CBT and OCD: I Thought It Was Just Me…

Posted on: October 15th, 2020

The psychological wellbeing practitioner (pwp) was on the phone reading out a questionnaire to me.

“Do you ever feel bad about yourself – or think that you are a failure or have let yourself or your family down?” she said.

“Everyday”, I sobbed down the other end of the phone.

This was my assessment appointment with the mental health service – the first time I had spoken to a mental health professional about OCD and really, truly let someone know how bad I felt. My OCD mostly took the form of fears about germs, viruses and bacteria as well as constant checking behaviours and these things had taken over my life.

After my initial assessment the first help I received was six telephone sessions of cognitive-behavioural therapy (CBT) with a pwp over the telephone. She asked me to read a book called “an introduction to coping with obsessive compulsive disorder” because this introduced the CBT technique called “exposure and response prevention” that we were going to use together in sessions. I sobbed through most of the pages just reading the examples – “I thought it was just me that had all these weird thoughts”.

In sessions we worked on making a table of the things that I found anxiety-provoking (the obsessions) and then the things I had to do to make myself feel better (the compulsions). Then we arranged them into a hierarchy. My table was huge and I felt overwhelmed just looking at it but I worked with the pwp on some of the things that were lower down on the hierarchy – the things that made me feel less anxious. The idea was that I had to stop myself from carrying out the compulsions so I would realise that, in time, my anxiety level would drop by itself. I didn’t need to try and stop my anxiety by carrying out a compulsion because, in the long term, this apparently made the anxiety worse. The whole concept sounded pretty terrifying:

“Do you think you can use the toilet brush without wearing your gloves?” she said.

“No, I don’t think I can do that”, I said.

The process was scary but after a few weeks we had progressed up the hierarchy and started working on some of the things that were more anxiety-provoking for me. I was still scared of a lot of things but was starting to feel more able to function. I was less frequently completely rooted to the spot and caught up in not knowing what to do next because I was so terrified of contaminating myself or something else. At the end of our six sessions I was a long way from feeling “fixed” but I knew that CBT was working for me. I requested to see a therapist face-to-face for more in depth treatment.

I remember feeling very nervous sitting in the hospital waiting room for the therapist to call me. I had up to twelve sessions with this therapist and I couldn’t imagine how two decades of OCD would be sorted out by the end of it. The therapist and I worked in a slightly different way to the way in which I had worked with pwp – instead of focussing on challenging my behaviour around obsessions and compulsions we also challenged the way that I thought about things. We used “thought challenging” and a technique called “Theory A/Theory B” both of which I found very helpful. Nevertheless, I still struggled with some of life’s basics.

“It’s pathetic, I can’t even touch a bin,” I said.

“I don’t think it’s pathetic,” he said.

At the end of twelve sessions I felt a lot better than I had in the initial telephone assessment with the first pwp. I wasn’t “fixed” but I was a lot less anxious and much more able to function in day-to-day life. The help that I received through CBT was invaluable to me and, whilst I accept CBT is not useful for everybody and it certainly didn’t make my OCD “go away”, I sometimes consider it as the thing that saved my life.

I went on to receive more sessions of CBT and also decided to explore my OCD using other talking therapies such existential psychotherapy. All of the talking therapies I have received were incredibly useful in different ways – each approach was different but enabled me to gain a different perspective on my OCD and allowed me to start challenging it in different ways.

I am not cured – I still have OCD and it still affects my life. However, by using CBT and other talking therapies I have (with many ups and downs) got better and better, even if OCD is still a work in progress. I am now able to live my life and enjoy living life again. What my journey has taught me is that there is hope – things can get better even if, for me, that means living with OCD.

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