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Episode 42

Acceptance and OCD, Part 2

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In this week’s episode of the Purely OCD, Lauren Rosen, LMFT, and Kelley Franke, LMFT, continue their discussion on acceptance.

To begin with, they talk about how acceptance related to having OCD is an important part of recovery. They also cover the essential practice of accepting uncertainty. They touch on accepting bodily sensations and making space for these experiences without assigning meaning to them.

During this episode, Kelley and Lauren aim to discuss the following:

• accepting uncertainty
• accepting the diagnosis of OCD
• mindfulness meditation, and how it can support acceptance
• do an expansion exercise

That said, they make note that may need an OCD and Acceptance, Part 3, as this is a lot to take on for one hour.

2:47 After doing a short summary of what was covered in Episode 40: OCD & Acceptance, Part 1, Lauren begins talking about Accepting the Diagnosis of OCD. 

Kelley and Lauren agree that one phrase often comes up in treatment: “I don’t want to have OCD”. 

They both give big “dittos” to that statement.

4:07 So how do we navigate that?  The short answer is through acceptance.  But they continue, “how do we get to a place of acceptance?” It’s not a simple answer.

This is where we can leave space for grieving of what you hoped things would be like without OCD, or what OCD has taken from you.

But that said, at some point we have to move away from grief and go more into committed action. Now that this is on board, how am I going to choose to live my life based out of values, and proceed knowing that I’m somebody who lives with intrusive thoughts?

Because honestly, that piece that Lauren’s talking about where people are stuck in the “Why do I have to have OCD?” “Why me?” “Why is this happening?” Their trajectory of recovery is a lot longer.

Kelley Franke, LMFT

Lauren agrees:

“You’re so focused on, “I don’t want to have this.”, that you’re not actually finding all of the experiences that you can cultivate that are different.”

Lauren Rosen, LMFT

5:46 Kelley and Lauren admit to being Mindfulness nerds.

They recall one of their favorite authors and people, an incredible Buddhist Monk by the name of Thich Nhat Hanh.  He wrote the book, No Mud, No Lotus, that Kelley introduced Lauren to.

“Thich Nhat Hanh talks about the fact that sometimes people try to eradicate unpleasant experiences, and he says, ‘This is not correct.’ I’m remembering his words, ‘happiness is possible right here today, but happiness cannot be without sadness.’ And I’d say the same for anxiety. Happiness cannot be without anxiety.

And so if we’re so focused on, ‘I don’t want to have this experience.’ ‘I don’t like this.’ Then we don’t get to look toward the joy and to find the joy.

What we’re working on is allowing the water to be muddy. Because the reality is, we’re rarely going to have the experience of pure happiness.

Can we live a lift that’s contaminated by the fact that we have OCD?”

Lauren Rosen, LMFT

8:00 Kelley and Lauren pose a question:

How much more time do we want to spend focusing on and giving our time away to OCD?

There’s already been time that has been sacrificed to OCD through compulsions of all sorts. Do we want to churn about it and think about what could have been or what might have been different?

“I can’t help but think about Dr. Jonathan Grayson, when he talks about the Wishing Compulsion.  Wishing I didn’t have these thoughts. And the reality is ACT (Acceptance and Commitment Therapy) would say you’re rejecting reality. The reality is, you do have compulsions. So getting upset about them is only causing more mental distress. The only way through this is acceptance.”

Kelley Franke, LMFT

9:19 Lauren adds:

“And that’s where the difference between pain and suffering comes into play. The pain is there. If you had the choice, you wouldn’t give yourself OCD.  And yet suffering is when we resist, “what is”.

The only thing that makes sense is to accept pain, accept challenging experiences, because the other option is to make them worse, especially when we can’t change them. We can’t change the fact that we have brains that work in a certain way

Lauren Rosen, LMFT

9:50

Kelley talks about our problem solving brains: 

“Brains are problem solving machines. So they’re trying to say, “Okay, how do I fix this, because I don’t like this feeling”.

