ReImagine Therapy

Do you know about EMDR (Eye Movement Densensitization and Reprocessing)?

It works by processing traumatic and core memories, letting your brain do the work and not having to discuss them in depth with a therapist.

It can involve following a light bar like this, or tapping your body, basically accessing both sides of your brain as you relive memories, whilst allowing you to keep one foot in the here-and-now.

EMDR can be really useful for trauma and self-esteem work, but it can also be used as part of OCD treatment. Sometimes, this will involve shifting old beliefs that make you susceptible to OCD. It might also include processing memories of when your mental health got scary that may have led to a fear of your OCD returning, to ease this fear and aid in the final bit of recovery.

I don't tend to use just EMDR for OCD, instead sometimes adding it in to my usual approach to overcome specific blocks and barriers to recovery.

Let me know if you have any questions.

Reviewing memories is really common in OCD. This isn't just involved in false memory or real event OCD, but most types.

The memory reviews are often habits, and also prompted by a thought or feeling that you might have done something wrong.

Memories are really tricky things. They aren't stored in a helpful way and can often have gaps that we fill in when trying to recall them. We also don't remember everything, which is often seen as a threat in those with OCD ( a reason why a lot of people with OCD often avoid drinking and things that can impair memory).

Memories are very susceptible to influence too, so purposely reviewing something for danger signs means your brain can conjure these up, distorting the memory.

We also can't help but look at old memories with our current knowledge bias and our values now. So looking at something you did as a teenager, you don't view things the way you would have at the time (when you couldn't think of consequences as well and when society had different rules and expectations), and so you judge yourself with the knowledge and behavioural standards you have now.

So, there really isn't anything helpful when it comes to reviewing memories.

If someone texts you saying you upset them the day before, then it's okay to have a quick review of what they were referring to (because something in the here-and-now says there is something you need to review). Apart from these occasions, leave the memories alone.

If you can't see, hear, smell or touch evidence of a problem in the here-and-now, it is extremely unlikely that there is a problem that you need to address right now.

And if it isn't a current problem, why are you doing things to problem-solve it (such as researching, ruminating, checking)?

OCD gets you to distrust yourself. You don't even trust your own senses. We want to tune back in to your senses data to make decisions and start to trust yourself again.

Now the holidays are coming to an end, it might be a good time to check in on how your OCD is doing and how to move forwards.

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Some little tips and reminders to help you tomorrow if you need them.

I will do some posts on me and my associates over the next few days. Reimagine Therapy started as a general therapy service, with just myself offering cognitive behavioural therapy to people locally.

Over the past few years, i increasingly specialised in working with OCD and expanded to online working to help people across the UK.

Now, I have carefully selected 3 other therapists who are as passionate as I am in helping those with OCD.

They have all dedicated time and experience to really heighten their expertise in this area. I also supervise each of them in this work, meaning we are all able to further hone our skills and expand our knowledge to be as knowledgeable and confident as possible to help anyone with OCD, no matter the theme or complexity. This also includes helping those who have had damaging previous therapy experiences.

We all have different availability for sessions, but between us, we cover the whole week and can offer different days and times. The sessions are online mostly, as we are based in different parts of the UK.

You can reach out to me via my website and I can arrange a free 15 minute call to find out what help you need and what availability, then I match you with one of us who can fit these needs to start therapy with. Between us, we still have a couple of open slots ready to start therapy very soon.

Get in touch to find out more.

I love this. It popped up on my social media with no credits mentioned, but I think it is such an important thing to discuss and so i wanted to share.

So many people come to me with such unrealistic expectations of themselves and such low self-esteem. This makes many other mental health difficulties even much worse.

Part of this is because it makes feelings like anxiety, restlessness and guilt worse. Partly, it is because the negative self-talk is louder and more frequent. But it's also because it makes it really hard to look after yourself by doing things you enjoy and that relax you, so you burn out quicker.

But why isn't everyone entitled to care? Why can't everyone be worthy by default? Perhaps thinking of it in this way, you might learn to be a little kinder to yourself.

One thing I've noticed working with so many people with OCD is that most people with OCD are also very good at visualising things.

It makes sense, because adding a strong mental image to a scary thought can make it feel so much more frightening and believable.

So, why not tap into this skill to help with challenging your OCD?

You can do this in many ways, but this is one of my favourites. We never aim to get rid of thoughts or push them out, but we can imagine freezing them at their current size and not delving into them.

Try out a few ways of visualising your thoughts and add visualisations into any techniques you are trying to practice to challenge them.

These references are in so many TV shows and are a nice reminder that everyone experiences the same content of thoughts, OCD just makes them feel important and like you're the only one thinking these things.

Here's how we might plot out the behaviours that are likely reinforcing your OCD.

It is often referred to as a vicious flower.

You can see that 'Theory A' sits in the middle. This refers to the things that your OCD are trying to convince you are true.

Theory A might include things like;
- Needing certainty about things
- Finding thoughts important and meaningful
- Questioning if you might be a bad person, and emphasising the need to know
- A distrust in yourself; your opinions, moral character and even eyesight

From here, arrows will point out towards a behaviour that you do because you're listening to this theory. So, if you believe that uncertainty is dangerous, then it makes sense to respond to uncertainty with anxiety and by trying to research to find certainty.

When you do this behaviour, another arrow points back towards the middle, where the theory sits. This is because, by doing this behaviour, you reinforce it.

