Reading for recovery: Books that help understand

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1. The Noonday Demon by Andrew Solomon 

You might think calling your book “an atlas of depression” is a bad case of exaggeration, but with his huge tome on depression Solomon earns it. He looks at depression from every imaginable angle, and ties it all together with stories of his own severe episodes over the years. Meticulously organized and eloquently written, this book is full of research– and Solomon’s hard-earned opinions on that research. It’s not an easy read because of its length and its intricate style, but if you want to advance your understanding of depression with just one book, this is your best bet. It’s at the top of this list because it’s just about as good as a book about mental health can get. Here’s a brief excerpt:

Perhaps depression can best be described as emotional pain that forces itself on us against our will, and then breaks free of its externals. Depression is not just a lot of pain; but too much pain can compost itself into depression. Grief is depression in proportion to circumstance; depression is grief out of proportion to circumstance. It is tumbleweed distress that thrives on thin air, growing despite its detachment from the nourishing earth. It can be described only in metaphor and allegory.

2. An Unquiet Mind by Kay Redfield Jamison

As far as there’s a canon of books about mental health, Kay Redfield Jamison’s “memoir of moods and madness” has been near the top for over twenty years. It was one of the first books blending experiential and scientific takes on bipolar disorder (a term she actually dislikes because the idea of two poles draws too strong a distinction when things are much more murky). Jamison has a unique dual perspective on the condition: she has a severe case herself, and she’s a professor of psychiatry at Johns Hopkins School of Medicine. People like to call this book brutally honest, and it is. Jamison is interested in the in-between moods that weren’t really discussed in clinical literature (and still isn’t, except by a few researchers interested in what they call mixed states). This line is characteristic of Jamison’s unflinching self-awareness, which so many people have found relatable: “I had been simply treating water, settling on surviving and avoiding pain rather than being actively involved in seeking out life.”

3. Reasons to Stay Alive by Matt Haig 

The title of Matt Haig’s memoir/guidebook on severe depression (and suicidality) makes things sound pretty drastic– and in a way they are. Haig, who advocates constantly for mental health online, has made it through some tough times, and tells us about them in a relatable way. This book has the opposite goal of Solomon’s, preferring practical advice to encyclopedic knowledge. But don’t let its small size fool you, because this tightly written book is full of wisdom you can start applying to your own experience right away. It’s a great one to keep around in case things get tough again for you or somebody you know. The lists in this book are particularly useful. Here’s part of one:

Here are things I wish someone had told me at the time:

1. You are on another planet. No-one understands what you are going through. But actually, they do. You don’t think they do because the only reference point is yourself. You have never felt this way before, and the shock of the descent is traumatising you, but others have been here. You are in a dark, dark land with a population of millions.

2. Things aren’t going to get worse. You want to kill yourself. That is as low as it gets. There is only upwards from here.

3. You hate yourself. That is because you are sensitive. Pretty much every human could find a reason to hate themselves if they thought about it as much as you did. We’re all total bastards, us humans, but also totally wonderful.

4. So what, you have a label? ‘Depressive.’ Everyone would have a label if they asked the right professional.

5. That feeling you have, that everything is going to get worse, that is just a symptom.

6. Minds have their own weather systems. You are in a hurricane. Hurricanes run out of energy eventually. Hold on.

7. Ignore stigma. Every illness had stigma once. Stigma is what happens when ignorance meets realities that need an open mind.

8. Nothing lasts forever. This pain won’t last. The pain tells you it will last. Pain lies. Ignore it.

4. Imagine Me Gone by Adam Haslett

This is the first work of fiction on our list, and as a warning it’s also the first in which suicide plays a central role– this makes it tougher to recommend, but the way Haslett’s novel explores suicide’s effects on everyone close to the victim makes the tragic event much more than a cheap plot point exploiting a difficult topic. Still, it’s a heavy book, and one that might inspire a good bit of sadness. A family contends with their father’s depression throughout their childhood, and deals with its legacy once he’s gone. But it reads quickly, has a ton of beautiful moments, and does a good job complicating our ideas about mental health. If we only read non-fiction we can start to slip into very one-sided views of “the way things are.” Luckily we’ve got fiction to remind us of how varied, and how nuanced, actual manifestations of mental illness can be. Here are a couple memorable quotations from the book:

“It struck me then, for the first time, how unethical anxiety is, how it voids the reality of other people by conscripting them as palliatives for your own fear.”

“Against the monster, I’ve always wanted meaning. Not for its own sake, because in the usual course of things, who needs the self-consciousness of it? Let meaning be immanent, noted in passing, if at all. But that won’t do when the monster has its funnel driven into the back of your head and is sucking the light coming through your eyes straight out of you into the mouth of oblivion. So like a cripple I long for what others don’t notice they have: ordinary meaning.”

5. My Age of Anxiety by Scott Stossel 

Scott Stossel’s 2014 book got a lot of buzz, partly because it’s good and partly because the editor of a major magazine, The Atlantic. Stossel describes the intense anxiety he’s felt throughout his life, and all the things he’s tried to feel better. You can tell that he’s been interested in learning about mental health for a while (and that he’s a journalist) because he seamlessly weaves research, interviews, and other people’s stories into his own tale. He has a lot of interesting stories to tell– like the time he got to live on Cape Cod with the extended Kennedy family while researching one of his books, and flooded their toilet after a bout of “gastric distress” while Arnold Schwarzenegger was visiting. Here’s a lengthy excerpt.

6. The Man Who Couldn’t Stop by David Adam 

Also a journalist, David Adam developed his first obsessions about HIV/AIDS as a college student in the 1990s. It’s been fairly common for people with obsessive-compulsive disorder to fixate on this possibility since the start of the AIDS crisis in the early 1980s. For Adam, the thoughts took over completely. He tells us that everyone working at the National AIDS Helpline knew his voice because he called so many times each day; it didn’t matter that he wrote for Nature, a major science journal, and knew that his risk wasn’t nearly high enough to merit all this anxiety. All that mattered– and this might be familiar to those with OCD– was that there was a risk. Like these other books, this isn’t a simple memoir; it’s full of useful research and helpful information on what might help other people get better too.

Here’s a review of the book written by… none other than our last author, Mr. Stossel.

What mental health books have you learned from?

Next time around, we’re particularly interested in highlighting books from writers of color and writers who don’t identify as men. Everybody’s mental health matters, and sometimes these stories aren’t prioritized. If you have a moment to leave us a reading recommendation, we’d love to hear from you.

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The OCD research that makes me hopeful

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How my search for hope led me to Biohaven

It was a cold winter day in early 2015, and I remember sitting in a dimly lit coffee shop in Liuyang, China researching medications that might improve my obsessive-compulsive disorder (OCD) symptoms. The wifi was spotty, and my VPN disconnected often, but I was in the zone. Nothing could break my focus– not even the waitress asking me, “Nǐ xiǎng hē gèng duō de kāfēi ma?” or “Would you like to drink more coffee?”