But the reality is the crux of everything we do is saying, we must accept those feelings if you do want to have relief on the other side. And by relief, I’m not guaranteeing that there’s no anxiety on the other side, but no additional compounding.”

Kelley Franke, LMFT

A listener asks, “How can we ignore unwanted thoughts that cause so much anxiety?

Lauren responds:

“We’re not talking about ignoring. We’re just talking about accepting without unwanted thoughts being the central focus of life. We don’t need to ignore anything. We just have to allow lots and lots of different experiences. The ones we like, the ones we don’t like: thoughts, feelings, diagnoses, and what have you.” 

Lauren Rosen, LMFT

13:00

Lauren and Kelley revisit the topic of accepting uncertainty?”

They discussed this in Part 1 of OCD and Acceptance, but agree that giving a nod to accepting uncertainty is pretty critical in this process of recovery and worth diving into in a little more depth. 

15:36 They start by covering the concept of treating all thoughts as equal, without judgment, rather than saying “This one’s more important than the other”.

Kelley says that sometimes we feel entitled to certainty. “There’s a little bit of arrogance involved in it. It’s like, ‘This one is super important…’ Well, no. We’re not sure of anything, actually.”

17:17

Lauren shares a real life illustration of accepting uncertainty:

“Kelley could not like me. But legitimately in moments in our friendship, I’m almost positive that, “oh, my gosh, but what if she changed her mind? What if she no longer likes me? She figured me out.” 

I have to accept that uncertainty (about whether or not Kelley likes me), even though, of course, that’s totally abhorrent to me. Kelley’s my dearest people on the planet. She might not like me, but accepting that that’s a possibility is imperative. Otherwise I’m going to be stuck all day trying to figure out whether or not she likes me,  and churning about it like, “oh, my gosh, well, I said this, and should I text her now?”

We’re saying we have to accept that it could happen. Otherwise it’s going to run the show.”

Lauren Rosen, LMFT

19:42 Apropos to this discussion, Lauren shares one of her very favorite books:

“It’s called Living Beautifully with Uncertainty and Change by Pema Chodron. I tell everyone in my life that they have to read it.

She talks about the fact that uncertainty is our birthright. It’s the only thing that we have. And so if we’re fighting that.  If we’re trying to get certainty. We get very rigid. Life becomes very unpleasant.

The work is really to just lean in and say, alright, here we go. We’re on this ride. And that makes my stomach drop. But that’s it.

Lauren Rosen, LMFT

Kelley laughingly remarks, “Groundlessness.  Oh joy.”

22:01 Moving onto questions…

Kelley and Lauren have received a number of fantastic ones and thank their listeners for their participation. 

They start with

“Can you share more about acceptance of body sensations as response prevention?”

23:12 Typically when someone’s talking about body sensations, they’re talking about either the benign obsessions, which is like automatic bodily experiences:

• blinking
• swallowing
• breathing

Sensations in the context of OCD can also involve:  

• groinal response (having a reaction in the groinal area and worrying “does that mean I’m attracted [to fill in the blank]?”)
• health anxiety (my leg hurts. Does that mean I’m having a heart attack?)

24:19 Lauren adds:

“And then there’s just the physical sensations that come with anxiety. And the whole ‘I don’t want to feel this part,’ which I think is different.

One is ‘I need to fix this experience. I want to figure out whether or not this sensation means something.’ Which is where accepting its presence without trying to figure out what it means is the response prevention.

And then there’s just the ‘I don’t want to feel this. Not because I’m giving it meaning, but because I just don’t like it.’”

Lauren Rosen, LMFT

24:53 Kelley asks:

“So how do we accept it?”

Well, it’s not fun, but, like we said, there’s freedom on the other side.

We accept it in the same way we would with anything: with intrusive thoughts or feelings.   Saying, “here it is”, noticing it, and coming back to the present moment. 

Kelley Franke, LMFT

25:19 Lauren continues:

And adding, “I don’t know what this means”. .

