Making the most of your sessions with the professionals

This post has been thanked 4 times. 13 July 2014 - 14:31

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Contact between patients and professionals can frequently be fraught as both sides can have high expectations of each other.

OCD is probably one of the most complex and wide ranging of conditions and many health professionals including some of those who profess to deal with OCD fail to recognise the extent to which it can vary from person to person and more importantly the true extent of the impact that the OCD has on the life of the particular individual that they are dealing with.

It doesn’t help that frequently we don’t recognise or acknowledge all our OCD actions. For instance it wasn’t until I came onto the forum that I realised that I had intrusive thoughts and to a degree magical thinking to name but two. We can become so engrossed in the obsessions and compulsions that we don’t always see the bigger picture.

Frequently we find it difficult to communicate to others including the professionals how bad our OCD is and how it’s limiting our lives and we can find ourselves being labelled as awkward or non compliant when we’re not.

Other conditions both physical and psychological can affect the way that our OCD manifests itself and the way that we deal with it, as can our personality, education and environment. It also affects the way that we relate to others and can have devastating results.

If the conditions are treated in isolation then you are liable to improve one at the expense of the others 

My personal theory is that we need to:

  • Be open and honest with your psychiatrist/psychologist/therapist. They can’t provide effective treatment and support if you only give them part of the story. There is nothing that you can say that will shock them, they’ve probably heard similar many times. Remember they are there to help you and won’t judge you.

  • Relearn how to relate effectively to others, by doing this we can get what we need especially from the professionals without getting distressed or angry. This includes improving our listening skills. It’s not sufficient to hear we need to listen too. Hearing is simply the ability to perceive sounds and happens without any input from us, but listening is something that we consciously choose to do, it requires concentration so that we can process the meaning of the words and sentences.

  • Learn to trust your psychiatrist/psychologist/therapist and be guided by their advice.

  • Before each session write down using bullet points what you would like to discuss/deal with in each session and then let the psychiatrist/psychologist/therapist know at the beginning of the session what it is that you’d like to discuss so that they can allocate time during the session. Don’t leave it until the end of the session as by then it’s too late.If you don’t understand something, either what has been said or what you’ve been asked to do, then let them know and ask them to explain it. Don’t leave without asking or you’ll walk away from the session feeling frustrated.

  • Let them know the impact that OCD is having on your life.

  • Don’t keep repeating the same thing over and over again at each session as this makes people, even the professionals, switch off.

  • Black and white thinking – this really does impede our recovery. We need to work to remove our black and white thinking and be open and receptive to new ideas and suggestions and willing to try them – and if one thing doesn’t work then we need to try something else.

  • Cherry picking – this too impedes our recovery and can at times be seen on this forum. This doesn’t just apply to the written word but also to what we are told. If you just pick out the facts that you like or find acceptable and ignore the facts that you don’t like or find difficult then you can’t make an informed decision. We therefore need to work hard to avoid cherry picking as it’s destructive especially in the context of therapy.

  • Homework – this is an important part of CBT. You need to negotiate homework with your therapist and then practise it frequently. The majority of the work needs to be done by you between sessions, your therapist is there to guide you but can’t do the work for you.

  • If you are having problems with the homework that has been set then tell your therapist at the next session so that they are aware and can help you.

  • Learn how to use various relaxation techniques. Ask your psychiatrist/psychologist/therapist to provide you with and show you how to use them.

Have a look in the OCD Action Information resources section for more information on OCD, in particular look at the following:

What is Cognitive Behavioural Therapy (CBT)

CBT checklist

Making CBT work

Revisiting CBT

14 July 2014 - 2:26

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This is absolutely awesome advice! Thanks for sharing!

14 July 2014 - 12:00

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Thanks for sharing your experiences, info and advice, just what I need for when I start cbt again. After reading OCDaction CBT printout confirmed to me what I had thought – the first cbt therapist I saw was useless and had a detrimental affect on my well-being – ocd behaviours increased and became far more intense. Now armed with OCDaction printouts and your advice I feel more confident about going to cbt.  Thanks Truddles.

15 July 2014 - 20:28

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Thanks Isabella and enough.

I just wish that I'd had the benefit of the various CBT information sheets found in the OCD Action Information resources section when I did CBT. At the time both courses of CBT that I was given weren't of any help. But now I'm able to use the CBT that I was taught thanks to what I've read on this site and also thanks to a brilliant therapist.

18 July 2014 - 13:05

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Hi Truddles, I also wish I had been better informed when I first had cbt, I was made to feel a freak. I have tried to block out that first course of cbt. Now I know that there are others who have similar concerns and worries as myself - although no one is an precise copy !!! - it is reassuring and I am not alone. I am anxious about more cbt as my recent assessment has reactive the memories of the first course, but I am better informed now. Thanks again. 

19 July 2014 - 21:55

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I have just had seven months of appalling CBT that had no direction. I kept going back cos I am really ill and did not know what else to do . My OCD is worse now than before. I think I was treated really badly.

20 July 2014 - 12:14

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Hi moonstone2014,

I'm sorry that you've had a bad experience with CBT.

CBT is a collaboration between therapist and client. So armed with more information about CBT (see the links in my first post on this topic), if you were offered more CBT, what would you do differently in order to get more effective CBT?

This post has been thanked 1 time. 20 July 2014 - 15:18

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Thanks a lot for the information Truddles,

If it's okay to ask anyone who has had a bad CBT experience what was it that went wrong? That way we can see if there are ways that CBT can be tackled or improved.

With my experience we did a couple of distraction techniques also talked about ways to expose myself to the things that cause me stress but I have to admit I did struggle with that part as I could feel my stress levels going up each time I picked up the feared object.

21 July 2014 - 17:11

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Hi Truddles, Moonstone, Grams,

Further thanks Truddles, I have just read though the Lynne Drummond presentation about revisiting CBT and why ERP doesn’t work - all 89 pages ! – now I know why my experience of EPR wasn't effective and also why I struggle when I try to do it on my own. I am on a learning curve !!

Hi Moonstone, I can empathise with you, my first experience of cbt was a very negative experience, like you I keep going because I thought I could trust that the therapist knew what she was doing – got that wrong!!! Have you looked at the information available on the ocd action information section, particularly the ones Truddles has suggested. I have found out so much relevant information from there and from other peoples experiences that they have kindly shared on this site.

Hi Grams, I have come to the conclusion that who you get as a therapist is a bit hit and miss !!! The ocd action cbt printout really says it all about what cbt for ocd should and shouldn't be. I wish I had it the first time but then that therapist was so fixed in her thinking, nothing would of altered her opinions.  I think Truddles has really summerised how to get the best out of cbt.

27 July 2014 - 15:46

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grams wrote:
If it's okay to ask anyone who has had a bad CBT experience what was it that went wrong? That way we can see if there are ways that CBT can be tackled or improved.
Perhaps you should start another topic. There's nothing wrong with discussing what has gone wrong previously provided that we learn from it and don't repeat it.

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