I was looking to either find a medication with minimal side effects or see if researchers had plans to produce one in the near future, since I was tired of suffering. Although Exposure and Response Prevention (ERP), the major type of Cognitive Behavioral Therapy used to treat people with OCD, had empowered me to “get back in the saddle” and re-immerse myself in the activities I once loved, a dull anxious feeling would still constantly tighten my chest, grip my throat, and stiffen my face– my body’s way of preparing itself for an intense OCD episode that could strike at any moment. I’m sure many of you can relate.

Liuyang, China. (Haluk Comertel, Wikimedia Commons)

Doing ERP alone helped me learn to manage my OCD in weeks, enabling me to leave my house and travel to China as an English teacher, but it didn’t reduce my anxiety all at once. The reason: it often takes people with OCD months, or even years, to feel the physiological benefits of ERP, which is why so many are prescribed one of the Selective Serotonin Reuptake Inhibitors (SSRIs) in addition to their ERP therapy. SSRIs are prescribed to reduce the sting of enduring ERP, and the combination of ERP and SSRIs has been clinically proven to be one of the most effective ways to treat OCD today.

However, research shows that the current “gold standard” treatment approach is not always golden for OCD patients. First, SSRIs are antidepressants, designed primarily to treat depression. Even though OCD patients can benefit from SSRIs, research suggests it sometimes takes a significant amount of trial and error before people experience improvement. Many people try a variety of SSRIs and dosages before finding the medication that works best for them. Second, they sometimes come with a variety of side effects that cause discomfort. A few typical side effects are weight gain, sexual dysfunction, fatigue, and agitation. Third, ERP therapy is widely inaccessible and tough to manage. OCD specialists charge extremely high rates for their service, and they often don’t take insurance. And, after seeing a specialist, people with OCD are often asked to manage their condition alone, without any additional resources.

For these reasons, and because ERP was already working well for me, I decided to pass on SSRIs while going through OCD treatment. As much as I wanted to feel better, I felt the risk of experiencing harsh side effects and managing haphazard results on top of the difficulties of ERP was not worth it. People with OCD can suffer quite a bit, so we want to get results fast, and in today’s world we should have the ability to get actual “gold standard” treatment in just minutes. At that coffee shop in Liuyang, I dreamt of a world where people with OCD could access better ERP and OCD-specific medication in minutes– not only to help myself improve, but also to help millions of others who were sharing their difficult experiences online.

When I read about Dr. Vlad Coric, CEO of Biohaven Pharmaceuticals, I felt for the first time as if someone else shared that dream. Defying the pharma stereotype, Dr. Coric cares deeply about the well-being of OCD patients all over the world, and his past work proves it. Prior to starting at Biohaven, Dr. Coric worked on the OCD research team at Yale University for decades, and his research on the neurotransmitter glutamate has encouraged researchers to explore alternative OCD treatment methods, like ketamine administration, that work on glutamate. Dr. Coric isn’t just a pharma executive; he has recognized major problems within the OCD treatment industry and is doing meaningful work to try to address them.

Flash forward to July 2017: Meeting Dr. Coric

China was great, but I missed huge pancake breakfasts

After conquering my OCD and working with my team to make nOCD the most widely adopted OCD treatment platform in the world, I decided to attend the International OCD Foundation Conference in San Francisco, mainly to have the opportunity to meet Dr. Coric in person. Before our meeting, I was both nervous and excited, because I knew I would be meeting one of the most dedicated OCD researchers in the world, and I wanted to make sure that I made a good impression.

The meeting went better than I ever could have imagined. Dr. Coric was humble and friendly, and brought up many amazing points about how we could enhance the nOCD platform to augment research and provide access to care more quickly. In addition, I could feel his genuine passion for helping people dealing with OCD and related conditions, and his desire to innovate psychiatric pharmacology with new technology and ideas. Leaving the conversation, I told Dr. Coric that I’d love to do whatever I could to enhance his research. That’s where our collaboration began.

With the recent partnership between Biohaven Pharmaceuticals and nOCD, I think we’ve just taken a major step forward toward creating a better world for OCD patients. If you have OCD or a related condition, or you’re concerned about a family member or friend, have hope! You have two new companies working nonstop to make this part of your life a lot easier. And now, because you’re the community we want to help, we need your voice. Let us know in the comments what you envision for a world with accessible, effective, and affordable behavioral therapy and medication.

Disclaimer: Biohaven Pharmaceuticals and CEO Vlad Coric, MD, did not contribute to the content of this blog post.

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Eight mental health myths that make us feel worse

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Sorry, it’s just that Shakespeare is the only author I could think of.

You would hope that all this confusion in the news over what’s true would stay far away from topics like health and wellness, but unfortunately these are just as prone to miscommunication and misinformation. In an effort to prevent people with mental health issues from struggling more than they already do, let’s debunk some common myths about mental health. We’ll also look at something closer to the truth for each one, so you can go around helping your family, your friends, and even your very worst enemies see things differently. Here goes!

1) Myth: People struggling with their mental health are more likely to be violent

Not only are people with mental illness no more likely to be violent than anyone in the general population, they’re ten times more likely to be victims of violent crime. If you’re walking around your school or office, or taking public transportation at night, or whatever else you do, consider keeping an eye out for people who are visibly struggling with their mental health instead of just avoiding them.

2) Myth: Depression is caused by low serotonin levels

Although the serotonin hypothesis became the dominant explanation for depression in the 1960s, the scientific community has shifted and no longer believes that depression is caused by anything as simple as a lack of serotonin. SSRIs and SNRIs are still the most widely used psychiatric treatment for depression, and the medical community still seems to believe that some kind of change in the way serotonin interacts with neurons can help people feel better. But the nature of this change– and the reason people get depressed in the first place– remains unknown.

3) Myth: Mental health problems are rare

About 20% of people in the United States have a mental health condition. For comparison, 16.6% of Americans have blue eyes. Although eye color varies significantly depending on the part of the world you’re in, mental illness incidence probably doesn’t. (Although it’s important to acknowledge that mental illnesses are diagnosed and treated in very different ways around the world.) The exact percentage doesn’t matter; this one is probably an underestimate anyways, because most people try to hide what they’re going through. The Rare Diseases Act of 2002 defined a rare disease as one that affects fewer than 200,000 people in the United States. Even if you take each form of mental illness individually, they don’t fit into this category.

4) Myth: People will be happy if they just choose to see the world more positively

This is a particularly painful one. We love to tell people who are struggling things like Just think more positively and the world will respond positively. But this isn’t true; your brain is not, in fact, in control of the world. It’s not even really in control of itself. Although there’s always a degree of intentionality that needs to go into the treatment of mental illness– you do need to choose to do things differently at some point– positive thinking is not a treatment. A number of studies have found differences in thinking and emotion in depressed patients, leading many to speculate that attempts by unhappy people to force themselves to think positively actually make things worse.

