Episode 47: Q&A on March 28th

On today’s episode of Purely OCD, Kelley Franke, LMFT, and Lauren Rosen, LMFT, answer questions from viewers about OCD. 

They discuss OCD and the “rightness” of a job and also cover how this might apply to “Relationship OCD” or fears about making the “wrong” decision more generally.

All this, and they manage to tie in OCD and pink zebras during their Q&A session.  

Question 1: Somebody was asking if sexual orientation OCD can start at the age of twelve to thirteen?  

Lauren says that, “While this question is very specific, she says that “OCD does commonly start in either childhood adolescent time period or in early adulthood.”

Kelley adds, “There’s a hormone shift. Good old hormones.” 

Lauren continues, “I know, given your area of specialization with postpartum, that’s something that certainly impacts that population as well.” 

Kelley agrees, “It likes to kick on whenever there’s a hormone jump or drop or any shift really. It can be any life changing event.”   

Kelley clarifies, “It’s hard for Lauren and I to answer a question like this, because it’s a loaded question.  We are trying our best.” 

Lauren adds, “And it sounds specific enough too that it might fall into, and I don’t want to make any assumptions here, but it does sound like it could have a flavor of reassurance to it.  OCD can start at any time really.” 

Kelley say, “In theory it could be changing your shoes.”  

Kelley continues with her feelings on people’s assumptions about OCD.

“I hate when people assume everything that I do is related to my OCD. There’s nothing that bothers me more, especially when people don’t have OCD. So that’s why we want to really make sure that we’re not assuming anything.”

Lauren agrees,

“I’m really glad that you brought that up, because nothing pisses me off more than when somebody’s like, “Tell you what, ma’am, this is your OCD. I’m like, really? 

I think sometimes it can be helpful if it’s framed in the right way. If somebody says, hey, I think that your OCD might be at play here. Do you think so, too? And can we come up with a response that would be good for you or helpful for you? Then it gives you the freedom to say, “You know what? You’re probably right. I think I can see that, too.  Or, “No, I don’t think that this is my anxiety, but thank you.” 

Kelley agrees,

“We deal with that regularly with clients, because we work with OCD, but there’s definitely a nice way to approach that and actually inspire insights and say, “OCD looks like this when it presents for you. Do you think that’s happening right now?” 

Lauren adds,  “Make it more into a discussion rather than a definitive statement.” 

Lauren continues, 

“I just saw somebody in the chat feed say that they are dating somebody with OCD, and this topic was well timed.  Having an open discussion with the person and saying, “I want to support you. How can I support you?”  If they’re in therapy maybe saying, “Hey, can I talk to the therapist, or is there a book that I could read so that I can provide you with optimal support.” 

Kelley adds,

“If you come into session oftentimes we figure out a language to use that, instead of giving reassurance, saying I know you’re struggling right now. I’m not going to give you reassurance, because we’ve agreed upon that. It’s not helping you, but I’m here for you. How can I be here for you without doing that?” 

And to be fair, a lot of the exposures we do, we don’t want to share.  If it’s relationship OCD, we typically don’t want to say,  “Oh, we’re going to tell them all about how I have doubts about this relationship, and if I’m attracted to them or not.” That’s usually not a good idea. They don’t need to be exposed to that.” 

As an adjunct to this thought, Lauren and Kelley say, “If being intimate with them is some sort of exposure, you don’t necessarily want to share that. That’s a hard thing to carry potentially for the relationship 

Question 2: “Is there a science behind suppressing an obsessive thought or distracting? Does this make it worse or better? 

Lauren answers with,

“Let’s just do a little brief experiment because there is some science behind it, and there’s a lot of research. Kelley laughs, because she know what’s coming.

Lauren says to Kelley, “Kelley, don’t think about a pink zebra, please.” 

Kelley responds, “Too late. Dang! 

Lauren asks Kelley, “What happened? 

Kelley says, “I instantly thought about a pink zebra.” 

Lauren responds, ‘Well, it’s such a trap, because the more that you try not to think about something, you have to think about it to not think about it. So it’s a total trap.”

Kelley continues, “Which is why it’s so great to be the one on offense with OCD. I’m just going to go ahead and think about the pink zebra on my time. And there’s something very powerful about that.” 

Lauren stubbornly says, “I’m going to bring it up on purpose. I love pink zebras.” 

Kelley laughs, “Pink zebras are the best!”

Lauren discusses the research,

“I think the funny thing is, and this is what the research shows, that when you actively try not to think about it, it comes up more. When you are ambivalent about it, it can come and go and you actually think about it less.”  

Kelley says, 

“Yeah. It’s very counter intuitive.  Even if we look at ACT, Acceptance and Commitment Therapy, we would actually argue that suppressing any emotion as well, like sadness, would almost be what’s pushing depression. Let yourself feel sad, but let’s go do something of value while we’re sad.  Trying to pretend like you’re not is not healthy.” 

Lauren, continues, “That’s not a winning choice. Just allowing it to be there and not letting it dictate your behaviors.” 

Lauren clarifies distracting vs refocusing/redirecting.  

