Have Pure O OCD dealing with harm and suicide

afraidofdiseases-

You need to expose yourself. Bargaining or reasoning with OCD isn't going to do any good as it's rooted in irrationality; if for example you had the thought that you were genuienly a chicken and not human being you wouldn't try and rationalise that as it's clearly ludicrous, yet no more ludicrous and unfounded really than the thoughts you're having currently. I would try to put yourself frequently in situations where you're uncomfortable - for example walking on a sidewalk next to a traffic heavy and fast moving road to confront your worries of jumping in front of traffic. I wouldn't try and tackle your thoughts as all that does is give them an over inflated amount of importance in your mind, just recognise them for what they are but don't ascribe any specific thought to them that you think might "deal" with them. In time exposure will minimise your worries by itself - it does just take a lot of time unfortunately.

Hello, thanks for replying, both of you

@never_give_up: Yes, I'm also feeling a certain "uniqueness" in my diagnosis. Mostly because I don't feel the intense anxiety that many of you are describing. Perhaps it's because I take beta blockers (which has an incredible effect on me regarding panic and physical anxiety symptoms). When I'm troubled by the thoughts, the following happens:

- A sudden heat sensation in the body
- Sweating
- Some weird skin aching sensation
- Cold hands and feet, mostly feet.

And - what I don't like - a certain feeling of sadness and discomfort (I truly don't want to harm myself)

My problem now is not so much the thoughts - I feel like I can handle that part fairly well. I've called the bluff enough times now to somehow understand that this is just "brain spam". An example; yesterday I had an image in my head that when I got out of bed and to the kitchen to make breakfast, I would cut myself instead of cutting the bread. What happened was; I got out of bed, went down to the kitchen, pulled out the knife, cut two slices of bread and put the knife back into the drawer. The same as the previous 1000 times I've had scary images in my head.

What I'm afraid of is what will happen if I feel really down. And I truly do NOT want to harm myself. Except this, I have no problems. Also, my brain seem to have locked itself on the idea that something bad will happen. That makes my future outlooks and optimism somewhat poor. I just want to look forward to the future! I wish I could have a guarantee - I will get at least 80 years old!!

@MagicSteve: My therapist is practicing "metacognitive therapy" and she is against exposure therapy, as this will provide an unnecessary focus on something I should get my focus away from. Personally I feel that metacognitive therapy is somewhat abstract and difficult to handle, no way I'm able to "accept" those horrible thoughts. I tried some exposure therapy yesterday, spending 15 minutes on my balcony (and no way ever did I consider to jump down). I actually felt somewhat better when I went in.. kind of happy to be alive and less afraid.

What exactly is metacognitive therapy? I've never heard of it before so I'm curious to know how it works.

I know what you mean about physical sensations as opposed to intense anxiety. At first when I started dealing with my OCD I was intensely anxious but then it kind over time the feelings of anxiety seem to lessen. Although this sounds like a good thing I do not mean it as such, as in my OCD was still bothering me but I just felt kind of numb to it. When I felt this numbness I often felt physical sensations in my body which I interpreted as I was going to act in a violent way (tingling sensations in my arms when I had an intrusive thought about harming someone, shakiness, etc.). On reflection I think over time you become to have less overt feelings of anxiety as your brain becomes aclimatised to it, so it takes a really big intrusive thought or concern to get you going again. I do also think it's a sign of progress too.

I feel like telling people to "accept" their intrusive thoughts or worries is a poor choice of a word, as it is in all the literature concerning OCD they all say these thoughts should be "accepted". Accept has positive connotations, and so to anyone hearing that they should accept their horrible thoughts their hackles are immediately raised. What is important is to realise the thoughts don't require any special response (avoidance, doing a compulsion as a physical or mental ritual) and they won't prompt you to acquiescence (thinking a thing doesn't mean that you're going to do it, so say you have a thought about doing the shopping later but you get tied up - the fact that you have thought about doing the shopping didn't make it happen; perhaps a poor analogy but still).