5) Myth: Kids have mental health problems because of bad parenting

We don’t know what causes psychiatric disorders– it’s that simple. While it’s believed that stressful home environments and difficult relationships with parents contribute to mental illness in children, saying that they cause mental illness is dishonest. To do so is to ignore the complexities of the brain and its illnesses, which are thought to come from some nuanced combination of genetics and environment. Of course, you should still treat children as well as possible. The point is more about the way we assess parents: don’t assume that they’ve somehow “ruined” their child if the kid is struggling.

6) Myth: Kids are overmedicated and shouldn’t be put on medication

Taking a broad societal issue (all those headlines about the overmedication of children) and applying it to specific cases is rarely a good idea. Yes, it’s bad to dispense a few of your extra Prozac to your kid like Tylenol in the hope they’ll feel better. But if you’re taking them to a psychiatrist, the psychiatrist should be doing a thorough examination and making a careful evaluation of all the options. Every treatment decision is a balance of potential pros and cons, and we don’t really know what most medications do to children or long-time users. But the same is true of adults: seeing as most of these medications have been around for just a few decades at most, we don’t really know what’s going to happen to people who take them throughout their lives.

We can address the broader societal implications later on, but for now it’s worth saying: if your child is working closely with an experienced professional who believes that medication would be a good treatment option for them, you should probably trust them and not the person on your Facebook feed posting repeatedly about how psychiatric drugs are turning children into zombies.

7) Myth: All therapists are basically the same

A lot of friends and family members have told me they don’t really like therapy, or therapy just isn’t for them, or something else like that. While there are real problems with therapy today (like financial and geographical inaccessibility), saying you don’t like therapy is a lot like saying you don’t like traveling because you had a bad experience in one place. More likely you saw one therapist, or a couple therapists, and decided that the whole thing was silly because you didn’t like how it went. There are tons of different approaches to therapy and different types of clinicians. And then there are the countless individual differences between therapists that can determine– much more than the type of therapy or the amount of education they’ve completed– whether or not you enjoy meeting with them on a regular basis.

Back when I was looking for a clinician, it was important that they had a good sense of humor, were always staying updated on the latest research, and were willing to draw from multiple different types of therapy as needed, instead of insisting on seeing everything through one methodological lens the whole time. If you don’t like your therapist, don’t stick with them; unlike most relationships in life, walking away from your therapist should be relatively uncomplicated (though not free of guilt or sadness). But try not to write off therapy as a whole, because you’ll risk missing out on really helpful stuff.

8) Myth: You need to have a diagnosis to start thinking more about your mental health

The times, they are a-changin’. Very slowly. And maybe not. But we’ve all been stuck for a long time thinking in terms of distinct mental health conditions, as listed in the Diagnostic and Statistical Manual of Mental Disorders (or the ICD, for those of you in Europe). The DSM has had its fair share of controversies since the first edition was published in 1952, like its inclusion of homosexuality as a “sociopathic personality disturbance” until 1974 and the fact that it seems intent on eventually classifying every deviation from contentment as a treatable disorder. But, in large part due to the pressures created by our daunting bureaucracy of insurers, pharmaceutical companies, and clinicians, the DSM has stuck around.

Another concern about diagnostic manuals is the difficulty of defining specific criteria for each disorder. If you spend three weeks feeling really down, are you depressed? How about four weeks? What does it mean to be really down? Then are you depressed, or just dysthymic? Do you have an anxiety disorder, or a psychiatric condition like OCD that has a lot in common with some of the anxiety disorders?

These aren’t the questions that people trying to feel better really need to spend time thinking about. Diagnosis can help people get the best possible treatment for their unique struggles, but it can also become a distraction for patient and clinician alike. Especially with anxiety disorders and OCD, many people end up fixated on their diagnosis, to their own eventual detriment.

Many clinicians and researchers have stopped thinking much of the DSM’s classification system, though they have to keep dealing with it in one way or another. In fact, some of them are proposing an entirely different system called the Hierarchical Taxonomy of Psychopathology. The HiTOP assesses people’s place in a bunch of different categories and takes a close look at the specific ways these categories come into play. Whether or not this new system is substantially different, the point remains: you don’t need to wait for a diagnosis to start improving your mental health, and any diagnosis you receive is going be a “best guess” based on your symptoms. Clinging to a diagnosis might help you find other people and new information that you can relate to and benefit from. But it won’t make you better.

Final thoughts: What can we all do to become better informed?

Drinking coffee while you look for studies saying coffee is good for you? Validation.

Health information has always spread in a way that makes it prone to misunderstanding: by word of mouth, based mostly on anecdotal evidence, credible only because someone you trust is telling you about it. If you’re interested in losing weight, and a close friend tells you that eating 30 almonds per day has been shown to make you lose weight, you’ll likely try it.

Further complicating things, the media tends to present all research as if it’s conclusive. People in media are evaluated based on the number of readers or viewers that their content attracts, because ad revenue comes from quantity. This means there’s constant pressure to make articles feel urgent so that more people want to click on them. I’ve done something similar in the title of this blog post, telling you these myths make us feel worse in an attempt to get people reading it. Nobody wants to feel bad; whether or not an article actually provides something that can help people feel better, the promise that it will do so generates a lot of interest. Look below: which of these two articles is going to get more readers?

Number 2 is more enticing because it offers a clean takeaway; Number 1 is more specific and speculative

The point isn’t to suggest that the media is evil; rather, it’s about understanding an author’s motivation and being more cautious when health news is promoted as conclusive information rather than as an impressive new step toward some unknown destination. Some media outlets are more responsible than others about the way they present health news, and even an article that seems like clickbait can deliver on the promise in its title.

But you can also help yourself. Let’s say you see a headline claiming coffee is bad for your mental health. Listening to that healthy skepticism in your gut, you look for the link to the actual study. There you see that the study never says coffee is bad for your mental health. Instead, it points to a more specific finding that might indicate some negative effects of coffee on the mental health of one subset of the population. (For the record, this isn’t a real study. And if it is, I don’t want to see it. I’m drinking coffee right now.)

Always try to read just a bit of the study that an article is based on. Most people don’t have time to read a bunch of scientific studies, but you only have to read a few paragraphs. The abstract and conclusion are usually quick reads, and will help you understand what really happened in the study. Almost every study will conclude with some thoughts about all the additional research that’s needed on its topic. This is the kind of humility that we all should bring to discussions of health, given how little we actually know.

As if health information weren’t already convoluted enough, mental health also has to deal with stigma and with the (related) fact that people have only been even trying to understand mental health for a few decades. People are afraid of what they don’t understand, and mental illness appears unknowable because we as a society have invested so little in trying to understand it better. Even more than the way media overstates new findings, our culture of fear creates mental health miscommunication. So you’ll have to be the first step for many people around you. Tell them all the things you know, but remember that all of our so-called knowledge could be flipped on its head at any moment.

That’s all for now. What other mental health myths do you want to dispel? Tell us on social media!

We are @treatmyocd on Twitter, Facebook, and Instagram.

