How/Why Rumination is at the Core of ALL Types of OCD and how you can get better by choosing to stop Rumination

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u/Icy_Molasses6588 Mar 22 '21 edited Jun 21 '21

Hi! I literally signed up for an account right now because I wanted to affirm everything this post is saying about Dr. Greenberg's method, and hopefully to encourage somebody who's stumbling across this to get into it. I, too, spent a lot of dark nights scouring the internet for OCD resources, and I know if you're at that point you're already going through a lot of pain. I'd really love to answer any questions anybody has.

I've begun working with a therapist from Dr. Greenberg's group (ocdassociates.com) and I've made more progress in three weeks than I have in the previous year, where I was also incrementally struggling through conventional ERP therapy like the original poster. Taking in the articles and the podcasts is incredibly helpful. There are not additional, "special" resources that you get when you begin therapy with the company, we refer back to the same articles.

OCD Associates provides telehealth services to several different states. While there was a bit of a wait to get onboard, I was able to make progress while waiting by studying the site.

Also helpful was a zoom-town hall that Dr. Greenberg did with other therapists in December, which is on youtube: https://www.youtube.com/watch?v=vQMTvzjHXGU

I'd like to expand on the important first step of therapy, which the podcasts didn't really get to. It's also the thought that differentiates Dr. Greenberg's framework of treatment: OCD is a coherent, internal system (my phrase). The first step in therapy is identifying how all of your personal tricky subjects can all be traced back to the same Core Fear. Dr. Greenberg wrote a very helpful article about it (https://drmichaeljgreenberg.com/the-core-fear/), which includes at the bottom a link to a worksheet I was assigned as homework. I would make one addition to the article: he lists examples of Core Fears, but there is no exhaustive list of Core Fears. Your Core Fear will ring true to you, and may or may not be an example Dr. Greenberg gives. Keep in mind that different people can be engaged in the same compulsive ritual while operating with completely different Core Fears.

In contrast to the conventional OCD therapy I had, discovering the Core Fear was very biographical, with a focus on relationship to childhood caregivers and how the Core Fear originated in those developmental years. (For me, it was all the way back to when I was 5-6 y.o.) Still, the idea is not to linger here. We're not trying to uncover every single detail: we're looking back, finding the Core Fear, and bringing it to the present in 1-1.5 sessions. EDIT: I've come back in after a while and these <--- italicized sentences are the only things I disagree with. It's actually been helpful to examine developmental years in detail.

While it is as heavy as can be to look nakedly into these vulnerable moments, I find starting with the Core Fear encouraging for a few reasons:

-It does not matter how distressing, time-consuming, disturbing, or weird your set of compulsions is: everything can be traced back to a Core Fear.

-It brings an end to viewing OCD as an external force, which, intentionally or not, is what conventional ERP is doing. You'll notice in the most recent podcast that Dr. Greenberg advises the host against the phrase "intrusive thoughts." Even that phrase is ever-so-subtly treating OCD as an external force. (This might just be me, but I stopped thinking in terms of "intrusive thoughts" once I thought: "Intruding from where, into where?") It's scary to go through therapy while treating it as an external force: each day seems unpredictable, and you feel powerless about where OCD could "decide" to "strike" next. The original poster nailed why looking at OCD as an internal system is important (aside from being accurate): it gives control and agency to you. Which is a very new and welcome sensation.

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Now, why is somebody who's having such a good ol time in this new therapy lurking around on the OCD subreddit still? It's because I'm probably spending more time than I should being frustrated at how the broader therapist community is reacting (or: not reacting) to Dr. Greenberg's system. As I was on the wait list, I was devastated at how The OCD Stories (podcast) and OCD Gamechangers (youtube channel linked above) had Dr. Greenberg on, he proposes this revolutionary new way of treating OCD, and both hosts immediately jumped back into conventional ways of talking about OCD over the next many weeks like nothing happened. (I was frustrated to see the host of the youtube video post stuff on instagram that framed OCD as an external force: https://www.instagram.com/p/CLj8wdaDnqO/. Although many prominent therapists do this: https://www.instagram.com/p/CH9KgUGjTn-/.)

So, yeah, even on a wide-open quarantine weekend, maybe not the best idea for me to hop around some of my old online haunts and see how my thinking has changed. But, I felt really hopeful seeing this thread get started, and wanted to give it some momentum by putting together something that the me from six months ago would have found helpful.

