![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 57 to 81 of 91. Go back in thread:
Posted by mattdds on June 7, 2003, at 21:49:02
In reply to Re: Another CBT question. Very specific. » mattdds, posted by Dinah on June 7, 2003, at 19:54:32
Hi Dinah,
I don't have OCD, so I probably can't understand completely what you are going through. I can conceptualize it, but have not experienced it. I imagine it is tough to deal with ego-dystonic intrusions all the time. My intrusive thoughts aren't ego-dystonic, but I do get all kinds of thoughts I don't like.
If I understand right, you have made a lot of progress in the behavioral department, but not so much in the way of intrusive ego-dystonic cognitions. And that you have sort of a split level of understanding; on one hand you realize it is illogical to worry so much about vomiting, but another (more irrational) part of you doesn't believe it. Did I get this right?
I've been doing some research on CBT thought on OCD, and the idea is *not* to settle for just behavioral improvement, but for improvement as far as the obsessions go as well. I would love to discuss this, and have some ideas, but it will take a lengthy exchange, if you are up for it.
My take is that you do *not* have emetophobia. This is just my opintion, but what you describe sounds more like a fear of a contaminated object (vomit). You are not so much afraid of vomiting yourself? Is this accurate?
CBT-ists call this Thought-Object Fusion (TOF). The belief (on some level) that thoughts can make things contaminated. This sounds a lot like what is going on with the fear of vomit, in your case.
You also described that you used to have to check your work to "make sure" you didn't write obscenities on it. This is referred to as thought-action fusion (TAF) by CBT-ists. There is the belief (on some level) that thoughts are fused to actions. Thinking something means that you will do it (or have done it). Another common example is worry about harming someone you love, like "what if I just stabbed my wife for no reason??!!". The corresponding compulsion would be to get rid of all the knives in the house, or something like that. This is thought-action fusion.
Just out of curiousity, are any of your intrusive thoughts religious (sacreligious?) in nature? This is extremely common. A good example would be a person who has thought intrusions that the devil will appear. He holds a belief (on some submerged level) that having this thought will make the devil appear! So the poor indidual will try to crowd out thoughts of the devil by praying or doing Hail Mary's or something like that. This is classic Thought-Event Fusion (TEF).
So these terms help to conceptualize the problem.
How do we solve it?
It appears you have the behavioral aspect pretty well nailed down. So now you work on the cognitive aspect of it. But here is where it gets tricky.
The goal is *NOT* to get rid of the intrusive thoughts! The goal is to change the beliefs about the meaning of the obsessive thoughts. In other words, freely let the thought intrusions enter. You might have heard about thought suppression experiments; they don't work! E.g. try hard for 30 seconds NOT to think of vomit....................................what just passed through your mind? Of course, vomit!
So trying to suppress the thoughts is not the goal, and will likely reinforce the belief that the thoughts are harmful or have some meaning (e.g. you are bad because you had such and such thought). Don't even try to figure out the cognitive distortions in the intrusions; they are self-evident, and already incredibly obvious to you.
Your problem likely is in your *appraisal* of the intrusions, i.e. fallacious beliefs about what "purpose" these intrusions serve. I remember in one of your old posts you wondered what "purpose" your panicky thoughts had when you were younger, and you said "they must have been important!"
Interestingly, this is where metacognition becomes important. The idea is to simply "watch" your intrusions pass through your mind non-judgementally. One method is to get purchase a golf stroke counter. Each time you have an intrusive thought, you simply make a click. "the vomit is EVERYWHERE" - click. "gross drunk teens probably barfed right where I was standing" - click. You get the picture. Keep a log of the number of intrusions. Supposedly, they will go up for a few days, as you become more aware of them. Then after a few weeks, they will go down. Try this with one particular set of thoughts once (e.g. vomiting), then move on to others.
I will do more research on this, but I'm quite sure the idea is NOT to try to control the thoughts; this just makes them come back stronger, as I'm sure you know. The goal is passive, non-judgemental observation of the thoughts, which hopefully will eventually de-fuse the thought intrusion from the action or object.
So CBT for OCD is quite different than for depression. It has certainly moved beyond the simple behavioral techniques. The problem is that most clinicians are too lazy/uninformed/busy/or whatever to keep up on the literature.
I got most of these ideas from Arian Wells books, a pioneer in cutting-edge CBT for OCD and generalized anxiety disorder.
"Cognitive Therapy of Anxiety Disorders : A Practice Manual and Conceptual Guide"
"Emotional Disorders & Metacognition: Innovative Cognitive Therapy"
Perhaps your therapist could take a look at these and formulate a treatment plan customized for you.
I'm only scratching the surface! There are many more techniques, but I'm already getting extremely long-winded. I hope I am not going overboard here!
