Cognitive Behavioral Strategies

Lynne S. Gots, Ph.D.
Licensed Psychologist

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202-331-1566

2440 M Street, NW
Suite 710
Washington, DC 20037

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Why You Shouldn’t Look to the Internet to Answer Your Questions about Distressing Thoughts

By Lynne Gots, posted on April 17th, 2016.

 

If you struggle with OCD, you’ve probably searched online for answers to the questions that consume you. Finding virtual communities of like-minded sufferers can make you feel less isolated, especially if your worries involve the very common but shameful-to-admit obsessions such as doubts about sexuality and thoughts about violence. But extensive researching and comparing yourself to others with similar symptoms—even if your efforts seem to give you some relief—can make your OCD much worse in the long run.

Here’s why the Internet can be problematic for someone with OCD:

1) Much of the information you’ll find is wrong.

This is hardly groundbreaking news, but I can’t emphasize it too much. One of my patients recently told me about a blog (which I won’t name) written by someone with OCD. Even under my careful professional scrutiny, it looked pretty helpful at first glance. There were some informative discussions about the symptoms of OCD and the importance of seeking treatment from an experienced cognitive-behavioral therapist.

But then I scrolled to a post the author had clearly meant to be reassuring (if you’ve been under my tutelage for any time at all, you’ll know where I’m going with this) but was completely off base in its message.

She had done an “informal survey” of 4 of her friends, two identified as gay and two as straight but with the type of OCD causing them to wonder if they really might be gay. She proceeded to list the differences she found between them: how certain they were about their attraction to individuals of the same/opposite sex, when they first “knew” (in the case of the two gay respondents), whether they sometimes found individuals of the same/opposite sex attractive in the absence of sexual feelings towards them, and so on. And then she went on to draw some conclusions clearly designed to be comforting to people with OCD doubting their sexual identity.

2) Advice, however well intended, can reinforce compulsions.

Aside from the obviously unscientific nature of her “study” (a comically small and biased sample, for starters), her attempt to ease the suffering of OCD doubters was misguided. It provided some with relief and had exactly the opposite effect for others, as evidenced by the varied responses to the post. Many even questioned whether they actually had OCD because they weren’t exactly like the people she described.

That’s what OCD does! It makes you wonder and doubt, dragging you down the rabbit hole of uncertainty. And the well-meaning blogger (who claims to be “cured” of her own OCD) unwittingly served as its accomplice by encouraging others to seek reassurance with “facts” and comparisons—thereby perpetuating the “checking compulsions” her followers had certainly already been relying on to make themselves feel less anxious.

So if you’re struggling with distressing thoughts and find yourself tempted to Google for answers, I recommend you consult one site and one site only (or none at all, if you won’t be able to keep yourself from looking further): the International OCD Foundation (iocdf.org). You’ll find credible information and a referral database of reputable professionals skilled in treating OCD.

 

 

 

 

 

 

 

 

 




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Old advice about coping with OCD is new again

By Lynne Gots, posted on May 4th, 2015.

OCD is a formidable opponent. It’s the sharpest prosecutor, the meanest bully, the dirtiest thug. Arguing, appeasing, or getting into a fight with it won’t work. You’ll lose.

If you suffer from repugnant mental intrusions, you may believe your thoughts are the problem. You’ve probably spent hours, days, or, quite possibly, years trying to reason with them or push them away. One obsession may resolve only to have another one surface. It’s exhausting and demoralizing.

Surprising as it may seem, your thoughts are not the problem. Everyone has thoughts, even bad ones. In a seminal 1978 experiment, psychologists Stanley Rachman and Padmal de Silva found that nearly 90% of the “ordinary” people (that is, a non-clinical population) they sampled admitted to having had occasional thoughts about committing violent crimes, engaging in taboo sexual acts (with children, family members, or animals), blurting out obscenities or racial slurs in public, harming themselves or loved ones, or doing something inappropriate (such as laughing at a funeral). The main differences between these so-called “non-clinical” obsessions and the “clinical” ones of someone with OCD are the frequency of the thoughts, the distress they cause, and the efforts expended (ie, the compulsions) to get rid of them.

British writer David Adam has recently published an excellent memoir, interspersed with fascinating historical accounts of the disorder, about his struggles with OCD, The Man Who Couldn’t Stop: OCD and the True Story of a Life Lost in Thought.