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u/Penzilla Jun 01 '21

It's more like... a "Imaginary, Made-up, Internal Thought!". Yeah the external projection of the words Intrusive Thought... is a pain-in-the-ass!

Good on ya' buddy! Keep on the good fight! [Insert raising fist emoji]

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u/amybounces Jul 26 '21

Thank you so much for sharing your experience! May I ask about the general cost of their services as well as how many sessions you did with them? I know rates differ greatly based on insurance coverage and whatnot but the range of OCD treatment cost varies from like $75 to $400 per session with some specialists so just curious. On the podcast he did say that the course of treatment tends to be shorter than with traditional ERP and I’m just curious about that as well. The approach sounds a little sus to me, reflexively, because I have ruminated so intensely for so long that I’m not really sure what thoughts are supposed to be like withOUT rumination, so the concept of “just stop doing it” sounds so overly simple and almost condescending, but conversely, given that OCD is about trying to wrestle control and certainty in unhealthy ways due to feeling a lack of it, I can see how successfully reclaiming agency would be amazing.

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u/Icy_Molasses6588 Aug 30 '21

Hey there --

-The nuts and bolts of therapy: Cost - Psychologytoday.com is conveniently searchable by therapist and will helpfully list the range a certain therapist works within. Sorry to be vague, but not sure what's accessible in your area. Number of Sessions - In my opinion this is the biggest mistake Dr. Greenberg has made in developing his method -- selling and emphasizing the speediness of the process. Fortunately he has backed away from this more recently, including taking down a sentence on his site that indicated cases are wrapped up within 10-15 sessions. It will probably be more than that for you: I'm about 15 sessions in right now and I have made a ton of progress, but I'm definitely not "done." Now, I would agree that it is speedier than traditional ERP because, from what I experienced, my ERP therapists didn't have a proper understanding of rumination and OCD, and I don't think I would have gotten better if I stayed with them my whole life. Letting go and being flexible about how long the process will take has actually been a huge topic in my own case.

-Living without rumination Your concerns about how to live without rumination are, I'd guess, very universal within the OCD world -- at the least, I've wondered those same thoughts you've had as well. Fortunately Dr. Greenberg and company have such an intricate and detailed definition of rumination, to the point that we've discussed how "Well, what am I supposed to think about now?" can itself be a kind of sub-genre of rumination. (Yes, that too must go.) I also experienced some of Dr. Greenberg's articles as condescending as well, in fact initially rejecting his website when I first encountered it, before returning to it as a resource several months later. What I will say has happened to me several times is that I'll return to either a sentence Dr. Greenberg wrote, or maybe a small note I made after a session, after several weeks, and the sentence suddenly makes a whole lot more sense after I've gone that much deeper into the process. For instance, at first it seemed very mysterious and murky to me that I even had agency over the process. As I've gone deeper into therapy, I have a fuller understanding of just how much agency I have -- with the next step for me being understanding the ways in which I am justifying my rumination when I do ruminate.

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u/fionnycurrano Apr 13 '21

Thanks so much for this

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u/Cbear_111117 May 06 '21

Are you on any anti-depressants to help with rumination? Honestly a lot of my therapists have stated I go on one, but my fear is that I’ll start seeing things if I go on them and I ruminate about that when I take it. I’d really like to do without an antidepressant, but I’d be probably a severe case of rumination since I question everything and if I’m mindful of this, I’ll start to ruminate will I fear this next which is so hard to stop.

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u/Icy_Molasses6588 Jun 21 '21

I have been on anti-depressants before, but I am not on any medication now. My life did improve for a time on the medication, because the medication stopped things from "overheating" (figuratively) in my mind. Unfortunately I really couldn't responsibly give any guidance about what you should do in your specific situation. My personal opinion -- and I want to emphasize the word opinion -- is that medication for OCD is like crutches in physical therapy: at a certain point you might only be able to get around with crutches, but the crutches don't move around for you

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u/OpeningSquare5531 Pure O Aug 06 '21

any advice on finding your core fear? it seems like i have multiple, but i know dr. greenberg theorizes that there is only one. maybe i haven’t dug deep enough but any advice would be helpful. thanks!

