COVID and Anxiety
COVID-19 and OCD. Wow. Can you believe it’s been a little over a year since the pandemic started? I’ve debated making this video multiple times and with multiple requests and emails I finally decided to take the plunge. I wanted to say with the disclaimer that I am not a medical doctor and I’m not giving you medical advice. I will however give you my thoughts on how somebody who struggles with OCD can do when it comes to the fears of possibly getting the virus. Not only the virus but any sickness.
Hi, my name is Nathan Peterson! I am a specialist with OCD and anxiety related disorders and the creator of the self-directed courses for OCD and BFRBs. I create videos every single week with tips and treatment strategies for OCD, anxiety, tics and Tourette’s, hair pulling and skin picking. Make sure you’re subscribed so you do not miss any of these.
You probably know what COVID-19 is. If you missed it, knock knock knock hello is anyone there. This virus in pandemic has sure set panic throughout the world. And rightfully so. When this thing first started, I made an ignorant comment. I said this is no different than getting the flu, or putting so much value and power on this thing. Boy was I wrong. With the countless lives lost, jobs lost, and mental health issues on the rise, I could never imagine what was going to happen.
Many people have asked me. Nate and I say uhuh, and they say so I’ve been doing treatment for my OCD, how does it now change because of the pandemic. This has been so difficult to figure out a great guideline. Because just like any other anxiety fear in our life, it is very uncertain. There isn’t going to be an answer that is given that is 100% sure.
When it comes to contamination OCD and the fear of possibly getting sick. Individuals felt the need to wash more, avoid more things, Thus sending them through massive spirals where they didn’t know they were following guidelines for fear creating their own rules.
Here is how I have been treating OCD in the midst of this pandemic. I have people create a guideline. How many times a day I want to wash my hands. Is it before I eat, after use the bathroom, or if I come in from outside. Maybe it’s if I physically see dirt on my hand. So typically maybe is five times or less a day.
I then say, we will follow the guidelines of the CDC. Even if we think they are incorrect or wrong. We have to follow some type of guideline or else the rules that your OCD will create could be catastrophic. For instance the CDC said, if you are vaccinated you no longer need to wear a mask. So guess over going to do, no longer wear a mask. But this doesn’t mean I’m no longer wearing a mask but I’m just gonna stay inside. We are following all the guidelines. They say I can go to a restaurant, I’m going to restaurant. They say I can hang out with my other friends vaccinated, I’m hanging out with my friends.
Here's the tricky part however, what about the things are not part of the CDC guideline. They can’t give every scenario possible that you are ever going to run into. This is where you take your best judgment. Meaning, the CDC didn’t mention if I go to my friend’s birthday party and is probably going to be 30 people there. What should I do? I say you do whatever you want to do. Sounds risky, but you do it following the CDC guidelines. They say wear a mask there’s over 20 people, I guess I’m wearing a mask.
I also wouldn’t want individuals to solely focus on this the rest of their life. I want individuals to live their life, sometimes feel like they are risking a lot. But knowing that the base of what I said was I want to wash my hands five times or less a day. How my going to do this.
Typically we use exposure and response prevention. We expose ourselves to things that make us scared or nervous and respond completely different to them. A lot of people hear this and I think that sounds pretty dumb. You want me to just go out and get myself contaminated and dirty and hug everyone I see. This is not an all or nothing approach. This means that I just went to the grocery store I got a lot of groceries other people probably touched, I’m putting them away in my pantry without washing them because the CDC did tell me I needed to. I did say however that if I come in from outside I can wash my hands.
But did the CDC say I need to wash my hands with 5 to 10 pounds of soap? NOPE! Did the CDC say that the water must be scalding hot? NOPE!
You may need to create your own guideline and foundation. I wash my hands for 30 seconds, one pump of soap, and the water may be hot or not.
Overall I want somebody’s experience to be a thoughtful one. Not in anxiety one. Meaning my decisions are based off of just general thought not my decisions are based off of my anxiety. And if anxiety is there I might risk the rules that have created in my brain and learn to respond completely different to them. A lot of times the magic words to the things we don’t know or maybe maybe not. Meaning I’m choosing to only solve the problem when there’s a problem presented in front of me. This is so incredibly hard to do. Because people have gone sick, people have died.