I wish you the best,
Matt
Posted by janejj on June 7, 2003, at 22:21:12
In reply to Re: Another CBT question. Very specific. » Dinah, posted by mattdds on June 7, 2003, at 21:49:02
I'm sorry that but I haven't read through all these messages...just wanted to say that CBT seems to have worked for me, albeit I just read the very popular book by Dr Burns.
It helped me see the way I think is completely warped and hence my life has become much more bearable. For instance I never base my self worth on my ability to perform a certain task or base my self identity on one facet of my life (eg. Career)etc. I no longer let percieved judgement from other people completely paralyse and depress me and I don't think other people are better than me any more. Its gone a long way to a much more stable and happy life!
Anyway certain treatments work for some and not for others, its just what works for you that you should worry about.
Regards, Janejj
Posted by shar on June 8, 2003, at 3:54:02
In reply to Re: But if I do bad things, aren't I bad?, posted by Dinah on June 7, 2003, at 11:39:22
>But if I do bad things, aren't I bad?
Nay, m'lady. Tis like "hate the sin, love the sinner." If one does something bad, one has DONE something bad, not BECOME something bad. We are all a mix of good and bad. To follow the logic of your question on the flip side: if you do good things, aren't you good?
> And if I'm responsible for making myself better, aren't I to blame if I don't?
Another nay. That's called blaming the victim in my book. Just like if one had cancer; there are some folks who believe that their treatments work, and the person who isn't getting well isn't [praying hard enough, following the diet rigorously, meditating with a pure heart, etc.] or anything that doesn't reflect badly on the treatment. One who is making a good faith effort to improve, cannot blame oneself for not trying, if one is trying. It is circular logic and bad for the brain.
>I agree with matt (I think it was) who talked about using words like bad, good, etc. They are extremely value-laden, so what I think is good may be quite bad to someone else. Some people think that thinking something is just the same as doing it (so thinking of murder is the same as murdering someone). Whatever we end up labeling good or bad is very personal; and, while I'm not against labels per se (because they allow us to make sense of the world), they do need to be used carefully, I believe. Sometimes, in therapy we learn that labels continually cause us problems and we have to get to what's behind the label to make even greater progress (such as, "bad" may turn out to be "self-aware" or "good" could mean "submissive").
Hmmm, hope this made some sense.
Shar
Posted by Larry Hoover on June 8, 2003, at 9:50:47
In reply to Re: But if I do bad things, aren't I bad?, posted by Dinah on June 7, 2003, at 11:39:22
> And if I'm responsible for making myself better, aren't I to blame if I don't?
>
> I still don't understand. Can you use baby words?I don't know about baby words, but I'll take another crack at it.
Taking responsibility involves attributions of all outcomes, good, neutral, bad. Blame focusses only on the bad. (I don't like judgmental words like good or bad. They taint observations.)
Responsibility involves anticipation as well as retrospection. Blame only looks back.
Responsibility assumes that all decisions have effects. Blame is a tool to distort responsibility, magnifying responsibility in some cases, and minimizing it in others.
I keep thinking about that case a few years back where a woman successfully sued McDonald's because she was injured when she spilled a hot coffee in her lap. IMHO, the woman was responsible (she made a number of decisions which led directly to the incident, alternative ones preventing the adverse outcome), but McDonald's got blamed.
Lar
Posted by Larry Hoover on June 8, 2003, at 9:59:58
In reply to Re: Another CBT question. Very specific. » Dinah, posted by mattdds on June 7, 2003, at 21:49:02
> The goal is *NOT* to get rid of the intrusive thoughts! The goal is to change the beliefs about the meaning of the obsessive thoughts. In other words, freely let the thought intrusions enter. You might have heard about thought suppression experiments; they don't work! E.g. try hard for 30 seconds NOT to think of vomit....................................what just passed through your mind? Of course, vomit!
I snipped everything else because I want to absolutely emphasize how much I agree with this concept. If you can learn to ignore the intrusive thoughts (in other words, not react emotionally too them), they no longer stand out from all the other thoughts that you might have.
When you react to the thought, you "lock it in". It doesn't pass by and fade away, like all the other thoughts do.
Everybody has unusual thoughts that pass through their brain. Some are quite bizarre. If you don't react to them, they have no significance.
The problem is the reaction, not the thought itself.
There are a number of different techniques you can learn, to desensitize your reaction. That's a matter of personal preference. One I like is "I don't own that thought. It doesn't spring from my spirit."
Lar
Posted by zenhussy on June 8, 2003, at 10:06:34
In reply to Re: Accepting intrusive thinking » mattdds, posted by Larry Hoover on June 8, 2003, at 9:59:58
> The problem is the reaction, not the thought itself.