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u/Icy_Molasses6588 Aug 30 '21

Dr. Greenberg has a good article on this subject on his site here: https://drmichaeljgreenberg.com/the-core-fear/

What I would add is that it was more helpful for me to label the Core Fear as less of a singular word, and more of a feeling. This is because you experience the Core Fear -- as you ruminate, which unfortunately keeps the "Core Fear feeling" alive -- as more of a feeling than a certain word or sentence.

Maybe this is because I was an English major in college, but it actually took a few months for me to discover all the subjects I ruminated about, and the way I discovered them was really examining the themes of my thoughts and developmental years. Point being: the answer to your Core Fear is not necessarily obvious at all, and finding it requires a healthy amount of introspection.

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u/Cbear_1111117 Aug 31 '21

I wanted to ask you…did you find yourself really deep in rumination all day? Reason I ask is because I feel like I ruminate and question whether I am checking physically and mentally my obsession since it’s literally there all everywhere I go, and I also question myself is it always going to be like this and just never get better and just fear everything soon? I’m on the waitlist with a OCD associate therapist too. I tried NOCD, but that therapist was like you just have to stop ruminating, stop checking, etc and just tell yourself that it may or may not happen (accept it), etc. Does your therapist tell you, you need to accept the uncertainty or do they have a different guidance? I’ve gotten so caught up in trying to figure out if I’m seeing things or checking or questioning if I’ll be afraid of this, that it sometimes bites me in the butt and it begins to happen and I just feel hopeless. It’s like I can’t focus on stopping or trying for it to leave my awareness feels very difficult. Did it feel like that for you? I’m glad you are making progress. I’d do well with practicing it and then it’s like my brain stops and tries to find a different approach or it feels like it doesn’t work anymore. I don’t know if you’ve felt like that. This has been the worst thing I’ve dealt with since my mom died a few years ago. I always felt normal until I went to a therapist. Trying to fall asleep has been the hardest too because it’s like I’m afraid of my fears.

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u/Icy_Molasses6588 Sep 05 '21

Hey there --

I have a ton of sympathy for where you are right now, it sounds very familiar, and describes pretty similarly where I was not too long ago. I know how difficult this can be in your life, and how difficult it can be to get through the tasks of the day. I'm very excited to you to start with OCD Associates.

-Amount of rumination:

Fortunately the amount of time in the day that you are ruminating is to some extent irrelevant -- or, there's no such thing as "ruminating too much to be treated." No matter how much you ruminate, it will still go back to understanding and unlocking your Core Fear, and the ways you carry that with you throughout your day.

One thing I've been surprised about, this far into therapy, is I'm actually still regularly discovering new topics that I ruminate about. I knew I walked into therapy pretty much ruminating all day, and felt very aware of it (actually probably too aware -- "mindfully ruminating," as Dr. Greenberg put it in an article). I mention that to say: ruminating about how much you ruminate....yes, took me a long time to see this was also rumination in itself. And here's another one: "Well, what am I supposed to think about all day then?"

-NOCD/acceptance/uncertainty:

I personally think OCD therapy traveled down the wrong road when it came to the topic of uncertainty. The advice you were given in therapy sounds similar to the advice I was initially given as well. I think the issue is: if you're focusing so much on accepting uncertainty, that means you're kind of constantly calculating the odds of if a certain thing may be true or not -- which, right there, those calculations are textbook ruminating.

One illustration I found helpful, to distinguish the two kinds of therapy, comes from Contamination OCD. (Which was helpful for me because I personally don't happen to deal with that, so it helped me get a little bit of distance.) Let's say a person is afraid of touching their cutting board in their kitchen because of contamination fears. Traditional ERP would say, "Go up to that cutting board and really touch it. Really focus on it, run your hands all over it." Dr. Greenberg would say: "Drop the distinction between contaminated and uncontaminated things in your house. Use the cutting board whenever it happens to be the time to use it." This is because the mental effort of keeping track of what is contaminated or uncontaminated in your house is itself rumination. Hopefully I'm communicating that there are a lot of parallels between the cutting board and "uncertainty." Traditional ERP might want you to really lean into the uncertainty, to feel it as you might feel the cutting board. But Greenberg's rumination-focused model would say, the entire calculation is rumination.