Here is some cutting-edge advice in Adam’s book on how to cope with obsessional thoughts:

“Grit your teeth in the face of your thoughts and for God’s sake be more obstinate, head strong and wilful [sic] than the most stubborn peasant or shrew. Indeed, be harder than an anvil . . .If necessary speak coarsely and disrespectfully like this: Dear devil, if you can’t do better than that, kiss my toe.”

The statement embodies all we’ve learned from evidence-based treatment. It’s exactly the type of approach psychologist Reid Wilson advocates when he talks about “chasing the bogeyman” (I attended a workshop he gave on this treatment method just a few weeks ago).

An up-to-the-minute strategy for dealing with intrusive thoughts. From the 16th century, courtesy of the theologian–and OCD sufferer–Martin Luther.

 

 

 

 

 




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The Power of Paradox: to Change Negative Thinking, Say “Yes” When You Want to Say “No”

By Lynne Gots, posted on March 23rd, 2014.

Much of the advice I dispense daily in my clinical practice involves guiding people beset by negative thoughts and feelings to respond to emotional discomfort in counterintuitive ways.  Anxious? Approach your fears. Depressed? Get moving. Impulsive? Ride out your urges.

It all sounds rather simplistic. Yet changing behaviors in this fashion can improve your mood relatively quickly. Even more important, moving towards what feels scary or hard can help you build a protective core of confidence, making it easier to cope with the difficult times you’ll inevitably have to face in the future.

I won’t ask my patients to do anything I wouldn’t agree to do myself. Some of the “approach behaviors” I work on with them—touching a public toilet seat, say, or limiting themselves to only one glass of wine—don’t present personal challenges. But I certainly generate enough of my own worries to give me ample opportunity to practice what I preach.

Here’s an example: I just signed up for an eight-week course on Mindfulness-Based Stress Reduction (MBSR).

Silly that a program designed to reduce stress should significantly increase mine, right? But just thinking about it makes my mouth dry up and my heart beat faster.

I’d been looking for an opportunity to deepen my meditation practice for some time now. Periodically I’d google “Mindfulness Meditation in DC.” The Insight Meditation Community of Washington (IMCW) always came up. I’d pore over the course offerings and then reject them because the timing wasn’t right or the center’s Buddhist orientation made me uncomfortable.

I had many of the same automatic thoughts and a few new ones yesterday when I found the listing for an MBSR course given through the Insight Meditation Community starting in just two weeks. “Maybe everyone will be a Buddhist. I hope they don’t expect me to practice Buddhism.” “I won’t know what to do.” “Will there be chairs or cushions? Should I bring my own cushion?”  “Seven to nine-thirty on a Thursday night . . . I’ll be so tired after work, I won’t feel like going.” “I won’t have time to eat dinner and I’ll be starving.” “I won’t get home until after 10 and I’ll be so wound up I won’t be able to sleep.” “It might be lame, like that last mindfulness course I took.” “I might not be able to find parking.” “I won’t be able to walk the dogs or exercise on Thursdays.” “I don’t know what to wear. Should I wear yoga pants?” “I’’ll have to bring a change of clothes to work.” And even, embarrassing though it is to admit, “We’ll have to take off our shoes. I hope we can wear socks because I won’t have time to get a pedicure in the next two weeks.”

In the end, I recognized my reservations for what they were—excuses designed to avoid an unfamiliar situation causing me trepidation. I don’t like being a newbie, and this class raises all those old first-day-of-school insecurities (probably dating back to the start of kindergarten, when I wet my pants because I was too shy to ask my scary new teacher where the bathroom was and, humiliated, ran to hide in the coatroom when she asked the class who was responsible for the puddle on the floor).

So I did what I’d tell anyone else to do. I signed up.

To be continued . . .




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Posted in Acceptance and Mindfulness, Anxiety, Behavior Change, Cognitive-behavior Therapy, Depression, Obsessive Compulsive Disorder, Self-help, Techniques |

This blog is intended solely for the purpose of entertainment and education. All remarks are meant as general information and should not be taken as personal diagnostic or therapeutic advice. If you choose to comment on a post, please do not include any information that could identify you as a patient or potential patient. Also, please refrain from making any testimonials about me or my practice, as my professional code of ethics does not permit me to publish such statements. Comments that I deem inappropriate for this forum will not be published.

Contact Dr. Gots

202-331-1566

2440 M Street, NW
Suite 710
Washington, DC 20037

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If you don't receive a response to an email from Dr. Gots in 48 hours, please call the office and leave a voicemail message.

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