>
> There are a number of different techniques you can learn, to desensitize your reaction. That's a matter of personal preference. One I like is "I don't own that thought. It doesn't spring from my spirit."
>
> Lar
My personal favorite is: that thought isn't my cup of tea thank you very much.Polite and to the point for my muddled head.
Good CBT discussion. Thanks.
zenhussy
Posted by mattdds on June 8, 2003, at 11:05:55
In reply to Re: Accepting intrusive thinking » mattdds, posted by Larry Hoover on June 8, 2003, at 9:59:58
Hey Larry,
Good to see you here again!
>If you can learn to ignore the intrusive thoughts (in other words, not react emotionally too them), they no longer stand out from all the other thoughts that you might have.
Exactly. For people with OCD or strong negative appraisals of intrusive thoughts, thoughts become just another neutral event. The problem with thoughts is that sometimes we get too "locked in" on them. This is what Adrian Wells refers to as "object mode". Metacognitive mode is getting out of this and saying "hey, this is only a thought / feeeling / symptom, and not reality". These are just big words for simple concepts, but it gives them names so we can talk about them.
One insight that I remember reading somewhere is that with intrusions, the thoughts become the "object" to which one tries to become desensitized. The mechanism seems similar to a simple spider phobia. Exposure to the spiders while allowing disconfirmatory information to be processed (i.e. erasing old beliefs, making new ones about spiders) is therapeutic. In many ways, OCD is thought-phobia. Cognitophobia?
>>When you react to the thought, you "lock it in". It doesn't pass by and fade away, like all the other thoughts do.
I'ts "selective abstraction" or "mental filter". Something in your belief system is causing the direction of an undue amount of attention toward the thought. This is the "getting locked in" you decribe.
The goal is not to try to stamp out the thoughts. There are too many, it's like using a fly swatter in the jungle! The goal, perhaps is to tease out the metacognitive beliefs that are causing the attention to be directed so strongly toward the thoughts. Examples of metacognitive beliefs are:
1. I am bad for having X thought
2. Thinking these thoughts can something terrible happen
3. This thought is reality (usually we aren't aware of this belief)
4. etc, etc.>>Everybody has unusual thoughts that pass through their brain. Some are quite bizarre. If you don't react to them, they have no significance.
Everyone has them, right. My feeling is just that only the *beliefs* about the meaning of the thoughts is the difference. Beliefs direct attention. Attention causes thoughts to grow in consciousness.
>>The problem is the reaction, not the thought itself.
Perfect. I was raised in a strong religious family. When I would get intrusive sexual thoughts, I would get anxious. I, on some level believed I was bad for the intrusion; as if it meant something about me as a person. So guess where my attention went? I try to look at intrusions as *totally* uncontrollable now! I truly believe they are. That absolves me of all ownership of them. Interestingly, I don't get anxious about these intrusions anymore, but I still have them. Now they just seem like any other thought (well, maybe a bit better :))
>>There are a number of different techniques you can learn, to desensitize your reaction. That's a matter of personal preference. One I like is "I don't own that thought. It doesn't spring from my spirit."
Good idea. My dad likes "oh, there goes another one...oooh, wow look at that, there's another one!"
This is true. There are various ways of getting into a "metacognitive" mode of thinking.
Thanks Larry, these are great insights! Sounds like you reinvented Adrian Wells' wheel without even knowing it! You seem to have a grasp on things that 99% of clinicians don't!
Best,
Matt
Posted by Dinah on June 8, 2003, at 15:46:13
In reply to Re: responsibility vs. blame » Dinah, posted by Larry Hoover on June 8, 2003, at 9:50:47
Hmmm, perhaps with all this help, I'm getting a glimmer. But it takes a while for things to sink in for me. It took me twenty years to understand the song "Amazing Grace". I'll cogitate on the matter, and hope for an ah-hah experience.
Thanks for your patience. :)
Posted by Dinah on June 8, 2003, at 15:51:54
In reply to Re: But if I do bad things, aren't I bad? » Dinah, posted by shar on June 8, 2003, at 3:54:02
Hi Shar. My more emotional self focuses a lot on good and bad, and does tend to believe that I'm a good girl if I do good, or a bad girl if I do bad (or make someone angry, or any number of things).
And it's moreso right now. This self correcting world is piling all my corrections on me at once. I ignored my diet and weight and family history of diabetes, and am now paying the price of food choice deprivation. I spent with happy abandon, and now am paying with monetary deprivation that will last at least fifteen years (the life of my debt consolidation loan). I am overcome with my natural consequences and rather obsessed with the idea that it is because I was bad. Because if I had been good, these things wouldn't be happening.
Sigh. I know it's an immature way of looking at things, but I can be quite immature.
