Re: Frustrated, need detailed info....

[Guest guest]

In a message dated 6/8/2006 8:08:55 A.M. Eastern Standard Time,

@... writes:

Seems the doc is still trying to focus on relaxing/de-stressing. I

*think* what I would do is give it another 2 appts and then see if

she moves past this towards more CBT/ERP for the OCD.

--

Thanks for the response. I know how much detail is given by different folks

on this board, so just a reminder.... our psychologist does not do ERP. She

doesn't believe it's the most effective way to deal with OCD, so she doesn't

do it. ****** I know, I know******* but she was the ONLY choice we had if

we wanted a doc who had any experience at all with OCD. She was IT.

So, you see my frustration when I say my dd just learned the 2nd of only 3

" tools " this doctor says she teaches. Let's just say, I don't have a whole

lot of hope for the last " tool " , given what we've seen so far.

What were the " tools " your son's doctor taught him in CBT to help with his

OCD??? Specifically.... did he suggest the same type of deep-breath

relaxation? did he suggest the tense/relax muscle thing that our doc did?

What is

there BESIDES breathing ???

I brought up switching docs again with my daughter yesterday. Of course, I

was stupid & tried to have this conversation on the way home from therapy

yesterday -- which made her immediately blow up at me. She HATES going to

these

appts. Yesterday was especially bad because we went from the psychologist

directly to the psychiatrist... literally... drove from one appt directly to

the other. We had about 20 mins kill before the 2nd appt, my husband got off

work early & met us (mostly for moral support - I wanted to adamantly refuse

any increase in meds for her.... I always seem to cave in with this woman.)

anyway, we took dd for a huge, gianormously fattening ice cream sundae at the

restaurant next door -- hoping it would help smooth things over between appts

( I think the sugar-induced coma helped a little :-) HA )

Long story longer -- dd again screeched at me, " WHY DO I ALWAYS HAVE TO

SWITCH & GO TO SOMEONE NEW JUST WHEN I GET USED TO A DOCTOR????!!!!! "

Which is mildly amusing because we've only switched once. The first one

knew NOTHING of OCD... at all .... she actually suggested we go elsewhere. At

any rate - I'm just going to make an appt at that other psychologist's office

that I found who actually offers both CBT & ERP. She wasn't listed on the OC

Foundation's doc list when I first looked, but then was added later. My

husband & I will go & check her out and talk to her first. If we think it

would

be a 'match' with my dd, I think we'll just say " hey, this is the way it

is... you're going " and then hold on for the big blow.

LT

[Guest guest]

LT, I had to smile as you seem just like me! I would have

thought/said the same thing (..but she hasn't tried it yet, blah,

blah) about the breathing/relaxing!

Seems the doc is still trying to focus on relaxing/de-stressing. I

*think* what I would do is give it another 2 appts and then see if

she moves past this towards more CBT/ERP for the OCD.

I know I've read that some OCDers do find the relaxation techniques

helpful but you are right in that they need that ERP/CBT to really

address the OC's.

It reminds me somewhat of when first began his OT

(occupational therapy). We were referred so he could try to get his

pencil grip changed to a more natural/easier grip. Those first few

appts they were doing all this stuff and didn't have him pick up a

pencil/write at all. They did things on a swing, on some roller

type board (roll/steer across the floor), use some vibrating type

pen (OK so did use a pen) to just doodle with, play cards/shuffle,

do fine motor activities.... I asked many times after the first

couple appts - " you know he's here to change his grip??? " thinking

*this* was all a waste of time. But it wasn't. They worked on

his " whole body " first and then began on his grip/writing. Now - he

didn't change his grip (too late to try in 6th grade I guess) but

the OT really helped his whole body/system and his writing

legibility did improve, his speed and his stamina. -- So after our

experience with the OT, thinking just give the doc a couple more

appts at least and then question what her plan is so far as perhaps

some ERP, etc.

Gotta get to work! Hang in there and it might not hurt to just have

some idea of anyone else to call for therapy later - just in case!

>

> Well, dd had her 2nd actual therapy appt yesterday with the

psychologist.

> When she asked my daughter if she had been practicing/using the

breathing

> technique she showed her last time, my dd was truthful & said

sometimes, not

> always (practicing) and never tried using it.

>

> The doc was ok with this (sometimes I think she's TOO ok with it,

[Guest guest]

In a message dated 6/8/2006 8:57:29 A.M. Eastern Standard Time,

julieaw66@... writes:

I'm still learning and hopefully the next person will be the right one.

-

We are SO sharing the same boat on that!!!

