Surprising Strategies for Managing Intrusive Thoughts
Hormones can impact intrusive thoughts. Find out more about the unique challenges for women, especially moms. I'll explain the influence of hormones on OCD symptoms and backing it up with research on how hormonal fluctuations effect your mental health.
You'll hear about Inference Based Cognitive Behavioral Therapy (ICBT) as a complementary approach to traditional Exposure Response Prevention (ERP) therapy. It's so cool how ICBT can help you reframe intrusive thoughts to break the OCD cycle!
If you're ready to take the next step, sign up for my intensive outpatient program for moms by going to my website at valuedriventherapy.com > Work With Me > ERP Intensives for OCD.
00:29 Exploring Harm OCD and Self-Trust
01:42 Episode Overview and Trigger Warning
04:19 OCD and Hormonal Influences
07:22 Postpartum OCD: A Hidden Struggle
11:15 Therapeutic Approaches: ERP and ICBT
11:31 Harm OCD vs. Suicide OCD
15:02 Practical Examples and Techniques
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We're partnering with NoCD to raise awareness about OCD. OCD is more than what you see on TV and in the movies. Imagine having unwanted thoughts about your relationship stuck in your head all day, no matter how hard you try to make them go away. That's Relationship OCD. It comes with unrelenting, intrusive images, thoughts, and urges about your partner or loved one.
Breaking the OCD cycle takes effective treatment. Go to nocd. com To get evidence based treatment in the idea of the harm OCD. In this model, it's saying, possibly you're afraid of being someone who hurts other people. Someone who's a serial killer or a murderer or a dangerous person. Someone who can't control themselves, right?
And then what you begin to do in this theory is you learn to trust yourself again. How wonderful is that? Right? And you start to uncover and reveal and lean into your real self.
Hi, I'm Erin, licensed clinical mental health counselor and OCD specialist. I'm also a wife, mom to three and small business owner, helping those who are spiraling from intrusive thoughts. To come out of that valley with long-term recovery and self-awareness. Reheat your coffee and pop in your AirPods to learn how to boss up to OCD.
Hey, hey, welcome back to another episode of Bossing Up, overcoming OCD. In today's episode, we're gonna be tackling the topic of harm OCD and suicide OCD all in one. So get ready for that. As most of today's focus is going to be about moms. Slash women, because there are some unique things that we're going to be talking about today when it comes to women who are struggling with OCD.
Now, if you feel overly triggered by some of this content, I encourage you to proceed with caution. You are more than welcome to go back to a previous episode. I suggest go back to episode 35 where I recorded a video guest episode with Sanyana, who is the co founder of Thryser. So in the episode, you can learn about how to maximize your out of network benefits when you're seeking.
Mental health care, whether that is through therapy or getting medication with a psychiatrist or nurse practitioner. So, go check out episode 35 if this particular episode is going to feel too overwhelming. And on another note, I'd like to give a shout out to a listener who commented on one of my YouTube videos that's out on my channel called Erin Davis Counseling Services.
So if you want to watch all The podcast and the video recording of the podcast, you can go to Erin Davis, counseling services on YouTube and find those videos there. And so this user commented on the video that was about tornadoes. And the listener wrote, I had five apps downloaded, got stuck also watching other states and found I was feeling the same level, constant NWS outlook checks in Louisiana.
We don't have basements, but I'm looking into the new steel residential centers to help even checking on days I knew were sunny or just rain. I've just started my journey. If you watch this, you are not alone. And so I really appreciate that listener. Sharing their struggles with the audience and then giving those words of encouragement that you're not alone.
That's exactly the type of community that I want to build and am building. So if you want to join up in this community, you can also join my email newsletter. By going to my website at value driven therapy. com and at the bottom of any of the pages, you'll find a spot where you can put in your name and your email address.
And I promise to only send you content that is worth the read. So we've been talking about the harm and OCD factors for the past two episodes. And I want to continue that conversation today because these summer slash fall months, those are the highest birth months for the United States. So we're talking like August, September, that timeframe.
And when you count back nine months, yeah, that's about like Christmas, New Year's time. There's not much to do except Stay in and party. No, I'm kidding, but you get the idea. So there's a lot of babies being born right now and. When you're struggling with OCD, it can feel even more guilt ridden or shameful when you are experiencing intrusive thoughts around the things you love most.
