ERP AND SCHWARTZ’S BOOK, BRIAN LOCK
I don't know about you, but whenever I do something that "unlocks" my brain and gives me complete release from obsessive thoughts, it's a
WOW!!!!!!!!!!!!!!!!!! moment for me.
That's how I felt yesterday about 4 P.M.
As some of you may know, I am making plans to start going to the Northbrook Anxiety and Agoraphobia center to be under the care of a knowledgeable OCD therapist. In preparation–I'll probably start in late August or early September–I ordered four books on OCD from Amazon.com. I know that the center does focus on CRT and ERP and I want to keep an open mind, so that I can participate fully in the program that is set up for me.
I found several things helpful from a book that we used to have in our OCD Christian Support library: The OCD Workbook: Your Guide to Breaking Free from Obsessive-Compulsive Disorder. Actually, as I tried to find it, I read it in another book, Obsessive-Compulsive Disorders by Dr. Fred Penzel. CRT helps "sufferers to improve their risk-estimating skills." That certainly makes sense. I need to increase my threshold for handling anxiety. Secondly, as I understand it, ERP (exposure response prevention) helps sufferers to desensitize themselves to the sources of their anxiety.
But here is what I found perplexing: on page 69 of The OCD Workbook the authors make a list of the behaviors that block the effective implementation of ERP. Here is one four and I quote:
"Ritualizing privately by counting, praying, and so forth in order to neutralize the anxiety or discomfort of the exposure."
What the two authors are saying is that as you experience anxiety in the presence of an obsessive thought or compulsion, any effort to divert attention away from the source of the anxiety, lessens the effectiveness of exposure.
I had read that several days ago. Then yesterday morning, I began to have an obsessive thought that became more pronounced as the day progressed. What I discovered was that entertaining that thought, meeting it head on so to speak, wasn't doing a thing. So I did what I have done so often in the past. I picked up my worn out copy of Brain Lock by Dr. Charles Scwhartz. I decided to reread his concluding three pages, "THE FOUR STEPS AND THE REST OF YOUR LIFE."
In this section he talks about the tremendous power that OCD sufferers discover in developing their Impartial Spectators, that part of one's self that is able to look at one's thoughts and behaviors from a "third-party" perspective. Schwartz states on page 125,
"One of the most amazing things that you will learn when exercising mindful awareness and using the Impartial Spectator is how much the mere observation of the content of your thoughts tends to direct them in a much healthier manner. In other words, knowing what you're thinking at any given moment tends to direct the mind away from destructive ruminations, onto more constructive and wholesome subjects."
There is more, but here is his crucial point:
"For instance, if a string of unwholesome ruminations on craving or anger, greed, or ill will, is broken by making a mental note that 'I am now thinking a thought related to ill will or anger,' the very breaking off of that stream of unwholesome thought processes by wholesome mindful awareness will itself lead to further wholesome thoughts concerning something functional and healthful to both you and others."
O.K., I thought. I've worked hard on Schwartz's third step, REFOCUS, but I've never really tried something this simple. So I said to myself, "I am thinking thoughts that are driven by my personal obsessions and malfunctioning brain. This is my OCD talking to me now."
Nothing………………
So, I reread the passage above by Schwartz and restated the exact words that I just shared.
Wow………………………………………….!
My brain unlocked. The obsessive thoughts totally left me and have not returned for the last 30 hours.
What is going on here? I did exactly what Bruce M. Hyman, PhD and Cherry Pedrick, RN said not to do. I diverted my attention away from the obsessive thought. And my brain unlocked.
But in some areas, my OCD meltdowns have been too severe to live with happily. ERP with it's SUDS list of anxiety-producing stimuli may help me desensitize some things that need to be addressed.
Any responses, observations? Please share them with me.
Leonard
Great post, thanks for sharing. Now I must admit that I read that slightly differently, and maybe that's what works for us, finding the most effective thing as an individual. But to me, divertin attention away means basically trying to deny it or to ignore it by focusing on something else entirely, and this is doesn't help you. Whereas thinking to yourself "i'm thinking an unwholesome thought of ill will or anger" isn't divertin attention away from the thought, it is acknowledging the thought but not placing importance on it – it is, after all, just a thought. The key is to recognise that it's just a thought and nothing more, and letting it go, but without getting hung up on why you're having it and what it means.
LeonardA – this can indeed become a complicated exercise in understanding what exactly works for us OCDers and in what order. I too have read BrainLock as well as many other books that promote ERP. I tend to think that there are many grey areas when using CBT and ERP. I think some of these authors are ultimately saying the same thing but just express their theories of "implementation" of ERP in different ways and in different orders. I don't think it is ever helpful to try to block the obsessive thoughts even by focusing on other things. I tend to strongly agree with billdoor79 in that acknowledging the thought is there and yet not significant (i.e. your OCD in action) is the way to go. With that said this is a very grey area and one that deserves much more discussion on this site. Thanks for the great post. Rob