Episode 49: Mental Compulsions Part 1

Episode 49

Mental Compulsions Part 1

In today’s episode of Purely OCD, Lauren Rosen, LMFT and Kelley Franke, LMFT discuss mental compulsions. To begin with, they chat about what mental compulsions are. They then segue into what these mental behaviors can look like. They also chat about the differences between thought suppression and disengaging from rumination. To end this episode, they answer a viewer’s question.

Lauren “takes the floor” and starts with a definition of Mental Compulsions, 

“Compulsions generally are behaviors that are done to eliminate: 

– anxiety 

– doubt and 

– discomfort 

that come up in the face of obsessions.

And these behaviors can be a lot of different things. They can be:

– visible

– avoidant  

– reassurance seeking 

“They can also be mental behaviors, which, the first time I heard that there was such a thing, I was like, ‘What do you mean mental behavior? But those are thoughts! That’s different.’ But it’s not different. And that’s super important, because we have agency when it comes to behaviors, and we don’t when it comes to which thoughts show up in our minds.” 

– Lauren Rosen, LMFT

3:15 Kelley adds,

“It’s all the same, whether you see it or not, because they both are serving the purpose, which is to get rid of that uncomfortable feeling. They’re also the trickiest because we can’t see them. 

And the average person does engage in rumination. Like worrying about, “Is my car going to run out of gas, because I’m on 5 miles.” We’ve all been there.” 

– Kelley Franke, LMFT

3:56 Lauren continues,

“There are all sorts of ways that this could manifest that have nothing to do with OCD. And in fact, we see Rumination a lot in depression, too. 

– Lauren Rosen, LMFT

4:10 Kelley gives examples of this:

– Is it ever going to get better? 

– I’m not good enough. 

– What are all the things I did wrong?

– Is this a reflection of me?

– Kelley Franke, LMFT

4:30 Lauren says,

“But when it comes to OCD, it’s all done to try to figure things out. So that’s really what the aim is, as with any compulsion, is to, “Let’s try to solve this.” 

And this is where I think maybe we could talk about some of the different subtypes that we discussed at this weekend’s conference that you have pulled up.” 

– Lauren Rosen, LMFT

5:00 Kelley begins with,

So we have mental avoidance or thought suppression, which I think we’ve all tried to do at some point. This is the “Don’t think of the white elephant.”  “Don’t think about kicking the dog.” Unfortunately, you all just thought about it.” 

– Kelley Franke, LMFT

5:20 Lauren inserts,

“It’s so tricky. It just doesn’t work because, in order to not think about it, you actually have to think about it. 

One of the questions that came up a lot, I think two different times, and that we talked about during the presentation this weekend, was the question of what the difference is between thought suppression and stopping ruminating, which I think is such an important distinction to make.” 

– Lauren Rosen, LMFT

6:35 Kelley explains,

Thought suppression versus not engaging with the thought. 

We don’t want to stop the thought, but we also want to acknowledge its existence, like,

“Oh, hello, thought.” “There you are.” And I’m going to keep talking to Lauren and listening to her voice and reading the chats. 

So that’s the goal. We don’t want to say, “Don’t think about it.”  But it’s here, just like the sound of the white noise machine, which I’m sure you’ve all heard me talk about a million times, because I despise that thing. But I’m making room for it.” 

– Kelley Franke, LMFT

Lauren asks,

“Can I bring up the example of what happened this weekend during our presentation? “It was so brilliant!”  

Kelley agrees.

7:25 Lauren continues: 

“So we’re doing this presentation on mental compulsions specifically. And we were talking about mental compulsions versus obsessions and how to tell the difference and how to navigate them differently. 

And this sound of a doorbell kept happening. And I guess it’s something that happens with Zoom when people are entering the room. Ding Dong, the whole time. The whole time. 

And so it was this really interesting sort of discussion point that we all brought up. Okay, we’re going to accept the presence of this doorbell, but we’re also not going to wish the doorbell wasn’t there the whole time, or push it away, or spend the whole talk talking about the freaking doorbell. We acknowledge it. We started to laugh at it, actually, because it was humorous. 

But that’s the thing. It’s noticing the thought and letting it be there without engaging with it. Like acknowledging the doorbell and letting it be there without engaging with it.” 

– Lauren Rosen, LMFT

8:48 Kelley adds,

“I meant to say to you after, but when the doorbell died down, I started to kind of forget about it. And then it started happening again, and I was thrown off again. But I was faster to get unhooked from it versus initially, when I was in the chat box, saying, “Someone help us stop the doorbell. Stop the doorbell!”

So when you’re just going about your life and you’re having a good day, let’s say a good “OCD” day, and you’re not getting a ton of intrusive thoughts. And then Bam, you just get T-boned, boom, you get thrown off harder. 

The metaphor is that I felt like the doorbell. I was doing okay, because I was getting a lot of doorbell ding dongs, I thought, it’s just here and it’s not going anywhere. But the moment you are not suspecting it, it hits you harder.” 

