This past week, my husband and I left our children in the care of my parents and flew to San Francisco for the International OCD Foundation’s 24th annual OCD Conference.
I thought I’d do write ups on each of the three days, based on which sessions we attended. Some of the sessions, frankly, were hit and miss. That being said, there were some amazing sessions and a ton of great and interesting information.
We started out in one session but were not super impressed and left to attend “Do I Laugh with the Sinners or Cry with the Saints? A Discussion About Scrupulosity” with Jedidiah Siev, Jonathan Grayson, Charles Mansueto, and Ted Witzig, Jr.
It was a panel/Q & A. One of the first questions we heard asked was whether or not avoiding religion was a good idea for those with OCD (so that they could avoid scrupulosity fears/concerns). I appreciated the answer(s) from the panel because they said that avoidance is not the answer. They did not say to stop going to church. They said that if it was a behavior you would normally do if you did not have OCD, you should continue it and not stop because of obsessive-compulsive disorder.
They also addressed a fear that I see many have with scrupulosity and therapists: will the exposures I’m asked to do violate my faith or the commandments I feel I have to follow? The panel said that appropriate exposures target uncertainty versus “the theme” of the obsession necessarily and that CBT “should not require you to violate your belief system” but rather the certainty/uncertainty principle.
One thing I loved that Dr. Grayson said was that exposures are never done to prove that the “bad thing” won’t happen. It may very well happen! But we do exposures to prove to ourselves that we can do it and that even if those bad things happen, we can handle it. We many not handle it gracefully, but the world likely will not end.
Following that panel, we heard Shala Nicely and Jon Herschfield present on “ERP Games for Living Joyfully with OCD.” This talk was actually awesome despite sounding a little silly. Herschfield said something that really resonated with me about how so many of us go around “unnecessarily bumming ourselves out.” We assume the worst will happen (including with our exposures and life in general) when really we can assume the best and show that attitude through our behavior and actions. We need to “live the life of a person who thinks it’s going to be fine.”
He talked about mindfulness, and Nicely talked about self compassion and giving ourselves permission to be imperfect. She mentioned that self compassion is “more motivating than beating yourself up.”
They then shared “games” we can use to make our exposures more fun, many of which were simple, like purposefully looking for our “triggers” in any given situation and trying to find as many as possible to eliminate the element of surprise and take on the offensive stance rather than being defensive. Herschfield said that we should try to make OCD a worthy adversary rather than an enemy—when we are cunning and fight back, it makes OCD seem less terrible. Other games I liked were “That’s for Other People” (ie when you see hand sanitizer in a store, say to yourself, “that’s for other people” when you would normally want to use it—he mentioned that we have to create new rules to fight our OCD: “This is war here. New rule!”) and “Do Things Halfway” (with ideas like leaving out details in a story when you tell someone something, fast forwarding a TV show and not watching those minutes, cleaning everything but one part, not getting everything on your grocery list, etc.).
After lunch, we attended “Sex, Love, Intimacy and OCD” with Elizabeth McIngvale, Jessica Kotnour, Thomas Smalley, and Genevieve Kales. It had good tips about relationships and how we need to make sure we don’t draw our significant others into our OCD (esp. reassurance and compulsions); they can support us without being a part of our illness. It was good for my husband to be there because McIngvale told a story about how her ex husband often noticed her failures or the things she still needed to change and work on rather than being proud of and encouraging the strides she had made in overcoming her OCD. I think that’s so common for loved ones—they notice what we still need to do rather than supporting the efforts that have already been made. Of course, we were also reminded that those of us with OCD need to be actively managing our OCD when in a relationships.
Telling Your Story
After that session, we went to “The Hero’s Journey (and You are the Hero!): The Healing Power of Telling Your story” with Shala Nicely, Jeff Bell, Stuart Ralph, and Alison Dotson. They mentioned different ways and means we can share our stories—writing, audiovisual, etc. Two thoughts that stood out to me were to “be who you are—whoever you are, be that” (I think from Stuart) as well as “we can never please everyone, so don’t even try!”
The Noise in Your Head
The final session of the afternoon was awesome. It was “The Noise In Your Head Videos” with Dr. Reid Wilson. I love Dr. Wilson and his book, so I was super pumped. He did not disappoint! The message was the same as his book, but it was a great reminder to “ditch the content” (or themes) of our OCD and remember that the tactics of OCD are the same and beaten the same way, regardless of their content. He emphasized being cunning, seeking anxiety, and making it a game as well. He also said for those who have a hard time stopping compulsions, it might help to start messing with the pattern of those compulsions: stop in the middle and do a jumping jack or do it for a minute and then clap your hands or whatever. (Oh yes, we also watched the videos, which were great. You can see them here)
He also reminded us that we cannot have closure (esp on our obsessions or fears). We have to want to do the hard thing and make decisions about how we will react before the obsession or problem arises. He also said that we need to be “careless.”
I loved to see how he reacted during the Q&A portion. My husband and I had noticed that for many Q&A’s, people were seeking for reassurance about their specific issues. During this session, it often happened like this:
person: “STORY STORY STORY. What should I do?”
Dr. Wilson: “What do you want to do?”
person: Well, I want to do (this compulsion)…. but if it’s OCD then I shouldn’t do it, right…??
Dr. Wilson: “What do you think you ought to do?”
He kept putting it back on the person rather than assuring or reassuring them. With one individual, he asked something like “Do you think you have OCD?” and then “Do you think this is an OCD issue?”
Basically, his responses followed a similar pattern: Screw “content.” Decide you have a disorder. Move forward. You cannot have closure. Act as though it is an OCD event. Bring attention back to what you were doing before.
One thing that I still need to do that he recommended was having an “outcome picture” about what we want to have or be like in our life that OCD is keeping from us. Without this end goal, it’s hard to know what to do or have the motivation to do it.
Overall, it was a great but exhausting day!