of time squashing one worry, only to have a different one pop up. This can lead you to an endless game of "whack a mole." Where the game of getting rid of worry only keeps going, and going, and going...kind of like the energizer bunny.
If you don’t learn about this game that worry likes to play, you can easily get stuck in the worry trap for years. In this blog, you will learn our top tips for handling those jumping worries.
Identify the Theme Across All of Your Worries
Worry tends to be pretty predictable and thematic. It may not seem like it on the surface, but if you spend some time exploring this, you will find that there is a common theme across all of your worries.
Understanding the theme of your worry can really help you to not get caught off guard the next time it shows up.
So how do you find the theme?
Make a list of all your worries. Include current worries and ones that you have had in the past.
Put your worry into a “what if” question
Ask yourself, if that were to happen, what would that mean about me or about my life? What’s the bad thing that would happen?
Take a look at your list. What do your worries have in common? Maybe it’s about fear of accidentally harming someone you love. Or maybe it’s about you getting sick. Or maybe not being able to enjoy your life.
Write down the theme. This is the scary story that worry wants you get absorbed in. And once you aren’t absorbed into it, then it tries to find another way. This is when whack-a-mole shows up.
Acknowledge the Worry
So now that you know your theme (or scary story) of worry. You need to get really good at spotting it. Because worry will try to trick you into getting caught up in different way. It’s like the worry put on a different halloween costume to spook you. But don’t be fooled.
When you notice that this worry has the same scary story as you’ve had in the past, acknowledge it.
You can practice saying “here is another scary story about being responsible for harming someone. I know what this is, I’ve seen it before.”
Or you can say “I don’t like these scary stories, but I can allow them to be there.”
Recognize Your Choice to Go Further
Believe it or not, you have to choice to engage in the scary story. It’s not an easy choice, but you do have one. Recognizing that you have a choice to begin with is very empowering. You don’t have to play the game. You can drop the rope.
You may find it helpful to think about what has happened in the past when you have bought into this story before. Did you get stuck in rumination? Did you seek endless reassurance from others? Did you spiral into panic?
Remembering the consequences you have experienced for engaging in the scary story can be useful for you in avoiding the trap. You can remind yourself “Yes, there is a scary story here. If I buy into it, it’s going to make it hard to enjoy time with my family, take away my energy, and so on.”
Once you have acknowledged the scary story and made your choice to not buy into it, then get back to being involved in your life. Get involved with what you want, regardless if worry wants to come with.
You don’t need the worry to be solved to get back to living your life (that can be another trap). Just get out there and keep living and use the skills along the way.
Written by Jenny Matthews, LMFT, LADC
Jenny is a therapist that specializes in helping over-thinkers and worriers get relief from anxiety so they can be more productive + do what matters so they can be present with their loved ones.
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A New Way of Treating OCD (A Non-Exposure Based Way)
The New Kid on The Block
For years we have known that ERP (exposure and response prevention) is the gold standard treatment for OCD. I have been using ERP with my clients for years, and many have been able to get their life back using this approach.
But the truth is, the research says that only 60% of clients will get better with ERP. So then what? Do those individuals just live with the suffering that OCD has caused them? Should they just give up? Accept that this is as good as it’s going to get?
Hell no. There has to be more. And luckily, there is.
For the past 9 months, I’ve been seeking ongoing training and consultation with hundreds of other OCD therapists across the country on a therapy called Inference Based CBT.
Is it new? Sort of, but not really.
What is Inference Based Therapy (ICBT)?
Inference Based Therapy has been around since the early 2000s. It has undergone many randomized controlled studies comparing it to ERP, and the data has shown to be just as effective as ERP.
This is great news. This means that we have more than one way to effectively treat OCD.
ICBT is a cognitive therapy for OCD. ICBT aims to resolve “inferential confusion.” Which is when someone confuses imagined possibility with reality.
ICBT works “upstream” by addressing the doubt (or what if?) that set the OCD into motion.
By working upstream, when you can resolve the doubt, then the anxiety and compulsions do not occur.