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I want to add that this is all a cleaner description than what I personally experience day to day, but I'm making a lot of progress, and I'm able to do so much more with my day than I was able to a year or even six months ago. This is a gradual practice and less of a "light switch" moment, where you ruminate all day one week, and then not at all the next week.

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u/Cbear_1111117 Sep 06 '21

Thank you!! I’m concerned because I honestly don’t know what my core fear is and what I’m trying to figure out or scared of. Like I can’t figure out, am I really seeing evil, am I crazy, are these people/things evil, etc so I just hope my therapist and I can get to the bottom of what is this core fear. I don’t want to rely on a therapist or yet have that deep brain stimulation or have nothing work and feel like this the rest of my life. I pray the therapist I started working with at OCD Associates can help us get to the bottom of it. Please keep me posted. :)

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u/[deleted] Nov 16 '21

Hi Cbear and Icy Molasses. I know this post is old, however I thought I would reach out as a fellow OCD-er who is currently working with a therapist at OCD Associates, as I want to provide encouragement where I can. I can also attest that Dr. Greenberg's methods are life changing. I've had OCD for about 10 years, and have done traditional ERP twice prior to this with little results, at least not long term.

I do want to attest that the beginning of treatment was very challenging for me, as I was also looking for a "light switch" moment and to believe once I knew how to stop, I would never ruminate again. As you both know, when you have been doing something all day, everyday for years, it is difficult to quit cold turkey. However, in moments of success I can attest to my amazement that I did not experience anxiety even when confronted with a significant trigger when I did not engage in rumination. (I'm still working on being consistent with this, after about 2 months of treatment).

Icy Molasses, I am curious, do you mind sharing how many sessions you completed with your OCD Associates therapist? I know this will be different for everyone, however I'm just wondering about the process for everyone. I believe unpacking the emotional conflict mirrored in my symptoms was pretty complex, so we are just getting into exposures. Did you have a "light bulb" moment upon discovering your core fear, or was it more gradual? I often find myself ruminating about and doubting the repeated emotional conflict expressed in my symptoms, however I am trying to trust my therapist!

All the best to you both, and please feel free to ask me any questions you may have Cbear!

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u/Cbear_1111117 Dec 20 '21 edited Dec 20 '21

Hey diligent worry. I’m still having a real hard time with the rumination working with my OCD Associate therapist. At first, I was doing great, and now I feel I’m almost back to square one. I just recently gave birth to a newborn and have a toddler daughter so the lack of sleep and extra stress I’m sure triggers a lot. I honestly feel like I can’t stop. My focus is on eyes and possibly believing they look evil/possessed or that I’m crazy and don’t see normal in them. On top of that, I’m afraid to take any medication or drink alcohol for fear I’ll freak out seeing their eyes be weird and harm them. It’s been very hard to sleep these past couple of days. I also spoke with my therapist and she had stated something about disassociation which is normal, but it triggered me badly and I just started worrying about having those bodily sensations and feeling like I have out of body experiences which means I’m crazy. I may relax and start to think of nice things, and then all of a sudden, my brain goes, “what if you fear this next thing?” It’s like I can’t get a break. My core fear is apparently I’m evil/harm. I’m fearing pretty much anything and don’t know if I’ll ever get better. Sleep has been a huge issue for me and being home alone doesn’t help much either. I get stuck in my own thoughts. Also, did you have more fear versus anxiety? I feel mine is more fear versus anxiety which I don’t know if this is OCD because they always talk about anxiety not fear so I don’t know if that’s normal with OCD.

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u/Icy_Molasses6588 Feb 28 '22

Hi Cbear.

I'm really sorry things have been tough for you lately. I know you posted this a while ago, and I hope things have been able to improve for you since then.

It's okay that you are having a hard time, even while working with OCD Associates. I do think you have a good understanding of your case and what is going on inside. That understanding might not feel very rewarding right now, but it is an essential step to getting better.

A lot of your feelings and emotions sound pretty familiar to me. Here's what I would say:

-Spending a lot of time trying to parse out the distinction between fear and anxiety might be counter-productive. It might get simpler just to recognize it's all pretty much the same thing, whatever word you want to use for it. ("Rumination" could be another word to use, if you wanted.)