Posted by Dinah on June 8, 2003, at 16:27:27
In reply to Re: Another CBT question. Very specific. » Dinah, posted by mattdds on June 7, 2003, at 21:49:02
>
> I imagine it is tough to deal with ego-dystonic intrusions all the time.
I only wish I was sure they were ego-dystonic. Sure, I know they aren't true. But I am equally sure that they are completely true. Sigh.> If I understand right, you have made a lot of progress in the behavioral department, but not so much in the way of intrusive ego-dystonic cognitions. And that you have sort of a split level of understanding; on one hand you realize it is illogical to worry so much about vomiting, but another (more irrational) part of you doesn't believe it. Did I get this right?
That would be right.
> My take is that you do *not* have emetophobia. This is just my opintion, but what you describe sounds more like a fear of a contaminated object (vomit). You are not so much afraid of vomiting yourself? Is this accurate?The emetophobe purists would agree. But the more liberal emetophobes use the term for fear of either vomiting yourself, or having others vomit, or just vomit in general.
>
> CBT-ists call this Thought-Object Fusion (TOF). The belief (on some level) that thoughts can make things contaminated. This sounds a lot like what is going on with the fear of vomit, in your case.
>
Could be....> You also described that you used to have to check your work to "make sure" you didn't write obscenities on it. This is referred to as thought-action fusion (TAF) by CBT-ists. There is the belief (on some level) that thoughts are fused to actions. Thinking something means that you will do it (or have done it). Another common example is worry about harming someone you love, like "what if I just stabbed my wife for no reason??!!". The corresponding compulsion would be to get rid of all the knives in the house, or something like that. This is thought-action fusion.
>
OK, that I definitely have. If I think I've done something, it *feels* like it's possible that I did it. Reality doesn't seem that well defined from the vividly imagined, or something like that. How do you know *for sure* anything? If I see my keys in my hand, how do I know that I'm not just imagining I see my keys unless I rub my finger along the edge. Otherwise I might just think I picked them up, think I see them, when I really don't. Then I'd be locked out. If I think I wrote something, how can I really be sure I didn't? Even if I check to make sure, how do I know I'm just *not seeing* what I wrote but it's really there? By the way, I'm getting way better at that sort of thing. Way, way better. But it's the way the thoughts work.> Just out of curiousity, are any of your intrusive thoughts religious (sacreligious?) in nature? This is extremely common. A good example would be a person who has thought intrusions that the devil will appear. He holds a belief (on some submerged level) that having this thought will make the devil appear! So the poor indidual will try to crowd out thoughts of the devil by praying or doing Hail Mary's or something like that. This is classic Thought-Event Fusion (TEF).
I do have what would be considered scrupulosity, or responsibility OCD. But the thoughts aren't overtly religious in nature. And I don't have thought compulsions, except for occasional undoing rituals if I say something that I think the fates might misinterpret. (And yes, I know how weird that sounds).
>
> So these terms help to conceptualize the problem.
>
> How do we solve it?
>
> It appears you have the behavioral aspect pretty well nailed down. So now you work on the cognitive aspect of it. But here is where it gets tricky.
>
> The goal is *NOT* to get rid of the intrusive thoughts! The goal is to change the beliefs about the meaning of the obsessive thoughts. In other words, freely let the thought intrusions enter. You might have heard about thought suppression experiments; they don't work! E.g. try hard for 30 seconds NOT to think of vomit....................................what just passed through your mind? Of course, vomit!
>
> So trying to suppress the thoughts is not the goal, and will likely reinforce the belief that the thoughts are harmful or have some meaning (e.g. you are bad because you had such and such thought). Don't even try to figure out the cognitive distortions in the intrusions; they are self-evident, and already incredibly obvious to you.I've worked at those techniques. Watching the thoughts float like leaves down a stream. Singing the obsessions. Laughing at them. It helps. But it only goes so deep. Then stops. On a level inaccessible by intellect, there is a certain belief in the thoughts.
>
> Your problem likely is in your *appraisal* of the intrusions, i.e. fallacious beliefs about what "purpose" these intrusions serve. I remember in one of your old posts you wondered what "purpose" your panicky thoughts had when you were younger, and you said "they must have been important!"
>
OK, I'm trying to be open minded and flexible about CBT. If you could try to be open minded about what I'm about to say, I'd appreciate it.I really do believe that OCD, in some cases anyway, serves a useful purpose. Mind you, like most dysfunctional coping tools, it also causes problems. And perhaps in some cases it is a simple brain glitch where thoughts repeat. But I really do believe that in some cases it works as a pressure valve, or a better simile might be a controlled burn in a forest fire.