ICBT looks at what is behind the doubt. There is a reasoning process you use with obsessional doubts that you don’t use with normal doubts. You reason differently in OCD situations than every other area of your life. We teach you how to see the difference.
ICBT says that intrusive and obsessive thoughts do not occur by random, there is a story behind them. The story is absorbing and takes you behind your senses.
ICBT aims to help people return to trusting themselves and their senses.
What I love about ICBT
I’ve been using ICBT with the majority of my clients with OCD for the past 6 months. I still consider myself a beginner but many of my clients feel like this makes so much sense. It’s also common for some of my clients to feel confused. Because this is very different than what they were previously learning through an ERP approach.
This was my experience in learning ICBT too. It has (and still does) take a lot of work to see how this approach works.
I love how well rounded this model of therapy is. In ERP, there is no real in depth discussion about how a person came to become so consumed with their worries. And in ICBT, we really help people understand this and I have seen this be so validating to my clients to have a deeper understanding of themselves.
I love how interactive it is. We use games and exercises to apply the concepts so that clients can arrive at these conclusions on their own.
And mostly, I love having an additional treatment option for clients. Exposure will still be a treatment I use in my practice but when a client isn’t making progress or isn’t ready to try ERP, it’s nice to have other ways of helping them regain their life.
Questions about ICBT? Send me an email at jenny@stateofmindtherapy.com
Written by Jenny Matthews, LMFT, LADC
Jenny is a therapist that specializes in helping over-thinkers and worriers get relief from anxiety so they can be more productive + do what matters + be present with their loved ones.
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How You Can Change Your Relationship With Anxiety and OCD
Created by Bryan Piatt
Bryan is a practicum provider that specializes in helping people get untangled from obsessive thoughts and worries so they can live more freely in a life they love.
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How To Support an Anxious Flyer
Traveling with someone anxious about flying? Check out this article on Travel and Leisure Magazine that Jenny contributed to for helpful tips on how to support your loved one.
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How to Handle Big Feelings
Dropping Anchor: A Helpful Tool for Handling Anxiety, Panic, and other big feelings
Dropping anchor is a tool from ACT (Acceptance and Commitment Therapy) that can be really effective for any big feelings-anxiety, anger, shame, etc.
The 3-part excercise is meant to help you gain more control over your actions (instead of freezing up, ruminating, or lashing out). This exercise also helps reduce the impact or power of the big feelings.
Please note, the goal is NOT to eliminate the big feelings or difficult thoughts. When that becomes the goal, we can easily get hooked further by these experiences.
Remember this acronym: ACE
It stands for Acknowledge, Connect, and Engage
Check out the exercise below. If you prefer to practice this exercise through audio, check out this recording I made that will walk you through it.
Acknowledge your thoughts and feelings
Notice them with curiosity and without judgment. It helps to say them in a matter of fact way, like “here is worry,” or “I’m noticing a racing heart.” You can also be more vague such as “here are difficult thoughts/feelings” or “I’m noticing pain.”
This part of the skill is critical. Many other strategies like grounding, deep breathing are good at getting you connected with your body but they are also aimed at distraction. The acknowledge part of this skill is helping you to not avoid or distract, by naming your experience you are actively accepting it and creating distance from it.
Come back into your body
Do any small movement to reconnect with your body. Have a gentle stretch. Wiggle your toes and fingers, walk, or shift in your chair.
While doing this movement, continue to practice acknowledging your thoughts and feelings (so this doesn’t become a distraction technique).
Engage in the world
Now it’s important to refocus and engage with an activity. The purpose of this exercise is to help you be able to take effective action, even if you are experiencing difficult thoughts or feelings. This can be done in several ways:
Actively notice the environment you are in right now. Name something you can see, hear, smell, touch, or taste.
Take note of where you can put your attention next to make the most of this situation. Maybe that means returning to some work you were doing. Taking the dog for a walk. Or maybe engaging in a game with your kids.