But we are living our life, OCD does not get to dictate what you do anymore. Because there is new value that is been placed in front of us doesn’t mean OCD treatment goes out the window.
A task that some choose to do is to write down all the rules are brain has created because of this pandemic. See if they match up with the CDC and the ones I don’t they may choose to do treatment with these. They feel like they’re doing a lot of risk. But without the risk there tends to not be the reward. The sound so incredibly scary, but what I’ve seen time and time again that the brains really good at saying once I get vaccinated then I will feel anxious about it. Once this one thing happens I will be nervous anymore. Guess what happens, a person gets vaccinated and there still anxious. The brain thinks it’s problem-solving but is continuing to keep you trapped. It’s only going to know that you’re the boss if you treated that way. Sometimes going against the rules that you’ve created in your brain.
I am in no way diminishing the effect that this virus is had on the world. I am diminishing the way OCD is making you think about the virus. Taking power and value away from OCD. It no longer deserves your attention.
If you’re looking for a little extra help, I’ve created a very specific course for OCD that takes you through understanding yourself, the treatment, and building your foundation for success. I will link this down in the description below.
Here’s my question for you. What rules are you following or are taking over your life because of this pandemic? Also, what you can start doing differently about your behaviors?
COVID and OCD
COVID 19 and Anxiety
Inhibitory Learning For OCD
When somebody is facing their fear, they repeat this process over and over again their body tends used to it. We’ve seen this in many different ways such as jumping into a really cool swimming pool. At the very beginning it is very cold but their body adapts and get used to it. We didn’t have to spend time convincing ourselves it was going to get better, it just happens. This can be seen when we are using exposure and response prevention. When you are exposing yourself to the upsetting fear it’s going to feel very difficult at the beginning. Overtime, you may face the same fear but notice that the anxiety level is a lot less. This is seen as the habituation model. That we essentially are doing exposures to reduce your anxiety by half or more. You’re getting used to it, you’ve taken the value away from it. When it comes to the habituation model, it’s all about this anxiety reduction in your body adapting just like the swimming pool. We will often use us as a measure of success if you were doing exposures correctly. If you’re anxiety is reducing this is a good thing.
There are definitely some drawbacks from using the habituation model. Anxiety is something that we want to take value away from as well. If we are focusing solely on anxiety and having us go up and down individuals can get stuck in paying attention to the anxiety and wondering if they are doing the exposure correctly or not. Let me start obsessing about the actual anxiety versus the actual fear. Many will start to question and wonder why they’re in anxiety is not reducing. Well evidence shows that the habituation model does work, individuals can you get stuck with these pitfalls often.
This is why there is another approach to exposure and response prevention called inhibitory learning. While this is still being researched there is evidence that shows that this helps reduce OCD symptoms as well. The difference is not the actual exposure you were doing but rather the way you were approaching it. With the inhibitory learning model you are teaching your brain more than reducing anxiety. Exposures are all about what can your brain learned from this experience. It doesn’t matter if your anxiety reduces or not. It might not even matter if you have anxiety while you’re doing the exposure. The whole mindset is all about your brain learning something new. So if I was facing a fear that really caused some anxiety, the way I approach is designed is to face the fear, expose yourself to it and RESPOND differently to the fear. You sole focus is what am I teaching my brain by every movement, words I’m saying, what I’m thinking, how I’m behaving.
If I avoid touching something because it’s contaminated, my brain learned that that thing is dangerous. If I touched it and acted like it wasn’t a big deal and didn’t do any compulsions, then my brain learns it’s not a big deal. You may learn time and time again that you faced your fear and NOTHING happened. That is what the brain is learning.
If you’re confused by the two, here is an easy way to remember:
The habitual model means your body is getting used to it and your anxiety is reducing.
Inhibitory learning model means your mindset is all about what your brain is learning from the exposure regardless of the anxiety felt.