When I first developed it, I was in pretty bad shape emotionally. The only reason I wasn't an early Columbine type shooter is the lack of a gun, and a punitive conscience. And if I had had easy access to a means of suicide, I probably would have acted on it. In the circumstances, having an obsession to divert my attention to may well have saved my life. Constantly thinking about how to avoid vomit, where vomit might occur, planning what to do if someone vomited, directed considerable attention away from my very real life problems. Life problems that were completely beyond the ability of an eleven year old to solve. Even the choice of obsession, vomit, had symbolic overtones that are absolutely obvious in retrospect.
The resurgence of OCD came with my marriage to a terrific man. Such a terrific, disciplined, controlled man that I constantly fell short of his expectations, or (just perhaps) my assessments of his expectations. At the same time, I lost the safety net of being a daughter in my parents home and really entered the adult world. And surprise surprise, my OCD centered around making catastrophic errors. Errors in work, errors in driving, seeing those areas as "bad" because they were potential sources of errors.
And when I got that safety valve largely controlled, by controlling my OCD, other symptoms popped up like Whack the Mole. The OCD somehow protected me from the pressures that an ego held together with spit and scotch tape (or inadequate coping mechanisms in other words) just couldn't handle.
I think any CBT to be truly and completely effective has to reach back beyond the OCD, beyond the obsessions, to the pressures I am unable to handle. And has to be coupled with additional therapy to help me be better able to handle the stresses.
And that doesn't mean I'm anti-CBT. You've given me a lot to think about and a lot to research, and I will do it, and bring the results to my therapist (who really does appreciate CBT). Perhaps I will discover some toolst that will bring me past the behavioral aspects to the pure obsessive aspects.
Thank you, Matt.
Posted by mattdds on June 8, 2003, at 18:31:03
In reply to Re: Another CBT question. Very specific. » mattdds, posted by Dinah on June 8, 2003, at 16:27:27
>>I really do believe that OCD, in some cases anyway, serves a useful purpose. Mind you, like most dysfunctional coping tools, it also causes problems. And perhaps in some cases it is a simple brain glitch where thoughts repeat. But I really do believe that in some cases it works as a pressure valve, or a better simile might be a controlled burn in a forest fire.
Absoulutely! I'm in 100% agreement here about this. Obsessive thoughts tend to get exacerbated when coping mechanisms fail. This is undisputed. I like your analogy of "whack-the-mole" (I hate that game!), it is so accurate. I think that CBT that fails to strengthen coping mechanisms is not really CBT, but cosmetic, patching psychotherapy.
I know when I am procrastinating things or otherwise avoiding dealing with something, I get an upsurge in generalized anxiety and panic attacks (which is just my own flavor of a pathological, psychic safety valve).
David Burns (sorry to mention his name again, but...) is a strong believer in this, and uses the "Hidden Emotion Technique", which is based on the assumption that anxiety (especially obsessive anxiety) stems from issues that are not being dealt with.
Do you have a tendency to procrastinate? Do you get overwhelmed easily? I ask this because you mentioned in your post to Shar that you had some things that you had let go (e.g. diet, finances). Certainly, if you are worried about these things on one level and are ignoring them, they could get expressed in some weird ways. I'm with Frued on this one!
So how about a *specific*, real-life problem that you are avoiding / not coping with well? These are highly accessible to CBT. Perhaps more than anything else!
I have learned some things that help with procrastination for me. If you are interested, I can start a new discussion or continue this one.
>>OK, I'm trying to be open minded and flexible about CBT. If you could try to be open minded about what I'm about to say, I'd appreciate it.
Sorry if I sounded dogmatic or pushy. One of my major flaws is trying to help people who don't solicit it; I do it with my whole family. It's like me getting new glasses and saying "hey, try these on, they really work!". Although I really am convinced (on nearly all levels) that CBT can be of at least some help to almost everyone.
So I apologize if I have sounded preachy. And I'll try to just listen better, how's that?
Best,
Matt
Posted by Dinah on June 8, 2003, at 19:21:32
In reply to Re: Another CBT question. Very specific. » Dinah, posted by mattdds on June 8, 2003, at 18:31:03
>
> >>OK, I'm trying to be open minded and flexible about CBT. If you could try to be open minded about what I'm about to say, I'd appreciate it.
>
> Sorry if I sounded dogmatic or pushy. One of my major flaws is trying to help people who don't solicit it; I do it with my whole family. It's like me getting new glasses and saying "hey, try these on, they really work!". Although I really am convinced (on nearly all levels) that CBT can be of at least some help to almost everyone.
>
> So I apologize if I have sounded preachy. And I'll try to just listen better, how's that?
>
> Best,
>
> MattOh, Matt. I hope I didn't imply that. If so, I apologize. I think we've been having a very pleasant discussion, and I appreciate the effort you've gone to. It's just that the view of OCD as an adaptive (if inefficient and unpleasant) mechanism seems to have fallen out of favor. The purely biological explanation seems to be prevailing. So whenever I bring up my theory, I do it rather apologetically.