And, you know, as a mom, what more do you love than your own child? And if you're not a mother, there are some research studies out there showing a connection between an increase in your OCD symptoms when you're about to start your period. In one of the studies in the National Library of Medicine, it was showing results that 49 percent of patients with OCD noticed an exacerbated situation with their OCD symptoms right before they're about to start their period.
And so you're thinking about, like, basically that week before your period. You may experience more anxiety, mood swings. If you're a lady, you've been there. Or if you are a lady and you haven't experienced any problems with your period, God bless you. But what they're finding with the research is that the hormone levels, particularly estrogen, has a lot to do with the spike in the OCD symptoms.
So as the estrogen levels rise, so do the OCD symptoms. Causation? Correlation? I don't know, but I'm just sharing the facts that I'm finding, and it's very interesting. Other studies that I'm also reading about in the Anxiety and Depression Association of America, the ADAA. org, It's also saying that women with OCD are likely to have abnormal hormone levels.
So that kind of makes you go, huh. So if you're a lady with OCD, it may be a possibility that your hormone levels are playing a role in triggering or worsening. your OCD situation. And you know, it feels like there's not a lot of shame or any kind of guilt or prejudice or bias, at least from where I'm sitting, whenever we're talking about postpartum depression.
Like, that seems almost mainstream. Like, when you go to the doctor for your checkup, like, they are really screening for the depression. And it doesn't seem all that uncommon for ladies to experience postpartum depression. But what about those ladies who have postpartum OCD? I know it may seem like, what's the difference?
But let's put it into perspective that as an OCD sufferer, you are experiencing intrusive thoughts about the things you love most because that's what OCD loves to do, right? It loves to attack the things you love and value. And so the complicated part is you're not going to be as forthcoming about these intrusive thoughts with your doctor.
You want to know why? Well, because it's frightening, feels embarrassing, feels shameful, and it feels like your doctor may call Child Protective Services on you. So in my previous episodes, when I'm talking about Child Protective Services or, you know, any other First responder or intervention when it comes to safety.
If you're struggling with OCD, you and I are going to talk through those safety checks. We're going to talk through your intentions and your values and your goals and just all the things so that we can have a clear understanding of your experiences. Because, unfortunately, some therapists do call Child Protective Services on their patients.
And how many times have you sat across the table, or you're having family dinner, and people are making jokes, or just silly things, and it's like, Oh my gosh, you better not say that in public, right? I remember a kid who, uh, said that his crib was his cage, right? And it's so funny because the crib, you know, it does have the bars, right?
So as a, young child who is learning to talk and they say, my daddy puts me in a cage. Like you don't want to say that too loud at a Walmart or when you're at Target. Like that is so hilarious that that kid would say that. So you might have a good laugh about that at your family dinner table, but I imagine you're not going to bring that up to your family doctor of like, Oh, I put my kid in a cage or my kid says I put him in a cage.
Like that doesn't come up. No, because you want your doctor and probably the other medical professionals in your life, for the most part, you want them to see you as responsible. And with your, if you are struggling with OCD, like even though I'm talking about harm and the suicide aspects of it today, you know, the OCD just has no limits, no bounds.
So you may feel overwhelmed. Ultra responsible, or you feel like this need for perfection to be the perfect mother. You're not going to make a peep about any thoughts of harming your child. And imagine how isolating that is too, which, I mean, if you're in it, you already know. It's not like you can go to your book club ladies and your book club or your tennis friends and be like, Hey, uh, have you ever thought about blank?
And you can fill in whatever blank you're, you want to put in there. When it comes to harming your child, since this is something that can feel ultra sensitive, private, confidential, that's why I have created my intensive outpatient program for moms, where you can get that one on one individual therapy where we're meeting for nine hours a week for three weeks to help you in coming out of that valley and enjoying the view.
And so you may. be struggling with these thoughts about harming yourself or harming your child and it can really limit your Relationship and your ability to show up for your kid so some of the ways that I'm tackling these symptoms with moms is I'm incorporating exposure response prevention and Another technique called inference based cognitive behavioral therapy more on that in a bit Okay, so let's get into the differences between harm OCD and suicide OCD.
And to kick that off, we know again that OCD comes with intrusive thoughts. Intrusive thoughts are the unwanted involuntary thoughts, images, or urges that subtly enter your brain. Maybe it's like a movie scene, or it's a voice. Whatever your experience is with the intrusive thoughts, normally, it causes a significant amount of distress.
