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Having negative thoughts with OCD. How to get cure?

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Dr. Jonas Sundarakumar

Psychiatrist

Practicing since :2003

Answered : 2190 Questions

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Posted on Thu, 17 Jan 2013 in Mental Health
Question: Hello again,

I hope you are doing well. I hope you don't mind another email, I do not have the money for a psychologist and I do not see the psychiatrist again, they just make the diagnosis.

I am reading the books and listening to the Cd's on mindfulness that were prescribed to me. I try to keep busy as you suggest and do other things. The problem is that my mind feels split into two pieces. One half is worrying non stop about the report the psychiatrist wrote about me and the other half functions normally. But I can't go more than about five seconds without thinking about it.

I don't know if I have OCD at all, in my worries I imagine that I am talking to the doctor and thinking I should have said this and that or wondering what about this or that. It is almost like a negative story or negative fantasy that helps me cope with the worry. It makes no sense to me that I could be this worried about something and I don't think I am but it's a game my mind is playing to torment me.

Do I need to figure out what it is I am really worried about in order to stop this or is there nothing really to figure out? I am actually at peace with my diagnosis of OCD but this doesn't seem like OCD, is it negative day dreaming? Do I need to analyze it or is it meaningless?
doctor
Answered by Dr. Jonas Sundarakumar 29 hours later
Hello again,

Please don't hesitate to ask your queries and I would always be happy to help you with my opinions and suggestions through this platform.

Now, the psychological phenomenon which you are describing is called "splitting". Like "dissociation", which we discussed last time, "splitting" is also a type of defence mechansim (and is closely related to dissociation). Unfortunately, like dissociation, splitting is also an unhealthy or a maladaptive defence mechanism. As I had mentioned earlier, "defence mechanisms" are subconscious or conscious psychological reactions to deal with stress or conflict.

Most of the unhealthy defence mechanisms come into play when a person, instead of accepting and trying to deal with the stressful conflict, tries to run away from the situation and "represses" it. But sooner or later, the repressed feelings try to resurface start causing anxiety and distress (because the conflict or stress is not really sorted out, but just temporarily pushed away). This distress and anxiety hinders and impairs the person's normal functioning. But since the mind is still not prepared to face the situation and handle the stress, it "splits", thereby trying to encapsulate these conflicts and anxiety into one half, whereas the other half tries to carry on with routine functioning.

Why this is an unhealthy defence mechanism is because, the person is actually not willing to face and handle the stress and conflict, but just tries to keep avoiding it. Though avoiding and running away from a problem may be giving temporary relief from the problem, the person never learns to face, handle or cope up with stress. Eventually, the pent up or repressed stress and anxiety come out in a more severe form causing more suffering, leaving the person with a feeling of helplessness and hopelessness.

After analyzing your problems and psychological phenomena, my opinion is that all these kinds of defence mechanisms seem to indicate that you are having a major problem of handling your stress and conflicts. Somehow, you seem to have ended up unconsciously learning unhealthy psychological mechanisms, and like I said, these mechanisms, though may temporarily make you feel less anxious, but are only pushing you farther away from facing reality.

I think that an calm and gradual introspection (not a desparate and hasty search for immediate answers) may reveal what issues are bothering you, which stressors you are trying to avoid or which conflicts you are trying to repress. Remember, this is a long drawn process and you must be willing to invest time as well as put in sincere efforts to understand yourself more deeply. I guess the "mindfulness techniques" are helping you slowly gain a better understanding about your problems and weaknesses.

Now the next important thing to do is to acknowledge these weaknesses, and start learning to handle and face stressful situations and deal with conflicts in a healthier way. This is definitely going to be difficult initially, but with practice and persistent efforts, you will acquire these psychological skills. It's good that you are starting to understand youself and some of your weaknesses, which may be contributing to your psychological problems. Now, the next important thing to do is to take positive and pro-active steps to improve yourself. Like I have said before, if an unhealthy behaviour can be learnt, it is also true that healthy and positive behaviours can also be learnt.

Wish you all the best.

Regards,
Dr. Jonas Sundarakumar
Consultant Psychiatrist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Jonas Sundarakumar 36 minutes later
Thank you so much. If you hadn't have told me that I would have been trying to figure out what the meaning of the obsessing about the psychiatrist visit means. It means I have to figure out what issues are bothering me in the real world and for now I just have to tolerate the "splitting." So this really has nothing to do with that at all is what I think you are saying.

I haven't started the medication yet, do you think this stuff could go away with out it or is that something I should consider more seriously?
I haven't gotten it yet as I don't like medications.

Thanks again. You are really helpful to me. I will continue to practice these techniques and will touch base again later.
doctor
Answered by Dr. Jonas Sundarakumar 21 hours later
Hello again,

Medication may not have a major role for these kind of problems, since I feel that your psychological problems seem to be a result of lack of adequate sress management skills, unhealthy defence mechanisms and poor coping strategies, rather than any specific psychiatric illness. Though medication such as antidepressants, mood stabilizers, etc. may be partly helpful in promoting emotional stability, still they are not the first-line treatment. Your problems have to be dealt with a predominantly psychological approach.

There are two things to be remembered when adopting this psychological approach. One is that it requires persistent efforts. This is because you have to not only "unlearn" the unhealthy defence and coping mechanisms, but also substitute them with healthier ones. Secondly, when you try to do this, it will be difficult initially. This is because your mind would naturally want to avoid confrontations and changes, and will tend to choose the shortcut way out, by partly shuttiing itself out from the pain of the stress/ conflict or dissociating into an imaginary stress-free world. So, the crux of these psychological techniques like 'mindfulness' is to make you be aware and face reality (however difficult or stressful it may be).

Obviously, the easiest thing to do when we are faced with a conflict is to avoid it or repress it and detach ourselves into an unreal world. But remember, just because we 'run away' from the conflict, it doesnt get resolved. On the contrary, it only keeps lingering subconsciously, causing pent-up anxiety, and keeps spoiling our peace of mind to a greater extent. So, however difficult the conflict or stress may be, the healthiest way is to face and confront it. If we learn and acquire good stress management strategies, then we will be in a better position to face and manage the conflict / stressor.

So, I would suggest that you look at this whole thing with a perspective that you are going to learn and attempt to improve yourself in the areas where you may be lacking. Work patiently and persistently towards this goal. If it iseems difficult initially, don't get worried, because it means that you are in the process of change and betterment. (Interestingly, if you don't experience any difficulty, it's not a good sign and means that you are in the same state). Like I have said before, a good "insight" into your problems and weaknesses is half the road to success. And with sincere and persistent efforts, you can cover the next half.

Wish you all the best.

Regards,
Dr. Jonas Sundarakumar
Consultant Psychiatrist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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