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The Inflexible Mind: Three Ways To Get Freedom Back

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“I know but one freedom and that is the freedom of the mind.” — Antoine de Saint-Exupéry

One of the cruelest things about obsessive-compulsive disorder is the way your need to control things actually ends up controlling you. If we take a step back, this makes sense: there are way too many things in our lives that exist entirely outside of our control. Life isn’t a problem you can solve, but OCD will make you try. So you end up trying to climb a mountain that’s always shifting under you. You wear yourself out, without even getting to a good spot to take photos.

Without getting into any of the philosophical questions or parsing through every exception, we know there are some things we do have control over. You generally can’t control your thoughts; but you typically can control your behavior. And, while none of these strategies will cure you of OCD, a few small shifts in your behavior can snowball into lots of other meaningful changes. These can impact your mood, your thoughts, your habits, and so on.

The part to remember is that there is never one single right way to get better. You can try a million things with no progress, then make one more change and feel a lot better quickly. And so, as you might predict, the important thing is to keep trying different things all the time. Because life is constantly shifting, you’ll have to get good at shifting with it too.

For all the talk about strength in mental health– how strong someone is for coping with bipolar disorder or dealing with PTSD each day– we ought to be talking about flexibility just as much. OCD makes mental flexibility seem like a distant possibility, but you still have it in you. So let’s look at a few ways you can try to find it again.

1. Find a creative pursuit that you like, and pursue it

Although Bob Ross never said anything about having OCD, he did talk about painting as an alternative to all the angry tendencies he developed during his military career. His television series The Joy of Painting has been helpful to many people struggling in all sorts of different ways. There’s an effortlessness to his method, even if the results aren’t your favorite.

But the point wasn’t really to talk about Bob Ross– just to use painting as one example of a creative pursuit that might help you explore the world in a different way. First, creative work allows you to expand your thinking beyond the very narrow boundaries that OCD places around it. It also allows you to enjoy a limited degree of control over something while still facing risks like messing up or never being as good as someone else. Lastly, it gives you something to focus on and keep getting better at. Building a sense of mastery at something contributes positively to mood and overall wellbeing.

So whether it’s writing, art, music, dance, or something else, find a creative outlet you can dedicate some time and energy to. This way you can start to develop mental flexibility again. In case you’re wondering: no, you don’t have to be good at the thing you’re doing. You just have to be doing it.

2. Expose yourself to the absurdity, even the comedy, of your obsessions

Although most of your obsessions probably seem like the furthest thing from funny, they can usually be taken to a place where you’ll see that there’s a certain humor to them. That’s because they end up seeming a little bit ridiculous once we take them outside their usual patterns. Let’s think up a few examples:

Usual obsession 1: “I could probably be happier in another relationship. I might be wasting my time in the wrong relationship. I might be stuck in this forever. I’ll probably never be happy.”

Attempt at comedy 1: “I’m definitely in the wrong relationship. Everybody can see it. In fact, earlier when we were out to dinner everyone was thinking it. The waiter was so shocked by how bad our relationship is that he went home and told his girlfriend, who is much better than mine in every way. Even that dog we saw on our way out of the restaurant could tell that we’re in the worst relationship– that explains why it barked at me.”

Usual obsession 2: “I’m probably a pedophile. I’ve just been fooling everyone thus far. I’m definitely a pedophile deep down, and everyone knows it.”

Attempt at comedy 2: “I’m probably a pedophile. In fact I’m definitely a pedophile. I shouldn’t be allowed near a single kid the rest of my life. I should start telling everyone I know that they need to keep their children away from me. I might as well tell my family I’m going to be all over the news soon when I do something horrible, because I’m definitely going to, sooner or later.”

These don’t exactly make for side-splitting comedy, but there is something funny about them. The inability to accept uncertainty comes from the assumption that the worst case will always come true unless we’re making sure it doesn’t. But if you consciously follow through on your obsessions by taking them to ridiculous extremes, you start to see the holes in this way of thinking. Using techniques like this one to gently undermine the stuff your anxiety is telling you can help you start to open up some space between you and your obsessions.

You can do this in your mind, write it down, or record it on your phone. It’s similar to an exposure, and in certain cases can be an exposure. You might find that, for certain obsessions, things become more intensely dark than funny. That’s okay, too, as long as you’re moving toward your thoughts and “doing something with them” other than turning to compulsions. If you follow up on them and end up laughing at their absurdity, that’s great; if you chase them to their extreme and end up more anxious, that’s a good basis for exposure.

3. Get really interested in things

You know that annoying thing when someone talks about how looking up at the night sky puts things in perspective because it reminds them how small all of our problems are? It never made all that much sense to me, because you still have to find a way to deal with all the same problems, even if Jupiter is out there looking great. It’s not like you can choose to just worry about space instead, simply because it’s much vaster and more timeless.

But at the same time, there is something to be said for tapping into the ridiculous amount of incredible things about the world and learning as much as you can. I don’t think it’s about finding out how small our problems are, but rather about filling our minds with stuff that’s much more dynamic than the extremely narrow content of our obsessions and compulsions. And in doing so we might gently bring a bit of perspective to the obsessions.

The OCD symptoms will make it feel like there are only a few things that really matter. Find what you matters a lot to you and prove them wrong.

This is only the start of many posts on practical, non-theoretical, easy-to-use strategies. The most important part is getting out there and experiencing things, because only by breaking free of the obsessive-compulsive routine will you start to get that mental flexibility back again.

Please let us know in the comments how these are working, and what other strategies you’ve found helpful!

If you’re looking for a great way to treat OCD, take a look at the free nOCD app. It features treatment strategies from ERP, CBT, and ACT– the most clinically supported forms of therapy for this condition. It’s available now for iOS and coming soon to Android. Tell your friends, show your family, use it yourself, ask your clinician about it! And let us know at if you have any questions.

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A Pretty Spectacular View: Keeping OCD in Perspective

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A guest blog post by Cara Rothenberg


Today we’re lucky to share this story from Cara Rothenberg, who writes film scripts, articles, personal essays, and just about everything else. She has a unique ability to write things about her own experience with obsessive-compulsive disorder that are viscerally relatable for anyone with OCD. Her stories blend honest accounts of how difficult things can become with a hopeful insistence that they can get always get better. Now I’ll let Cara introduce herself:

“I’m a 27-year-old pizza enthusiast navigating the world with OCD and trying to laugh as much as possible along the way. I’ve found that the only thing harder than talking about my mental health is not talking about it. We don’t have to hide. Not anymore.”

OCD might be part of you– but it’s not who you are

By Cara Rothenberg

Labels are inescapable. Every single one of us uses them, whether we mean to or not. It starts off simple enough: Mom. Dad. Boyfriend. Girlfriend. Best friend. Good. Bad. Right. Wrong. But the labels get more nuanced as we get older. I’ve been in situations where I’m catching up with friends or family and someone’s name will come up, and to remind each other who this person is we’ll say something like, “You know, that guy who lost his mom in a car accident?” or “Remember? The girl who went to rehab in high school?” Why do we do this? Is it simply because labeling people makes it easier to distinguish one person from another?

