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OCD with absent insight or delusions

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OCD with absent insight or delusions

Postby peripatetic » Sat Jan 02, 2021 3:13 am

my diagnosis got updated to the title. I have a hard time with believing my obsessions and need to carry out my compulsions. I have a lot of harm OCD intrusive thoughts, suicidality as a result of believing without carrying out compulsions (which often involve suicide attempts/planning/rehearsing), and I have a lot of trouble believing I'm a good person with these violent thoughts on repeat.

I was discharged from the hospital on the 21st. I'm not reading anything good about prognosis with absent insight.

does anyone else have this particular absent of insight/presence of delusions? I would like to connect with others who have this particular presentation of OCD.

if it helps clarify, my highest ybocs score was 38, I routinely score high. my babs was pretty bad, indicating a high degree of delusion. my modified GAF is abysmal. I just really want to not be alone with this tricky diagnosis.
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Re: OCD with absent insight or delusions

Postby Snaga » Sat Jan 02, 2021 4:01 am

Hello, and welcome to the forums!

I... hadn't heard of that diagnosis before, and had to look it up. I take it, that that means, that you do not recognise your obsessions or compulsions as irrational, yes? Yet... here you are. So surely, on some level, you understand that they are, yes? I... had a lot of work anxiety (until work decided to relieve everyone there of work anxiety, by closing us down, using the Wuhan Coronavirus as a poor excuse)- oh.... some level.... I understand that my need to drive a certain route to work, listening to certain music, and repeating certain mantras, did not, could not, rationally affect my fortunes during a shift (having a good day, bad day, or abysmal day- usually, a bad day was the best I'd have). But... it's... it sure didn't feel irrational- it felt necessary.

There is... a very fine line, between OCD and delusion, that's for sure.

I also (I feel very ignorant, at this point) hadn't heard of the YBOCS. Going on how I was, while I was working... I would have been about 24, at my worst. That felt pretty distressing, I... would rather not try to imagine what a score of 38 must do, to you- outside of work, I'd probably score rather less.

But now, do you care to talk about these intrusive harm thoughts? I have had harm OCD for oh probably about 45 years, maybe a little longer. Over the years it has waxed and waned, in intensity. I've never had therapy for it, but finally I reasoned that if I were going to do something terrible to people or pets (my harm thoughts are the usual run-of-the-mill themes), I'd have done it.

When I was a child, I didn't know what OCD was, and I pretty much thought I was getting demons. I mean, why else would someone get violent thoughts telling them they're going to do, or want to do, this, or that?? Until again, finally I was like, you know, I ain't never done those things... it was... very hard, at first, to make myself not worry about having the thoughts- it's no good trying to not think them- ofc you're going to think them!

**trigger warning**



But you can learn to just not care. "You're going to kill your partner" No, I'm not... "You're going to" No.... tell you what, OCD- I'll worry about doing it, when I've done it. "You won't be able to control yourself, you'll black out, you'll do it in your sleep, you'll dissociate, you'll-"

Stop right there! Maybe I didn't make myself clear- I. Don't. CARE. At all. I'll worry about it, when I come to, standing over a dead body- until then, piss off, because I'm not going to do that, anyway- you can't make me.

And... OCD pisses off- for a while.

It's super-dee-duper hard to get started doing that- because your brain is screaming at you to care. It's a conscious decision, and is.. nothing magical, it just takes whacking away at it, over and over, until it starts to take hold. Once I got over the hard part, the beginning- I have much fewer episodes of intrusive harm thoughts- and when I do, I have a much easier time of blowing them off, shrugging them off. I remind myself, nothing is going to make me do, what I have determined shall not happen. Coupled with, making myself not care, that the thoughts are there.

I can't evict my harm-OCD, but I sure can starve it out, and make it weak. I view harm OCD as, well, a demon, of sorts- it has squatter's rights, in my brain. I can't get rid of it, entirely- but I can leave it hungry and weak and half-starved. I just have to out-stubborn it- and the more I can do that, the less fear I feed it, and the weaker it gets.

It's what works, for mine. YMMV, but it's been a lot of help, to me.

One thing, that helped a lot, is I've read that everyone gets harm thoughts. Everyone- just that Normies must shrug it off, or something. I find that... incredibly hard, to wrap my head around. How can someone get a harm thought, and just take it in stride! A person has to be a monster, to think such thoughts! Well, apparently not- apparently, it's just being human. I... can't understand that, but I remind myself of that, and it helps, greatly. Everyone thinks harm thoughts. Therefore, I can handle this.
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Re: OCD with absent insight or delusions

Postby peripatetic » Sun Jan 03, 2021 9:50 pm

insight fluctuates, so when I've been in hospital it's due to a lack of it. I always come out better than I went in, though, so having been recently discharged my insight is rated as poor currently. or was when I was discharged.

I'm getting the sense that this isn't a common presentation of ocd. which is fine; it's just lonely.
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Re: OCD with absent insight or delusions

Postby Snaga » Mon Jan 04, 2021 2:44 am

I can see why it would feel that way.

I think a lot of us get almost to where you've been, but not quite. I've read that sometimes OCD does waltz over the line, into delusion, but you're the first person I've spoken to, that's been Dx'd with it. The wisdom I'd always heard, was that pwOCD never not know on some level, their thinking is irrational; but the last four or five years, I'd been reading otherwise.

I know, that for myself, I have gotten really close. I mean, really close. But not for long periods of time- and I think, that if pressed, I would admit it was 'in my head', but.... yeah... it's like I feel as if I've walked up to where you've been without quite taking that last step, into it.

So far- I'm old; but I'm not dead yet. Given I have family histories of diagnosed mental illness, on both sides of my family (in extended family, not immediate), including schizophrenia, I sometimes feel mildly surprised, I'm not more disordered, than I am.

So give me time and save a seat for me- I might join you...

I can't say for sure, but I think my OCD might be something like PANS, or PANDAS- I had a mystery infection, as a young child, and it seems sometime around then I begin to have memories of anxieties, unwanted ideas (although my real fight with intrusive thoughts didn't begin until I was ten or eleven), and well, paranoia.
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Tell someone you love them today, for Life is short. But scream it at them in Klingon, for Life is also terrifying and confusing.

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