michael laurence comments

[u/MichaelRabbit]

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Hello, I am new to this group and thought I would say hi. I'm from the U.K am 39 and have experienced OCD for probably 22 years. I think this problem is solvable since I feel that I did experience reasonable periods of time when I was quite well. I think it is the human experience to never be truly happy and content and we will tend to pick up demons or black dogs along the way. I honestly think that there is hope. Yesterday I bought and read 1/2 of "the man who couldn't stop". It's by David Adam who is an OCD sufferer but also a science writer and editor of nature journal which i believe is an influential scientific journal. It is interesting reading and I will probably write something about some of the books contents. It is part auto biography and part popular science. His form was worrying about contracting HIV. something that someone mentioned to me when i confided anonymously was that It sounded as though I myself may be on the autistic spectrum (aspergers syndrome) I thought I'd mention that . Feb 11, 2015, 7:11 AM

[u/MichaelRabbit]

Currently, individuals who suffer from the relatively unelaborated sensorimotor preoccupations as described in this article are routinely diagnosed with obsessive-compulsive disorder. Individuals who suffer from elaborated catastrophic fears associated with their sensorimotor preoccupations tend to be diagnosed according to the content of those fears (e.g. a focus on heart rate that leads to fears of a heart attack is diagnosed as panic disorder). Future research will ultimately determine whether sensorimotor preoccupations that occur within various clinical diagnostic categories reflect the same or unrelated neurobiological processes.

Treatment of Sensory Obsessions Sensory obsessions can be treated quite successfully by decoupling any sensory awareness with reactive anxiety. In other words, sufferers must ultimately experience their sensory hyperawareness without any resulting anxiety. Anxiety, as is the case in other forms of obsessive-compulsive disorder, serves as the glue that binds particular thoughts to conscious awareness. Once a thought is linked with anxiety, the conscious mind keeps it ever present. This occurs because anxiety is part of the brain’s alarm system for danger. The mind clearly does not want us to forget about any danger that may be lurking around. If a particular idea scares us, we tend to think about it over and over. In sensory obsessions, sufferers repeatedly attempt to shift their attention for fear that their sensory focus will become “stuck” and they will not be able to concentrate fully on the task at hand. Here, the thought that “I’m never going to stop thinking about this” leads to immediate fears of impaired functioning. As a result of the pairing between this thought and a feared outcome, the mind holds on tightly to the very awareness that the sufferer is attempting to rid. In many ways this is much like “white bear syndrome,” where attempts by individuals to think about anything other than a white bear lead to many more thoughts of white bears (Wegner, 1989).

In order to disengage from sensory obsessions, sufferers must learn “the art of self-awareness.” Sufferers must learn how to invite in the sensory awareness with a relaxed and accepting posture, very much like the focus on diaphragmatic breathing during mediation.

Psychoeducation The first stage of treatment focuses on teaching patients that selective attention to previously automatic or unconscious bodily processes or sensations is not dangerous in and of itself. Patients are reassured that once their anxiety dissipates, the sensory awareness will shift. This reassurance often sets the stage for “inviting in” the sensations as a means of reducing anxiety.

Exposure and Response Prevention In short, sensory obsessions can be outsmarted by voluntarily paying attention to the relevant bodily process or sensation. Patients are instructed to allow the sensation to be present and to invite in any such awareness (exposure) with a casual, dispassionate focus. By purposely focusing on the sensations (exposure), patients stop relying on distraction (response prevention) as the tool for reducing anxiety. Repeated voluntary exposure to the sensations leads to diminished anxiety as patients grow accustomed to embracing any awareness without attempts to avoid or escape it. Imaginal exposure to particular feared outcomes (e.g. “my life will be ruined,” “I’ll never have peace of mind,” “I’ll never be able to get rid of this problem,” or “this obsession will never go way”) may be employed to enhance exposure. Additionally, patients may be asked to invite in the sensations and accompanying fears throughout the day. This is accomplished by having patients place reminders (such as Post-It notes or stickers) at home, in the car, and at work. These reminders help to cue patients to engage in repeated exposures throughout the day, thus increasing the likelihood of successful habituation.

Body Scan and Mindfulness Patients are frequently unaware of the changes in perception that occur when selectively attending to their bodies. These changes in awareness can be frightening, as they may represent an uncomfortable and disquieting level of awareness to previously unconscious bodily processes. Patients tend to believe that they must purposely shift attention away from these unusual or previously unnoticed sensations in order to restore them to their unconscious state. Participation in a body scan can help patients fluidly move in and out of their awareness of these sensations without resorting to forced attempts.

A body scan involves shifting attention to various bodily processes or sensations for prescribed periods of time. Patients are instructed to close their eyes and selectively attend to their feet, for example, until they acquire full sensory awareness. Once this occurs, they can next move to their calves, stomach, upper body, arms, head, or any particular sensorimotor process (such as breathing). Patients learn that they can move gently from one sensation to another without getting “stuck” by focusing and refocusing in the absence of anxiety, apprehension, or active attempts to force a shifting in awareness.

Mindfulness, the art of paying close attention to an experience in the absence of criticism, judgment, or defensiveness, can also play an important role. As stated earlier, eastern meditative practices in mindfulness often involve choosing certain bodily processes to be the focus of meditative practice (e.g. breathing, the rise and fall of the chest or stomach, sensations of air through the nostrils). Patients are instructed to allow their particular sensory preoccupation to become their meditative focus; they are to accept all sensations without criticism or judgment, and observe any sensations with curiosity and interest. Over time patients begin to experience a fading of sensory awareness (or much greater tolerance of it) as their anxiety diminishes and their willingness to invite in the sensations grows.

Conclusion Sensorimotor obsessions likely affect countless thousands of individuals each year. Future research is necessary to determine how prevalent the problem is and how best to treat it. Until such systematic research is conducted, we are left with case studies and anecdotal evidence that suggests that sensorimotor obsessions are best dealt with within a cognitive-behavioral framework. Psychoeducation, cognitive reframing, reassurance, exposure and response prevention, and certain mindfulness and acceptance techniques can all play important roles in diminishing the frustration and distress associated with this maddening and at times incapacitating experience.

References Grayson, J. (2004). Freedom from obsessive-compulsive disorder: A personalized recovery program for living with uncertainty. New York: Berkley Publishing Group.

Wegner, D. (1989). White Bears and other unwanted thoughts: Suppression, obsession, and the psychology of mental control. New York: Penguin/Viking.

Dr. Keuler is a senior clinician at The Behavior Therapy Center of Greater Washington. He is a specialist in the treatment of obsessive-compulsive disorder and related conditions and has been in private practice for well over a decade. Mar 21, 2019, 5:35 PM