Dropping Anchor Audio Recording
When practicing a new skill, it can be more effective to listen and be guided through the exercise instead of reading instructions. So I made an audio recording that you can use to listen to when you are practicing this skill. After awhile, you won’t even need the recording, the skill will become natural to you.
Written by Jenny Matthews, LMFT, LADC
Jenny is a therapist that specializes in helping over-thinkers and worriers get relief from anxiety so they can be more productive + do what matters + be present with their loved ones.
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How to Overcome Your Fear of Flying
5 Strategies to Help You Overcome Your Fear of Flying
Get Started with Our Flight Anxiety Toolkit
What’s Your Core Fear of Flying?
Your afraid of this behemoth machine crashing?
You’re afraid of turbulence breaking the airplane apart?
You’re afraid of flying into a thunderstorm and crashing?
You had a panic attack on the airplane last time and you’re afraid that the panic will return?
You’re claustrophobic, so the slightest idea of sitting in this tiny cylinder would drive you mad?
You’ve seen media stories of passengers losing control on the airplane and trying to escape out of the emergency exit and now you’re afraid that could be you?
You have a history of health anxiety and the idea of being too far away from a hospital is keeping you from boarding that airplane?
Why Do You Want to Fly?
Is it something else? If so, dig deep to see if you can extract your core fear.
I yearn to participate in a family vacation (without having to drive alone)?
I yearn to apply for a job that requires air travel?
I yearn to tap into my adventurous side and see the world?
I yearn to break away from the shackles of fear and develop confidence in myself?
Is it something else?
3. take action
If your fear is centered around not understanding how airplanes operate or weather/turbulence related fears, commit to learning how airplanes work.
If your fear is FEAR OF FEAR, try to become more mentally flexible with scary, uncomfortable thoughts, feelings, memories, and bodily sensations:
Practice using your attention muscle (that thing you use to read and communicate) to not engage with all of the “What if’s” that pop into your awareness. Learn more about attention vs. awareness and rumination here.
Increase your willingness to FEEL ANXIETY and not try to push it away, fight it it, or pull you into more avoidance or rumination.
Remind yourself why you’re willing to expand your comfort zone and face your fear. (I want to be able to get away in the winter months, I want to visit my relatives, etc)
4. Anxiety is uncomfortable but not dangerous
Remind yourself that after you face your fear, you will learn that fear is simply an emotion that can’t harm you. You will also learn that fear loses its power after you face it head on!
5. Seek Additional Support for Your Fear
Overcoming fear is not easy, and you don’t have to do it alone. Having a professional, like a therapist that specializes in treating anxiety disorders and phobias, that can walk you through this challenge can be a game changer.
A therapist can help you create an individual plan to how to work on facing your fear. Therapists can be great for accountability if you know you have a tendency on letting avoidance take over.
At State of Mind Therapy, our therapists are skilled at treating flying anxiety. We work with clients one-on-one and have digital courses that you can join to give you the tools you need to overcome your fear.
Scheduled a free 15 minute phone consultation to get started working with one of our therapists at State of Mind Therapy.
How Rumination May Be Keeping You Prisoner to Anxiety/OCD
Let me guess.. It feels like there’s a never ending NASCAR race in your mind - the cars being racing thoughts that produce scary thoughts, images, memories, and catastrophic predictions. Your mind keeps SPINNING, SPINNING, SPINNING! Eventually, it makes you feel like a prisoner to this endless race that you never even signed up for.
We get it. And we can help.
As clinical mental health therapists, we often see people struggling with - what we often hear as, “overthinking.” Our clients tell us that they just can’t relax because their mind is in constantly spiraling out of control and they can’t stop the SPINNING! But the truth is - they are doing something and they are most likely doing it without even realizing they’re doing it. This is a process called rumination. When working with us, clients are often surprised how much they’ve actually been ruminating without even knowing it!
What is rumination?
Professionals in the field have often suggested that mental rumination is thinking about past or future life events.
It’s often been said that when we are ruminating about the future, we are dealing with anxiety - and when we’re thinking about the past, we are in the arena of depression.