It makes you doubt everything you know, everyone you love, and everything you are. But it also tries to reduce you to a label– and never a positive one.

Or is it a lot more twisted than that? Do we do it because, deep down in the depths of our souls that we’re too afraid to explore, we point out the darker side of someone else’s life so that we can deflect attention from our own demons? We reduce people to the worst part of their lives when our biggest fear is the same thing being done to us. None of us want to be defined by the most “troubling” thing about us. Maybe it’s an addiction, a past mistake, a family tragedy, a bad relationship, a mental health disorder. Our traumas and mistakes and afflictions are certainly part of us, and denying their existence is dishonest and unhealthy. But I simply have to believe we’re all more than that.

OCD is known as the “doubting disease.” It makes you doubt everything you know, everyone you love, and everything you are. But it also tries to reduce you to a label– and never a positive one. You just thought about cheating on your spouse: you are a philanderer. You just wondered if you’d ever be able to harm someone: you’re a violent psychopath. OCD tries to place you into a category based on events that, more often than not, never even happened. Even if they did happen, OCD dramatizes and exaggerates them so much that you barely have a hold on what’s true and what isn’t. Your own mind becomes unreliable, and that’s really scary.

Reason and logic don’t work with this disorder.

I’ve done this my whole life. Oh, the places OCD has taken me! I’ve been a sociopath, a cheater, a liar, a deviant, a bad friend, a disappointing daughter, a terrible sister, an all-around awful person. These thoughts pierce your heart and your brain until you succumb to the idea that maybe it’s all true. If you don’t have the proper help and support, it’s very easy to fade away into those concocted labels. I almost did. Not once, but approximately 3,652 times. Here’s an example of one of those times:

Last year I wrote an article where I basically “came out” as having OCD. It was featured on a pretty well-known website, and the obsessive and neurotic side of me was absolutely sure I’d receive backlash from it. Why was I so certain? Well, as my therapist would say, “It’s not you who was certain. It was your OCD.” Reason and logic don’t work with this disorder. But really, it made no sense how unbelievably anxious I was that this article would break the internet. It was actually a little (a lot) narcissistic. I’m not even remotely well-known. I have virtually no internet presence (unless you count my tweets to Survivor host Jeff Probst, which went unanswered– still a tough pill to swallow).

I wasn’t saying anything slanderous or scandalous. But even still, my OCD manufactured this “gut feeling” that there’d be some kind of fallout. Not from the people closest to me — most of them knew about my OCD and were unbelievably supportive. It was everyone else. I waited for the whispers from my past to surface: old classmates, colleagues, teachers, coaches, general acquaintances. I waited for the nasty comments from complete strangers declaring either that OCD is made up or that I should stop complaining because some people have “real problems.” Worst of all, I’d get slapped with the label of “crazy.”

(As my mom always says, “No one is thinking about you as much as you think they are.” I could devote another ten paragraphs to how OCD warps your sense of reality and people’s perception of you…but I’ll save that for a rainy day. You probably hate me now for getting so off track. You hate me, don’t you? I knew it. Shit. I did it again. I digress).

The day of reckoning never came. In fact, the response was overwhelmingly positive. People I hadn’t spoken to in years, as well as complete strangers, reached out to me, thanking me for writing it. I was blown away by how many people could relate to the article. That’s when I realized that the only person, at least in that moment, who was labeling me…was me. I was preemptively and internally labeling myself as “the crazy, attention-seeking OCD chick” because I wanted to beat people to the punch. I wanted to inflict the pain before they could.

Writing that article was one of the most cathartic experiences of my life, and I almost didn’t do it because of how fearful I was of the labels that might come my way. It was so humbling to see how decent and understanding people could be. I really wish I could say that was the last time I ever let OCD define me, but it wasn’t. It wasn’t because OCD isn’t curable and it will always be there. But you know that dark, twisted part of us I mentioned earlier?

Well, I think that next to that tiny dungeon in our souls covered in cobwebs and dead bugs and other sinister accoutrement is a really good part filled with light and goodness and — dare I say, hope. We all have that part of us too. That’s where we store our love for other people and ourselves. It’s where we keep the parts of us that make us good and kind and complicated and flawed and beautiful and a whole list of other adjectives that make up who we are as people. Nothing, not even OCD, can touch that. So I say we try as hard as we possibly can to visit that part of ourselves more. It’s a pretty spectacular view.

Cara is @caranotkaren on Instagram, and also has a cool website. Both mention pizza at least once.

Thanks very much to Cara for bravely taking on OCD every day and sharing this part of her story with us. This blog is better when I’m not the only person (or even the main person) writing on it. So, if you’d also be willing to share your story with us, please fill out a quick form. We’ve received a bunch recently, so it might take a few weeks for us to get back to you. But rest assured– we read all of them and we’ll be in touch soon.

Lastly, if you’re looking for a great way to treat OCD, take a look at the free nOCD app. It features treatment strategies from ERP, CBT, and ACT– the most clinically supported forms of therapy for this condition. It’s available now for iOS and coming soon to Android. Tell your friends, show your family, use it yourself, ask your clinician about it! And let us know at if you have any questions.

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Getting Support From Those Who Really Understand

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As we at nOCD have explained in a few of our recent posts, we’re always interested in getting more voices on our blog. So today we’re very excited to share an original blog post from one of mental health’s most active and engaging voices, Chrissie Hodges.

Chrissie is dedicated, full of energy, and well-versed in the latest and greatest OCD treatment techniques; we’re lucky to count her as a key part of the OCD community. She’s an advocate, speaker, author, blogger, vlogger, and licensed Peer Support Specialist.

And now, without further ado, here’s Chrissie telling us about peer support and the value of having experienced people alongside you during your journey to recover from obsessive-compulsive disorder and other mental health disorders.

The Power of Peer Support in OCD Recovery

By Chrissie Hodges


Peer support is a term heard more often in the last few years in relation to supplemental support for mental health recovery. It is a form of support where someone who lives with a mental illness and understands the complexity of recovery can help provide hope and motivation for those in crucial stages of recovery. Peer support specialists are trained professionals certified through their state or working toward certification in the state where they reside and practice.

My journey to becoming a peer support began when I saw a real need for OCD sufferers to know they are not alone in their symptoms or the grief of mental illness. I quickly found out that helping others with their recovery actually became a positive turning point in my own recovery. I had achieved symptom management with OCD, but the emotional turmoil was still plaguing me. I struggled with questions of Why me? and What did I do to deserve this? I lived with the sadness, the anger, and the stigma of being someone who lived with mental illness, and trying to find my place in a society that didn’t look fondly on that label.

Mental illness is traumatic in so many stages of its development and existence in the lives of those who suffer. And I believe many of us underestimate the impact trauma has on us in relation to our journey of mental illness. Each time we experience trauma, our physical brain can change, our worldview can change, and the ways we relate to the world can change.