Realistically, there isn’t the right choice comes to do an exposures. You do what you feel like is best for you. I have used both models together where I focus majority of my time making sure that the person knows that the brain is learning something. We use anxiety as a measure but ultimately it doesn’t matter if the anxiety reduces or not.
If your brain can learn that the fear that you have is not happening and it is it because you’re trying to control the situation what is the compulsions and to me that’s one of the best ways to do an exposure. Let things be. Stop controlling. It feels like an experiment, but the experiment is worth taking for your brain to learn something major. That you’ve never been a danger.
Habituation For OCD
Inhibitory Learning Exposures
How To Stop Compulsions with OCD
How many things do we do in our life because “just in case”. Our brain comes up with an idea of “something bad” happening and we tend to follow it up with….well just in case, I’ll do this behavior. I want to talk about the traps we can fall into when we use “just in case” when it comes to OCD and anxiety.
So if you really think about it, this just in case mentality is the root of a lot of anxiety and OCD. Most people are not doing certain compulsions because they know a hundred percent no doubt in their mind that the thing they're scared of is going to happen. They are doing these behaviors because they want to prevent something that they don’t know could happen.
For instance, those who may struggle with contamination OCD wash their hands just in case there are germs or contaminants.
Those who struggle with sexual orientation OCD might ask for reassurance again just in case the person didn’t understand them correctly.
Someone who struggles with relationship OCD may just end the relationship just in case it was never meant to go anywhere.
Someone with real event or false memory OCD may spend a lot of time ruminating, their thinking through all these different types of scenarios just in case they find some new evidence to what they’re thinking.
These just in case behaviors keep people trapped in their OCD. And what I want is for people to turn this all away around and say just in case my theory is wrong I’m willing to risk it. Risking it means they are using exposure and response prevention. This is something to think about when you are going through your OCD topics or themes. You think about your motivation for why you are doing whatever you are doing. You can follow it up with I’m doing this just in case ….. -- if there is even a just in case there and you know it’s part of your OCD this is a moment to step back and say I am purposely not going to do this behavior or this compulsion.
Because what the brain needs to learn is that you are saying I’m going to fix this before there’s ever a problem. The problem that doesn’t happen in all the brain knows is that you had a lot of control over the outcome. This can be completely false because in reality, you may have not had any control. The brain doesn’t know this, this is your job to teach it. The only way for it to learn is for you to not do the compulsion to respond differently to the thoughts and fears.
Because what happens is that when your brain says This thing five times or a family member will die. You choose not to. You see that the outcome most likely doesn’t happen. When it doesn’t happen it starts correcting the brain and retraining it to say, hey you completely lied to me. You said I had to tap five times, and nothing happened. Maybe it’s time for you to stop lying to me.
Your brain congratulates you for taking care of the just in case moments. Of course, we can never be 100% sure that these bad things will never happen in your life. But that’s not the point, the point is that you may need to risk that the fear in your mind may happen but it’s not because of any compulsion were not doing a compulsion.
So the next time your brain says just in case. Look around you, if you don’t see immediate danger then you may choose to make a different choice, you may learn to sit through the anxiety, not ruminate through it, not do any other compulsion…. And see what the outcome is. You may be surprised.
So here’s my question for you, what just in case things do you do?
Stop What if with ocd
Just In Case with OCD
How To Stop Ruminating with OCD
Rumination and OCD
This video is a long time coming. Let’s talk about rumination. Do you know what rumination is? I would say most, If not all individuals who struggle with OCD ruminate. The official definition of rumination is “the action of chewing the cud”……
Wait, that’s not it. How about this. “a deep or considered thought about something.” That’s better. We can all be in deep thought from time to time. It can whisk us away from the present moment. It can distract us from noticing the surroundings around us. Some have said that rumination is often considered to be a silent mental health issue. No one can see what’s going on except the person. They often don’t know the harm they may be causing themselves because of this rumination.
But why would thinking something very deeply be an issue? Well, it only tends to be an issue when it actually starts interfering in a person’s life. When it comes to anxiety, rumination is essentially a way for the individual to gain answers and problem solve whatever they’re feeling anxious about. It’s trying to problem solve the future. Trying to problem solve the “what if’s”.