– Kelley Franke, LMFT

10:01 Lauren agrees,

“Which is where relapse really comes into. People think, “Oh, I’m relapsing, because the thought came up, and I immediately responded that way.” But of course you did, because you’re not necessarily in the practice of it. Like you were saying.  But you have this history, and you can drop on that and you will likely be quicker to pivot, to turn back toward. “Ah, Right.” “The doorbell.” “Yes, it is.”

– Lauren Rosen, LMFT

10:36 Sarah, a listener, asks, “So what if this is really disturbing intrusive thought? 

10:48 Kelley answers, “Same practice. Yes. This applies across the board.” 

“So thought neutralizing. When we replace the bad thought with the good thought.”  

10:57 Lauren gives an example,

“When you have a really disturbing thought, we might then respond to that by thinking something really pleasant. Like singing, “Rain drops on roses and whiskers on kittens.” 

– Lauren Rosen, LMFT

11:26 Kelley continues,

“Counting doesn’t just happen out loud. Turns out people count inside of their head. All of the time. It could even be like this ritualized behavior. Maybe it’s just not even counting. It’s just you’re so used to washing our hands three times this way and three times the other way. It’s just the counting steps. Counting everything.” 

– Kelley Franke, LMFT

11:55 Lauren mentions,

“And a lot of the time this is tied to the idea that there are good and bad numbers. So some people will like even numbers, some will like odd numbers, and we’ll have some numbers that they can’t do. 

Asking them, “Okay, you can do your compulsion one time or you can do it three times, even though three times is actually an easier step. They might say, “Well, no, I won’t do it three times, because three is a bad number.” 

So the counting itself is often part of this idea that we got to get to the right number just right.”

– Lauren Rosen, LMFT

12:42 Kelley brings up tracing and tracking. 

“Tracking and tracing.  So you drop your AirPod into a bucket of wet paint, and the person with OCD can see all the places it’s touched in the house, because they’re very aware they spend a lot of over attention and overvaluing of this object (AirPod). 

So it’s seeing all the places and points of contact and trying to totally avoid them completely.” 

– Kelley Franke, LMFT

13:30 Lauren shares an example she takes from the show, Arrested Development.

“I’m going to show a little anecdote for anyone who’s an Arrested Development fan, because there’s a character on there that is the most ridiculous character ever. His name is Tobias Funkey. He actually calls himself an analrapist, which is supposed to be Analyst and Therapist together.   

He decides that he really wants to join the Blue Man group. So he covers himself in blue paint and walks around and so people can tell where he’s been, because there are little splashes of blue everywhere. And that is, to your point, when people are tracing. That’s the experience.” 

– Lauren Rosen, LMFT

14:51 Kelley continues,

“This can come up with Emotional Contamination as well. It can look like someone who’s emotionally contaminated. They say are triggered by their cousin who has a personality trait that they don’t want to get.  Kelley, laughs, “because personalities are contagious. Everybody knows that.” So they will avoid any places the cousin has touched. 

This can even come up with the fear of becoming depressed again or anxious, or getting more intrusive thoughts. It’s like the locations where a person felt or experienced a high intensity of anxiety. Just avoiding those places and locations. We want to relearn new experiences in those locations.” 

– Kelley Franke, LMFT

They pivot to Mental Review as a compulsion. 

16:02 Lauren begins with an explanation,

– “Let me think back into the span of my life and see if I did anything offensive”. Or, 

– “Let me review a moment to see if somebody was offended.”  

This actually comes up a lot in social anxiety, too, since we are responding to the fact that people who don’t have OCD, who have other anxiety disorders, depression, and people who have no disorders, will ruminate.  I think mental review comes up in that context. 

– “Let me go over what I said in that situation. 

– “What I did in that situation.”  

– “Let me go back and review the false memory.”

– “When you review that, does it feel like it’s a memory?”

And that’s where we get into a nice overlap with types of mental compulsion. So that would be mental review/emotional check.”

– Lauren Rosen, LMFT

17:30 Lauren shares something that they both mentioned during last weekend’s conference about categorization.

“We’re going through these because it’s really helpful, like when we 

go through different sub-types to explain how we can get stuck, and where we can get stuck. It helps people to feel less alone in their experience, too. 

However, you don’t need to memorize all of these. You don’t need to make sure that you know exactly what type of mental compulsion you’re doing any more than you need to know what type of OCD you have.  There is so much overlap that you could be doing several of these at any given time or even at the same time.” 

– Lauren Rosen, LMFT

18:14 Kelley adds, 

And I would say that I feel the same about distorted thinking. It’s really hard to say that something isn’t Catastrophizing and All or Nothing. Right. They can have kind of bits and flavors of a bunch, and they compound into one another. 

Turning to emotional checking. 

Lauren loves how Kelley calls it Emotional Temperature Checking, because that’s exactly what it is. 