Not only do these behaviours reinforce the Theory A (and therefore the OCD) by making your brain thinks they must be true because your actions match it, you also prevent yourself from ever testing and finding evidence for an alternative point of view.

How will you ever know if you should get certainty if you never stop driving towards it? How will you know your true coping abilities by never challenging your anxiety? And how will you know if you are trustworthy by never testing yourself?

These 'petals' build around the OCD and there are often so many of them, that you have to consistently snap quote a few of them off (and leave them off) to start believing any alternative theories.

I'm converting my go-to OCD formulations and information into nice worksheets for my clients to keep. This is one of my starting points for picking apart elements influencing and maintaining the OCD.

We have 3 parts at play here; longer term factors such as past experiences, personality types, family culture and biology, making people more susceptible to OCD and maintaining OCD patterns. Challenging and adapting these can mean less likelihood of falling back into OCD patterns, and also prepares you for the 'scarier' behaviour work and gives you confidence in coping with changes.

We then have the middle, which is the day-to-day OCD cycle. This is where any ERP, or exposure work, comes in. We build an understanding of how your interpretation leads to an emotional and then behavioural response, then forming a feedback loop which keeps the OCD going. Not only do we focus on exposure work around changing behaviours, but we also look at the interpretation of the OCD to challenge this. I've recently added in concepts from Inference-based CBT too, understanding what led to the story behind that interpretation.

The final area is the grey area on the right. This is where all of the talk of self-care and general lifestyle habits come in. By emptying that stress bucket a little and looking after yourself, you have more capacity to challenge the OCD, but you also aren't treating yourself like a bad person and are letting other thoughts naturally filter into your mind, so that the OCD is one thought, not the only one.

-care

Have you noticed this? It's a really good concept from Inference-based CBT, and a lot of my clients connect with it.

Rather than falling into compulsions around checking the thought, it can be helpful to start looking at them more objectively by looking out for little tricks like this.

Is this a theme you've heard of before? Did you know that it isn't because you don't like people with a different sexual orientation to your own, but rather fears around your own identity, future, and relationships?

This path is a rocky one, and I get so many people telling me how frustrating it can be when they have insight but haven't yet changed their behaviours.

The process has steps and takes time. Sometimes, those steps can be really challenging. Sometimes, you absolutely smash them and get a huge confidence boost.

I get so many people leaving therapy with goals and lifestyles they never knew were options before, as they never realised how much their OCD had dictated so many areas of their lives.

May all of your paths lead you to where you want to be, and may you all learn to live life confident in who you are and your ability to cope, with goals and aspirations that are dictated by your passion and enjoyment, not your fears.

Is this something you've experienced or come across in your work? If you don't already have an idea that there's OCD there, it can be pretty daunting to experience, making you question such an important thing.

Myself and my OCD associates are happy to answer questions and give you support in managing this (and all other) theme of OCD.

Feel free to comment, send a message or email me to ask about rOCD or how to get help with it. Please do also feel free to share tips and experiences on this post if comfortable.

Can you imagine what that looks like?

OCD often makes you want to make sure that an unlikely scenario isn't true or won't come true. But, in turn, it makes you live as though it is a current reality. And by doing this, it feels more likely.

But what if you let that fear sit there for the unlikely scenario, but lived as though the most likely option was true?

Examples:
You have no evidence that you are someone who will cause significant harm to others but your thoughts say you might: live as though you are unlikely to harm someone. Let yourself act naturally around people and have exposure to situations that your brain tells you to avoid.

Your brain says you may have hit someone with your car and you want to check, but you didn't see, hear or feel evidence of this when driving: continue with your day without going back to the road.

You have a potential false memory that you behaved inappropriately in the past but noone has ever said anything and the memory might not be true: stop searching memories as if there's something to find and stop checking old messages from people to scan for odd tones. Instead, focus on your behaviour now and maintaining current relationships in a way that fits with your morals.

You don't spend your life preparing for unlikely scenarios like meteor disasters and winning the lottery, so don't live your life as though other equally unlikely things will happen.

There's a common misconception that people with OCD fully believe that the thoughts they are having are true, or that the danger they are perceiving is completely accurate.

Many people with OCD feel MOSTLY sure that the OCD isn't telling the truth, but the uncertainty around this can lead to doing behaviours 'just in case' or to try and get certainty that they aren't a bad person or didn't do/won't do the thing they are worried about.

Some people do worry that the thought is true and believe that they are preventing harm by carrying out compulsions.

It doesn't matter where you are on thus continuum, and you may move up and down. The response you have is still an OCD response, and we can target this and the beliefs you hold.

Have you heard of this sub-type? I've worked with this a lot alongside other forms of OCD.

I'm also getting an increasing number of people getting in touch, worried that they don't have OCD because this feels different to other versions they've experienced.

But look at the behaviours; classic OCD behaviours, which impact on the beliefs you have.

Even if you worry that your behaviour wasn't how you wanted to act and you feel guilt for whatever is it you're ruminating over, doesn't mean it isn't OCD. It also doesn't mean that you shouldn't get help and find out what is making this so hard for you right now.

Do you have any questions about this type of OCD or how it is treated? We aren't aiming to 'prove' that you've never done anything you regret, we are just trying to prose the OCD away from things you are focusing on.

My associates still have some availability for OCD clients, so get in touch if you need help with this.