Obtrusive Thoughts, Obsessive Compulsive Disorder (OCD) and Mental Health
The life worth living group met today where the discussion surrounded around intrusive thoughts, OCD and mental health concerns more widely. As always it was a lively, constructive and considered sharing of our own lived experiences and/or those of others.
The first question posed was:
What is the definition of Intrusive thoughts and how might they impact on someone?
It was agreed that whilst intrusive thoughts are almost hard wired into all of us, they are mostly dismissed or filtered out so we don’t even notice them. However when someone is affected by a Mental Health condition these can become a major problem, and are chiefly experienced by people with OCD, Depression, Anxiety, Post Natal Depression and Post Traumatic Stress Disorder.
Some examples given on intrusive thoughts were:
- Over analysing our responsibilities and exaggerating the impact were we to fail.
- Catastrophizing: always imagining the worst possible outcome.
- Unwanted inappropriate sudden thoughts such as kissing or punching someone when that is entirely against our actual wishes, but driven by a false anxiety alarm.
- Where we recognise how vital our care is such for a child, we might imagine harmful thoughts when all we are really focused on is care and protection for them.
Sometimes such thoughts lead to compulsive behaviours which may initially seem to offer comfort, but end up making things much worse. These can include excessive checking of locks and appliances to avoid danger or harm to others, and ideas of magical thinking, where the use or avoidance of certain numbers or tasks can either prevent or cause damage to loved ones. People who experience such thoughts know deep down that they are irrational and untrue, but shame and stigma can make these feel very real.
Depending on the extent of the problems there are a variety of treatments available such as:
- CBT: Cognitive Behavioural Therapy. Individually tailored help.
- Exposure Therapy: Gradual exposure to acclimatise to and overcome particular fears, e.g. contamination or social anxiety in busy public places.
- Personal Insight to learn how to diffuse delusional thoughts.
- Shared experiences and humour: There can be much stigma to any mental health condition but possibly more so with less understood and frightening conditions like OCD. Whilst sharing these experiences can be daunting, if able to do so, using humour and openness, it can serve to diffuse the power of negative thoughts and help affirm how we’re all affected by mental health and there’s no place for shame or blame.
Ahhh, sleep is an issue isn’t it? Vastly undermined as to how bad we actually feel after a bad night’s sleep, or run of them, or full blown insomnia, affecting mood, concentration, appetite, libido and serious health conditions both physical and mental. Affected focus and slower reflexes mean that lack of sleep can be as dangerous as alcohol when it comes to driving on a lack of sleep.
People spoke about their differing sleep problems, whether that was being unable to get to sleep, or falling asleep ok but then waking up and having a disturbed sleep, or only being able to sleep for a few short hours at a time. Some people also recognised that they can sleep too much and use sleep to escape from facing daily life; we know that sleep disturbance is one of the symptoms of depression.
Some of the reasons for being kept awake are internal such as worries, thoughts and processing the events of the day and problems. Other things are external such as noisy neighbours, children, seagulls or perhaps getting sucked into box sets! For some people it can be the anticipation of unwanted dreams or nightmares and it is the fear of that which keeps them awake. Some people spoke about feeling guilty for going to sleep when they needed to others view this as being lazy.
The discussion moved towards seeing our sleeping patterns as a cultural issue. We have a 24 hour society, people are expected to work late, having breaks can be frowned upon, and people are expected to respond quickly to work emails and messages. There is no space during the day to process what is happening. By the time we lie down at night to sleep, our brains can become very busy processing the day and keeping us awake.
We considered cultures where siestas are a natural part of the day, with an early start and a later finish but with a much more relaxed part of the day in the middle.
Other cultures, or business models recognise that not everyone is productive 9-5 and encourage people to finish when they are done and start when they are ready and this can achieve greater creativity and productivity. It was suggested that perhaps western society has informed our sleeping patterns due to the current business model and the layout of the working day; also industrialisation and digitialisation whereby we are further and further removed from our natural world and we are trying to fit our bodies into artificial schedules.
The group discussed that what might help better sleep is a more holistic approach; trying to find a sleep pattern where we can sleep when we need to-some people find power naps useful for example. Reducing stress overall would be helpful and what may assist this is creating space throughout the day, giving oneself time to process and reflect on the day’s events as they occur.
People gave their different experiences as to what has helped them to sleep, these included meditation, hypnosis, sleep apps and power naps. Interestingly, most people did not remember having difficulty sleeping as children.