I believe most therapists continue to be in alignment with this definition of rumination.
However, this definition has recently been vastly expanded, and thankfully so - because we are now seeing at least one reason why people continue to find themselves stuck in their anxiety, panic, and OCD recovery.
What most people with an anxiety disorder or OCD don’t understand is how much their rumination contributes to their anxiety symptoms as well as their reluctance to engage in their exposure treatment plan.
The mental health research field has begun to realize that more attention needs to be focused on how a sufferer is engaging in rumination. Dr. Michael Greenberg is also a specialist in the field of anxiety and OCD. Dr. Greenberg has established a very detailed list of ways he’s seen clients ruminate - see if you can relate below.
Ways We Can Ruminate:
Trying to figure something out
Directing attention/monitoring thoughts and feelings
Keeping ones guard up (mentally)
Pushing away thoughts, trying to not let thoughts enter ones awareness
Using mindfulness or ‘bad distraction’
Engaging in self-talk
Rumination is a Choice (but often feels like it’s not)
Many of our clients will tell us “I overthink, worry, or obsess.” But actually, what they are really saying is that they are engaging in rumination (but they don’t know it).
Obsessions are when a thought shows up automatically. which is something we have no control over.
A compulsion is effortful. So when you engage with the thought using any of the 6 examples listed above, you are actively directing your attention towards it (compulsion).
Rumination keeps people stuck because they don’t realize their mental behavior can be a mental compulsion. Clients often feel like rumination is something they don’t have control over, but I’m here to tell you otherwise.
Let me provide an example of why this is an unhelpful behavior and how it may be keeping you prisoner to your mental health disorder.
Let’s say that Johnny Doe has been diagnosed with health anxiety OCD. Johnny’s core fear is that he has an illness, but nobody is able to come up with a diagnosis. Johnny recognizes that he has minimal evidence of a medical issue, but his fear is very convincing and overwhelming. Johnny has also been medically cleared numerous times by medical professionals, but he’s still partially inclined to believe that he’s contracted some sort of illness (even thought there’s zero objective evidence of an illness).
Because Johnny tends to experience obsessional thoughts about being sick or having an underlying condition that is not being addressed, he may begin to engage in various forms of rumination, such as directing attention/monitoring, trying to figure it out, and self-talk.
Monitoring may include scanning their body for any type of abnormality (skin defect, noticing minor aches and pains, tickle in throat, weird sensation, etc.).
Johnny may also try to “figure it out” by engaging in research throughout the internet (Dr. Google) - hoping to find an answer to their feared/hypothesized illness.
Or Johnny may try to figure it out by thinking about all the toxic substances he has recently been exposed to as a means to hopefully solve the mystery of his “illness.”
Johnny may also use positive self-talk compulsively, by saying something like, “I’m going to be ok” or use excessive prayer in his mind in hopes that this will prevent his illness from continuing.
Johnny is utilizing rumination as a means to establish a sense of safety or protection against a (most likely) mentally fabricated, phantom illness. However, what this behavior is actually doing is maintaining his high anxiety state.
Now you may ask, “well what if there is a problem?” or “why is it a big deal to do this!? “
Fair question!
However, there’s a reason why Johnny is seeking out mental health treatment: he is suffering with anxiety and struggling to live a normal life.
Now Johnny could continue to find answers by visiting more specialists, spending more time on the internet or more time monitoring his body for more evidence of illness, but this all comes with significant costs:
Time
2.Energy
3. Worsening anxiety
4. Conflict with relationships
5. Avoiding going to places that trigger anxiety
Important note: Ironically, Johnny is doing a bunch of rumination because he feels like he needs to do it - so he can then hopefully feel better/safe. However, once Johnny sees what he is doing, he realizes that he’s actually worsening and fueling his anxiety/OCD.
So what do we do once we have come to understand that rumination is a compulsion and something you actually do have control over?
We must let the thought be there, and not direct our attention to the feared thought that’s in our awareness!
Attention vs. Awareness
Attention is the mental muscle you use to read a book, engage in communication, solve a math problem, watch a movie, notice the sunset, etc.