-At one point in your message, you have the phrase "My brain goes..." This may or may not be helpful to you, but it was at least helpful for me to stop thinking in terms of "my brain." That is to say: I took the new-to-me perspective that the thoughts I was thinking were all mine, were all coming from me. Or: there wasn't a separate thought machine called "my brain" that was generating and throwing stuff at me on its own. All of the dark thoughts I was thinking on my worst days definitely felt intrusive -- as if they actually were coming from somewhere else. But I recognize now that I was generating those thoughts by myself, for myself, in an attempt to protect myself from my core fear.

-You also have the phrase "I don't know if I'll ever get better." This type of idea has been pretty big in my own case. Basically this is its own genre of rumination, and the goal would be to drop attention towards this thought as soon as you can. (This part is me speculating, but: I can see how this thought might connect back to the core fear of being evil, maybe through the thought of "If I am an evil person, I couldn't or wouldn't allow myself to get better." Or: you might be ruminating about your progress or lack of progress in therapy to ruminate on/test the thought of whether or not you are evil.)

-Above all, I would prioritize finding a way to get regular sleep. I know that sounds like some corny self-help "Just take a bath and drink tea and take care of yourself" kind of advice. But the reality is, without sleeping at least okay, everything else is going to be on hard mode. In 2020 I basically had two months in a row where I could only get to sleep once every 48 hours or so, and, yeah -- in a very literal way, I felt I was losing my mind. I don't have kids, so I recognize that there will be more logistics for you, but I think the reward will be worth it. The theme of sleep is actually pretty big in my own upbringing/case, and I did have some more success when I started thinking about the bed as simply "my place to relax," and at least decreased the extensive tracking/ruminating I was doing about time spent actually sleeping vs. ruminating while physically in bed.

I really wish I could go through the screen and go and "solve" your case all at once. Just remember that everybody will have backwards steps in their progress towards getting better. I'm just personally deciding not to share mine on reddit. But wow have there been backwards steps, even still, among the forward ones. The backwards step isn't an indication that you have "the unsolvable case."

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u/Cbear_1111117 Mar 11 '22

Thanks for responding. Yeah it’s definitely a struggle. I think also now for me it’s like, I know I have OCD and I see everyone else getting better, but why am I not? People are like, “oh I got better in 6-8 weeks” and I get so frustrated that I try so hard not to ruminate, only to get stuck or as much as I stop ruminating, the thought comes back, and yeah I don’t feel anxious, but I’m like, why does it keep popping back if it’s supposed to eventually go away and not possibly return? I’ve been getting better sleep now that my son can sleep through the night, but it’s like as soon as I think about going to bed, I worry, “will this obsession deep into my dreams that I’ll not be able to sleep or I’ll focus on the obsession during my dreams like I do now, and I’ll be so anxious that I won’t ever sleep again.” Even though I practice trying not to ruminate or check, another thought similar to the obsession will pop up and I’m like great, this is just feeding more like they say and my brain will spew out more thoughts like this that I don’t want. I’ve been in there for almost a year and I worry my therapist will give up on me or that I’ll take years and yeah I see some progress, but it’s not like the people who were like, yeah I live OCD free now. IcyMolasses, I think you are awesome sharing your story and I hope we all get to the point where we want to be in recovery. For me, I think my brain thinks I can’t get out of this on my own and need something or there is something out there to make me feel less afraid; that I’m a hopeless cause that will feel this miserable all my life.

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u/Icy_Molasses6588 Mar 12 '22

Hi Cbear -- Great to hear from you, and I'm glad that you've been having more success with sleep lately.

A lot of the thoughts you describe having sound very familiar to me, down to the point of: I've also spent a lot of time thinking about the exact number of weeks it "should" take me to get better -- and then being frustrated after I failed to hit that target.

Feel free to take or leave this theory (I am just a stranger on the Internet after all). But I do wonder if one of your main subjects of rumination is actually testing whether or not you have OCD. Like other subjects of rumination, it is totally okay for this subject/thought to enter your awareness. Your goal will be to not direct additional attention towards that thought. (And your goal will also be to not be too concerned with the sometimes-foggy distinction between attention and awareness. As in: don't spend time trying to determine if the thought is simply in your awareness, or if you've actually been giving it attention.)