Now, it's also common that these thoughts are disturbing, or you may even find yourself in a Doing a compulsion in double checking how distressing are these thoughts? Am I upset by these thoughts? Or is this something that I actually want to do? So it causes you to question your values or your behaviors or your self control, right?
Because OCD is a con artist like that. We're partnering with KnowCD to raise awareness about OCD. OCD is more than what you see on TV and in the movies. OCD. Imagine having unwanted thoughts about your relationship stuck in your head all day, no matter how hard you try to make them go away. That's Relationship OCD.
It comes with unrelenting, intrusive images, thoughts, and urges about your partner or loved one. If you think you may be struggling with Relationship OCD, there's hope. KnowCD offers effective, affordable, and convenient OCD therapy. NoCD therapists are trained in exposure response prevention therapy, the gold standard treatment for OCD.
With NoCD, you can do virtual live face to face video sessions with one of their licensed specialty trained therapists. It's affordable and they accept most major insurance plans. Breaking the relationship OCD cycle takes effective treatment. To get started with NoCD, go to nocd. com slash savage. Alright, so with harm OCD, those intrusive thoughts typically involve causing harm to other people.
Suicide OCD often involves bringing harm to yourself or ending your own life. The focus of these fears are also different because again, it's about the them versus you. Now, the content behind these sessions, you may have worked with an OCD specialist before who has said, don't give attention to the content.
What does that mean? That means don't entertain the story. Like if you were in a Buffalo Wild Wings, you know that there's a lot of TVs playing, a lot of sports going on. But if you're there to eat with your family and focus on, you know, filling up for lunch, then you're going to turn your attention away from the TVs and just focus on your family.
So when we say don't focus on the content, that's basically what we mean. You're turning your attention away. And this can be like a mindfulness approach where you notice that your attention is focused. is getting caught up in the content and you're going to shift back into the here and now. This also comes up in the inference based cognitive behavioral therapy, which again, I'll get into, and I'll give you a really great example of how harm OCD shows up for a mom and how it can be treated through that technique.
of the inference based cognitive behavioral therapy, or let's just start calling it ICBT for short. HARM OCD obsessions, those include violent thoughts and images towards your loved ones or maybe even strangers. Suicide obsessions are violent thoughts and images of self harm or ending your life, even if you have no desire to die.
Then moving into how the person experiences these thoughts. If you are having harm obsessions, you may feel triggered into guilt or feeling like you're a quote unquote bad person. Then the suicide OCD, that can be frightening as well because you don't want to die. And so some of those triggers for these subtypes and these themes, it can look like, so for harm OCD, you may avoid.
Movies about violence or stories about violence, or you may completely avoid being around people because you are so worried that if you go out in public, you may quote unquote lose control and hurt others. Then the triggers with suicide OCD that could be like, you know, coming up on September being suicide awareness month.
Like maybe it feels very alarming and triggering to. Even hear the word suicide, or you may not even say the word suicide. Like maybe that's your S word. You know what I'm saying? Like, we all have those words where it's like, Oh, you don't say that. And so for you, your S word is suicide because you're like, that is not coming out of my mouth because it gets you anxious.
You may avoid conversations about the topic. You may avoid people who have had relatives who've ended their life in suicide. Suicide affects so many people. Many people and if you are struggling with suicide We do have the national hotline where you can call nine eight eight and get twenty four seven support.
So I love that What I will say, too, about the folks who are struggling with harm OCD and suicide OCD, more often than not, they are the ones admitting themselves to the hospital to get help. And I've worked with plenty of patients who have done that because they reach a place in their OCD where they have an intense episode where they feel like they're actually going to act on these thoughts.
And here we again, they think they're going to, but they have no intentions, no plans, nor desire, but they just think that they're going to do it because it feels so real. And that's what I love about the ICBT approach because it does take into consideration how you feel with these thoughts. So with these themes, some of the compulsive behaviors that happen and the ways that you're trying to help yourself feel better is that maybe you are avoiding sharp objects.
Maybe you're avoiding certain people like I've talked about. And then if we're in the suicide OCD realm, maybe we're avoiding heights or tall places. Maybe we're avoiding medications or anything associated with pain. self harm. So if you're a mom with either of these themes, like, you know, you have to cut up fruits and veggies for your kids because they are not developmentally old enough to do these things.