This group regularly cite music and the arts as an important therapeutic tool for their well-being. Today we wanted to continue this musical theme in a more light-hearted way and look at music and performances which made us chuckle. As musical tastes are totally subjective this can lead to some finding certain songs to be funny that were not necessarily intended to be so.
Below are some of the videos we watched. Enjoy!
We started to explore this topic by firstly thinking about how do we know when we are well and what keeps us well. When mental health is good people acknowledged that they are more likely to stick to a routine, sleep is likely to be better. People noticed that they were more likely to keep things in perspective and stay in contact with friends and family. In well times there is a more positive view of the future along with good motivation to get up and do things-and to enjoy and find pleasure in those things, other people notice that ‘I’m my normal self’.
So in becoming ill, people notice that the above factors start to be affected; instead of having things in perspective ruminating can occur with the negative voices become louder. There may be disruption to routine, sleep and eating habits and maybe use of alcohol or drugs or other behaviours which can be destructive such as unhealthy reward seeking like self-harm or excessive shopping. Debt can become a problem along with avoiding people and irritability if with people, or a highly anxious energy. We asked also what happens with relationships, people said they may become more withdrawn, and feeling like they are not deserving.
We then began to think about what can help in these times; having a place to communicate how you are feeling is really important whether that is a supportive family, friends or a group like this. People spoke openly about how it feels to be suicidal and that it helps when you can talk about it openly and directly rather than people skirting around the issue as they are worried that mentioning suicide may put the idea in someone’s mind.
It’s useful to know what keeps you well, as when these things start to change this is an indication of becoming unwell, with the awareness of this people may be able to recognise that this is a time to use support and self care plans and to go gently.
We started by identifying what is difference? The group came up with that difference is something that stands out, something out of your comfort zone or familiarity, it can be empowering, exciting, it may be something which is unexpected, breaking free of conformity, it may be different attitudes or the first experience of something.
Next we looked at ‘how do I feel different, and how does that affect me’? Here people were able to talk about how they felt stigmatised due to their mental health and feared rejection if they were honest about it. Other people referred to how their gender was perceived or assumptions made about it and how this could be frustrating and can leave people feeling dis empowered and almost having to prove their identity.
Finally we talked about how we respond to other people’s differences. Some people avoid or ignore this so that there is no conflict. We talked about how sometimes we overcompensate because while culture is in a state of flux of how certain groups are identified and what is appropriate or not, we get worried about offending people resulting in us going over the score (like positive discrimination) and we can accidentally patronise people.
By the end we agreed it is important to keep listening to difference and to just ask people and be curious about how they would like to be seen and treated and hopefully as we educate ourselves and build relationships, ultimately the relationship will be important, the rest won’t matter, it’s just what we are housed in.
While constructing a group programme we try and make the content as varied and diverse as possible. When we do group sessions on art and crafts we find that it creates a real sense of ‘freedom’ for members to engage in their own creativity. This setting also seems to make people more relaxed to chat.
This is really interesting article from mindfood.com on the benefits art and crafts.
So with yoga seeming to be very much on trend with yoga centres springing up everywhere and the group already enjoying breathing exercises where we connect with the breath to our bodies, we thought we would explore this a little more and even experiment. It is not clear as to whether yoga is ancient or modern, some say it is a practise which is thousands or years old originating in India, and others say it is a form of Scandinavian gymnastics originating last century which became very popular in India. Either way many people are benefiting in a number of ways from this form of exercise. Physically, yoga can increase flexibility, muscle strength and tone, it can help to improve respiration, energy and vitality. It may help with metabolism and weight reduction. It can help cardio and circulatory health improving athletic performance and strengthening which can help to protect from injury.
Yoga is reported to benefit mental health by bringing bodily awareness, enabling people to notice stress, anxiety and tension. Therefore the exercises can provide stress relief, relief of muscle tension, reduce strain and inflammation, calm and centre the nervous system and a sharpening of attention and concentration.
So with so many benefits what’s not to like?
There are a number of apps to take you through yoga poses. We downloaded a free trial and as a group experimented with quite a gentle 5 minute work out which was partially seated, and used a chair.
All in all this was quite a relaxed session for the group in beginning to introduce people to yoga should they wish to attend a class somewhere for any number of the listed benefits, not least having a social activity.
Below is a video demonstrating some more yoga poses.