This trauma is prevalent in onset of symptoms, prolonged suffering, diagnosis, and even treatment. Even after successful treatment of OCD, the trauma can linger, and the stigma and fear of expressing those emotions are often kept silent. Therapy is available to help people work through trauma, stress, and even emotional regulation. But what I found in my recovery, and while helping others in theirs, is that a crucial element of recovery is getting support from those who really understand what it is like to walk in the shoes of OCD. There is power in the words “me too.”

In the depths of emotional turmoil during my own recovery, I believed I was the only person floating in that abyss of judgment, rejection, and isolation with the weight of stigma surrounding my mental illness. It wasn’t until I began working with a peer support who helped empower me to give myself permission to feel these emotions. I didn’t know how to feel okay about being angry. I didn’t know how to embrace that I was a victim of my illness. I feared that the other side of that negative emotion would be the loss of myself. I assumed I needed to just be grateful I got treatment and deal with it.

Little did I know, I would have been heading down a path of loss and separation from myself. My peers reminded me that I was actually just like everyone else on this journey to recovery, that I wasn’t alone, and that it was necessary to grieve. It validated me. It made me feel important. It gave my emotions value. It made me feel like the things I had been through really mattered. My peers made me feel like my story mattered, like it had a place of importance in my life and maybe the lives of others.

When I began working as a peer support, I found that walking alongside people and supporting them in the midst of their traumatic emotions and came natural to me. I had been there before, so I could easily understand and empathize. I wanted clients to know that if I had been able to get through it, they could too. I don’t answer the questions of Why? or What does it all mean? I don’t give advice. I don’t provide reassurance. I don’t tell them that it will be easy. I am just a presence with them that has walked the same difficult path to recovery, and just being there helps them feel less alone and hopeful. My job is to hold hope for my clients when they can’t hold it for themselves.

There was a time in my life when I hated the illness of OCD and everything it had brought into my life. I saw it as the ultimate stain on a life that could have been great. But, in the last four years of working as a peer support specialist, I can truly say the suffering and torture I endured from the illness feels rectified by the people I am lucky enough to support in my everyday work. I get to offer them what I believed would have been so beneficial in the darkest of my days. And the most beautiful part of being a peer support is that it is symbiotic. I learn as much from my clients about myself and my recovery as they do from my experience and support.

Peer support is a valuable, supplementary resource in helping those living with OCD to move toward recovery. It helps individuals to sustain hope and to know they are not alone. It helps restore value, importance, and a sense of normalcy to an individual’s experience in the midst of suffering and turmoil. Peer support will hopefully continue to grow and to be implemented in every person’s therapeutic plan in the future.

If you are interested in becoming a Peer Support Specialist, please check with your state credentialing body for license and certifications for more information. If your state does not have a certification in place, other states may accept out-of-state trainees upon inquiry.

If you are interested in receiving peer support on your journey to recovery, please visit my website or email me for more information about my services and rates.

Thanks to Chrissie for taking time out of her busy schedule to write this great blog post. If you’d like to submit your own blog post, or an idea of what we should write about, please fill out this quick form. We’d love to hear from people with OCD, their friends, their family members, clinicians, researchers, and anyone else. Check out the form! Do it now! (Please.)

Lastly, if you’d like to learn about the nOCD app, another great way to get the support we all need along the way to recovery from OCD, check out our very cool website!

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Getting Unstuck: How to Help a Child with OCD

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Why parenting a child with OCD feels counterintuitive-When exposures are more harmful than helpful — On the benefit of getting professionals involved — A personal story from the producer of a documentary about kids with OCD

Other than inquiries about the status of our Android app, questions from concerned parents about how to help their children with obsessive-compulsive disorder might be most common in our inbox. So this will be the first in a series of posts highlighting strategies for helping kids with OCD and real perspectives from parents at various stages in this journey.

Today, after some preliminary thoughts, we’ll hear from Chris Baier, producer of UNSTUCK: An OCD Kids Movie, a unique and impactful documentary film that we recently reviewed. Chris is based in New York, where he seems to be always involved in a bunch of creative projects. He’s a copywriter, film producer, and mobile app creator. Find out more about Chris here.

Many parents of children with obsessive-compulsive disorder (OCD) feel stuck. Watching your kids suffer is horrible, so you want to help. But many of the more intuitive strategies for alleviating your child’s suffering– reassuring them, giving them what they want, trying to take away their pain– end up making their OCD symptoms worse.

It can be really difficult to understand– and even more difficult to tolerate– the need to let your child endure pain in service of their long-term wellbeing. Because of the way OCD works, they will never get better if the whole family shapes itself around the child’s anxieties and allows them to rule. Getting better will usually look more like getting worse at first, because learning to tolerate the extreme unpleasantness of OCD is not easy.

There’s always a lot of nuance to someone’s distress, and no single strategy should be applied to every situation. It’s essential that you learn to recognize when your child is suffering in the service of getting better and when they’re just suffering. For example, when we talk about exposure and response prevention (ERP), any exposure that’s done without response prevention will cause unnecessary pain– and will probably launch the family into one of those moments of utter turmoil (you know the ones). Consider an example:

Let’s say a parent reads about exposure online and says to their child, “You’ve been extremely afraid of the school cafeteria because you might get sick there. We can’t live like this anymore. You are going to the cafeteria today and that’s it.” The child, seeing no other option, goes to the cafeteria and becomes extremely anxious. This is an exposure, but it’s not going to do them any good if they just start doing compulsions when they get there. They’re going to be suffering unnecessarily, because there was no plan in place for how the child was going to expose themselves to their anxiety and prevent any compulsive responses that would make habituation to their anxiety (the goal of ERP) impossible. Add to that the fact that they might get bullied for their compulsions by other kids and you’ve got a recipe for even worse situations.

To avoid this sort of misunderstanding it’s best to get professional help whenever possible. Although you’ll naturally want to be the main person helping your kid get better, this can be a setup for disaster because treatment strategies like ERP feel instinctively wrong to a caring parent. It’s also easy to let your frustration boil over when things aren’t getting better– and OCD treatment includes a whole lot of steps back along with the leaps forward.

The ideal scenario is one in which you’re learning along with your child, because the whole family needs to be involved in the treatment process. Once a professional has taken the time to explain the condition and their treatment rationale, you’ll be more prepared to help your child learn how to manage their own symptoms. As a parent, you will be a huge part of their recovery process; but getting a clinician involved will help ensure this journey isn’t marred by frustration, misunderstandings, and misplaced blame.

Now, for a perspective from a real life parent, we’ll hear from Chris Baier. For Chris, obsessive-compulsive disorder isn’t just another topic. He’s the father of Vanessa, who has OCD and starred in UNSTUCK, the documentary film he produced. Many of the insights that fill the documentary clearly arrived through the trial-and-error process of learning how to help Vanessa. He has been kind enough to share some thoughts on that process with us today.