I think you should bear in mind too that there is a big difference between suicidal ideation and OCD thoughts about suicide and self-harm. In retrospect about my own OCD I realised that my own thoughts were short, sharp and tailored to prompt a reaction from me (the particular one that bothered me was breaking someone close to me's neck) and yet now I can see there was no fantasy element to this - I neither had a positive reaction to the thought nor did it have enough detail like something I'm looking forward to would do (as in I would have a lot more complex a thought about going to the cinema than I would do an intrusive thought). With suicidal ideation though it's often something their not happy about it is something they feel like doing, and so they would put more thought into it than just "I'll randomly jump off a balcony". Of course this realisation will probably only sink in after you've dealt with your OCD; I know if I was told something like this I would have immediately thought well what if my thoughts are slightly more detailed than I gave them credit for and are in fact fantasies? etc.

I feel like acting counter to your thoughts (using a knife when you've had a thought or image about hurting yourself with it) is definitely a good thing and you should keep doing it. I do it all the time still (as I still have the thoughts, I just don't have an ounce of the anxiety or worries I used to about them, they are also far less frequent) as I know as soon as I don't it's validating that these thoughts are something to get bothered about, which is just not the case.

As a final point, Winston Churchill very similar OCD thoughts to you (kept well back from trains when they were coming into the platform, never slept in hotel rooms with balconies). Most books would mention this to be slightly demeaning and say "Well he was a world leader and he thought like this, so for someone like you things should be especially fine!" but I'm just sharing it mainly because it's interesting.

Thank you so much for replying again

Regarding metacognitive therapy, it's fairly hard to explain, but I can try to illustrate with an example, someone with fear of flying:

Cognitive approach: Chance of crashing is less than 1 to 5 million, chance of dying while driving to the airport is far higher, flying is the safest way to travel.

Metacognitive approach: Do you think you can avoid crashing by being afraid? Are your thoughts appropriate and necessary? Do you think they will help you? The point is to observe the thoughts but stay detached from them.

In my case, observe the thoughts and let them fade away. My problem is, I often tend to suppress the thoughts, which is neither helpful or inspiring, because when you do, you also suppress reasonable thoughts and you will get emotionally "numb".

My problem is also the constant doubting and "what ifs". Could it be that I'm really suicidal? Is there a little part of my brain that wants me to die? I spend much time convincing myself that I truly want to live (which I assume I wouldn't do if I didn't want to live). Also, I'm afraid of normal negative thoughts, as I fear they will "push me over the edge". I just visited my therapist today, the session started great, she did a depression test (to convince me that I'm not depressed) and the result was no depression. However, the doubt returned "did I lie during the test just to convince myself that I'm not depressed"? "Did I just feel better when I was there"?

By the way, did you use any antidepressants? If so, how long time did it take for them to have effect?

Just to add something I find interesting:

I believe much of this has something to do with an existensial anxiety. To use a classic example; if you are standing on a high cliff, you will feel anxious about the possibility to fall down, but you will also have an anxiety about "what is preventing me to jump down"? The answer is "nothing" which I assume is the root in this anxiety and the cause of all the "what-ifs". We are afraid of the "nothing", and we build up "something" by all the mental rituals.

I guess when we get sensitized to "pure-O" (whatever we fear), we discover this awareness. Yes, you could in fact grab a knife and kill your family or burn down your/their house, or swear in the church, or jump from a balcony.

Maybe we should try to build up "something" by increasing life quality?

It sounds like metacognitive therapy is just one of the regular parts of cognitive therapy - to realise that your thoughts are inconsequential by probing them intellectually - but by focussing on those types of logical questions you're no more highlighting and enlarging your fears than you would be using exposure therapy; at least to me. Also I knew my thoughts were grounded in irrationality, trying to deal with them using rational questioning was to me always pointless because my thoughts never would bow to sound reasoning.

