OCD: "Thought Records"

In my first counseling session, I was just told to try to relax and take some of the pressure off. I needed to sleep better, and avoid tiring and stressing myself out. So after telling me that it was okay to feel the way I was feeling and do the things I was doing, I was told that I needed to take some steps to get better. I needed to realize that I ought to stop, but not suddenly as that would put too much pressure on me, which is what I had been doing by trying to force myself to stop. That's why the counselor kept insisting that it was all okay for me to be like this. I needed to take small steps. Baby steps. Itsy bitsy baby steps. If I tried to run when I couldn't even walk, I'd be flat on the ground.

In the next session, I was given these sheets to fill out, called "Thought Records." It contained the following 4 questions:

• Where were you when the obsession began? How were you feeling? What were you doing at the time?


• What intrusive thoughts/images/ideas did you have?


• What meaning did you apply to the intrusive thoughts?


• What did you do?

Here's an example:

• I was in the washroom, washing my hands, concentrating hard on doing it right


• Then I started to wonder what if some water splashed up onto my hands from the sink, what if I touched the sink by accident, what if I touched the faucet by mistake...


• It meant that my hands were now dirty again. Anything I touched thereafter would also be dirty, like the doorknob of the bathroom


• I washed my hands again

I had to fill these out every now and then when something would happen to trigger my obsessive thoughts. I didn't really see the point of this at first but when I showed it to my counselor, she simply read through all of them and looked out for common factors. We discovered that all my thought records were related to the washroom, so it was plain enough that my fears are mostly bathroom-centered. This was a pretty useful way of finding out what my triggers were and the things that were in common in all my "episodes". She was also able to see how I had progressed (or digressed) week after week, to show whether I have been improving or not.

You could give this a try and see if maybe you are able to find a pattern or a link in your triggers and the things you do afterwards to deal with the anxiety. It forms a good basis to know what needs to be worked on. This is basically having a look at the way you react to certain situations, and realizing that there are other ways to react. Like for instance, the counselor noticed that in my earlier thought records, my reactions were pretty much the same: panic, crying, beating myself up. In the later ones, we saw that I wasn't crying or beating myself up anymore. The stress and doubt was there, yes, but I saw that I was dealing with it in a much better way now. The counselor told me that the next step would be coming up with evidence to fight off the irrational meanings and conclusions the mind jumps to, in order to rewire the way the brain thinks.

The meaning I usually give to certain things that happen is: It's dirty. It will contaminate other things. Everything will become dirty.

The counselor asked me what evidence I had to show that it really was dirty? For instance, let's use the same example I presented earlier about hand-washing. Say some water splashed up on me from the sink. Is that really as dirty as I think it is? What proof do I have that it is not dirty?

• The water that flows out of the faucet is clean. I cannot see dirt in the water that flows from the faucet and into the sink.


• I have already washed my hands once and soap washes away germs. Anti-bacterial soap kills germs. So anything that falls into the sink thereafter will be cleaned by the soap. So technically, the sink is also clean because the soap has fallen into the sink and then washed away with the water.


• The sink isn't dirty to begin with. It's cleaned out everyday.


• Washing my hands once is enough. The number of germs on my hands is way lesser than the number there was before I washed my hands. So the germs have reduced and washing my hands again and again will not make me 100% germ-free as that is impossible!


• Even if dirty water was in the sink, the clean water that flows out of the faucet will have washed away the dirty water by the time I had finished soaping up.


• Water will splash if there is an obstruction in the way, in general cases. So any water that may splash may have hit my own freshly-washed hands andthen bounced off and hit my arms or hands, etc. So if I believe my hands are clean, the water than hits my hand and then splashes will also be clean.

Then I had to ask myself what proof I had that it is dirty:

• Well, I rinsed my hands first and my hands were dirty, so the water from the first rinse became dirty and flowed into the sink. Therefore the sink is dirty. Thus anything that splashes up on me from the sink will also be dirty.

Wow, that sounds silly! Does anyone even think of these things? I know I never used to. I never cared about such stuff! Anyway, the counselor then evaluated these proofs against each other and she said that the first set of evidence that shows it is not dirty trumps over the other set of evidence. There's a lot more evidence, and needless to say, they make a lot more sense than the other set.

Try it out. Try filling about 5-6 of these forms at first and see how it goes. It really helps to write down how you think and feel. It's kind of like journalling which is also very useful. It will help you understand your thought processes better and see how your reactions could be changed. I think that in the frame of mind we tend to shift into when we're faced with obsessive, intrusive thoughts really really clouds our sense of judgment. Filling out these thought records and reading them at a later time when we are in a stabler state of mind sort of compels us to look at ourselves from the eyes of an outsider. That can be truly beneficial as we start to realize how we tend to become when we're being obsessive, and how we really ought to be. It really encourages you to realize that you need to take some corrective measures and change things. Writing really helps put things into perspective and makes things more tangible. Journalling will compel us to note down our fears, successes and failures, and we can see how far along we've come, somewhere a little further in time. Of course, we ought to focus more on the successes than failures, but then again, we're human and moreover, OCD makes you dwell on things and makes you keep thinking about it, trying to rationalize, justify and reason again and again all in vain because thinking about it makes me obsess over it even more. For some strange reason, the doubts give way to anger and guilt. Writing helps vent and get it all of your chest to lessen the stress somehow. Writing is a way of letting it all out, so that it doesn't have to stay in. Journalling does that, and these "Thought Records" are a structured form of doing it.  and anxiety. One neat idea is to write down how you're feeling and then try to look at things from an outsider's perspective and tell yourself what a normal, non-OCD person would do, how they would behave, react, etc. This doesn't work for me all the time because ever since OCD, my sense of logic has gone all fuzzy (not that I had much sense to begin with - always been poor with logic and reasoning!) I've just forgotten what it's like to be "normal" and how normal people go about doing things. If it's hard to realize these normal behaviors on your own (like it is for me), observation really really helps. Observing the way people behave and how they react to things is really useful. If it makes you feel like a stalker, then don't worry - just use the internet. I watch videos of people washing their hands on YouTube to relearn how to do it. Sounds stupid but it sure helps!

So anyway, back to the "Thought Records." I had to keep reminding myself of this new set of evidence to prove to myself that it wasn't dirty and I didn't need to wash my hands again and again. Some days it worked, some days it didn't. But I'm not complaining. Earlier, I never even thought there would be a day when I would feel peaceful again, when my hands wouldn't feel raw and chapped... I thought that every single day I would wake up and it would start all over again. But now I know that there will be some days when it will not be like that. I know that slowly, the number of these days will increase and slowly, things will go back to normal. We just have to keep fighting, don't we? OCD behaviors are just habits. I reckon we'd have to treat it like any other habit we may be trying to kick, like smoking. Phasing it out is the key, I believe. Stopping suddenly will only result in relapses. I phased out plenty of OCD habits, but sadly, other new habits crept up on me. That is why I say we need to keep fighting. Surely one day, the war will be won.

Here is a good link for more information on "Thought Records." There's also a lot of other great stuff: http://www.camh.net/About_Addiction_Mental_Health/Mental_Health_Information/OCD/ocd_treatments.html

Until next time!