Our “Favorite” Things About OCD, Part 1
For the next several episodes, your show hosts Kelley Franke, LMFT, and Lauren Rosen, LMFT, are discussing their “favorite things” (read sarcastically) about OCD. So, basically, the ways in which OCD is tricky and gets us stuck. The two talk about navigating these pitfalls, accepting uncertainty and much, much more. The begin with a discussion about one of OCD’s favorite lines when new obsessions arise – “This thought is different. This thought is special.”
To start, Lauren talks about the fact that the “Favorite” Things episodes are meant to pay homage to old school talk shows (like Oprah) that had favorite things segments. In fact, it looks like these lists are still a thing (see here).
So, essentially, as Lauren says, they’ll be talking about “Our favorite ways in which OCD is a butthole”
First up: In this episode, Lauren and Kelley talk about one of OCD’s favorite ways to hook people – i.e. by saying “but this thought is different” or “this one is special.”
That’s the technical term, anyway.
4:25 Kelley and Lauren discuss the whac-a-mole feature of OCD
“When you’re hitting a content area, it’s like putting a helium balloon under water, you’re going hard at something and then “boop” it pops up forcibly in another area.”Kelley Franke, LMFT
5:13 Kelley and Lauren land on a topic “This one’s different.” As in – this thought is different. It’s special. I can’t possibly treat it like OCD.
This type of thinking also leads people to wish they had other forms of OCD.
“I understand why people think it because, of course, If a content area is not your content area, chances are it’s not triggering to you.”Lauren Rosen, LMFT
Sometimes when new content comes up, people worry that this content is different and needs their attention.
6:40 – Kelley talks about how treatment for one subtype can generalize to all subtypes because the content of the thoughts is less important than accepting the underlying uncertainty.
“We’re doing exposures to generate this uncomfortable feeling of uncertainty across the board. For it to generalize.”Kelley Franke, LMFT
It’s important to learn to make space for uncertainty. This is how treatment with one theme can generalize to recovery related to many different subtypes. We can move in and out of accepting uncertainty.
“I move out of uncertainty acceptance all the time. I’ve probably done it like 15 times today already.”Kelley Franke, LMFT
Kelley: As therapy progresses usually… [people] do start to go… ‘Oh wait, thinking about anything, whether I think it’s OCD or unrelated, it’s useless to ruminate on this, and I have to accept that ultimately uncertainty is all there is.”
Lauren: Right, yes, and that the attempts to control it or get rid of it, that that’s the problem. Because of the fact that, like you were saying, that the only thing that exists is uncertainty… understanding it on that level is a game changer.
10:15 Generalizing this knowledge can be more of a challenge when a new theme pops up because of the…
“This time is different”
Lauren suggests responding with:
“Oh, it’s feeding me the “this one’s different” story line. ‘Okay, yeah, I’ve seen this one before.’
Lauren: The content is so intense sometimes that the idea, it might even sound flippant to hear Kelley and I say ‘Oh well the content doesn’t matter’ or ‘None of it’s special.’ Us both having been there, I’m thinking right now of your experience of a lot of obsessions related to your child and of course it feels special and of course the experience is ‘Oh this is different.’ But, at the same token, taking any of the content seriously even if the ideas or concepts are in theory, if they did come to pass, would be serious, we still can’t treat the thoughts like they’re serious.
Kelley: Nailed it
Lauren: Thank you.
Kelley: That’s right. And then the floor falls beneath your entire body. That’s what we want.
Lauren: Learn to ride the wave.
14:00 Kelley mentions the complications of cognitive fusion. You can read more about this and Acceptance and Commitment Therapy on Lauren’s website:
Lauren continues on to talk about cognitive fusion versus cognitive defusion:
[It’s when] the thoughts are… hardly distinguishable from reality versus having an awareness of “Oh I had that thought. That’s words that happened in my mind. Now it could be true, it could be false, like a book could be… fiction or non-fiction.Lauren Rosen, LMFT
Question: Can OCD create new intrusive thoughts every day or are they always repetitive?
OCD can, in fact, create new ones on the daily.
Kelley’s approach – let’s not be too impressed by all the different types of OCD that come up.
Lauren: There’s words again…
Kelley: There’s some letters put together. Symbols actually…
Lauren: Like Plato’s cave… the images being projected instead of the actual things… I want to work on something here with all of you and with you Kelley. I’m thinking of the Mickey Mouse song “Who’s the leader…”
Lauren: I’m going to start doing that with thoughts
Lauren: So when a thought comes in – and then you have to think about how to spell it, so, takes some brain power.
Kelley: Yep. Takes the pre-frontal [cortex].
Lauren: I A-M A S-O-C-I-O-P-A-T-H, Sociopath…
Lauren There’s an interesting exposure idea there.
20:35 When the “it’s special” thought comes up, this can start to play on depression.
“It feels like you’re just getting hammered constantly and you feel like you’re not getting any ground under yourself and doing all this hard work and there’s new content. “Is this ever going to get better.” And that could actually become its own obsession as well.”Kelley Franke, LMFT
OCD and Depression co-occur quite a bit.
According to this study, 67.2% of individuals with OCD will experience Major Depressive Disorder over their lifespan.
22:15 If you think that you’re not able to handle your OCD because different thoughts keep popping up, you might start to feel hopeless and incompetent. If you recognize that OCD is going to capitalize on whatever uncertainty it can find, then when it grabs onto a new topic you can see that OCD is just getting desperate when it grabs onto something else.
23:50 People might feel hopeless when OCD Therapists say thoughts and feelings don’t go away, but just because they don’t go away doesn’t mean that your experience of them will be what it is now.
Question: Can it trick you into feeling like you want to do something bad?
“Or whether or not you may have done something bad or you’re gonna to do something bad or something bad already di happen and you don’t even know about it.”Kelley Franke, LMFT
Question: How to accept uncertainty?
Using the example above – hypothetically
“’Is this common’ is the beginning of the question ‘For OCD to do _______?’ To make me feel like I wanna hurt somebody, to question my identity… and then we say ‘Yes,’ that gives reassurance that ‘Yes for sure,’ and then that person goes ‘Oh, this is definitely OCD then!’ We’re saying we actually don’t want to do that. We actually want to say “Yes, OCD can do that and we have to accept that maybe this other truth could happen. And that’s really the scary part. That’s accepting uncertainty – that’s choosing not to ruminate… that’s choosing to say “Maybe, Maybe not…
Compulsions… are done with this false belief that somehow you have the ability to control everything, and you don’t. All you have control over is how you respond to it. That is it. The rest we have to just truly accept. It’s there anyways. Those behaviors are not helping you. ”Kelley Franke, LMFT
Kelley and Lauren talk about accepting uncertainty with another subtype, chosen by the audience:
But first – more about general acceptance of uncertainty
29:35 The thing about accepting uncertainty is that it’s… the absence of something, just allow it to be there. So it’s actually more not doing than it is doing.
30:15 Redirecting and refocusing is a challenging practice
31:10 Choosing not to pick up the search for certainty again is an active process
Fun fact: December 6th is St. Nicholas Day!
33:00 Lauren and Kelley role play supporting someone accepting uncertainty about both Pedophilia OCD and Relationship OCD. Lauren starts by portraying someone with POCD and Lauren supports her in accepting uncertainty.
36:25 Next, Kelley plays to role of someone with Relationship OCD and Lauren supports her in accepting uncertainty.
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