And so that can make it ultra challenging. And I have worked with people y'all who totally fall in this boat of They won't use knives and so it creates this complication within the family of like, well, how are we going to cut up our fruit? And it's like, well, you just kind of keep smashing it until it breaks apart.
But what's so cool is like through treatment, you get to that place of cutting up a pineapple with an extra large and sharp knife and you don't. feel worried in the least bit that you're gonna stab any of your loved ones with it. Another compulsive behavior is like maybe you're avoiding driving or being on bridges because like in the driving scenario, and this may fall under like some of the responsibility OCD So I'm not trying to go too far off topic, um, you know, with like the hit and run or the responsibility OCD in today's episode, but I think, you know, in general, if you have that fear of hitting somebody with your car or driving your car off a bridge or driving your car into the guardrails or to a, uh, Or into a building, you know, something like that.
You may avoid driving, you may avoid going on bridges and all the things. So, you've heard me talk a lot about exposure response prevention, which I do use and I do love that technique. What I would love to share with you in today's episode is more about this other intervention called inference based cognitive behavioral therapy.
So in ICBT, what is fascinating is that it really goes into the story of why, how, and where your intrusive thoughts come from. And how those intrusive thoughts are actually a part of your imagination, well, because it's not actually happening and it's not what you're wanting to do. And so it pulls you into what they call the OCD bubble.
And so once you recognize that you're in that OCD bubble, you will cross the bridge back into the here and now using your mindfulness techniques and assess for the evidence for your doubt. And ICBT comes with 12 modules or 12 chapters. And so you can do one module per session. And what it focuses on is how the intrusive thoughts are a representation of your feared self, because this is who you fear becoming.
Like in the idea of the harmociti. In this model, it's saying, possibly you're afraid of being someone who hurts other people. Someone who's a serial killer or a murderer or a dangerous person. Someone who can't control themselves, right? And then what you begin to do in this theory is you learn to trust yourself again.
How wonderful is that? Right. And you start to uncover and reveal and lean into your real self because the trickery And the con artist of OCD, it wants you to fall into the traps of the feared self, and that's where people stay stuck. And so what you begin to learn in this model is that these fears are a product of your OCD and is not a reflection of who you truly are.
So let me close this out with an example of a mom who is struggling with Harm OCD and she's on a cruise ship, right? Wouldn't that be lovely? Like, I'm sure the kids are back in school right now, so it feels like the end of summer, but maybe some of y'all did take a cruise over the summer. I love to go on cruises, but you know, OCD never takes a vacation.
Let's imagine you're on a cruise ship and you're holding your toddler on the ship. The intrusive thought pops in, what if my baby falls overboard? Then it could even shift into, like, if you're in that hormone CD bubble, it could shift into, what if I throw my baby overboard? So in that moment, imagine how your anxiety can go from zero to 100 super fast.
So in this model, we're slowing it down. So instead of going from zero to 100, we're going all the way back to say 10. We're going to look at that obsessional. Doubt, because with doubt, I mean, most of us, we experienced doubts from time to time in just about anything, right? And so with doubt, we normally feel resolved whenever we have the answer.
Like once we get the information, we're good. But with obsessional doubt, that means. We have all the information, but we still don't believe it. Sound familiar? Yeah, probably so if you're struggling with OCD. Because you've got all the information, but you still don't believe it. So, we're going to look at your reasoning sequence, and how this doubt grows hijacks your mind.
Then the other thing, this obsessional doubt about throwing your baby overboard, if this is what you're struggling with, we're going to say, it's not random. And you're like, wait, what? It's not. What, then what do you mean? Well, what I'm saying is you are experiencing this doubt because of some sort of evidence that you've come across in your life.
This intrusive thought is not coming out of the blue, but it's coming from some sort of. Reasoning or evidence or logic behind the doubt. So that logic or those reasons behind your doubt could be based on facts. It could be based on Rules, it could be based on things you've experienced or stories you've heard or just the mere fact that it's possible.
So just in general, I think we can all agree that we have to be cautious with kids on a cruise ship because accidents do happen. And then in module three, we talk about the story. Stories can feel very captivating because they involve all of our senses, sight, touch, sound, smell, and taste. And if you've ever been in a movie theater, you can feel very caught up in the movie and in what's happening.