Awareness is anything that you notice in your mental periphery.
For example, as I type this sentence, my attention is directed toward my screen and keyboard.
But in my awareness I notice that I can hear my neighbor’s ridiculously loud leaf blower, I can hear birds chirping, and I can hear the sound of the blustery wind whooshing through the trees.
Attention and awareness are two very discrete attributes of the brain.
However, it’s worth noting that there is no distinct line where attention and awareness meet.
But that’s ok - once you begin to practice re-directing your attention, you will notice the difference between the two.
So The Point Is…
Johnny does have some degree of control of where he directs his attention.
The hard part of course is resisting the strong urge to direct attention to the fear of a possible illness (but trust me, with practice you can do this).
It’s also important to note that people with anxiety/OCD disorders are also often afraid of experiencing their current emotional state forever.
Often, people believe that their anxiety will stick around FOREVER if they don’t continue to direct attention towards their perceived problem. However, that’s typically not the case.
Often what we see in our clients is - if they are successful at not continuously ruminating and are able to maintain some control of their attention - after 2-3 days they begin to notice improvements in their anxiety symptoms as well as a reduction in the urge to ruminate.
Some therapists may argue that this approach is distraction. But actually, it’s not.
This is actually an exposure exercise because we’re not allowing ourselves to pursue certainty - or in other words, we’re exposing ourselves to uncertainty by not answering the questions/fears of the mind that’s demanding answers. It is here (bathing in uncertainty) where we need to be in anxiety and OCD recovery.
Additionally, once an individual gets practice having more control of their attention muscle and they’re no longer engaging with unhelpful thoughts screaming in their awareness - we find that exposure exercises (intentionally triggering one’s anxiety in a particular context) are often less anxiety provoking!
Putting All Of This Into Practice: The Choice Point
Once you have determined that your obsession or fearful thought is not rational or helpful, you’ve arrived at the choice point.
Here there are two choices: continue to direct your attention towards the phantom threat by continuing to ruminate, or, you can redirect your attention through these steps:
Aknowledge and label the thought once it enters your awareness (ex. “I’m noticing a thought and fear related to my health anxiety”). Note: you don’t need to do this every time
Open up and make space for the emotion to enter your mind and body with radical acceptance and compassion towards it
Direct your attention to anything else or simply to nothing - as long as it’s not directed to the feared/obsessional thought or feeling
Let the feared/obsessional thought or feeling camp out in your awareness as long as it needs to without fighting or resisting it
You’re human - so you will slip up - just notice that you did slip up and direct your attention back away from the unhelpful thought or feeling
If you find yourself still really anxious - you’re probably ruminating - time to check-in with yourself by asking, “Am I ruminating right now? How am I directing my attention to this thought?”"
Repeat
That’s it.
Not engaging in rumination is hard work. we get that. So if you are struggling with this, don’t give up. This doesn’t mean your brain is broken, you just need to keep at it.
The human mind has been evolved to notify us of any sense of danger. The mind is like a problem-solving, analytical, judgmental, catastrophic thinking machine. And it does this really well!
The problem with this default mechanism is that sometimes it sends out a false alarm to our conscious mind (where we notice thoughts).
Fortunately, humans have the ability to notice this alarm, which often presents as various physical or mental symptoms: increased heart rate, sweating, racing thoughts (what if’s), predicting the worst case scenario, and plenty more!
Once we are able to notice the fear signal, we can decide if this notification is helpful or unhelpful - and then we can direct our attention towards whatever we want (even if it’s towards nothing).
How State of Mind Therapy Can Help With Rumination
Let’s be honest - it can be hard to put these skills into practice.
With the help of an anxiety or OCD therapist, you can learn about the ways in which you ruminate and set up a plan for practicing effective skills.
To get started, schedule you free 15-minute phone consultation to determine if we would be a good match to help you gain freedom from anxiety and OCD.
Written by Justin Matthews, LGSW
Justin is a therapist that specializes in helping individuals get relief from anxiety and OCD by teaching them how to be more flexible with their unhelpful thoughts so they can spend more time doing what matters.
