APTC Blog

As a follow-up to my last blog post on using mindfulness to manage an anxious mind, I thought I would furnish some additional resources for how to learn more about mindfulness and if you’re interested in becoming more mindful, how you might begin to develop a mindfulness practice

Inevitably as you seek to manage your OCD and do the necessary exposure work, you will be bombarded with lots of anxious thoughts. Being aware that this is going to happen and having some strategies in place to deal with it, greatly increases your chances of a successful outcome. Most of us aren’t aware of our thoughts, but I guarantee they are there.

As I’ve written about in other places, uncertainty is at the heart of OCD. One of OCD’s many tricks (go here and here for previous posts on this topic) is to make you think you can’t move forward unless you feel sure that nothing bad will happen.

The issue of (hyper-)responsibility and the accompanying guilt shows up everywhere in OCD and across all forms of OCD. For many clients it is the core of their struggle with OCD. It can show up in a variety of ways. When experiencing an intrusive thought or image (“I could hit someone in that intersection!” Or ”What if there is asbestos or lead in my home!”) most of us would take reasonable precautions and then would drive through the intersection or continue to replace the old flooring in our homes, but when we have OCD we take this “threat” more seriously and are more likely to engage in excessive avoidance or safety behaviors to be absolutely sure that nothing bad can happen. If the avoidant and safety behaviors are not engaged in, the result is usually very strong feelings of guilt and shame.

It is often recommended that when doing exposure therapy that a hierarchy be constructed. By “hierarchy” we mean that you identify situations that make you uncomfortable or scare you, give them a ranking between 0 and 100 (this is usually called a SUDS rating, which stands for Subjective Units of Disturbance Scale) and then to list the items from the most difficult at the top to least difficult at the bottom. This list usually consists of between 10 and 15 different potential exposures and can form the framework for the exposure therapy work to come.