I don't really have a good idea of the underlying fears right now, other than a general one of being a grownup in the real world. I'm facing the medical and financial problems, if not with grace, then at least relatively realistically. :) I've got a million ways of distorted thinking, and I'm slowly working on them. Awareness is half the battle, right?
If I remember correctly, you've done your CBT work without a therapist? Or have I got you confused with someone else? If so, I really congratulate you. It takes a lot of self discipline and rigorous self examination even with a therapist, and even moreso without one.
And if you've found something that works for you so well, it would be natural for you to want to share it with everyone.
Thanks again.
Dinah
Posted by habbyshabit on June 8, 2003, at 22:56:05
In reply to CBT and metacognition » Larry Hoover, posted by mattdds on June 2, 2003, at 1:55:30
Matt,
I really like the idea of metacognition. I'm am quite familliar with both CBT and Tibetan Buddhist Mindfulness meditation. I think if you read H. H. The Dalai Lama's book "Transforming the Mind" you'd find he was describing metacognition - though not in those words of course.
Training the mind is a lifetime opportunity. I have found incredible changes in my perspective and life experience through "watching my mind".
Your writing is impressive. I haven't read much of this thread. I am new here, but I just needed to comment on your discovery of "secular buddhism". That's what I feel like in my life mostly, a secular jewish/buddhist. Mindfullness meditation and practice has really changed my world. I've delt with manic-depression for over almost 30 years, so I had a lot to work with!
Habby
Posted by lucy_fyrr on June 8, 2003, at 23:33:36
In reply to Found Psychological Babble - ready to babble;, posted by Squiggles on June 1, 2003, at 11:36:38
hi everyone, I've read over a couple of random threads over the past month or so, and now I'm just about ready to post my own.
Here it goes...
I have a long history of depression, anxiety, marked by several nervous and emotional breakdowns. Currently, I'm on Prozac, and unlike other times, I do not see a psychiatrist. (Hopefully, though, I will find a psychiatrist once I get back home from my vacation)
I'm not very trusting of drugs, but I got to a very low point at which I was very desperate so I agreed to try this Prozac. During this low point, I had a flood of suicidal thoughts interchanged with cravings for cocaine or amphetamines. I generally have a bad relationship with drugs of most sorts. I become easily addicted.
Anyhow, I went to my reg. doctor to see my blood test results. (I had gotten a blood test done because I recently put on quite a bit of weight during a short period of time). The doc told me my results were fine, so I admit that the weight gain must have been due to my depression... my doc suggested Prozac.
She took a look at my body, and weighed me. She claimed that Prozac would help me lose some weight and that it should help. I had never before been told that I needed to lose some weight, it was always quite the opposite. I was anorexic on and off for about three and a half years, and only lately did I recover. I am currently (what I think is) a normal weight (5'7, 127lbs.) I don't want to fall back into my awful obsession of exercising and counting calories, but then again, I don't want to put on anymore weight. I've already gained 20lbs over the past year and a half, I don't know if I could handle anymore. It's very depressing to see my body become fatter.
I've only been on prozac for 2 weeks so I'm not feeling very much yet. I've been sleeping a lot more than usual, and my mind was a little cloudy the first couple of days, but otherwise nothing physical has changed significantly. My depression has cooled down a bit. I don't have half as many suicidal thoughts, but my outlook isn't exactly the most sunny. But I guess I prefer feeling some sadness than not being able to tap into that part of me at all.
Last year I was on Effexor, but I took myself off of it after 3 months because it was making me numb. I was not able to feel anger or sadness. I don't know if my dose was too high, but nevertheless I didn't react to it well.
I apologize now for my excessively long post.
But there's a question of sorts in here...
I am feeling nearly like myself, but I am not sure if it would be a good idea to be on prozac for an extended period of time? if I should try to deal without it? or if I should take it during times when I need it?
It would be great to hear about anyone else's experiences with coming off of prozac, or any other experiences with any SSRIs. I am a university student, so i'm very concerned with how SSRIs may affect concentration skills, or anything study-related.
This forum is a great idea, and thanks for reading if you got this far.
bye for now.
Posted by Dr. Bob on June 9, 2003, at 3:31:11
In reply to Re: CBT and metacognition » mattdds, posted by habbyshabit on June 8, 2003, at 22:56:05
> I think if you read H. H. The Dalai Lama's book "Transforming the Mind" you'd find he was describing metacognition - though not in those words of course.