When you re examine these intrusive stories and slow them down, you may notice how your senses are getting activated and playing into the obsessional story. And in any case, we know that stories are powerful and they can change how we feel. So that's the critical part right there, y'all. If we can change the story, we can change how we feel, right?
So, for example, if you Are holding your toddler on the cruise ship and you've got this story of what if I throw my baby overboard? What if you were to change that story of what if I take my baby to the kiddie pool, right? Much different Sensation and experience you're getting when you lean in to that story Because a lot of times the stories we tell ourselves are Feel very convincing.
And that makes our doubts and worries feel more real. So in those stories, we are experiencing a reflection of our feared self, right? Which I've already mentioned, we're afraid of becoming. A dangerous person, a violent person, but all in all, those stories are built up in your imagination. And it's in your imagination because there is not any direct evidence in the here and now that your baby has gone overboard or that you're going to throw them overboard.
That story started and was generated from your mind from within. Okay. And so with that imagination, we're recognizing that you're in that OCD bubble, or as some of my other clients call it, I allow them the opportunity to kind of name their own OCD bubble. We've called it worry land. And one of my clients, I love it.
They called it a daymare. I'm like, that is, Epic. So when you notice that you're in that daymare, you can pause because you can recognize that you're between your two worlds, reality and imagination. And so you can pull yourself back into reality. And recognize that you're going to trust yourself and choose reality.
You're not having to double check anything because you are in reality. Again, you can start to form a different story about this moment. Maybe it's also a thing of wouldn't this be a beautiful photo right now? You know, holding my baby on the cruise ship. With the water in the background. Because you have held your baby a million times before and never have you ever thrown them?
So why would you throw them now? But yeah, so it's really nice to start to really tease apart the reasoning sequence and then start to identify a new story, a story where you're in reality. So you can start to slow down the intrusive thoughts and examine where they're coming from, what the story is behind it and the tricks that OCD is trying to play on you.
So if you want to practice this, you can Like look at any situation happening in the here and now and I'll encourage you to try to come up with like two or three different stories and see where that leads you because the power of the mind is incredible And OCD loves to take things out of context. It loves to make you doubt, but that's not what you're going to listen to anymore.
You are going to listen to the facts and the evidence of your real self, your authentic self that you know to be true. And if you're ready to step into your real self, I encourage you to go to my website at value driven therapy. com and click on my intensive outpatient program for OCD. Fill out the interest form so that we can have a kickoff call and make sure that this program is going to be a good fit for you.
And I'm only seeing one person at a time. In the program. So what's lovely about this program is you don't have to do group work. It's solely individual work and I want you to have that privacy and confidentiality and success. So that you can be seen, you can be heard and you can get the results that you're looking for and the results that you deserve.
All right. All in all, we talked about a lot today. We talked about how hormones can impact your OCD symptoms. And we know hormones have a play in the menstrual cycles as well as pregnancy and postpartum life. And so you are not alone in those struggles. And we also talked about the differences in harm OCD and suicide OCD.
As well as the main concepts behind the ICBT model. So you've heard me talk a lot about exposure response prevention, but I'm now incorporating the ICBT techniques. So if you're located in North Carolina or Virginia, go to my website at valuedriventherapy. com and click on the tab that says intensive outpatient program for OCD and fill out the interest form to get started on your mental health wellness journey.
Today, we're partnering with NoCD to raise awareness about OCD. OCD is more than what you see on TV and in the movies. Imagine having unwanted thoughts about your relationship stuck in your head all day, no matter how hard you try to make them go away. That's Relationship OCD. It comes with unrelenting, intrusive images, thoughts, and feelings.
And urges about your partner or loved one, breaking the OCD cycle takes effective treatment. Go to n ocd.com to get evidence-based treatment. Alright, and come back next week as I bring on a special guest who is hosting a podcast award show. She has a very special gift for the listeners and I'm so happy to bring her story.
And her free gift to you guys. So come back next week to hear her advice and what led her into starting a podcast and building a community and the free gift that she doesn't normally share, but she's willing to share with y'all. So have a great weekend and I'll see you back here next time. Thank you for listening to another episode of bossing up.
Overcoming OCD. This information is intended to be helpful and not a substitute for professional counseling. If you're struggling with any mental health challenges, I encourage you to seek help from a qualified therapist or healthcare professional. If you enjoyed today's episode, please take a moment to rate and review the show.
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