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[Video] 5 Minute Guided Mindful Break For When You Feel Overwhelmed
When you feel stressed, anxious, and overwhelmed it can help to take a break to regain a sense of peace so you can focus and be present in the world around you.
Written by Jenny Matthews, LMFT, LADC
Jenny is a therapist that specializes in helping over-thinkers and worriers get relief from anxiety so they can be more productive + do what matters + be present with their loved ones.
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Ready to work with an anxiety therapist?
State of Mind Therapy in Bloomington can help. Click the button below to sign-up for your free 15 minute phone consultation today.
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Response Prevention Tips to Help You Stop Engaging in Compulsions & Rituals
We know that overcoming OCD isn't easy. And you have probably tried to reduce or stop engaging in compulsions many times and found it to be really difficult. In this post, we want to share some tips with you about ways to prevent yourself from engaging in compulsions.
First of all, why is this important? I'm sure you have many of your own personal reasons why you want to stop. No matter what is motivating you, it can still be really hard. The important thing to remember, is that if you don't stop the compulsions then you just keep feeding the OC cycle and will stay stuck.
Stopping compulsions isn't as simple as just deciding to stop (you already know this though!)
There are some strategies that can help you be more successful. There is no right or wrong way, so you may want to experiment with different ones and find out which ones helps you the most.
Delay the compulsion: if it's hard to completely stop a compulsion, then make a plan to delay it. Give yourself a specific time and set the timer. Increase the delay by a few minutes over time.
Do it wrong: If your compulsion involves doing something in a particular order or a particular amount of time, you can choose to do the compulsion in the incorrect way (ex: touch 5x instead of 3x)
Do something that is active and brings joy: this sounds like distraction, and in some ways it is (more about the difference later). But when you are just starting out, it's hard to know what to do when you are choosing not to do a compulsion. And if you are just sitting there and feeling really uncomfortable, then you might be more likely to engage in ruminative, worried thinking which won't help you either. We want to work on helping you be able to function with anxiety, which will help you resist rituals in the future. So pick something you will do instead, maybe it's picking one cute puppy video and sending it to a loved one, playing a game of tag with your kids, or complete a sudoku / crossword puzzle. Pick a specific amount of time you will do this activity so that you have a clear way to measure your success.
Write a script: grab a note card or place to jot notes in your phone. Write down all the reasons you want to get better. What would your life be like without OCD? Write down any encouraging or motivating phrases. If you are struggling with resisting the urge, take out your note and read it. This may give you just what you need in that moment to resist, even if it's just for a few minutes.
Try responding with uncertainty. Examples include: "maybe" or "we'll see" or "what's done is done."
If one of your compulsions is to seek reassurance from others, make sure they know how to respond so that if you are unable to resist asking for reassurance than they can help you by not giving you the answer.
Written by Jenny Matthews, LMFT, LADC
Jenny is a therapist that specializes in helping over-thinkers and worriers get relief from anxiety so they can be more productive + do what matters + be present with their loved ones.
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State of Mind Therapy in Bloomington can help. Click the button below to sign-up for your free 15 minute phone consultation today.
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Exercise: "I Notice I'm Having The Thought"
When you have constant what if thoughts it can be hard not to pay attention to them.
We love to teach our clients how to create more distance between their thoughts and them so that you aren't running on auto-pilot anymore.
If you have more distance from your thoughts, it's easier to see them for what they are (streams of ideas in your head) and not get hooked by them.
Try this exercise to help you get more distance:
“I’m having the thought” exercise
Write down a thought that hooks you with anxious feelings
Say that thought 10 times, how does that make you feel? (rate it from 1-10)
Now say same thought, except add “I’m having the thought” in front of it
Now add “I notice I’m having the thought.”
What did you notice about the difference between the first, second, and third change? If you found it helpful, we recommended that you practice this skill daily to help you be able to use this tool more easily.
You might find it helpful to have a log, journal, or note section on an app to keep track of your progress.
