Resources
Mindfulness Exercise
Mindfulness is the act of being present in any given moment. OCD likes to take us out of the present moment and have us worrying about the past or future. Mindfulness is a key coping skill to use when managing OCD.
One way to practice mindfulness is by listening to music intentionally and mindfully.
· Pick a song (classical music tends to be an easy genre to start with)
· Play that song and pick one instrument you are going to focus on Focus only on that instrument.
· You might be distracted or notice the other instruments, and that’s ok. Just remember to bring your intentional focus back to the one instrument
Example
· Song: Danse Macabre
· Only going to focus on the string instruments
· I listen for the flute. Sometimes it is very loud and the only instrument I can hear. Other times it is very quite and I need to try really hard to hear it. Some of the time I find myself getting distracted by the other instruments. I remind myself that this is ok, let those instruments be there, and then bring my attention back to the flute
This is a great example of how we can manage intrusive thoughts that OCD sends our way. While we can’t control whether or not the intrusive thoughts are there, we can control where our attention is and how we respond to those intrusive thoughts. When we are going for a walk with our friend, we may be walking along, enjoying nature, but then BAM an intrusive thought pops into our head. At that point, we can choose to be distracted by that intrusive thought, let it ruin the walk, take us out of the present moment, etc. or we can let that thought be there and refocus on the present moment.
Try this activity out with any song. Focus on the lyrics or a musical instrument. Notice the differences in tempo and volume. And remember that you don’t have to do this perfectly to be practicing mindfulness! GROUP OFFERINGS M
Mindfulness/Self-Compassion Moment
Think of a situation in your life that is difficult, and that is causing you stress (distressing emotions, loss/grief, intrusive thoughts, etc).
Call the situation to mind, and see if you can actually feel the stress and emotional discomfort in your body.
Now, say to yourself:
1. This is a moment of suffering:
That’s mindfulness.
2. Suffering is a part of life:
That’s common humanity.
Now, put your hands over your heart, feel the warmth of your hands and the gentle touch of your hands on your chest.
3. Say to yourself: “May I be kind to myself”. You can also ask yourself, “What do I need to hear right now to express kindness to myself?”
This practice can be used any time of day or night, and will help you remember to evoke the three aspects of self-compassion when you need it most.
Neff, K. D. (2012). The science of self-compassion. In C. K. Germer & R. D. Siegel (Eds.), Wisdom and compassion in psychotherapy: Deepening mindfulness in clinical practice. The Guilford Press.
Spring Into Self-Care
As I sit writing this, I look out my open window and breathe a sigh of relief. The grass is beginning to turn green, the sky is a comforting shade of blue, and the birds have begun to sing. Spring is finally here (although being Colorado, snow is in the forecast tomorrow). I imagine that I am not alone in feeling like this was an unusually challenging winter. After a season of uncommonly frigid weather and near-constant post-COVID illnesses, I am grateful for the warm days and fresh air to come. As winter turns to spring, we have a wonderful opportunity to consider the role of self-care in our own lives. During the dark cold winter months, self-care can feel like a reactive measure to get ourselves back into health both physically and mentally. With spring's arrival, perhaps self-care can mimic the season and take on an energy of growth, potential, and beginnings. Maybe that means pausing to feel the sunshine on your face when you eat your lunch outside instead of at your desk. Perhaps a walk around the neighborhood to admire the new flowers is in order. Maybe self-care comes from a deeper place of appreciating and acknowledging the bravery, strength, and kindness within all of us. Perhaps it means making that change that you have been thinking about or maybe it means allowing yourself to stay put, grow some roots, and see what fruits may come. Whatever self-care means for you, consider how it can be used not just to return to health, but to grow into something new and tender and full of potential (just like spring).
Love and Loss
Think about the people in your life who you love the most. Maybe it’s your partner, your parents, your children, a beloved pet. Think about how you feel when you are at your most connected. Feel your heart open and soften. Notice the feelings of warmth and safety. At this point though, another type of feeling may begin to creep in. A constriction in the throat, a clenching in the chest and stomach. Dread, fear, anxiety.
When we love someone dearly, we naturally fear losing them. For many with OCD, this fear can feel unbearable and can lead to compulsions that help it loosen its grip in the short term, but ultimately keep people trapped in an endless cycle of distress and compulsive thoughts and behaviors.
Some of these compulsions may seem reasonable. Double checking that doors are locked at night, making sure a car seat is installed correctly, or reassuring ourselves that everything is going to be okay. Sometimes these compulsions may be less logical. Knocking on door frames to be sure that no harm comes to our loved ones, replacing distressing feelings with pleasant ones, or avoiding saying certain words.