The Baier family, stars of the documentary film UNSTUCK: An OCD Kids Movie

A Lesson Learned Parenting a Child with OCD

by Chris Baer

When my daughter, Vanessa, started to have strange and odd fears a few years ago, the first thing my wife and I did was try to get help. After she was diagnosed with obsessive-compulsive disorder (OCD), our initial response was to search for a cure. We thought we had the power to fix her.

In this way, we did a lot of things wrong. We accommodated. We participated in OCD rituals. We gave in.

We initially approached OCD like it was a virus and told her to “Get plenty of rest” or “Try to relax.” We thought that distracting her — turning on the TV, letting her sleep in our bed — would help. But treating a mental disorder like a physical one did not work.

What really happened was that we allowed OCD to take control of our lives. OCD didn’t stop there– it started to monopolize our entire family. But as we started to read about OCD, understand symptoms and therapy, and learn about how effective OCD treatment works, we shifted our approach.

We thought that distracting her would help. But treating a mental disorder like a physical one did not work.

We pulled back from accommodating. We made Exposure and Response Prevention (ERP) the most important activity we did with Vanessa every day. More important than homework, playdates, or after-school activities. We treated OCD as an unwelcomed invader.

Slowly we realized that we couldn’t fix or cure anything. We had to give up control because beating OCD was something Vanessa had to do herself. (Yeah, not an easy thing for a parent to accept.) Turns out, our role in all of this was not to be the miracle workers. We were better suited to be her cheerleaders, advocates, teachers and, sometimes, disciplinarians.

This is a role we still play today.

Vanessa is more aware of how OCD affects her and has better tools to fight it. But if a worry floods her mind, we know our role is to help her focus, make a hierarchy of her fears, and encourage her to do exposures so she stays strong.

Turns out, our role in all of this was not to be the miracle workers. We were better suited to be her cheerleaders, advocates, teachers and, sometimes, disciplinarians.

I do not care that it wasn’t a cure. I’m content knowing that I am one of the reasons she was, and is, able to fight.

If you’re feeling generous enough to submit your own story, or to suggest a topic for us to write about, please fill out a quick form. And if you’d like to learn about the free nOCD app, which helps you use ERP and other techniques, we invite you to check out our website.

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Big News at nOCD: Whats the big news?

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Today is a great day! When the new year began we set ourselves the important goal of keeping the nOCD community updated on major events. So now I bring you some very exciting news.

I’m honored to announce that nOCD has just completed a $1 million fundraising round with 7wire Ventures, a premier venture capital firm in Chicago that strategically invests in promising new healthcare technology initiatives. With this new financing and strategic direction, nOCD will have an opportunity to provide more effective treatment to people struggling with obsessive-compulsive disorder (OCD) all around the world. It will help us every day as we continue our work of helping people take charge of their symptoms, regain mental freedom, and say no to OCD.

If you aren’t familiar with OCD, it’s a debilitating psychiatric condition that affects around 1 in 40 adults and 1 in 200 children. Unlike the way it’s constantly stereotyped, OCD is not synonymous with being too neat or uptight. It’s a mental illness that causes people to have specific, torturous thoughts called obsessions that repeat nonstop in their heads. To alleviate the extreme anxiety caused by their obsessions, people with OCD often perform specific actions, or compulsions, which give them short-term relief but exacerbate the anxiety over time. Clinical evidence suggests that people can drastically reduce the negative impact OCD has on their lives by confronting those situations that trigger their obsessions while preventing themselves from turning to compulsions. So, naturally, you might ask, “Why don’t more people with OCD do that?”

The answer: retraining oneself to tolerate distress without resorting to compulsions usually requires extensive treatment. But the OCD treatment system today is broken. It takes the average person 14–17 years to get effective treatment for OCD, and most specialists operate completely out of network, charging $200-$400 per visit. Because effective treatment is so inaccessible, comorbidity abounds: for example, 27% of people with OCD develop a substance use disorder, and 33% end up with major depressive disorder.

Our personal experiences dealing with this condition brought the nOCD team together, and continue to help us relate to the people using our treatment platform. We’re unique in that we combine this first-hand knowledge of OCD with real experience in software development, digital marketing, and data science. Given the urgency we feel to make effective treatment more accessible, and the fact that we have the skills to make it happen, we believe the future of OCD treatment must incorporate always-on treatment resources, giving people the freedom to live more and worry less.

This type of model can also exemplify a new age of mental healthcare, since its always-on, low-cost, and community-centered. That’s why we’re even more motivated to scale nOCD, because we know our hard work will lead to real change for millions of people with OCD and other conditions.

Most importantly, your support has been crucial in helping us build nOCD, and we’d like to wholeheartedly thank you. A little bit of positivity goes a long way, so on behalf of the nOCD team I hope you can celebrate with us during this exciting time.

Thank you,


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How to Tell a Therapist Your Scariest Thoughts

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Have you ever thought about doing one of these?

running car off the road
insulting strangers
hurting strangers
fatally pushing a friend
jumping in front of train/car
causing a public scene
stabbing a family member
choking a family member
getting a fatal disease from strangers
giving a fatal disease to strangers
exposing oneself to strangers

These come from a well-known inventory of the intrusive thoughts faced by 293 “normal” students. Just about everyone deals with some of these thoughts. Most people either don’t really notice the thoughts or don’t spend much time worrying about them. They’re just part of the passing strangeness of everyday life in a confusing world.

But for people with obsessive-compulsive disorder (OCD), some of these thoughts will stick, launching an agonizing cycle of questioning oneself and trying desperately to get rid of the unpleasant feelings that result. OCD isn’t about the content of your thoughts, because everyone has strange and unpleasant thoughts. It’s about the amount of distress you feel in response to those thoughts, and the ways you try to get rid of (or avoid) that distress. People with OCD tend to have a few types of thoughts that they feel completely unable to ignore. And those thoughts can start to dominate their life.

(A brief pause to note that not everyone with OCD deals with this same experience of having certain thoughts and trying to convince themselves things are alright. Studies suggest a majority do, but there are other types of OCD that don’t involve these exact symptoms. More on these in future posts, but telling your therapist about symptoms might be tough even if they’re not linked to specific thoughts so most of this should still apply.)

At this point you might be thinking: Yeah, but my thoughts are much worse than the ones you listed. The examples above are just a few of the thoughts from one study, and research studies probably don’t dive into the strangest or most disturbing thoughts we can experience. (Another pause: When I say strange or weird throughout this article, I’m trying to capture the experience of having those thoughts, not saying people who have them are strange or weird.) We tend to avoid talking about it, but your brain will throw just about anything at you– and it’s often at the worst times, like when you’re with family, at a funeral, in a meeting, around kids, and so on.

Nobody is quite sure what causes it, but something about OCD makes it much harder for people to accept the uncertainty at the core of these thoughts:

Would I really do something like that?
Am I the type of person who might do that?
What’s wrong with me?
How can I make sure I don’t do that?

