Episode 58
Optimism in OCD Recovery
In this week’s Purely OCD podcast episode, Lauren Rosen, LMFT, and Kelley Franke, LMFT, discuss optimism in OCD.
The recovery journey can be long and full of bumps and dips along the way, so how can we make the process as effective as possible? And what can we do to best help and support ourselves?
In this episode, we will talk about setting expectations, practicing self-compassion, and restructuring thoughts. All of these elements go a long way to bringing an optimistic outlook to the recovery process which makes it a whole lot easier.
Setting expectations in recovery
(3.42)
Kelley: …we need to start with setting expectations of recovery. A lot of issues come up when people think that their recovery should look different. And they wonder then if there’s something wrong with them and why their recovery doesn’t look like that other person’s recovery which they saw on Instagram stories.
Lauren: I remember talking to Kevin about it, too. He said something like, it’s the difference between the person who nails their pins on Pinterest and your attempt where you think you nailed it, but really you haven’t. That’s the discrepancy, right? But sometimes it’s what the experience is like.
Kelley: I always think of the happiness trap, it’s the perfect example. It’s that gap between expectation and where you’re at. So step one, have realistic expectations. So let’s set those, shall we?
(5.19)
Lauren:…you’re gonna have thoughts, period, so long as you’re alive. This thing is going to keep churning them out. And some of them you’ll like, and some of them you’re not. So it doesn’t matter if you have OCD or otherwise, having the expectation that they will somehow magically evaporate, especially the ones that you don’t want, is unrealistic. And it’s going to set you up to experience yourself as a failure even though you’re absolutely not failing.
Kelley: Right, it’s similar to when patients come in and say that their anxiety isn’t getting better or they’re not managing to reduce it, that’s a common one. And we say, well, that’s not the goal of treatment. The goal of treatment is to learn how to live with anxiety. Yep, I wish we could take our anxiety away, or at least 95% of it. But unfortunately, that’s not the case. Maybe one day, they’ll come up with a headset that you can put on your head. My psychiatrist told me this months ago…
…he said imagine one day you could put these headsets on that scan your brain and it tells you that your brain is in this deficit or need this type of medication or diet. It sounds great. I said, Dr. S. Don’t tease me like that.
…we have to accept that we have anxiety and we have intrusive thoughts. Do not measure your recovery based on your frequency of thoughts, the type of thoughts you’re having, or your anxiety levels.
Kelley Franke (7.19)
The problem with not feeling fear
(7.39)
Lauren:…there’s a great episode of Invisibilia, it’s another podcast on NPR. It’s a great podcast. And on it, they talk about this woman who has a disease that actually calcifies the amygdala, which is part of the brain that is largely responsible for our fear response. And she didn’t feel any fear, which ended up being hugely problematic for her.
On the podcast, they couldn’t release her name because it would put her in danger and at risk of being taken advantage of by other people because she just had no gauge for danger. So we think of fear as this really bad thing because for those of us who have overactive fear centers, it does tend to become rather cumbersome, especially when you’re not trained in how to deal with it. But the reality is that we don’t want to get rid of our fear. Not really.
(9.58)
Lauren: …as somebody who also lived for many years trying to find the solution, I can say that I would not recommend going down that rabbit hole. It’s like we have both lived two lives. One where we have tried to fight it and fix it, and the other where we have become friends with it and learned to accept those anxious thoughts and feelings. And of those two experiences, I can say, undoubtedly, that the latter is far superior. I would choose it 10 out of 10 times. It’s not ideal, but nothing in life is. Even the thing that we all purport to want, which is no anxiety, isn’t ideal. So having those expectations going into treatment is super important in maintaining optimism again, because if you think otherwise, you’re going to start beating up on yourself for doing it wrong. When you’re not doing anything wrong. You’re just being a human.
Self-compassion in OCD recovery
(11.47)
Kelley: …when reframing it in this context, or using it in this context, how do I maintain the optimism?
Lauren: …let’s say that you’ve just been triggered, and you did a compulsion. We gauge recovery on how often you’re doing compulsions and how distracting they are from your life. So let’s say that you have done something that wasn’t really a recovery-oriented choice and you’re mad about it. In the aftermath, you might start to want to feel really pessimistic. And then you’re going to want to turn to self-compassion. How would we do it?
Kelley: We would notice that we are feeling anxious and have the urge to convulse.
Lauren: Or if you’ve already done the compulsion and you start feeling really disappointed in yourself.