Written by Jenny Matthews, LMFT, LADC
Jenny is a therapist that specializes in helping over-thinkers and worriers get relief from anxiety so they can be more productive + do what matters + be present with their loved ones.
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State of Mind Therapy in Bloomington can help. Click the button below to sign-up for your free 15 minute phone consultation today.
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Our Favorite Books for Help with OCD
Learning all you can about OCD can make a big difference in your recovery. By reading self-help books, you can increase your understanding of how OCD works, feel less alone, and learn helpful strategies to deal with OCD.
There are so many great books available today to help you on your journey. We wanted to share a few of our favorites with you.
These are not affiliate links, just ones we think are great.
Freedom from Obsessive Compulsive Disorder by Jonathan Grayson, PhD
The Mindfulness Workbook for OCD by Jon Hershfield, MFT
Overcoming Unwanted Intrusive Thoughts by Sally Winston, PsyD
ACT Workbook for OCD by Marisa Mazza, PsyD
Written by Jenny Matthews, LMFT, LADC
Jenny is a therapist that specializes in helping over-thinkers and worriers get relief from anxiety so they can be more productive + do what matters + be present with their loved ones.
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State of Mind Therapy in Bloomington can help. Click the button below to sign-up for your free 15 minute phone consultation today.
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How to Stay In The Present Moment
Our minds drift to many different places throughout the day. What should I eat? Did they like my presentation? I need to remember to call the doctor. And so on.
It's normal for minds to drift.
But if you have a mind that is prone to worry thoughts, then you can find yourself distracted often which makes it hard to do the things in life that matter most to you, like focus on your job, enjoying time with you family and friends, and working towards your goals.
Although it's normal for minds to drift, we can work on strengthening our ability to stay in the present moment through attention training. We can do exercises for our mind, just like we may exercise our body through running or lifting weights. Below are two ways to help you strengthen your ability to return to the present moment. (Remember, the goal isn't to never drift, because that's just what minds do. Your goal is to get better at noticing when you drift and bring yourself back to the moment)
Attentional Training in Two Ways
Self-focused Attention
This is where you notice thoughts, feelings, and sensations that are occurring inside of you. The point isn't to try and control them or make them go away, but instead notice them without judgement. For instance, you may say "I notice my heart racing" or "here's anxiety." By doing this in a matter of fact way, we stay curious and in the present rather than pulled into a story our mind tells us.
Task-focused Attention
You can practice staying present in the moment through an everyday task, such as washing the dishes. While doing this task, you can focus on:
Touch: what does the water feel like? What is the temperature like?
Sight: What catches my eye? What colors or patterns do I see?
Hear: What sounds do I notice?
Smell: What smells do I notice?
Taste? what flavors do I notice? what is the quality of the flavor? Strong? Mild?
Written by Jenny Matthews, LMFT, LADC
Jenny is a therapist that specializes in helping over-thinkers and worriers get relief from anxiety so they can be present with their loved ones.
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State of Mind Therapy in Bloomington can help. Click the button below to sign-up for your free 15 minute phone consultation today.
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5 Ways to Handle Setbacks
It's not uncommon for people to make great progress on handling stress and anxiety to then really struggling. Sometimes the struggle is small and sometimes is a major setback. Here are some tips to help you get through tough times like these:
Remember that your progress can never be unlearned. Even if you have a setback, it likely won't be as difficult as it was back before you got the help you needed. You will bounce back much sooner because of the previous knowledge and changes.
Evaluate changes in your life. Was there something that contributed to this setback? Life changes and stressors can often cause setbacks. If you can identify a contributing factor, it can help you to assess what you need to help you get back on track.
Have you been taking care of yourself? If we are not meeting our most basic human needs that can be enough to impact mental wellbeing. You can remember the acronym HALT (Hungry? Angry? Lonely? Tired?) to help you check-in with yourself.
Go back to therapy. Even if you haven't seen your therapist in awhile, it can help to go back and work through the setback. Reviewing your skills and getting support can go along way. Even just one session could be enough to get you back on the right track.
