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Compulsive Behaviors (Expert Forum)
repetitive thoughts and odd habits
Answered by
Ted A Grossbart, Ph.D. - http://grossbart.com
Harvard Medical School
Questions in the Compulsive Behaviors forum are answered by Ted A Grossbart, Ph.D. from Harvard Medical School.
repetitive thoughts and odd habits
by heyhey36, Nov 08, 2009 08:57PM
Info: 36 y/o F, Anxiety nos with dysthymia (diagnosed several years ago).
Between 9 and 11 years of age, I started to have repetitive thoughts. My family life was very turbulant at the time. I don't really know what to call it. Always thinking about the worst possible thing that could happen but replaying it over and over. Fantasizing ? I have tried counseling (several years) and medication several times which helped for some of the anxiety. I am now on lexapro. I started having anxiety attacks again several months ago; I was also having some OCD having to check and recheck 4 or more times before completing certain job functions. I also, embarrasing as it is to admit, did some skin picking on my pets. The last therapist I went to see told me these thoughts, present even on medication, are very hard to stop since I have had them so long. He tried to get me to see a psychiatrist so I could get a break. I also have at "i hate myself" mantra that I repeat often. I have some other ideations, that I won't get into the nature of here, my mind replays over and over. I do understand the nature of and unwanted side effects of some of the meds that could possibly help the unwanted ideations but I would rather know some CBT that would be helpful.
I guess my question is 1. Are there any online sites that would guide me through or teach me the CBT to help this problem? Or is this one of those things I should just learn to live with or is impossible to break?
Thank you for your time.
Between 9 and 11 years of age, I started to have repetitive thoughts. My family life was very turbulant at the time. I don't really know what to call it. Always thinking about the worst possible thing that could happen but replaying it over and over. Fantasizing ? I have tried counseling (several years) and medication several times which helped for some of the anxiety. I am now on lexapro. I started having anxiety attacks again several months ago; I was also having some OCD having to check and recheck 4 or more times before completing certain job functions. I also, embarrasing as it is to admit, did some skin picking on my pets. The last therapist I went to see told me these thoughts, present even on medication, are very hard to stop since I have had them so long. He tried to get me to see a psychiatrist so I could get a break. I also have at "i hate myself" mantra that I repeat often. I have some other ideations, that I won't get into the nature of here, my mind replays over and over. I do understand the nature of and unwanted side effects of some of the meds that could possibly help the unwanted ideations but I would rather know some CBT that would be helpful.
I guess my question is 1. Are there any online sites that would guide me through or teach me the CBT to help this problem? Or is this one of those things I should just learn to live with or is impossible to break?
Thank you for your time.
Doctor's Answer
by Ted A Grossbart, Ph.D., Nov 09, 2009 05:35AM
, Nov 09, 2009 05:35AM
I am very glad you wrote in. I think the "just learn to live with it" approach is definitely NOT the way to go. While these symptoms are sticky and persistent, they are definitely treatable. Given how much they are taking away from the quality of your daily life, you should definitely fight back.
Meds are a useful tool but take real patience to get the right one and the right dosage. Everyone is different both in terms of therapeutic effects and side effects, so you have to be willing to keep experimenting.
It sounds like you have done some therapy with some benefit but have much more to be gained on that front. There is a lot of CBT material on the web and in book form (I don't have a specific site to suggest) that can be useful. For the skin picking, check out my Skin Deep site at grossbart.com for an overview of what works.
Given the severity and long standing nature of your problem, I strongly urge you to work with a live therapist, unless that is totally impossible financially or geographically. Most areas have low fee treatment available if needed. If you are far from mental health facilities try phone work. I have been doing more and more of this with people around the world.
CBT approaches are great for the OCD symptoms and an important part of treatment for picking. Ideally you could find a therapist who is comfortable with both these approaches and who could help you deal with the historical and self-esteem issues.
A three sided approach of the meds, symptom-focused CBT, and psychotherapy that goes after the emotional damage, would be ideal. If you are willing to really stick with these you can substantially change the quality of the rest of your life.
Does this make sense to you? What resources are available in your area? Are you ready to get going on this? Let me know.
tg
Meds are a useful tool but take real patience to get the right one and the right dosage. Everyone is different both in terms of therapeutic effects and side effects, so you have to be willing to keep experimenting.
It sounds like you have done some therapy with some benefit but have much more to be gained on that front. There is a lot of CBT material on the web and in book form (I don't have a specific site to suggest) that can be useful. For the skin picking, check out my Skin Deep site at grossbart.com for an overview of what works.
Given the severity and long standing nature of your problem, I strongly urge you to work with a live therapist, unless that is totally impossible financially or geographically. Most areas have low fee treatment available if needed. If you are far from mental health facilities try phone work. I have been doing more and more of this with people around the world.
CBT approaches are great for the OCD symptoms and an important part of treatment for picking. Ideally you could find a therapist who is comfortable with both these approaches and who could help you deal with the historical and self-esteem issues.
A three sided approach of the meds, symptom-focused CBT, and psychotherapy that goes after the emotional damage, would be ideal. If you are willing to really stick with these you can substantially change the quality of the rest of your life.
Does this make sense to you? What resources are available in your area? Are you ready to get going on this? Let me know.
tg
Post Comment
After starting the lexapro, in the past few months, the skin picking is much better, plus my little dog died :(. Most of the outward stuff that others would notice has improved drastically. I have really come a long way from where I was. It is the unseen stuff that is really bothering me.
As far as therapy, I really hate to start over with someone else. My therapist moved last year. I hadn't seen him in awhile because he had moved into a busy office with other providers, to many possible people to see me there. Now he lives hours away.
Meds; I have tried many different types of meds mostly SSRI's (paxil, lexapro,prozac, made matters much worse) SNRI's (Effexor, Cymbalta, (didn't take it long enough) the price was too high) sleep meds I have tried; rozarem, vistaril, ambien, trazadone, and valium. Currently taking restoril prn.
The meds I haven't tried are the ones that cause EPS and tardive dyskinesia.
I work in the psychiatric field in a somewhat rural area. The communities around here are close knit. These thoughts aren't something I share freely. I have an online counselor I have spoken with, yet more ocd. FB has been my latest OCD thing.
This anxiety seems to cycle somewhat. I will manage without meds for awhile, then the anxiety reoccurs with a vengeance. Either I start having anxiety attacks again or what I call mood swings (therapist said it was anxiety as well).
The therapy does makes sense but not here in this area because of the above. I don't have insurance that would cover therapy. This is the reason I was looking for some on line resources. I should be more hopeful than I am that one day I won't have this bagage to carry around. Everyone has something right? I would love to get going on this BUT . . . .
thanks
hey
It sounds like there are old demons bubbling up from below and that the meds and other techniques can keep them at bay for a while. For a more definitive fix think about what it would take on the financial/insurance side and the geography/anonymity side to be in a position to be in therapy long enough to confront them.
I wonder if it would be possible to do some phone work with your old therapist. Some therapists are comfortable with that others not. I've been impressed how effective it can be. Even if it wasn't frequent because of financial issues, given your history together a bit could go a long way.
Is this a possibility?
tg
hey
I'm very sorry for all your difficulties and for the loss of your dog.
You mention the anxiety seeming to cycle. Could this be related to your menstrual cycle? It was just a thought.
The doctor on the mental health and emotional eating expert forums has recently launched a new self-help program. I don't think it is cbt but you may like to have a look at that and see if it could be helpful. The website is myvirtualshrink.com.
He has mentioned free sessions and that could give you an opportunity to look around.
Good luck with everything.