I’m sad to report this is going to be the last episode in our themes and treatment series for a little while. I will tell you there are a couple more things that I want to cover. I did have a guest request for TMS, which if you don’t know what that is, it uses like magnetic energy, it’s my best way to describe it, on the brain.
And sometimes it’s being used for OCD now, maybe a little bit more than it used to be. Traditionally it’s just been for treatment resistant depression. I did want to find somebody who was doing TMS with OCD and had tried to reach out to somebody, but we just never could connect. And I would also love to talk with somebody who works at an inpatient center for OCD.
However, we haven’t been able to make that happen either. Today we’re wrapping up with Just Write OCD. I’ve delayed this episode because I really wanted a guest. I don’t feel like it’s my strongest theme to be talking about because it’s something I don’t see quite as much as the other ones. Usually if I do have a client struggling with just right OCD, they have other pressing OCD concerns that are impacting them a lot more that we end up focusing on in our therapy time. So you know that you’re experiencing just right OCD if you feel like certain objects have to be arranged in just the right way. Could be the clothes in your closet, the items on your desk, even maybe your food has to be prepared or cut a certain way.
Common obsessions might involve like wanting items to be symmetrical or in a certain color order, number arrangement. Writing may need to look a specific way, or you may feel like you need to rewrite something. People can get really fixated on numbers, like this number is good, that number is bad. There may be some magical thinking involved in Just Write OCD.
Compulsions can include arranging, checking to make sure no one’s moved your items when you weren’t looking, or they don’t need to somehow be rearranged. And you may not necessarily know why, but you may feel really uncomfortable if things are out of place or they aren’t ordered the way that you want them to be.
Now can be similar to perfectionism, but different in the sense that perfectionistic people are trying to achieve. an unrealistic goal or standard. Whereas someone with just right tendencies is looking more really to just feel a certain way about the objects or things that they’re trying to make just right.
And there’s nothing wrong with being neat or orderly, obviously, but it can cause problems. Let’s say you’re yelling at your family members because they didn’t put the pillows on the couch back in a certain way. Or you’re spending an hour in your closet trying to organize your clothes by color. As a side note, I used to work for Joann Fabrics.
Kind of sad they’re going out of business. And there was a specific way that the fabric had to be rainbowed when you put it back out on the floor. I had no idea how to do this. They really did try to train me. God bless them. Especially when it came to fabrics that weren’t a solid color. I really couldn’t figure that one out.
But there is a specific process to it. Maybe you’re finding yourself spending a lot of time in your closet trying to get things a certain way. I’ll tell you one thing that bothers me is when hangers are in different directions, like all the shirts need to look, be hanging up the same way. That just makes sense, right?
One thing that differentiates the Just Write OCD from other themes is that there may be a lack of anxiety present, which is probably why I don’t see it a bunch in therapy. So if it’s taking up a large amount of time or it’s interfering with family relationships or causing a lot of anxiety, Obviously, people are more likely to then seek out therapy for it if they’re, they’re struggling to function.
Otherwise, they’re just gonna sit there and say, Well, I’m just neat and I like to be organized and everyone else is not doing it my way. Well, they’re living some kind of version of chaos that I don’t know anything about. And this is where we can talk about different people having different levels of awareness regarding their OCD.
Here’s something super interesting. I find that people think they know a lot more about their OCD than they actually know. When they slow it down and when we start treatment for it, then they go, Oh, I’m realizing how much this is showing up now. I didn’t really realize how much my OCD was impacting me.
Until I started to see it all over the place. Maybe I had different themes that I wasn’t really recognizing were obsessional. And you have some people who are completely unaware that they have OCD or not aware of the impact that has on the other people around them. Maybe they are just like, well, this is the way it should be.
And I don’t know why y’all are so upset about it. It can be really hard if you’re dealing with a family member that doesn’t realize that they need help or that they could change. Other people are on the opposite end of the spectrum, are very aware of their OCD, but awareness doesn’t mean that you can change it.
That’s really only one part of the equation. It’s an important first step that I think a lot of people skip over. Ultimately, you also have to have the right tools to manage the OCD, not just the awareness of what it is and how it’s impacting you. Regardless of the theme of OCD that you’re dealing with, your treatment options obviously look similar.
And here’s where I would normally chime in about ICBT, which is, I believe, fabulous. But I actually want to take a moment and talk about acceptance and commitment therapy, because there are certain elements that we can get from acceptance and commitment therapy, such as looking at our values and this discussion about what does it look like to move towards what we really value.
And is what we’re spending our time on what we say that we really value or what’s most important to us? Let’s think of a common day to day example. I may say that I value my marriage, but if I haven’t had a date night in two months and I only talk to my spouse about logistics, then clearly I am not prioritizing my marriage.
