The loop of anxiety

How lunch with an old friend got me reflecting

I just came home from lunch with a really old and treasured friend who I haven’t seen for a year. We were at school together 25 years ago, and are godparents to each other’s children. I love catching up with old friends, because not only is it wonderful to hear their news, you can go over your news to the other person and yourself. 

I told her about the last year of being treated for OCD with Exposure and Response Prevention (ERP) therapy. In the old days this was called Exposure therapy, and was mainly used to treat phobias. ERP is normally used by CBT therapists (it is a derivative of CBT or what you might call behavioural therapy). 

I was in humanistic / psychodynamic therapy for ten years, and I have worked in that field for just as long as a psychotherapist. This is the therapy where you go through how the past impacts the present, if that doesn’t sound too basic or degrading of the work, which for me has been monumental and life changing. There is a huge place for this type of therapy, and I am a huge fan of it, to a point. However, not once was my OCD picked up. I am staggered as to why when you train as a therapist, you are not trained to spot at least the main stream mental illnesses – OCD, ADHD, Bi Polar, General Anxiety Disorder, to name but a few. 

Having the year from hell last year allowed me to rethink how I want to work, and who I want to work with. I now want to spend my time helping people recover from one of the most brutal of mental illnesses – OCD. 

The way I think I can do this is via ERP. ERP is now known as the gold standard treatment for OCD, and, when it finally worked, it was life changing. It allowed me to get used to being uncomfortable, to acclimatise to uncertainty, and not perform a compulsion which was keeping me in the loop of anxiety.

It is always really useful to explain to someone who hasn’t heard of ERP what it is. I told my friend ERP trains the brain to reduce the fight or flight mechanism when it is not needed. You need it when a lion is chasing you (which was one of the original jobs of the cave man amygdala, or reptilian part of the brain) but you don’t need it when you have a nasty, sticky thought. Chad Lejeune talks about these unpleasant thoughts as cognitive fusion in a brilliantly helpful book called Pure O. These are thoughts that don’t budge, or as another colleague said to me, they are like a car being stuck in a ditch with the wheel spinning round and round, going nowhere, a lot of mud flying. 

So you expose yourself to the thought and rather than do the C of OCD which is the compulsion, you learn to sit with the uncertainty and the anxiety. Spoiler alert – it is very very uncomfortable, but if done correctly it is not totally terrifying. You teach your brain that anxiety is not actually going to kill you. By doing this, over time, you get out of the loop of anxiety. 

© Jessica Drake