…So you acknowledge the feeling in a non-judgemental way and then you tap into your humanity. You consider all of the people who also have OCD. Who also feel this way when they do a compulsion.
…and then from there, we would pivot toward self-kindness.
Kelley: It’s also the opportunity to do an exposure here. Just because you have done a compulsion, it doesn’t mean all is lost. You can go back and do an exposure from a place of compassion.
Exposure Therapy is Compassion
(14.36)
Lauren: Exposures are 100% the most compassionate thing you can do for yourself if you have OCD. And at the same time, you can do that in a compassionate way. You can tell yourself that yes, this is hard, but you’re going to get through this and celebrate the fact that you’re trying.
Every exposure is an act of self-kindness because you are doing it to help yourself have a better future, no matter how uncomfortable it feels in the present.
You can control how your respond to your thoughts
(15.53)
Lauren:…while we can’t control our feelings, we can control how we respond to those feelings. And to the thoughts that often bring up the feelings. And so if you respond to a thought with a 10-hour session of berating yourself for the choice that you made, which is like the verbal mental lashing that you’re doing in your mind, that is building pessimism. That is building the opposite of optimism. So if you’re doing that, dropping it like it’s hot, it’s important to recognize because it will impact your recovery in an unhelpful way.
…one of the biggest struggles is really being a non-judgemental mindful observer of your own of your mind.
Kelley Franke (17.21)
Restructuring Thoughts
(19.27)
Kelley:…So the thing about restructuring your thoughts is that it can be very compulsive if it’s not done appropriately. ..if you are not familiar with restructuring your thoughts or CBT, we’re not trying to be the cheerleader. We’re not trying to say that everything’s gonna be okay. That’s reassurance-giving. Lauren, throw me a cognitive distortion.
Lauren: Everybody else is doing so much better than me. I see it all over Instagram, and everyone’s great. Whereas I am not where I should be.
This happens a lot….Dr. Jonathan Grayson says that sometimes we’re viewing the world through sh*t-colored glasses. We at least need to know that we’re wearing suckers you know what I mean?
…those would be the lenses through which I’m viewing the world and when I know that I can say, “Okay, what’s off about that thought?” Well, I’m comparing my insides to somebody else’s outsides. I’ve absolutely no idea what’s actually going on inside of them. Because I’m seeing their Instagram highlights reel. And I’m comparing myself to that. There’s also a little bit of mind reading as if I know how everybody’s feeling. Because I see them talking. I’m watching Kelly and Lauren talk right now. I know how they’re feeling or what they’re thinking; they laugh and smile, and joke and stuff like that so everything must be good.
And if we take those thoughts at face value, things are going to look really sad.
…it’s like the cardinal sin of mental health. Never compare yourself to other people, you will never win.
Kelley Franke (22.38)
Summary
(26.11)
Lauren:…the highlights are to watch when your mind is feeding you stories that are making you feel strong emotions. You might want to check those out and see whether or not you’re filtering the information from the outside world through these lenses that are making it look a very specific way, just so that you can maybe hold those thoughts with a little bit more flexibility.
Kelley: Take the poopy glasses off.
And stop acting like the world is shit just because you’re wearing shit-colored glasses.
Lauren Rosen (26.54)
Anchor yourself in your values
(27.10)
Kelley:…if I value being somebody who is really playful and a funny person and my OCD is getting in the way of that, then that’s an opportunity to notice that you’re not getting to be yourself. It’s an opportunity to recalibrate and make some choices with self-compassion. You might think, okay if I don’t do this then I don’t get to play with my daughter tonight. Right? So it’s saying to yourself, I’m doing this in the name of being the playful mom and joking around with her and being silly and not really hearing what OCD has to say.
Lauren:… I think in terms of how that really informs optimism and recovery, is that it’s empowering.
Questions: ROCD stole my wedding season joy. How do I stop OCD from ruining more joyful moments?
(31.48)
Lauren:…I think having this kind of comes back to expectations in many ways because if you’re walking into any big life experience as someone with OCD, and you’re thinking that you want OCD to go away and if that doesn’t go away then the life experience is going to be ruined, that’s when we’re in a lot of trouble. We don’t know what tomorrow brings, we don’t know what comes down what’s coming down the pike but we can be reasonably sure that anxiety and upsetting thoughts are a part of that and so if you go into your life knowing that that’s part of it and making space for that, then it’s not going to crowd out the experiences.
There can be no happiness when there is sadness, right? But that is incorrect. In order for happiness to be, there must also be sadness.