I'd just like to plug the double double quotes feature at this site:
http://www.dr-bob.org/babble/faq.html#amazon
The first time anyone refers to a book without using this option, I post this to try to make sure he or she at least knows about it. It's just an option, though, and doesn't *have* to be used. If people *choose* not to use it, I'd be interested why not, but I'd like that redirected to Psycho-Babble Administration:
http://www.dr-bob.org/babble/admin/20020918/msgs/7717.html
Thanks!
Bob
Posted by Dr. Bob on June 9, 2003, at 3:34:49
In reply to hello, new to the board, posted by lucy_fyrr on June 8, 2003, at 23:33:36
> hi everyone, I've read over a couple of random threads over the past month or so, and now I'm just about ready to post my own.
> Here it goes...
> I have a long history of depression, anxiety, marked by several nervous and emotional breakdowns. Currently, I'm on Prozac, and unlike other times, I do not see a psychiatrist...Welcome! And sorry if it's confusing here, Psycho-Babble is the board for medication-related questions. Here's a link:
http://www.dr-bob.org/babble/20030604/msgs/232552.html
Bob
Posted by habbyshabit on June 9, 2003, at 10:04:31
In reply to Re: double double quotes » habbyshabit, posted by Dr. Bob on June 9, 2003, at 3:31:11
Thanks! Dr. Bob. I had not read that part of your web site. "Transforming the Mind" Thought I'd give it a try. It is a good book for those seeking psychological change through thought transformation.
Habby
Posted by habbyshabit on June 9, 2003, at 10:15:33
In reply to Re: double double quotes » Dr. Bob, posted by habbyshabit on June 9, 2003, at 10:04:31
I tried the link created and it didn't take me to that book at all. In fact I had to do a search under The Dalai Lama's name as author to find it in a list of over 200 books. It was #24 on that list. Hmmm? Maybe this should be redirected to administrative thread or book thread, but just wanted to say what happened.
Habby
Posted by Larry Hoover on June 9, 2003, at 10:35:10
In reply to Re: double double quotes » Dr. Bob, posted by habbyshabit on June 9, 2003, at 10:04:31
> Thanks! Dr. Bob. I had not read that part of your web site. "Transforming the Mind" Thought I'd give it a try. It is a good book for those seeking psychological change through thought transformation.
>
> HabbyHabby, it should have looked like this:
"Transforming the Mind"
double double quotesLar
Posted by Larry Hoover on June 9, 2003, at 10:47:04
In reply to Re: Accepting intrusive thinking » Larry Hoover, posted by mattdds on June 8, 2003, at 11:05:55
> Hey Larry,
>
> Good to see you here again!Thanks. I'm glad we're doing this examination of cognition.
> Thanks Larry, these are great insights! Sounds like you reinvented Adrian Wells' wheel without even knowing it! You seem to have a grasp on things that 99% of clinicians don't!
>
> Best,
>
> MattReally? That's your impression, that 99% of clinicians don't grasp these ideas fully?
That was really kind of you to say what you did about my own cognitive processes.
Yes, I've borrowed from many sources, but it has become a very personal/subjective technique for me. I have my own terms for major concepts. For example, I've been calling metacognition "pseudo-objectivity" for some time now. Pseudo, because no one can be perfectly objective via a subjective process. But it is the same thing, adopting a third-party observer status with respect to the self.
Just a few days ago, I was discussing with my own cognitive therapist what my future might hold for me, given my continued gradual improvement. I know I don't want to be a trucker for the next twenty years. My therapist, totally of his own initiative (he brought the topic of my future up, not me), suggested that I consider becoming a therapist. Specifically, an addictions counsellor. It kind of took me off guard, my therapist suggesting I'd make a good therapist. I have a degree in psych.....going into counselling isn't too much of a stretch, qualification wise.
Something to think about, I guess. I'm not at a place where a decision is necessary, so it's just a thinking point.
Lar
Posted by Larry Hoover on June 9, 2003, at 10:59:10
In reply to Re: responsibility vs. blame » Larry Hoover, posted by Dinah on June 8, 2003, at 15:46:13
> Hmmm, perhaps with all this help, I'm getting a glimmer.
That's very good news.
>But it takes a while for things to sink in for me.
That's how it is for everybody. When you try to grasp a new cognition, at first you find that to be difficult or impossible. But that's only because the cognition itself has no experiential base in your patterns of thinking.
You may get an "A-hah!" moment along the way, but that usually happens after the glimmer of comprehension has taken root in the psyche. The light-bulb moment is the recognition of the validity of the cognition in your real-time experience. Kind of like, "Oh, there's one! Now I get it!" But first, you have to have the glimmer. It's a process, not just for you, but for all people.
> It took me twenty years to understand the song "Amazing Grace".
Well, you're way ahead of me on that one. Amazing Grace is over my head (though I'll admit to not putting much effort into it).