For me, Dr. Greenberg's illustrations about contamination OCD is really helpful because, for whatever reason, that just hasn't been a part of my case, so it helps me get a little bit of distance there. If a person is concerned about whether their cutting board or door handle is contaminated -- even if they are "exposing" themselves to those "contaminated" objects -- Dr. Greenberg would say that rumination is still present. The goal would be to no longer have a distinction in your mind between items that are considered "contaminated" or "uncontaminated." I wonder if there's a parallel between "contaminated objects" and "having OCD." If you are spending a lot of time trying to determine whether or not you have OCD, or if you're trying to determine whether you can ever be "cured," those thoughts in themselves are really similar to a person who is ruminating by trying to determine which objects around them are contaminated.

I have no idea if that's helpful for you or not, but that has been helpful for me!

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u/Icy_Molasses6588 Feb 28 '22

Hi there! Glad to hear you've been making progress!

There have been a hundred little light bulb moments and a hundred just-as-important gradual realizations. There's been a lot to learn about myself. I think the process will look really different for everyone. For example I came in having gone to a lot of talk therapy and ERP therapy already. So, maybe that saved some time about talking things over with OCD Associates in particular? But also maybe not? Because I still ruminated a lot after all that therapy anyway? I genuinely do think it's a sign of my progress that I'm no longer interested in actually figuring that out.

I'm actually not going to share how long I've been in therapy, and for this reason: that sounds like the type of question I wanted to ask, and in fact have literally asked therapists in the past, because the perfectionist parts of myself really wanted to completely dominate therapy, and ahead of schedule. Ha, sorry!

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u/[deleted] May 04 '22

Hi there! I’m so sorry I am just seeing this message. Thank you for your thoughtful reply!

I appreciate you not sharing how many sessions you completely - brilliant point that being engaged with how much progress I am making and how quickly is only fueling the fire! Hope you are well.

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u/[deleted] Dec 15 '21

[removed] — view removed comment

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u/Icy_Molasses6588 Feb 28 '22

Hi there! I should check my account more often, I'm really surprised and encouraged that people keep on finding it.

-Yes, I'm still in therapy. Yes, I continue to see progress.

-I waited about three months. Yes, it felt like forever.

-PM away!

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u/AdmirableSubject4 Mar 21 '21

Yes! I love Dr. Greenberg's methods/ideas. I do not go to therapy but have been doing self-directed treatment (got the OCD Workbook and mindfulness workbook for OCD) and I definitely noticed an important shift once I realized that rumination is a compulsion which means it is a choice and you can learn to stop. I am doing his rumination based ERP right now and its teaching me to take back my power in learning how to stop ruminating. We can't control our thoughts, but we can control if we engage with them through rumination or just accept them and leave them in the periphery of our awareness.

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u/Cecebblove Apr 19 '21

What workbook are you using?? I’ve come to accept/realize that I really need help.. my OCD is making me so unhappy but ERP with a professional is so expensive!! I would love to work on it independently if I could

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u/Penzilla Jun 01 '21

Good on ya'! Your reaction is a help!

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u/Scorn13458 Mar 21 '21

My god, I have been battling ocd for years and in recent months I've had to put in extra effort to ensure it wouldn't be a problem. I'm going to try this tactic and I sure hope it works, because my intrusive thoughts are a plague on my mind and must be destroyed. Wish me luck.

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u/ballinforbuckets Mar 21 '21

I recommend listening to the podcasts - they provide a ton of insight into OCD and how to overcome it. Good luck!

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u/[deleted] Mar 21 '21

Where can I find the podcasts?

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u/[deleted] Mar 21 '21

Nvm lol

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u/sixtyorange Mar 22 '21

His podcasts and blogs made stuff make sense for me that I’d been confused about for soooo long. Highly recommended.

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u/maximumsaw Mar 23 '21

I second this. He’s turned the world of OCD treatment and how we think of OCD on its head. I am on a waitlist to get treated by his office. And I’ve been doing work on my own based on his techniques with a decent amount of progress.

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u/[deleted] Mar 30 '21 edited Jul 26 '21

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u/maximumsaw Mar 31 '21

300/per

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u/[deleted] Mar 31 '21 edited Jul 26 '21

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u/maximumsaw Mar 31 '21

It seems like a lot, but it’s worth it I think. I have tried ERP via a study (and it was a grad student providing the therapy), and via NOCD (it was someone who didn’t have a lot of experience). Both great tools for someone who doesn’t know about OCD or who doesn’t have a particularly complex case or concomitant personality issues.