LT

[Guest guest]

In a message dated 6/8/2006 9:24:42 A.M. Eastern Standard Time,

julieaw66@... writes:

And

although he doesn't like taking meds, I think he sees they do help and

is more willing to go to the p-doc.

My daughter also realizes the meds are a huge help -- tragically, this

realization hasn't made the least bit of difference in her attitude about going

for her med checks. She always protests & demands to know, " Why can't YOU just

TELL her how I'm doing??? " ha.

LT

[Guest guest]

In a message dated 6/8/2006 10:52:20 A.M. Eastern Standard Time,

melbiscuit5@... writes:

The wrong therapy can even make ocd worse!

If you want specifics of ERP email me directly.

Sandy

Thanks for the information & encouragement. I've got a pretty good idea of

what ERP would entail from what people have posted & what I've read about it.

It's the other comment you made that makes me so nervous - because I know

it's true - OCD can get worse with the wrong therapy.... and it seems anything

else, too.

I find myself hesitant to make any changes if dd isn't going along with it,

for fear of stressing her out SO much that I actually cause the OCD to

spiral. That being said though, I still know what I have to do... I have to

call

that other doctor & at least go in & meet with her & explain our situation.

Hopefully she will be WONDERFUL and I will think " oh my God.. my dd will LOVE

her. " Then I won't feel so bad about forcing the switch.

Thanks again.

LT

[Guest guest]

In a message dated 6/8/2006 10:52:20 A.M. Eastern Standard Time,

melbiscuit5@... writes:

Bre was taught the relaxation technigue you described during P.E.

one time.

Sandy -

That was in PE --- what did Bre learn from her doctor other than breathing?

Anything???

LT

[Guest guest]

Hi LT,

I can't give you specifics of the tools my 11 year old son was learning

in therapy, because I wasn't in the sessions. But they were some kind

of relaxation techniques focusing on breathing that the therapist said

would help him relax. This therapist also said he was familiar with

ocd and would use cbt/erp but after about 5 sessions said he had tried

it on only the first visit and that had not really responded to

it. The last appt. we went to, ran out of the car into the woods

near the office. I had to literally carry him back and then he would

only speak by a forming letters with his hands. I really got the

feeling this guy didn't understand ocd fully so I decided not to return

after that.

Before going to this guy, (and before I joined this group or had really

read anything about ocd) I had brought to a therapist who admitted

she didn't do erp but would try a kind of talk therapy. Looking back

now, I think she was actually more helpful because she understood ocd

better but just didn't have the training for erp.

I am still looking for a new therapist that really knows cbt/erp and is

on our insurance. The p-doc is also trying to find someone for us.

I'm still learning and hopefully the next person will be the right one.

[Guest guest]

Hi again LT,

I wanted to add to what I posted before. The last time my ds had an

appt. with the psychiatrist I didn't tell him till just before we left

and told him I would buy him a book afterwords(one from a series he

really likes). This seemed to work for him and didn't give him time to

think and worry about it too much. I think that when I do find a new

therapist I will try the same thing. It may be difficult though,

because he doesn't see how the therapists have helped at all. And

although he doesn't like taking meds, I think he sees they do help and

is more willing to go to the p-doc.

[Guest guest]

Hi LT, I hope you didn't bang your head too hard! I know how

frustrating it is to get proper help. Ocd specialists seem to be

hard to find. Then we have to try and get our kids to participate in

the therapy!

Bre was taught the relaxation technigue you described during P.E.

one time. She came home and read a paper and had me on the floor

tensing up my muscles and then relaxing them. It is a good technique

but Erp needs to be the main focus. The hard part is getting them to

do the erp homework! For Bre, rewards worked good. Maybe use the

relaxation tech. before the ERP homework.

I would just tell your dd that you wouldn't take her to a heart

doctor for her foot. That seeing someone who really knows ocd and

uses ERP and CBT is very important. You as the parent need to just

switch her even if she complains. I know it is hard, but in the long

run the therapy will produce results if it is the correct one for

ocd. The wrong therapy can even make ocd worse!

If you want specifics of ERP email me directly.

Sandy

-- In , jtlt@... wrote:

>

> Well, dd had her 2nd actual therapy appt yesterday with the

psychologist.

> When she asked my daughter if she had been practicing/using the

breathing

> technique she showed her last time, my dd was truthful & said

sometimes, not

> always (practicing) and never tried using it.