The reality is that we will lose the ones we love. Whether or not we die first or they do is the mystery, but ultimately we cannot control these inevitable losses.
It also seems that love and loss are actually two sides of the same coin. To love is to risk loss, and to dampen the grief and sadness that comes with loss is to dampen the heights of our love. You can’t have one without the other. By using ERP to accept that loss is an inevitable part of love, we free ourselves up to love completely. We free ourselves up to open our hearts to some of the most poignant and meaningful experiences that we can have as humans. Although leaning into loss and grief is painful, it is well worth the effort
Self Compassion
It has been a very long day and I am tired. Nothing extraordinary has happened, but a seemingly endless parade of stressors has worn me down. I am a parent to two small children though, and so I trudge on through my evening, counting down the minutes until they are asleep and I can have a break. I’m working hard to stay calm, to stay patient, and to be the parent I want to be. With gritted teeth, I manage to remain placid (at least on the outside) through the afternoon, through dinner, until finally, I can’t take it anymore. There are too many people talking to me at once, needing something from me, touching me, and finally, I snap. “Get off of me” I scream as both of my kids argue for space in my lap. My older son jumps away from me and I see his eyes widen in fear. I instantly feel a double layer of guilt (layer one for yelling and layer two for being the type of parent who feels so overwhelmed that she needs to yell in the first place). My stomach hurts and my chest feels heavy.
Rewind the tape to a very similar scene 3 years ago. This time though, that terrible feeling I have when I lose my patience with my kids (probably a combination of anger, shame, and overwhelm) immediately triggers a barrage of self-criticism and an entry point into an OCD cycle. My mind is inundated by thoughts that I am an unfit parent, that I have ruined my attachment to my child, and that there must be something wrong with my child for him to have overwhelmed me in the first place. A need to ensure that nothing like this ever happens again takes over and I begin to compulsively consume parenting podcasts and books. I look over my notes from the developmental psychology class that I took as an undergraduate. I want to hug him and tell him that I love him (a lot). I try very hard to figure out how to manage my child’s behaviors as well as my own emotions. On and on this cycle goes on until one day I begin to read the book Self Compassion by Kristen Neff.
In her book, Dr. Neff defines self-compassion as when “we are kind and understanding rather than harshly self-critical when we fail, make mistakes, or feel inadequate. We give ourselves support and encouragement rather than being cold and judgmental when challenges and difficulty arise in our lives.” As a therapist, this is slightly embarrassing to admit, but this was a revelation to me. The idea that I could be kind to myself when I made a mistake was truly radical, and I’m not exaggerating when I say that it changed my life. Through reading her book and completing two self-compassion trainings I learned how to cultivate a new way of relating to myself when I (inevitably) experience challenging emotions and when I make mistakes.
Exposure and response prevention (ERP) is the gold standard for treating obsessive-compulsive disorder. In ERP, we essentially expose ourselves to something that we know will trigger our obsessions (in my case that I am a terrible parent, will harm my child, and/or that there is something wrong with him) and then prevent our typical responses (listening to podcasts, reading books about parenting, hugging my kids, telling them I love them, and lots and lots of ruminating). It’s not enough to just prevent our compulsive responses however, we must learn to do something else instead. For me, and for many of my patients, this is where self-compassion comes in.
According to Dr. Neff, self-compassion has three components:
1. Mindfulness: being open to the present moment’s reality
2. Self-kindness: choosing to soothe and comfort ourselves when external life circumstances are challenging and feel too difficult to bear
3. Connection to common humanity: recognizing that all humans are flawed works-in-progress, that everyone fails, makes mistakes, and experiences hardship in life.
Fast forward to my recent evening screaming at my kids to “get off of me.” I still feel anger and guilt and overwhelm in moments such as these. My first instinct is still to look for that magical podcast that can tell me how to be a perfect parent. But now I have learned how to use the three components of mindfulness as response prevention to practice staying out of my OCD cycle. It might sound something like this. “Woah, I’m feeling really overwhelmed and guilty right now”-mindfulness. “It’s really hard to be a parent sometimes. That was a rough day and I’m feeling really burned out. This is really hard”-self-kindness. “Mistakes are part of life for everyone. No one can stay calm and patient all the time.”-connection to common humanity.
For me, self-compassion has proven to be a powerful response prevention tool. It gives me the grace to be a messy, imperfect human so that I can more quickly get back to just doing the best I can with what I have. My hope in sharing my experience is that it can help others cultivate that grace and disrupt their OCD cycles too.