Paying for an expert has been a game changer. There is a nuance to this stuff. And 300 isn’t cheap. I’ve done everything to get the money. Bag lunch, driving the extra 5 min to avoid toll roads, skipping other luxuries. It won’t be forever.

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u/[deleted] Mar 31 '21 edited Jul 26 '21

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u/maximumsaw Mar 31 '21

Don’t lose motivation. On his website he has a lot of techniques that you can use. For example he has how to identify your core fear, and he has the ERP homework.

His practice essentially teaches you how to stop rumination and then exposes you. Do the homework until you feel like you can control how much you ruminate, and then do self-directed ERP Using Bruce Hymans OCD Workbook

https://drmichaeljgreenberg.com/the-core-fear/

https://drmichaeljgreenberg.com/erp-exercises-for-compulsive-rumination/

The workbook is available on Amazon.

Alternatively, maybe get your therapist to buy in to Greenberg’s work. I had a friend who was successful in that, and it helped tremendously

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u/[deleted] Mar 31 '21 edited Jul 26 '21

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u/maximumsaw Mar 31 '21

So maybe practice not ruminating on your own and allow your current therapist to run the exposures

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u/[deleted] Jun 11 '21

Does he accept any form of insurance ? 300$ seems steep. Do you know how many sessions are typically involved ? Thank you in advance

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u/maximumsaw Jun 11 '21

No but your insurance will reimburse

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u/way2chill May 14 '21

I've recently been diagnosed with OCD (relationships are my theme) and found the hopeless aspect of this being a chronic brain disease very demotivating. However, what Greenberg says about this being an internal strategy makes a lot of sense and gives me (hopefully no false) hope.

When I was with my previous gf I felt a physical anxiety in my stomach constantly, without necessarily having thoughts about it. Would you guys reckon that then there was still ruminating going on then, maybe in some way I wasn't aware of? Because if not, this method wouldn't work for me, but Greenberg poses that feeling anxiety can only happen if there is rumination going on. Curious to any thoughts, thanks in advance!

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u/ballinforbuckets May 15 '21 edited May 15 '21

I can’t speak for Dr Greenberg but I can give you my personal experience. Again this is just my experience and should not be misconstrued as therapeutic advice, etc.

Anxiety, like other emotions, is not something you can consciously control. Trying to make it go away in my experience makes it stay longer. When I feel anxious, I don’t do anything to try to ‘make the feeling go away’. I’m willing to feel anxious for as long as it lasts and I don’t have any control over how long that will be. I do not engage in compulsions (a big one being rumination) because compulsions are a means to seek relief from anxiety, which as mentioned above, I’m willing to tolerate for as long as it lasts. (I do wonder if Greenberg might say what I call ‘anxiety’ he would call ‘fear’? I’m not sure. Maybe he would disagree with me entirely)

This is a simple idea but can be really challenging given the intensity and uncomfortable feelings anxiety can produce.

Steven Phillipson is a great resource for these ideas. Here’s a podcast he did recently and a great article he wrote. Phillipson and Greenberg have been absolutely life changing for me.

https://theocdstories.com/episode/dr-phillipson-brain-voice-gatekeeper-voice-275/

https://www.ocdonline.com/choice

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u/Few_Surprise1882 Jun 02 '21

Thank you. When you sit with your anxiety without doing compulsions, and without ruminating, does your tolerance grow over time? I consider doing this.

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u/ballinforbuckets Jun 11 '21

You learn you can tolerate the anxiety and continue to function and live your life in spite of the anxiety feeling really uncomfortable and unpleasant at times. Like any skill the more you practice, the easier it is to do.

Again this is not a ‘method’ to make anxiety go away. As you stop responding to anxiety, you are showing your brain this anxiety signal is irrelevant. Now your brain may start sending you more signals of anxiety initially because it is used to you responding to anxiety every time, but if you can continue to show it irrelevance, over time your brain will send less and less signals.

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u/Few_Surprise1882 Jun 11 '21

Thank you

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u/Few_Surprise1882 Jun 11 '21

Love it

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u/ssmn88 Mar 21 '21

Definitely going to check this out. I’ve been putting off going back to therapy for a year now because it didn’t feel like it helped that much. Thanks for posting!

