Written by Samantha Wall, LCSW
Edited by Joe DeNoon
In the last blog, I discussed what OCD is and how it relates to nursing. As a reminder, the cycle of OCD starts with a trigger, which turns to the obsession, leads to an increase in anxiety, and then the compulsions/strategies used to cope with the obsession. Learning alternative ways to cope when experiencing obsessive thoughts can be challenging, due to our explanation on why we need to obsess and complete the compulsion. These thoughts are intrusive, and even if they don’t make logical sense to other people or ourselves, they increase our anxiety so greatly that the only way it feels like we can decrease the anxiety is through completing the compulsion.
Another way to explain the obsession part of OCD is having intrusive thoughts. Intrusive thoughts are not exclusive to the OCD diagnosis, but, when people struggle with OCD, they experience intrusive thoughts. Ways to cope with these thoughts can include increasing our understanding of our own triggers, confronting uncomfortable feelings, and, when we cannot tolerate the feelings any longer, distract, ground, and attempt to move past the anxiety. To break the cycle, we have to stop engaging in the compulsion or safety strategy that decreases our anxiety in the moment. When we are able to challenge this anxiety and prove to the negative thoughts/obsessions that you do not have to complete the compulsion over and over again, it will help decrease the overall anxiety we feel. When we think about challenging our anxieties related to work, this may drain us even more when we are working. That is okay and expected. This is not to make sure the thing your brain is obsessing about never happens, this is to be able to tolerate the uncomfortable emotions and thoughts, so we can start to challenge the thoughts.
When we begin to challenge the cycle, we will experience an increase in anxiety at first. This is the obsession telling us we need to complete the compulsion, and what is important is we push through that anxiety. I recommend getting support from a professional when you begin to challenge this cycle. In this process, it is important to have support to regulate and someone pushing you to not engage in the compulsion. If you feel able to tolerate the anxiety, begin challenging at work in little ways. Instead of checking multiple times that you have completed all the steps in your job, only check twice. You will feel a pull to check and experience an increase in anxiety, but this is when you label the thought and increase in anxiety as an obsessive or intrusive thought and accept the increase in anxiety. Accepting the increase in anxiety can look different for each person, so think about what helps you stay in the moment and tolerate uncomfortable emotions. Some ways we accept the anxiety is to take a deep breath, normalize and validate the feeling, while not trying to make it go away with a compulsion or safety strategy. Within challenging this cycle, there is also an acceptance that this does not mean things will not go wrong. You must trust that you can tolerate your fear when it occurs.
One way to work on these behaviors is to upset your current pattern. I like to follow the acronym PIVOT :
Postpone Ritualizing to a Specific Later Time – tell yourself you will ruminate on the thoughts at a time and date in the future
Include a change to the Ritual – an initial new step can shift the process
Venture to new terrain – when you see yourself begin to engage in the repetitive behavior or thoughts, take a walk, drink some water, chew minty gum – anything to signify a sensory change
Opt Not to Ritualize – take back control and tell yourself “it can be optional”
Take time to practice kind self-talk while you work to adapt – we all benefit from recognition of the effort we put in and respond to praise
If you feel you are suffering from OCD or OCD tendencies, I encourage you to reach out to a professional. They can not only help support you in trying to combat these patterns of thought, they can also support you in the stress you experience daily. OCD and OCD tendencies are tough to address and challenge, and it can seem so overwhelming to try and address these patterns when we have the end goal in mind. Take it day by day and make sure to compliment yourself in each part of the process. Compliment yourself when you successfully identify a trigger, tolerate an anxious feeling for 1 minute, or are able to acknowledge you experience this cycle. Each step you take towards addressing an anxiety cycle is so difficult, and every person starts somewhere different in the process. It is important to remember that your progress is worthy of a compliment, no matter where you are starting.
Exciting news is that Francine Baffa is joining the Theraspace Team! Please read to find out more about her!
Creating an engaged therapeutic relationship is where we start. I became a therapist because I believe in the power of relationships. Moved by my own experiences, I wanted to guide others to push past perceived limitations, obstacles, and fear to live a full and meaningful life. I am a licensed Board Certified Behavior Analyst Doctorate (BCBA-D), and a Master Level Social Worker. I have over 20 years of experience providing individual and group therapy, focusing on grief and loss, and family systems work.
I work with adults treating a broad range of diagnoses including anxiety, depression, ADHD, and ASD. One special interest is family relationships. My areas of expertise are Applied Behavior Analysis (ABA), Acceptance Commitment Therapy (ACT), and Interpersonal Therapy (IPT). I utilize an integrated, transdiagnostic approach.
Interests include: writing, hiking, and cycling. I am also a certified yoga teacher and enjoy time on the mat.
“Healing takes courage, and we all have courage, even if we have to dig a little to find it.”
—Tori Amos
It’s not uncommon to experience pain or lose; however, there are those who use the authenticity of their suffering as an excuse to not heal. Medical intuitive; Carolyn Myss used the term “woundology” to describe how some people define themselves by their physical, emotional, or social wounds. Woundology is about using the wounds — the trauma and the hurts as the means to maintain relationships with others. Myss writes that many people hoping to heal “are striving to confront their wounds, valiantly working to bring meaning to terrible past experiences and traumas, and exercising compassionate understanding of others who share their wounds.” To heal fully we must redefine our lives outside of our wounds and process accepting them. It takes courage to move through the fear to the stage of learning and ultimately growth.
The sharing of wounds has become the new language of intimacy and can act to develop trust and understanding. The exchange of intimate revelations can be a bonding ritual, yet it is important to be mindful of continuing to expand outside of the pain. When it comes to this collaboration around wounds, healthcare workers describe nuanced interactions characterized by expressions of empathy, valuing others, offering help and support, demonstrations of physical and emotional presence, and vulnerability. Those in a helping profession share being able to both offer and receive in emotionally-connected relationships requires intentional attention and effort; this use of resources and demand can be draining and contribute to burnout and stress. Research supports the notion that social support is imperative in times of crisis and adversity.
Pain is also the ticket that gains the wounded entrance into well-meaning support groups where members receive, perhaps for the first time, validation, understanding, and acceptance. Support groups of all kinds, from AA and other twelve-step programs to those that help people who have lost a parent during childhood, can provide vital assistance and insight. The sharing of wounds has and will provide a climate that frees people and enables them to recall their painful memories and explore them with sympathetic, nonjudgmental companions dedicated to supporting them.
It takes courage to explore your suffering, to peel away layer after layer of beliefs, behaviors, and assumptions and rigorously hold yourself accountable to life.
Rather than relieving the unfortunate past events, chart new courses for a more empowered, healthier future.
BE A VOICE NOT AN ECHO.
We are so excited to have her as a part of the team!
Sources Used: https://www.medicinenet.com/what_does_it_mean_to_break_the_cycle/article.htm
https://www.psychotherapynetworker.org/blog/details/439/breaking-the-cycle-ocd-treatment-that-works