It's probably one of those cases where different styles of therapy are better suited to different people - the trouble is anyone with OCD will always think their current therapy isn't working for them because we're all pretty pessimistic so it is one of those things that is hard to objectively judge by yourself. If you're surpressing your thoughts, then it seems like your brain is working against the therapy (not something you consciously want, but just a result of the fact OCD is slippery) - I'd say exposure would now be better as that would bring the thoughts to the fore of your mind and allow for more confrontation. However in time I'd imagine you'll doubtlessly find away to focus on your thoughts mentally too, so it's up to you. Personally I always tried to do what would make me feel "worse" (more at odds with the safety seeking behaviour), whether that was mental or physical.

I think "what ifs" are what typifies any form of OCD, say when someone who is worried about contamination will think "What if that spilled drink causes people to contract dysentery and die"; however I think you're correct in that Pure-O does focus on existential anxiety which is why Pure-O types don't normally have overt complusions. From how you phrased your response, it sounds like you think that by building better life quality it will assume the role of mental rituals in protecting you against harming yourself as you would feel like you now have "more to live for"? I put this in quotes not to be demeaning but to highlight that having more to live for is intimately linked with your own perception, even if you do have more to live for by whatever arbitrary standard you chose to make (wealth, friendships, love, status) you won't feel like this is the case whilst under the sway of OCD. Also surplanting mental rituals with a better quality of life doesn't hold under scrutiny as it implies that OCD is solvable as long as the right external factors are in place, when really the problems only exist in your mind. As an anology to my own problem, I thought well maybe if I feel closer emotionally to my partner I'll have less thoughts about harming her - but it just doesn't work like that. Of course though, improving quality of life is its own reward.

As to taking antidepressants, I tried citalopram but it didn't work for me and seemed to make my anxiety worse. There is a big caveat to this however in that I was also getting drunk on a regular basis as well - I don't think the two mix well at all. If I had have stopped drinking it may have worked like a charm, but that's the beauty of hindsight. I'm doing a medicinal chemistry degree and have in fact written an essay on SSRIs like prozac, sertraline and citalopram (may have different names depending what side on the pond your on); so I know for quite a lot of people they do work. I'd try which ever your doctor thinks would be applicable to you (if they do think one is) as they may help your progress. However, you should be prepared that you normally have to take them for 6 months minimum before your doctor says that you can get off them again - something to bear in mind if they don't work as you expected.

I don't check these forums too often, so don't be surprised if sometimes I take a little while to reply. I guess as a closing comment if you think that taking a course of action or thinking a certain way will fix or help your OCD which is not dealing with exposing you mentally or physically to your obsessions, don't do it. All it will do is make your OCD persist longer, because as I said there is no solution just an aclimatisation to the thoughts so they don't trigger anxiety anymore. In a different thread to someone else I said that Tormenting Thoughts and Secret Rituals was a reasonable book for reading about OCD; in that as a suggestion for Pure-O people it says that taping your worst fears in as much explicit detail as you can manage and then listening to them on repeat for an hour every day is good exposure. I never tried it personally, but it might be worth a shot and if it didn't work then you can always try something else.