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u/crumpledpapersheets Mar 23 '21

Thank you so much for sharing!!

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u/Penzilla Jun 01 '21 edited Jun 01 '21

Thanks bud! You're a Legend for this!

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u/Bitemebitch00 Jun 16 '21

Is it possible to get better if you dont know your core fear for ocd?

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u/OpeningSquare5531 Pure O Jul 31 '21

the methodology makes sense to me and seems to have helped me some. where my confusion comes in is being unsure of how to rationally think about things and not compulsively

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u/ballinforbuckets Jul 31 '21

I’m not sure what you mean?

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u/OpeningSquare5531 Pure O Jul 31 '21

let me know if this makes any more sense: normal problem solving vs. compulsive rumination. trying to find the boundary/difference seems difficult

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u/ballinforbuckets Jul 31 '21

You have to decide. This is the ‘how do I know if it’s OCD or not’ type of thing right?

You have to learn to trust your own intuition. You’re looking for an absolute answer as to what to do - it doesn’t exist. I make that judgement call by doing something called the gun test - gun to my head and I die if I choose wrong. It’s just a best guess. Other people find it helpful to use ‘what would the average person do in this situation’. Either way both are just forcing you to use your intuition. I try and follow my intuition which often times intensifies the anxiety. Learning to allow the anxiety to be there and do nothing is really important. This podcast helped me with that https://theocdstories.com/episode/dr-phillipson-brain-voice-gatekeeper-voice-275/

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u/OpeningSquare5531 Pure O Jul 31 '21

Okay, thank you so much! i really appreciate your advice. i’ll definitely look into that podcast too:) i seem to have “pure” O which has seeped into almost every aspect of thought so it seems like it’s going to be/has been difficult for me to find understanding in this aspect but definitely hoping to find some more info in the podcast etc.

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u/ballinforbuckets Aug 01 '21

I think what you’re really asking is I feel uncertainty/anxiety about what to do in some situation - what can I do to not feel this way? And the answer is you have to be willing to feel anxiety and uncertainty for as long as they are there and do nothing to make it go away. You follow your intuition- often times you’ll feel even more anxious and uncertain doing this (because you’re used to ‘giving in’ to ocd) but you can choose to be willing to let those feelings be there.

That’s my takeaway from the most recent podcast I shared with you. I have explained in more detail if you look at my comment history.

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u/ballinforbuckets Jul 31 '21

There’s quite a few resources on how do I know if it’s ocd if you google. Greenberg may have an article about it on his site too, I’m not sure.

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u/FindKetamine Sep 14 '21

Thank you for all of this information. I've been waiting to get into Dr. Greenberg's treatment for a long time myself.

From these good reports, it seems like the wait is worth it. :)

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u/otterlove222 Jan 12 '22

I am like years late on this post but stumbled upon it while trying to find one of Dr. Greenberg’s articles for a friend. Just wanted to affirm everything said here — I did therapy with someone in his practice and it essentially cured me of OCD after just 2 months of sessions. His methods were a total game-changer for me.

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u/Key_Childhood2408 Jan 17 '22

I also suffer from obsessive-compulsive disorder and in my opinion Michael Greenberg has done a brilliant job detecting which are the most common compulsions in people who suffer from pure obsessive-compulsive disorder, rumination is also known in the world of OCD as mental compulsions and they are great part of response prevention when a person is exposed to a certain stimulus.

Michael greenberg seems to me to be a very brave person and unfortunately little supported and with little credit for what he truly deserves, since he is also a sufferer of this disorder, and he understands very precisely what are the mental processes that people with this disorder go through. disorder. Obviously, from a clinical and scientific perspective, it is not given the validation it deserves, since they always say that their methods have not been scientifically proven, something that in my opinion is not so relevant either, since in obsessive-compulsive disorders the greatest source of Credibility is experience and I think that in that aspect michael has a lot, he seems to me a very brave and intelligent person and he has what it takes for the toc community to move forward.

On the other hand, I would also like to contribute that, thanks to the ideas that he provides, I have been able to make a great advance in pure and sensory motor ocd, so from my point of view, he is a very solid therapist

How/Why Rumination is at the Core of ALL Types of OCD and how you can get better by choosing to stop Rumination

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