Remember that you are human. Setback are not a sign of failure. They are common. Life is stressful so setbacks are bound to happen from time to time. We can't stop it but we can learn from it. And you will get stronger each time.
Written by Jenny Matthews, LMFT, LADC
Jenny is a therapist that specializes in helping over-thinkers and worriers get relief from anxiety so they can be present with their loved ones.
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State of Mind Therapy in Bloomington can help. Click the button below to sign-up for your free 15 minute phone consultation today.
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The One Thing Families Should Stop Doing
OCD impacts individuals and their loved ones. You may need your loved ones to reassure that nothing bad will happen or maybe they participate in compulsions so they can make you feel better.
In OCD treatment, it's important to learn about all the ways you try to get rid of anxiety or other distressing feelings to add them into your response prevention plan. One important piece to consider is ways your family participates in this.
This is called family accommodation. This means any changes your family member(s) does to prevent you from being triggered or to make you feel better.
Examples of Family Accommodation
Participating in compulsions by changing clothes when they get home, handwashing, or showering
Saying "you won't get sick from that."
Changing their work schedule or other activities because of your compulsions
Why Family Members Should Stop Accommodating OCD
They are reinforcing the message that your fear and anxiety are "bad" and can't be handled
It is impacting their life by creating anger, frustration, burn out, anxiety
The accommodations make your OCD worse in the long-run
How to Reduce Family Accommodations
It's best to do this together as a team
Sit down with your loved ones and educate them about family accommodations. Many times families don't know that this is harmful and/or don't know how to stop. They can think they are helping you.
List all the accommodations they do and make a plan on how to start to remove them
Give your family permission to remove one accommodation at a time so it's not so overwhelming
Written by Jenny Matthews, LMFT, LADC
Jenny is a therapist that specializes in helping over-thinkers and worriers get relief from anxiety so they can be present with their loved ones.
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Ready to work with an anxiety therapist?
State of Mind Therapy in Bloomington can help. Click the button below to sign-up for your free 15 minute phone consultation today.
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How Should OCD Be Treated?
One of the most common things we hear from clients who come to us for OCD treatment is that they have done years of talk therapy without much improvement.
This doesn't mean talk therapy isn't helpful. Many people find it helpful to talk with someone about their feelings and get validations. But most people with OCD will not see improvement in their symptoms by talking alone.
In fact, much of the time talk therapy can involve "co-compulsing" with the therapist by analyzing thoughts, seeking reassurance, and making meaning out of thoughts by looking for hidden traumas.
It's important for you to know that there are treatment approaches for OCD that have been backed by research. And this may come as a surprise to you, but most therapists have no idea how to use this treatment approach.
The majority of graduate school programs for therapists do not include training on OCD assessment, diagnosis, and treatment. Therefore, the only therapists that can adequately treat OCD are ones that have sought more specialized training.
What is the most effective treatment approach for OCD?
Research has shown that Exposure and Response Prevention in the most effective way of treating OCD. There are some additional treatment approaches proven to be helpful as well. A combination of medication has also shown to improve OCD symptoms. There is also a growing amount of research on the use of Acceptance and Commitment Therapy (ACT) for the treatment of OCD (which blends very well with ERP!)
At State of Mind Therapy, Jenny and Justin use both ERP and ACT in treatment of anxiety disorders and OCD.
What is ERP?
ERP stands for Exposure and Response Prevention. In its most simple form, it means to gradually expose yourself to your fear while not engaging in any behaviors that may serve to reduce your anxiety.
When you engage in an anxiety reduction behavior, you reinforce the need to keep doing the behavior. This prevents you from learning that anxiety is safe and tolerable. And it can make your world a lot smaller by keeping you from doing the things you love in life.
ERP helps you to change the relationship you have to the feared stimuli. Its helps you to be more flexible with how you respond and makes you better able to handle difficult thoughts and feelings.
We know it can feel scary but it's worth it.
You can check out some related videos here that we did on this topic:
How to Effectively Treat OCD (video)