If you think about yourself, are you ever able to actually come up with a good answer to the things you are ruminating about. I would guess the answer is no. Because we think we have a good answer, we react as if we have a good answer, we do behaviors assuming we have a good answer, and in the end it ends up being different than what you thought.
Rumination is a huge part of obsessive-compulsive disorder. Individuals who struggle with this often are looking for certainty. They want to know for sure what they are experiencing is true or not. If there really that type of person or not. If they would really do that thing or not. If that catastrophe in the future is going to happen or not. Rumination is thinking about all these things. Thinking about your specific topic or fear when it comes to your anxiety and OCD. Often rumination is just trying to figure out if what you are experiencing is OCD related or not. It’s problem-solving through what your brain says is a potential problem.
Here is an example: somebody you may experience contamination OCD may attach to door handle. Their brain has attached meaning to this. Here’s the rumination and what my sound like: “ I can’t believe you just touch the door handle. Do you have any people touch the door handle? What if somebody was sick that touched it? Do if you touched your face or no after you touch the door handle? No is probably okay to touch it. But if it’s not okay then I’ll get sick. I get Sick, then I won’t be able to go to work. If I can’t go to work, then how am I going to support my family. You know even though it’s probably fine, you should probably wash your hands just in case.
The person goes to wash their hands.
I know you washed your hands, did you know if you touched your pants afterwards? I know you trust your phone is a something you probably need to wash? How about you just change her clothes just in case. Well I know now you just kept yourself safe, but did you see that your child just touched the door handle. What things did they touch. Maybe need to go ask them, wash their hands change their clothes washed the door handle.
As you can see, this person is problem-solving they are doing just in case behaviors. There trying to think through it and prevent whatever the fear is from happening. Often I see rumination as very automatic. It will throw out these threats to you as quick as it can. If you go down this road and problem solve or think through the situation. You are doing a compulsion.
The compulsions are the things that are keeping you trapped. All your brain knows is that you may have saved yourself from whatever fear it says was going to come your way. It is a liar. You cannot think your way through your fear.
I say don’t engage with rumination. Do not give it any power whatsoever. This is a very tough task. But here are some tips you can use. Making sure you give your brain the same answer every single time it threatens you. It says you hit someone with your car are you thinking through this whole situation. Your answer is maybe I did maybe I didn’t. Some choose to agree with the threat to take the power away. They may say, sure I totally have someone of my car.
I can only imagine the OCD screaming you just gave it that answer, that you agreed with it. Are you sure you actually love your partner? Maybe I do maybe I don’t. Are you attracted to somebody of your same gender? Maybe I am maybe I’m not. Will I harm my child? Maybe I will maybe I won’t.
There is not a topic or theme you cannot use this phrase with. Everybody thinks their special and that their specific topic or fear does not apply. To help you not ruminate, it’s committing to not engage by giving it the same answer every single time. Even if it feels real, even if you feel like this one’s different.
Some choose have different catchphrases. That’s not my thing. Sure man totally. Thank you for your opinion.
These statements need to be followed up with not engaging in the compulsions. The individuals that do the compulsions are not really committed to the maybe maybe not’s that they are saying. Because you cannot say maybe maybe not, and then go wash your hands because you’re just not sure. Or avoid the knife because you’re just not sure. Or go back and check to make sure you did hit a pedestrian because you’re just not sure. Ask for reassurance again because you’re not sure. That is the whole point. You need to be unsure. Being unsure on purpose as a way to stop the rumination.
One of the first parts is recognizing that you’re even ruminating in the first place. You might think about what is my reasoning for thinking through this right now. Am I just genuinely curious, or do I feel this urge for this need to figure out this answer right now. If it’s the urge, you’re not gonna do it, you choose not do it. Is actually your choice. The thoughts will start coming in that’s the automatic part, but you engaging with them is completely your choice. Give yourself that power.
Did you know that I created a very specific course for OCD. It takes you through understanding yourself, the treatment and a way to maintain your progress. We talk about rumination, hierarchies, exposures, writing scripts so much more. There are over 41 videos in this thing. I’ll link it in the description. You can preview you it for free.
Do you ruminate? What do you ruminate about?