But let’s take sexual orientation, OCD. Having some sort of a groinal response to someone who you believe is not in line with what you’re identified as being attracted to. Saying, “I don’t know, maybe that does mean that I’m attracted to this individual’.

Lauren Rosen, LMFT

25:53 Kelley adds:

“And we can even add exposures in there as well. These are always fun exposures. Right?

Exposure work actually does get us closer to accepting uncertainty, because we’re doing an over correction and proving that this theory is likely untrue. Or if it is true, you are likely to be able to handle a catastrophic event. And it’s not as catastrophic as you thought it was.”

Kelley Franke, LMFT

26:36 Lauren adds one more thing to what Kelley said about exposure as an overcorrection:

“It’s acceptance in action. It is saying, ‘I’m accepting this uncertainty so much so that I’m just going to do this exposure, and I’m going to “bring on” the thoughts, and “bring on” the feelings, with this “bring it on attitude.”’

It’s a step beyond acceptance in some ways, but it supports us in really practicing with them.” 

Lauren Rosen, LMFT

27:10 Kelley moves on to the next question:

“Would it be possible to explore the role of depression as an OCD related emotion? I know it’s often anxiety, but sometimes it’s low mood. And I’m curious how to make space for that experience”. 

(Remember: This is not therapy or a replacement for therapy.)

“We don’t want to get in deeper with depression.  At what point do I say, ‘okay, this is not helping me anymore.’  We don’t want to swim deeper into the pool… we want to say, ‘okay, sadness is here, but how am I going to bring sadness with me in my life and make space for it?’ And you treat all emotions like this.”

Kelley Franke, LMFT

29:10 Lauren discusses people’s confusion around the differences between having the thought (the cognitive, the words) and having the feeling (the emotional experience).

You can have the emotional experience without having any thought. The emotional experience is totally independent of the thought.

But so often when we talk about, “okay, I’m going to accept sadness”, people think, “oh, I have to sit around and think about the sad thing.” They think they need to really churn about it, and turn on some sad music, and get all up in it.

Lauren Rosen, LMFT

30:00 Kelley agrees:

And same with joy and happiness.  You can’t hold so tightly to these emotions.

And I think it’s very tempting to especially if this individual is talking about this fear of, “well, what does sadness mean and depression mean?” “Does that mean I’m going to kill myself, or does that mean these thoughts are never going to go away?”

On the other hand, it’s indicative that this person is holding closely to joy and happiness. We have to make space that it’s transitory. It’s never going to stay like this.

Kelley Franke, LMFT

30:36 Lauren supports what Kelley is saying with a nod to a phrase from the one and only Pema Chödrön: “We’re not going to realize our dream of constant. Okayness.”

“And I think that regardless of what’s going on emotionally, if we look at it from the vantage point of recovery, it’s all about taking actions that support your goals, your values, your priorities and then accepting whatever comes up.

So that’s frustration, that’s sadness, that’s anxiety, that’s anger, that’s guilt,

All of that is allowed to be there in the service of you doing the things that matter to you.” 

Lauren Rosen, LMFT

31:26 Kelley reminds the listener:

“Remember, you move in and out of acceptance. It’s not a permanent state.”

31:45 Lauren agrees, “It’s a practice, because you have to bring that attitude of, ‘okay, I surrender to this. It’s here.’  Every single time. And it’s okay. If you miss that and you have to come back, you have to pivot. It’s okay.

32:12 Kelley laughs, “I would be a really good basketball player if it was a mental game, because I’d be pivoting all the time.”

As Lauren and Kelley wrap up the episode, they thank the listeners for being part of this community. It means a lot to them to get to have this dialogue.

They offer that next time, they’d like to talk about meditation and OCD, because it’s a continuation on this topic of OCD and Acceptance.

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Disclaimer: This information is meant to be general information not unique to any individual. Before following any guidance or advice found on this site or in the Purely OCD Podcast a visitor or listener should always consult with their own licensed healthcare practitioner. The Purely OCD Podcast and Website are not therapy or intended as a replacement for therapy. They are for educational purposes only.