>I'll cogitate on the matter, and hope for an ah-hah experience.
You will not get an "A-hah!" from cogitation. Cogitation may help you prepare yourself for the new idea, but the evidence comes from observation. You have to see yourself acting in the way predicted by the new cognition, to make it valid for you.
You may have seen my earlier posting of this phrase, but it speaks to this process, so I'll repeat it here:
"You can't think you way into a new way of acting, but you can act your way into a new way of thinking."
> Thanks for your patience. :)You're welcome. Thanks for having an open mind, and the courage to express your personal issues to us.
Lar
Posted by Larry Hoover on June 9, 2003, at 11:09:32
In reply to Re: double double quotes » habbyshabit, posted by habbyshabit on June 9, 2003, at 10:15:33
> I tried the link created and it didn't take me to that book at all. In fact I had to do a search under The Dalai Lama's name as author to find it in a list of over 200 books. It was #24 on that list. Hmmm? Maybe this should be redirected to administrative thread or book thread, but just wanted to say what happened.
>
> HabbyYou're right. Please accept my apologies. I didn't realize the second set of double quotes didn't come through in the actual posting. I put two sets around the title, but only one was visible in the final product. And, like you, I found that the desired book was not directly linked.
Lar
Posted by habbyshabit on June 9, 2003, at 12:10:22
In reply to Re: Accepting intrusive thinking » mattdds, posted by Larry Hoover on June 9, 2003, at 10:47:04
Lar, regarding your concept of a third party observer to the thinking mind; I have heard it called and call it myself 'the witness'. In other words, I am witnessing my thoughts, I am not my thoughts. Just another way of putting the concept into words. It's good to see that there are others working with these concepts outside of a buddhist framework. I think that some of it goes beyond CBT theory, though I've never actually had a cognitive therapist before...
Habby
Posted by Larry Hoover on June 9, 2003, at 12:34:37
In reply to Re: Accepting intrusive thinking » Larry Hoover, posted by habbyshabit on June 9, 2003, at 12:10:22
> Lar, regarding your concept of a third party observer to the thinking mind; I have heard it called and call it myself 'the witness'. In other words, I am witnessing my thoughts, I am not my thoughts. Just another way of putting the concept into words.
Yes, I agree, witness conveys much the same concept.....however, my personal preference lies more towards "chairperson", because certain voices are easily drowned out. When I think of the voice of my spiritual self, it never speaks loudly. It's not an aspect of its existence to be loud. One of the attributes of a chairperson is to give each voice undivided attention.
Meditation is one way to give the spirit undivided attention, but it is not the only way to do so.
>It's good to see that there are others working with these concepts outside of a buddhist framework. I think that some of it goes beyond CBT theory, though I've never actually had a cognitive therapist before...
>
> HabbySome of my insight arises from 12-step work. In that method of recovery, we speak of a spiritual disorder as the root of the "disease". Even the word disease is quite useful, in a variety of contexts. It arises from an Old French word, "diseasu", meaning "not at peace". And, how can you be at peace when you are in denial about any aspect of your being?
Absolutely, quite apart from CBT, there are applications of this mindfulness. Self-respect, IMHO, arises from respecting all aspects of our being, not from selecting certain components (implicit approval), and denying others (rejection).
Lar
Posted by habbyshabit on June 9, 2003, at 13:09:19
In reply to Re: Accepting intrusive thinking » habbyshabit, posted by Larry Hoover on June 9, 2003, at 12:34:37
Larry,
It gave me a chuckle when you referred to the witness as the chairperson, a quietly speaking one at that! It also reminded me of the phrase, 'the still small voice within' as a way of talking about the voice of spirit. However, I have found, over time, that that small voice is not only not small, but neither is it still - indeed it's a rather large part of my consciousness - if quiet indeed.
I find the voice of my spirit/soul to be soft and really have no sound as I usually think of it. Like recalling the voice of a person one knows well, you can actually hear the tone and inflections and resonance of that remembered voice. The sound of my 'witness' has no such human quality. I guess it's monotone with out being monotonous!
I too have done recovery/12 step work. One of the aspects of the 12 Step Program that drew me to it was that it recognized the spiritual nature underlying dis-ease, to use a new-age version of the word.
Also, we are in complete agreement regarding the nature of mindfulness practice. If one is judging oneself and accepting and aggrandizing what one finds is good about oneself while avoiding and denigrating that which is personally felt to be negative, then that is not true mindfulness practice. That is common thinking running amok as is the nature of thoughts themselves.
Thanks for the enjoyable conversation. I guess it’s always nice to find someone who relates to themselves and the world in a similar fashion, unfettered by religious trappings.
Habby
Go forward in thread:
Psycho-Babble Psychology | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.