Overthinking and OCD
Recovery of OCD
We talk so much about what to do when you’re in your OCD. But what about when you’re not in your OCD? What is life look like after OCD treatment? You finally feel like you’ve overcome a lot of your OCD symptoms. So what now?
Now it’s time for you to live life. To enjoy the things that OCD has robbed you of. While I want anybody going through treatment to focus their efforts on enjoying life. Many may see this as an all or nothing approach. I cannot enjoy life until OCD is gone. Stay away from this kind of thinking. There are moments where higher symptoms may come in moments where symptoms will be gone. You can live life and enjoy regardless.
What I find is that individuals who are at the end of treatment and are not feeling many symptoms describe it as kind of a strange feeling. There almost not sure what to do because the anxiety has been there guiding light for years. This told and what to do, how to think, and how to behave. All of a sudden individuals are now set free and needing to learn to live life without these anxiety prompts.
Life after OCD means learning to live in trust in yourself. Trust that anxiety was a liar this entire time. OCD completely lied and had no value. Often individuals need to learn who they are without their OCD. It feels uncomfortable. It actually takes a lot of effort to understand yourself without OCD. Just like doing and exposure individuals learn to tolerate this feeling without their OCD. It’s almost like losing a buddy that’s been with them for so long. Even though it’s wreaked havoc on their life some may feel lost without it. This is where trusting in your self goes a long way.
Individuals learn to live life again. Do things they never done before. Enjoy life and follow your value system. It is absolutely okay to feel uncomfortable after OCD treatment. This feeling will pass the more you start living and enjoying life. Ultimately you are living your life the way you want to, not the way OCD wants you to. You might start identifying goals that you want to achieve, what you want to get out of your life.
You may need to start working on self compassion. It is not your fault that you have OCD. We don’t focus on the time lost were missed because of your OCD. We focus on what you’re going to gain. Start working on any residual depression that comes your way.
We also know if you have OCD then you have OCD. So life after OCD treatment turns into maintaining the progress that you have made. Meaning, you are willing to do treatment strategies and exposure and response prevention anytime you have an intrusive thought. Anytime you feel like OCD is rearing its ugly head. So life after OCD really means life. Feeling relief, gratitude, excitement. But not forgetting about what treatment looks like and maintaining progress.
If I wanted to get really fit, I started exercising and eating healthier. I get to a point where I’m happy and content. I’m living my life. Do I stop exercising? Do I stop eating healthy? If I do I may end up in the unhappy rut I was in before. Where I might not have to try as hard to stay in this happy zone, I still need to do something to maintain the progress.
This is just like your OCD. Remember where you come and what you’ve done. Enjoy life. Have some self compassion, talk about all the successes that you’ve done and where you’re going. Focus a lot of your time on gratitude. The things that you are grateful for every single day.
Freedom from OCD
How to do an exposure for contamination OCD
Everyone talks about doing exposures, but do you actually know how to do it? Here is an example of what an exposure looks like AND how to respond. This is why the name of the treatment is called exposure and response prevention. It's your choice how far you're willing to go when it comes to your Contamination OCD.
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Externally, the contamination ocd concerns associated with OCD don't appear to be an extremely complicated topic. Dust, bacteria, washing-- what could be less complex? Actually, when you take a closer look, contamination is a fair bit much more complicated than that.
First off, this issue breaks down right into 2 parts contamination ocd fixations as well as purification compulsions. Let us initially examine the nature of obsessive contamination worries. Unlike the popular sight, contamination isn't simply limited to dust, bacteria, and also viruses.
There are virtually no limits to the things that can be infecting. From my own experience, I would certainly presume that the fear of certain diseases might still the leader. Many years ago cancer was one of the a lot more frequently been afraid health problems, however in the last 20 years or so this seems to have been changed by HELP.
One uncommon belief patients have is that extremely small amounts of contaminants can cover huge locations. For instance, they might believe that a decline of blood or urine can somehow be infected layer whole spaces, or even every little thing they possess.
From my very own experience, I would presume that the fear of particular illnesses may still the leader. Numerous years ago cancer cells was one of the much more generally feared ailments, but in the last 2 decades or so this seems to have actually been replaced by AIDS.
