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
Mental Hoarding OCD | The need to remember
How is your memory? Do you remember the important things? Do you remember the bad things have happened in your life? Do you remember small little details that really don’t matter, but your brain remembers it anyway? What if you felt the need to remember everything, and when I say everything I mean EVERY-THING. The details, It can be conversation, the way the room looked, how fast you are driving, something your boss told you, how many notifications came up on your phone, really anything your brain puts power and value to to tell you to remember. If you don’t remember everything your brain may convince you that something bad may happen. It could just be an uncomfortable feeling because of something that you don’t remember. It could just be that nagging feeling that there’s something that you forgot that you may be obsessing about because he just simply can’t remember.
It’s not just an annoying thought or feeling, it’s anxiety, it’s anxiety of the unknown, anxiety of the uncertainty. If you feel like you must remember every detail about a situation, a place, a conversation, or somebody’s life, and you feel anxious if you missed something, or if you simply just cannot remember; you may struggle with what is called memory hoarding.
So what in the world is memory hoarding? We think of the word hoarding, it’s a collection of things, a lot of things, often things that have no value or much purpose. This is the same with somebody’s memory. Our memories are actually not the best. Just by nature our mind is designed to remember things that it deems important. This is why remember negative experiences in our life, he wants us to learn from these experiences. But how often are we remembering the good? How often are we remembering the small little details? My guess would be not too often.
Memory hoarding is when an individual feels the need, the urge, anxiety to be able to remember every detail about the way they may be living their life. It can be something that was said to them. It could be a facial expression. It can be the way that their driving. It could be even the feeling of wanting to know something about someone else. They may spend a lot of time really focusing on every single moment of the day to make sure they don’t forget something. Really hyperaware of their situations. But, as we know it is impossible to remember everything and this is where the anxiety likes to live. It lives in those moments and those things that you can’t remember.
You may be thinking? Why in the world would somebody want to remember every detail about something? But here’s why, they may feel the need to review their memories to see if they hurt someone’s feelings are not, to know if they harmed somebody or not, to make sure they did not make any mistakes, to make sure you can review and see if there are good person, sometimes to make sure that the memory that they have is true or not. That it really happened.. They need the memory to help them know if the way they were feeling was accurate or not. Sometimes they don’t know why they need the memory they just know the feeling comfortable if they don’t have it. Sometimes it is just plain old, I might need to know this information in the future so just in case I’ll remember it.
This lives in the person’s mind. Hence it being a memory. A mental ritual. Which is essentially problem-solving and ruminating. They may feel like they need this memory so badly because it’s very all or nothing. If I don’t have is my life is ruined. I do remember it out prevent something bad from happening in the future.
Here are some common compulsions or individuals do. The compulsions are things that help you gain certainty in the perceived fears or threats that come to your mind.
Obviously one of the bigger ones would be focusing very hard and straining in order to commit something to your memory.
Carrying around notepads or using your phone to write down notes and details about everything.
Sometimes carrying this around with you anywhere you go just in case you need to recall this memory. People may have bags and bags full of paper of different details and memories just in case.
Reassurance seeking. Individuals may ask others with the memory they are having is accurate or not. They may ask them if they saw the same thing that they did.
Taking pictures or video. A good way to remember detail to take a picture of it. Their phone can be riddled with thousands and thousands of pictures that can be reviewed at any time.
Doing specific random things in order to remember an event or detail.
So what’s the treatment? Treatment is called exposure and response prevention. Your goal would be to reduce the compulsions you are doing down to a point where you are no longer doing them. You may be risking that you’re going to lose a memory. You actually want to lose a memory. You want to risk whatever that perceived threat is in your mind on purpose to test out the theory to see if it’s true or not. For instance if my brain says I don’t remember the thing my teacher said so if I don’t write them an email to verify I may not go to college.
Using exposure and response prevention we would definitely not send that email. You would actually work really hard to not have that memory. Allow yourself to feel uncomfortable or anxious if needed. Allow that feeling to go down all by itself without controlling it. Using a lot of maybe maybe not statements to say “I may or may not go to college we will see.” And have you risk this.
When the brain is mentally replaying situations, your quickly responding with uncertainty answers or agreeing with the threat. Something bad may or may not happen. I’m willing to take that risk and not have this memory right now. Closing times where you feel like you need that memory and you’re starting to focus, distract yourself do something so you can’t remember on purpose.
You are essentially facing your fears and responding differently to them. The compulsion’s are the things that are going to keep you trapped. But you must respond differently to the upsetting fears you have. Act like you don’t care. Get in the mindset of not wanting that memory.
Treatment For Mental Hoarding
Fear of Forgetting a memory OCD
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.