We have already seen in the previous blog that obsessive thoughts don’t come out of the blue. They always have a trigger. The trigger can be an internal thought or an external situation. This trigger then elicits an intrusive thought, which in turn causes discomfort. This is followed by a ritual, a compulsion that can be a thought or a physical behaviour. This is the sequence. From blog 1, you could have learned to log down your OCD patterns according to their sequence. Now, we know that over 90% of people have unwanted and intrusive thoughts, but the difference is that people without OCD are easily able to filter out the thoughts and do not appraise a threat from the same.
Though the thoughts may appear illogical and unreasonable, there is a set of structures based on the reasoning of intrusive thoughts. In iCBT therapy, it is suggested that the justification of these thoughts follow the following. It could be based on whether they are abstract facts or ideas, whether they are based on General rules; the thought could be based on their past, what they have heard from others (Hearsay); it could be based on their own experiences. Or it could just be a possibility. When we consider an obsessive thought followed by a ritual, one may have many reasons behind it. For example, if one has intrusive doubt about whether one has switched off the gas stove before going to bed, it may follow the reasoning pattern, as we can make sense of it using the iCBT therapy technique. One may think, “Gas stoves can cause fire, leading to the entire house burning”. This is a FACT. Next, “If gas is not switched off, it is a risk” is a RULE; “I have read in the news that many accidents have happened due to gas leaks” is a HEARSAY; “I remember when I was a child, I left the gas stove on, and it burnt the milk” is an EXPERIENCE; “Well…it’s always possible that gas stove can lead to fire accidents” is a reasoning based on a POSSIBILITY.
For this week’s task, you can combine the blog 1 and 2 suggestions and write a story for each intrusive thought—or you can write down the entire list of intrusive thoughts.
Next, pick one intrusive thought.
Write down the sequence of the entire cycle of the OCD symptoms, including the trigger, the ensuing intrusive thought, the discomfort following the thought and the compulsive ritual.
You can then write the reasoning for the intrusive thought based on the reasoning behind it. You can always use the five format structures suggested in iCBT therapy: FACT, RULE, HEARSAY, EXPERIENCE and POSSIBILITY. If any other reasons are outside this format, you can make note of that, too.
You can now weave a story based on the sequences and reasoning. You will have a story for each OCD symptom. This will give you insight into the various facets of the symptoms and help with the therapeutic work for OCD especially the iCBT based therapy.