One unusual belief patients have is that extremely percentages of pollutants can cover huge areas. For instance, they might think that a decline of blood or urine can somehow be infected coat entire spaces, or perhaps everything they have.
Another kind of obsession can consist of double-checking by a patient to see to it that they have actually not become infected, or asking others for confidence that this has not happened. Patients will certainly often repetitively ask others to inspect parts of themselves they can not get to or see, or points they can not go near. Some will reach to make checklists of things they think may have happened in the past, so as not neglect this important details.
In an attempt to keep clean as well as decrease compulsions, some victims will certainly create 2 various globes for themselves; one clean as well as one dirty. When contaminated they can relocate easily concerning their unclean globe and touch as well as do anything, since whatever in it is already polluted. They might likewise be able to live freely in their clean world as long as they themselves are clean when they enter it and likewise stay that way.
For magical kinds of contamination ocd the service is frequently a magical purification ritual developed to remove or negate the problem, believed, name, picture, or idea. Claiming special words or prayers, assuming opposing or great thoughts to negate poor thoughts, as well as doing actions in reverse, are just some of the compulsions that can be seen. Sometimes the typical washing or bathing may also become part of the wonderful ritual.
" Washing machines" as they are described are possibly one of the most visible among those with contamination fixations. It is not unusual for them to wash their hands fifty or even more times per day. In more extreme cases, hands may be depleted to 200 times daily. Showers can take a hr or longer, and also in severe scenarios can last as long as eight hrs.
Obviously, washers go via huge quantities of soap and also paper towels (utilized in choice to fabric towels which can just be made use of when and also produce laundry). Alcohol preps and also disinfectant hand wipes are additionally popular.
Compulsive bathing and also cleaning are truly fairly futile, as the alleviation from anxiety just lasts until the washer calls something else that is seen as infected. In order to cut down on cleaning, victims sometimes resort to using paper towels, plastic bags, or non reusable gloves to touch points.
In some cases, member of the family have been drawn right into the patient's internet of compulsions. They are made to comfort to clean points that can not be come close to, to inspect the sufferer or the environment for tidiness, or to touch or utilize points that are believed to be infected. This sort of aid, naturally, does not truly assist, as it just locks the sufferer into the health problem as well as boosts helplessness. It additionally brings about bitterness and battling, as relative feel progressively imposed upon and also their lives end up being limited. This is particularly true when a relative is viewed as the resource of contamination.
This is where instead of being scared of coming to be polluted, sufferers fear spreading out contamination to others. The kinds of contamination that can be spread out to others are regarding the same as those that trouble various other victims. There is not just a concern of possibly hurting others, but additionally a fear of having to live with the resulting sense of guilt.
This type of therapy motivates people to gradually experience raising doses of that which is contaminated, while withstanding washing, inspecting, avoiding, or performing magical rituals. By staying with the anxiety, victims come to discover the fact of the matter-- that absolutely nothing truly takes place when they encounter their fears, and also that their efforts at taking preventative measures serve no genuine function. I such as to inform my patients that "When everything is contaminated, absolutely nothing is infected."
Therapeutic encounters are like little experiments to examination people' theories concerning the risks of their specific kind of contamination. If a feared substance or scenario is also difficult to challenge in one entire action, it is come close to more slowly. Some patients can just touch something that has actually touched a feared material or object, and also only later do they go on to touch straight what is feared.
On the surface, the contamination ocd and anxieties associated with OCD do not appear to be a very challenging topic. Allow us initially check out the nature of obsessive contamination anxieties. The kinds of contamination that can be spread out to others are regarding the very same as those that problem various other sufferers. There is not just a concern of perhaps harming others, however also an anxiety of having to live with the resulting guilt. Some clients can just touch something that has actually touched a feared substance or object, and just later do they go on to touch straight what is feared.
Treatment for contamination OCD
Contamination OCD help
Nathan Peterson, LCSW
OCD can be tricky! I want to provide useful information for your OCD, anxiety, tics, tourette's, BFRBs, and many other anxiety related disorders.