19:08 Kelley laughs,

What’s the weather inside today?  It’s a sunny day. What’s the temperature currently inside my body? 

19:43 Lauren says a listener just said that they do mental checking as soon as they wake up. And this is kind one of the things that happens with emotional checking.  You want to make sure that you’re feeling better, and then, when you’re not, you get disappointed and then you start to resist the feelings. And resisting feelings really doesn’t work. 

21:12 Lauren explains about rumination.  

“Basically the word Rumination refers to a behavior done by a class of animals called ruminants. What they like to do, vows, by the way, are one of these animals. They chew on their food. So you’re chewing on your grass if you’re a cow, and then you swallow it, and then you decide, you know what, I wasn’t quite done chewing that. Let me regurgitate that and chew it some more.”

– Lauren Rosen, LMFT

Kelley adds,  Like we have multiple brains to process, that is the experience. 

22:00Lauren continues,

“Essentially, I bring this up, because it is exactly what we’re doing. When we’re ruminating.  In our minds, we are going over and over the same information again and again. And the second that we put it to rest, which anyone here who has engaged in rumination could probably attest to this, “Okay, now I’ve got it.”  “It’s fine.”  “I’m good.”  “Got it.” “I’m cleaning my hands of this.”  

But then a couple of minutes later, it’s like, 

– “What about this?” 

– “Have you thought about this?” 

– “But wait, it still could be messed up.” 

– “So don’t forget about that.” 

And then you’re back to the races. It’s really an issue to do that mentally, because you never “digest” your mental food and, therefore, can never move on with your life.”

– Lauren Rosen, LMFT

23:34 Kelley adds, 

“But there is an antidote. It would be called Mindfulness. It’s true. You have to be a Mental Ninja. I’m sure that 90% of the people listening to this, despise that I just said that,  and if anyone was ever against it; it was me. It turns out that it’s so important, because: 

If we’re not aware of what’s going on internally, how could we ever be able to jump in and stop and intervene

We wouldn’t be. It’s a necessary thing. It has to happen. We have to be aware that we’re having thoughts and this process of thinking, this active thinking, so we go, “Hey, we’re chewing our thoughts again.”

– Kelley Franke, LMFT

24:50 Lauren agrees, 

“In this context, we’re really talking about the thoughts and the thinking. And that’s the main difference between thought suppression and disengaging from thinking.  

One is thoughts, which are passive, and one is thinking, which is active.”

– Lauren Rosen, LMFT

27:37 A listener asks,  “What if thoughts are on loops? 

27:47 Lauren begins,

Try just allowing them.  Thoughts and feelings always keep coming until the end of your life, which is not a bad thing. It doesn’t mean that they’re always going to be there 100% of the time, that you’re allowing them. They’ll tend to come and go. They’ll come in and out of your consciousness. But it’s actually a good sign. 

In fact, that’s something Kelley says a lot “That’s like, oh, good news.” “ You have a functioning brain.”  “Your brain is online”.  “Congratulations.”  

And this is where mindfulness comes into play. We tend to judge that we don’t want this experience. And approaching it from this nonjudgmental acceptance perspective allows for us to be less disturbed when they arise and to just allow them.” 

– Lauren Rosen, LMFT

29:07 Kelley continues, 

“I think we need to just really acknowledge the fact that the the intrusive thought loop just keeps coming, and keeps coming. It’s just so relentless. It doesn’t take breaks. 

Next week, when we talk further about how to meet our thoughts, and we are able to recognize that that’s just a painful experience and that anybody in the whole world who is getting these thoughts on loop would want them to be gone. And remember, these are very distressing thoughts. They’re not just like a passing thought, like, “Oh, I have to go pee.” It’s not that.  It’s like your worst experience ever. So just acknowledging that it’s there.  Having rules of self compassion. That’s really important and say, “This is really difficult.” And when we use this mindfulness intervention/trick, it’s going to be doubly hard initially, because you’re working against it.”

 – Kelley Franke, LMFT

30:42 Lauren finishes this episode by saying,

“And when we use this mindfulness intervention, it’s going to be double down hard in comparison to even doing mental compulsions initially, because you’re working against it.  When you are learning to flex the muscle of dropping the rumination and feeling those feelings, first of all, it’s not intuitive for anybody. And to your point, I love what you said about the fact that anyone would resist these thoughts. But, I think it makes sense that it would be difficult to learn not to resist them, not only because culturally, nobody talks about that. Nobody teaches you how to do that. And also because tolerating discomfort is hard. It’s just ultimately a lot less hard than losing your life to mental compulsions.” 

– Lauren Rosen, LMFT

Thanks for joining us. Just as a reminder, this podcast is not therapy, nor is it intended as a replacement to therapy. If you need further support, we encourage you to seek treatment with a registered professional who specializes in OCD.We hope you will join us in the future as we continue our discussion on all things OCD.

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