“The one thing I want to add to this that I think is important is this distracting piece of the question, because I don’t think that distraction is helpful. I think refocusing is helpful.   I know it’s semantics, and for some people, I’m sure, that distracting means refocusing. But from my vantage point, what we’re talking about is allowing for thoughts to be there, and then bringing your attention to wherever you want.  If we can make space for both thoughts and feelings, and then go on with life, that’s the goal.” 

Kelley adds to what Lauren is saying,

“If I tell someone, “Okay, what we’re going to do is we’re going to go for a walk.  Every time the intrusive thought comes, we’re going to just come back, keep having the conversation with our friends while we’re walking. Redirect.”  You’re going to have to redirect refocus 1000 times in just a five minute walk.” 

Lauren concludes, “It’s so true. It’s the element of returning over and over and over again. And it’s a practice. 

Question 3: Any tips on how to stop obsessing over if my job is fit for me? 

Kelley begins, 

“I’m so curious if this person gets stuck on other decision making stuff. It also reminds me a little bit of Relationship OCD (ROCD).  Because ROCD people traditionally think it’s partner related, but I would argue it could be relationship with anything, including a job, a friend, a child.” 

Lauren adds, 

“It can be the rightness of fit. It can be how I feel about the person. It can be whether or not I’m good enough person or is the job right for me.” 

Kelley replies to the part of the question on how to stop obsessing? 

“Well, it’s not obsessing we’re worried about. It’s the compulsing we’re worried about. The intrusive thoughts we have to let them be there, but the compulsions are likely mental rumination, checking, comparing, asking others.” 

Lauren adds to this, 

“What it’s down to is accepting that we don’t know whether or not the job is right for us. Accepting the uncertainty around, “Maybe it’s not the perfect job.” Assuming, of course, that it’s the good enough job, because it’s quite common to reflect generally on whether or not a career suits you. But there’s obviously a limited viability in asking that question over and over again and trying to answer it over and over again. 

So if you find yourself in a mental debate about whether or not the job is a good enough fit for you,  do what we were just talking about and say, “I don’t know.”

Kelley reiterates,

“This is not a replacement for therapy. We don’t know the details of your case, and we can’t specifically tell you any advice; just general tips on how, if it’s in fact OCD, to respond to it, which is “We don’t have the answer, and choosing to actively not figure that out and accepting the risk that comes with that. There’s no right fit for anything.” 

Lauren agrees, 

“That’s the thing. It’s such a trap. What does that even mean? Is “right” the job that you enjoy most?  Is it the one that you’re best at?  Is it the one where you have the most to learn?  Which, if we’re going back to Relationship OCD, that can also apply. What’s the right partnership? Is it the partnership where everything’s smooth sailing, and you never have any disagreements. That doesn’t actually really serve your growth.” 

Kelley warmly interjects about her relationship with Lauren, 

“Although I do feel like that with you.” They laugh.  That’s right! We have the perfect relationship, obviously. Yeah, I know. That doesn’t count.” 

Lauren continues,

“This sort of dovetails into what we were talking about before which is “What to do when you were overthinking?” This ability to go into the back and forth around pretty much anything. I’ve worked with people who have difficulty choosing the type of fruit they’re going to buy at the grocery store. And then once they find the type of fruit, which one is the right one?”

Tying into Lauren’s statement, Kelley says, 

“So this can really come up with anything. Anything. Even Cheesecake Factory. 

Dr. Jonathan Grayson has a great article on this on his website, if not, it’s in his book. He breaks down all the choices in life, like buying a new car, getting a house, choosing college, choosing what groceries, what you’re going to eat that night, what gas to buy, what color shirt you should wear, etc.  He breaks down tiny decisions, medium, and then harder decisions. He says, generally, this is how long we want to take. It’s kind of like a split second, which I thought was interesting.” 

Lauren adds, 

“To that end, the work that I usually do with clients around this is, “Okay, we’re going to limit the amount of time that you have to make a choice, and then you’re just going to land, and you’re going to make the “maybe good enough” choice, but who knows.” 

Kelley does the same,

“In session, we might set an alarm… 

I mean, we’re not going to do this with College where you say, “Okay, am I going to go to Pepperdine? Am I going to UCLA? Okay, you got 1 minute on the clock. Let’s go. Good luck.”

But if it’s something like, “What, am I going to have, almond milk, or am I going to have oat milk? You got 30 seconds. I’m going to time it, and then if you don’t choose it, I’m going to choose it for you, and then you have to live with that for the whole week.” So moving fast.”

Lauren sees that somebody just mentioned, “We want lasting peace.” 

Lauren responds,

“I think it’s absolutely right. I don’t want to make the wrong decision, because that’s going to make me uncomfortable.  It’s this sort of false promise that, at the end of one of the choices, whether it’s about your sexual orientation, or your relationship, or your job, or anything, if I make the right decision, then I’m going to have lasting relief, which is just such a lie. Lasting relief doesn’t exist.” 

2. What language can be used when supporting a loved one with OCD?

3. Does suppressing make OCD worse?

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