When we are not living in line with our values, we feel a sense of internal distress inside, and we may not even realize why we’re so distressed. This can happen a lot in terms of people pleasing. That’s another topic for another day. But back to Just Write OCD, I might ask somebody. I know it feels really uncomfortable that you don’t feel like your clothes are aligned a certain way.
Spending two hours in your closet, is that what’s most important to you to like alleviate that feeling? Or are there some other values that you would say are more important to you? Let’s say maybe this is a single person who maybe doesn’t have immediate family. And they might feel like, well, this does give me something to do.
It does, in essence, occupy time, keeps me from being bored, keeps me from being lonely. But maybe it’s keeping them from cultivating healthy social relationships because they’re spending so much time in their house arranging things or rewriting things or trying to get things just a certain way. And that might be something that we explore.
It’s absolutely amazing how protective OCD can be. OCD can protect you from a lot of uncomfortable stuff. It can protect you from uncomfortable feelings. It can protect you from uncomfortable relationship dynamics. It can protect you from reaching out and developing new social relationships, or dating can keep you from being vulnerable.
This is not something that I typically hear people talking about, but I see it all the time. OCD can keep you in an uncomfortably unhealthy level of relationship dependence on another person. It may feel unsafe to disconnect and become your own independent person. I think this is why treating the whole person who has OCD is so important.
It’s not a situation of, Oh, you have OCD? Here’s a treatment. Here’s some ERP. Here’s ICVT. They’re evidence based. We’ve researched them, and they’ve shown to be effective. Yes, that’s incredibly true. I can’t name one therapist for you that I know that only uses one therapeutic model. If they do, they are an incredibly rare therapist.
I would like to meet them and I would like to know how that is working for them. Even people who are using ERP are incorporating things like acceptance and commitment therapy. Which I just talked about. We have to look at all the things that might be contributing. Is there a trauma in a person’s past?
And not just, oh, big T, massive trauma that happened to you, but something that you can point to and say, Hey, that impacted the trajectory of my life, and I was not the same after that event. My belief system changed as a result of this event. So yes, we can teach someone with just right OCD the skills of ICBT, looking at what is in the here and now, what is in the sense data information, what is showing you that something needs to be moved, or needs to be perfect, or has to be a certain way.
What’s the story behind how we got to doing these behaviors or there’s something about this behavior that causes you to feel safe and okay? I think there would be a lot of work surrounding this on recognizing when You’re going into that OCD bubble state. When am I spending a lot of time, how can I recognize this is OCD, and notice, like, when I’m just so solely focused on fixing this one thing, that I’m excluding everything else in my life.
Because that’s not a healthy way for anybody to be. We don’t want to be so consumed with one thing that we’re not paying attention to what else is going on around us. And what I see is when people build that awareness, when we’re able to slow things down, I think that’s the key, because people get so stuck on, you know, well, I just do this automatically.
I have all these automatic compulsions. Yes, of course you do. But we can slow that down through the ICBT process in recognizing the obsessional sequence. Recognizing the story, recognizing how you get into the OCD bubble. Once we’re able to slow those pieces down, once we’re able to identify that feared possible self, then we’re able to see, Oh, okay, if I know how I got to inferential confusion, How I got from an everyday normal reasoning process that I engage in every time I’m outside OCD.
If I know the difference between that and how I got in the bubble, then I can differentiate and go, Oh, okay, I’m doing the thing again. Let me slow it down. Let me recognize what’s actually going on versus what OCD is telling me. Let me get in touch with my true self, which this is where your values come in.
What do I really want to be doing? How do I really want to be spending my time? And move in that direction. Obviously, it’s going to look different based on what the compulsive behaviors are. If someone is having food preparation compulsions, obsessional story than someone who has the need for symmetry in their personal space or in their bedroom.
That’s the thing that I like and appreciate about ICBT is that it feels very personalized to the individual based on the reasonings behind their obsessional doubt and the way that OCD is drawing them into the story. For any therapist thinking about pursuing OCD treatment further, I would encourage you to do it because you will never get bored.
There are lots of nuances. Everyone’s a little different in how they approach things. So the OCD warriors, keep me on my toes and keep me continuing to learn more and more things that can hopefully help people get to a place of greater peace and recovery. That is my prayer for all of you who are listening to this podcast.
This is a labor of love and I appreciate you so much for taking the time out today. If you have been wondering when Christians Learning ICBT is coming back around, I am teaching live in August. If you can’t wait till then, we hope to have a fully self help version out by May. That’s my goal. The best way to keep up to date with all that is going on is to join the waitlist at carriebock.com/training