Hey everyone, i myself am dealing with Pure-O and anxiety. I just started seeing a therapist well last night lol, and i went to my doctors today and he gave me Zantac and some CeleXA and also a few clinics i could go to if it gets really bad but idk like i don't wanna go to those places cause like okay with jail, a half ass crimminal could get locked up then come out a better person and realize they need to make a change for the better, or it could go the exact opposite way and come out a much worse crimminal, and i don't wanna make it any worse but if i cant get control i see no other option cause i swore id never act on these thoughts, but the pills are helping at least the pills for my anxiety are the anti-depression pills wont take effect for a while from what iv read and what he told me, and that scares me because all i can think about is taking all of them at once but i wont, like it just pops in my head then lingers in the back of my mind for awhile then sorta fades away but then it comes back ((but i really have no intent on hurting myself or others)) And my therapist was helpful on telling me i need to get on medication like now, but he said something that my brain clung onto and it's really worrying me because i really don't wanna die or hurt others but the images are getting worse and after i told him that he just said "well if we cant get the thoughts to slow down then you will make them after you cant take them anymore, iv been in the business since 78 so i know" like that just made me even more worried cause no matter how much i research he may know more then me, and i keep reading that no one acts on these thoughts but him saying that made me feel like wtf you know? Like im an emotional wreak because of this and your gonna say that to me, idk just really threw me. I wanna call him and tell him i got my pills but im worried he's gonna say something to trigger my thoughts, im just gonna have to man up but it's just so not me to be this depressed like iv seen my mom try to commit suicide and my brother but i was brought up in the church and always told them it is the most selfish thing you could do, and that i would just be lost without them, and now im just turning into a huge hypocrite, but they are okay now and happy but now this is going on with me and god only knows how embarrassing/revolting these thoughts are and go against all my morals but they seem to just be getting worse and when i have thoughts about killing my self or hurting loved ones i just say nah im good, and that would work for the most part but now it's not working or not lasting as long as it did a few days ago, so any insight or just what i should do cause i don't know i never expected this from me, cause in my family iv always been the creative/smart/one that the family turns to for advice. I don't say smart to sound like im full of myself, cause i suck at math but philosophy and religion and having a good point of view on life, like i do graphic design, and write music like the last song i wrote looked like a doctor seuss suicide note. Just looking for any help.

Side note: I am starting at the gym tomorrow tho so i hope it will help take my mind off things, and i was able to eat tonight

Last night was going okay till i got home from the gym, my mom and brother where fighting and that stressed me out and then she started drinking and brought over people i dont really feel comfortable around, and i was trying to just be okay started watching a movie with a friend (ace ventura the pet detective) and it was going okay i was laughing then idk like if i dont have the thoughts for awhile my brain goes wow i havent had those thoughts in awhile i must be doing better, then bam they come back.

LIke i tried to take a shower and just be a peace but the thoughts got worse and i thought about that wrestler who killed his family, then i started thinking about getting the gun and killing myself and it made me just feel awful and because of my pills my stomach didnt hurt as much as it usally does when i get those thoughts. In a way my stomach feeling like that gives me reinsurance i dont wanna do these things and without that pain i was scared.

So then i just came down stairs and forced myself to sleep but today i feel even worse, and i cant go see my counselor today, i just feel like i wanna throw up or cawl in a hole. ahh really dont like this feeling.

-- Sun Dec 02, 2012 11:51 am --

But just so everyone knows, it's locked and i dont have the key and i dont know where it is in the house. But it just makes me worried cause i know i wanna live and never have i had the feeling of suicide, i wanna live i really sincerely do.

I know how much it would impact my family, and how horrible it would be for my mom. Plus there is so much i haven't done yet and i just wanna be okay again.

JustbeingMe wrote:Last night was going okay till i got home from the gym, my mom and brother where fighting and that stressed me out and then she started drinking and brought over people i dont really feel comfortable around, and i was trying to just be okay started watching a movie with a friend (ace ventura the pet detective) and it was going okay i was laughing then idk like if i dont have the thoughts for awhile my brain goes wow i havent had those thoughts in awhile i must be doing better, then bam they come back.

LIke i tried to take a shower and just be a peace but the thoughts got worse and i thought about that wrestler who killed his family, then i started thinking about getting the gun and killing myself and it made me just feel awful and because of my pills my stomach didnt hurt as much as it usally does when i get those thoughts. In a way my stomach feeling like that gives me reinsurance i dont wanna do these things and without that pain i was scared.

So then i just came down stairs and forced myself to sleep but today i feel even worse, and i cant go see my counselor today, i just feel like i wanna throw up or cawl in a hole. ahh really dont like this feeling.

-- Sun Dec 02, 2012 11:51 am --

But just so everyone knows, it's locked and i dont have the key and i dont know where it is in the house. But it just makes me worried cause i know i wanna live and never have i had the feeling of suicide, i wanna live i really sincerely do.

I know how much it would impact my family, and how horrible it would be for my mom. Plus there is so much i haven't done yet and i just wanna be okay again.

Dude, I have been going through the same thing with self harm Pure O for seven months. I have a discussion going on PM with afraidofdiseases. You are welcome to join in.