All four of these questions are troubling, but it’s the last one in particular that drives people to compulsive behavior. Making sure of something means getting rid of any uncertainty, and if we think about it for a minute we’ll realize this is an impossible task. Let’s look at what Dr. Jonathan Grayson, a leading expert on OCD, has to say about this in his helpful book Freedom from Obsessive-Compulsive Disorder:

For some of you, the failure of logic and the resulting vicious circle of endless questioning and anxiety have left you feeling that you are no longer able to discern whether or not something is safe: that not washing your hands really may harm your family, that you did run someone over on the way to the office, or that you don’t know whether or not the door you are staring at is locked. You know what you are feeling, but you don’t understand why… It is hard to separate how you feel from what you know, when you don’t have the language to communicate what is happening inside. (12)

When OCD flares up, it’s really hard to trust anything. You can’t trust yourself, other people, or even the world itself. So you end up in the impossible position of holding everything together, because who else will make sure it doesn’t fall apart? you think about it, nobody is ever completely sure that they won’t do any of the things that pop into their mind. How do you know that you won’t spontaneously “lose it” and hurt someone you care about? How can you be sure you won’t contract a fatal disease from someone you meet? Nobody gets to have total certainty, but most people are able to tolerate this lack because telling themselves “I’m pretty sure it won’t happen” is good enough. So how does someone with OCD start to learn how to accept uncertainty as an inevitable part of our lives that can be tolerated, and even appreciated?

One of the best places to start is in therapy. As Dr. Grayson explains, just having the language to tell someone what you’re going through can open up a life-changing separation between you and the “vicious circle of endless questioning” that you’ve found yourself in.

But, of course, this involves telling your therapist about the thoughts that have been bothering you. So many people get stuck on this because they’re afraid their therapist will be disgusted by them. Because this is such an important first step if you’ve chosen to try therapy, here are a few things to keep in mind:

1. Your therapist isn’t a friend or family member at least they shouldn’t be. All the hangups you understandably have about disclosing your most frightening or disturbing thoughts to someone in your personal life don’t need to apply here. It helps to remember that your therapist is a professional whose job is to help you as best they can. Your therapist will know better than to judge you for your thoughts, but the goal is not for them to like you or see you in a certain light anyways. Whatever is bothering you, tell your therapist. That’s the whole point of working with them.

It might also help you to know that your therapist can’t tell anyone what you tell them, unless they think you’re going to harm yourself or someone else. A trained clinician will be able to tell the difference between thoughts and intentions, so you needn’t worry that they’re going to tell anyone else or report you to the police. Not that you’ve done anything wrong by thinking.

2. This isn’t the first time your therapist has heard it may seem like you’re a uniquely horrible person for having thoughts like I could hurt these kids I’m babysitting, but as your therapist will likely explain to you, they’re pretty normal. And not just for people with OCD, as we saw above. The difference is that people with OCD might latch onto these strange thoughts and start asking themselves unanswerable questions about them. Don’t quit your babysitting job. Tell your therapist about your thoughts, because they’ve heard much “stranger” and “more alarming” things before. (There are quotation marks because they probably won’t think you’re strange or see any reason to become alarmed.)

3. It’s the only way to start getting proper treatment your therapist doesn’t know about, they can’t help you with. Unless you go rogue and start treating yourself, you’re not going to be doing exposures to one of your obsessions unless you work your therapist to come up with them. Lots of people are afraid that acknowledging their thoughts will make something bad happen, or will mean that things will never be the same once they start along the whole path to treatment. These are understandable concerns, and they might be good things to mention to your therapist. Know that having extra violent or “messed up” thoughts doesn’t mean your OCD is more severe, so try not to avoid your most alarming thoughts simply because it feels like admitting them means you’re a worse person or a more difficult case for your therapist.

Not to be too repetitive, but remember that the difference between someone with OCD and someone without OCD is not the thoughts you experience but the way they respond to them. So tell your therapist about your thoughts and the way you’ve been responding to them, and you’ll be on your way to becoming less burdened by OCD.

4. Your therapist can help you see your thoughts differently you look back at Dr. Grayson’s quotation from above– don’t worry, I forgot it too– he talks about the importance of having “the language to communicate what is happening inside.” The clinical approach your therapist takes will help you reframe what’s been happening to you. You might arrive at your first therapy session telling yourself that you’re a horrible person, bound to eventually act out the horrible things that pop into your head.

Your therapist will listen, and then they’ll tell you about things like thought-action fusion, a fancy psychological term for the belief that thinking about something is basically the same as doing it, or that thinking about it means a specific behavior will inevitably follow. This isn’t an especially adaptive belief, because it tends to make people take their thoughts far too seriously.

Let’s say you’re cruising along on the highway and you suddenly think I could just drive off the road into that barrier. When thought and behavior are fused it feels like you’ve already done something as bad as driving into the barrier: even considering it. Or it can feel like you’re bound to actually drive into the barrier now that you’ve thought about it. Maybe you can hold out for now, but eventually it will really happen, right?

In this scenario, your therapist might help you learn to react differently whenever the thoughts appear. You might tell yourself “Wow, there goes that thought again. It’s really bothering me.” This is using language to distance yourself from the bothersome experience. And the more you do that, the more natural it will become over time.

We’ll have more on all these topics soon, but in the meantime please leave some tips for your fellow readers in the comments. Thanks for reading!

Today’s post was suggested by one of our readers– thanks to our anonymous friend for the great idea. If you want to submit an idea, or even a completed blog post of your own, we’d love to hear from you.

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The Latest at nOCD: Android Update

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Because I know how it feels to have OCD, it tears me apart every time I have to tell someone that the Android version isn’t ready. So today I’d like to apologize for all the vague explanations we’ve been giving, and tell you why the Android version has been delayed. Then I want to tell you about our plans to release nOCD for Android in 2018.

In the past few years, management of our iOS app has fully occupied our part-time development team and pushed back any plans we had made for Android. We knew we would need full-time developers, so we focused on growing our business to make this financially possible. But the most important thing we have at nOCD is our community, and we should have been more transparent with you throughout this process.

In 2018, we’re committed to offering you nOCD on Android. We started the new year by hiring two full-time engineers who will be working to build a great experience for you. We’re working hard to learn from any issues our iOS users have faced so that the Android app will be the best nOCD experience we’ve ever offered. And we’re building a great community every day by creating the best resources for OCD awareness and treatment.

As you probably know, half of our team has obsessive-compulsive disorder. We know how difficult it is to cope with frightening thoughts all the time, and we’ve all endured the isolation of having nobody understand what you’re going through. To make sure we’re not leaving anybody stranded, we plan to give you more regular updates on our progress.

Your enthusiasm about nOCD motivates us every day, and your willingness to trust us on your path to recovery from OCD means more to us than anything else. Thank you for your continued support as we enter another productive year with lots of exciting plans. Please continue to check back for more nOCD news updates on those plans, from the Android app and innovative new resources on our website to exciting collaborations with people doing the latest OCD research. We’ll all need to work together to come up with better solutions to mental health issues, and we look forward to sharing the next part of that journey with you.

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