>

> The doc was ok with this (sometimes I think she's TOO ok with it,

quite

> frankly.) I actually raised that concern during the session. My

daughter

> adamantly stated that this breathing thing just isn't going to

work for her - the

> doc basically rolled over & said " oh sweetie, that's ok, it

doesn't work for

> everyone... yada yada yada. " I simply could NOT hold my tongue

at that point

> & blurted out ( I almost feel bad for doing it, because I'm sure

I had a ARE

> YOU A WHACK JOB OR WHAT, tone in my voice...) " How can it

be 'ok' to say it

> doesn't work if she hasn't even TRIED it yet??.......... " then I

went into a

> rant session about how I really had a problem with the fact that

my dd has

> completely shut down the idea of using something she hasn't even

tried yet -

> blah blah blah.

>

> Thankfully the doc ended up agreeing with me & told my daughter

that I was

> probably right - she should at least TRY it before she discounts

it. Ok, so -

> on to learning the 2nd " tool " ... wherein lies the " frustrated "

part of my

> subject line.....................

>

> The doc had her lay on the couch & do this long, involved process

of

> mentally 'sectioning' her body into parts 1, 2, 3,.. etc from toes

to head and then

> had her tense up muscles in each section, one at a time, then

relaxing

> them... all the while going through a detailed story about laying

on the beach...

> warm sand pouring over each body part... blah blah blah. The

entire process

> took several minutes - maybe 10. Which, yes, it made my daughter

relaxed, but

> is HARDLY what you can put to use in the middle of day when she's

stressing

> out at school about sitting on the seat at her desk or going to

the bathroom

> between classes, etc.

>

> I mean, I get the reason for doing it, I really do -- but being

that this

> is the 2nd of only 3 " tools " this doctor is teaching her --- I am

VERY

> dissolutioned about this " therapy. "

>

> I just have to know exactly what methods everyone else's

psychologists are

> teaching them -- I mean... in detail... exactly what techniques do

they tell

> your kids to try? Is it all the same as what we're getting??? I

really,

> really want to know what other doctors do. Yes, I know about

ERP. I know it's

> considered essential.... but I'm only referring to the CBT part

of therapy

> right now. I need something to compare to what we're seeing

here. Maybe then I

> can mentally justify what we're being told. I admit (again) I'm

very new to

> all this - even though dd has been diagnosed since Nov/Dec last

year, this

> is only our 2nd therapy session. I have nothing to base an

opinion of this

> therapy on.

>

> AAARRRRRRGGGGGGHHHHHHHHHH...................

> LT (<----- banging head on desk)

>

>

>

[Guest guest]

LT,

From what I've gathered -- when actually in the moment

of doing ERP it is counterproductive to do relaxation.

The idea is to feel and sit with the anxiety and

actually TRY to think about the intrusive/disturbing

thought until the anxiety naturally goes away

(without doing any ritual!!!). Thus your brain learns

that it can survive the anxiety without doing the

ritual and after repeating this for as many days/weeks

as necessary the brain has ACTUALLY RELEARNED and

formed new chemical pathways!!! around the anxious

reaction to that particular obsession.

As your current therapist said -- it is true that it

is for a particular obsession and then another will

pop up. That's OCD! BUT after a few successes the

OCer learns to do it more efficiently with each new

threat of an obsessive thought. And has gained

confidence that the anxiety can be tolerated and

something horrible will probably not happen. It is a

lifelong challenge.

One example -- My son's main thing is germs. He's

pretty afraid of the kitchen and especially the trash

can. He drops things into the trash can from 2 feet

above so of course they miss and he doesn't want to

pick it up from the floor and get close to the trash

so he would just walk away and leave it for me. If I

pick it up and let him get away with this that is

enabling.

So we have done ERP on the trash can. (It's important

to start ERP therapy with one of the fears that are

not REAL high anxiety so that success is possible and

the sufferer gains confidence that they can do it.

SUCCESS IS IMPORTANT!! so start low anxiety.

My son said that he could touch the trash can without

too much anxiety so we jumped in. This was after

about 12 monthly appts with a psychologist trained in

ERP but who never actually did it with Ian because he

percieved too much anxiety coming from him and wanted

to put him on meds first (which I declined because I

didn't think Ian was as bad as the psych did.) BUT he

did give us suggestions about ERP sessions we should

do at home and how to do them. It basically comes

down to facing one's fears. The hard part for the

parent is finding out what the fears are.

The trash can was obvious tho so we had Ian sit down

with the emptied (but quite dirty) kitchen garbage can

in front of him and the first time he just touched the

rim lightly every few seconds. I sat with him and

tried to NOT offer reassurance like saying he wouldn't

get sick. Because I really don't know that and the

main thing OCers need to learn is to live with the

uncertainty. There are no guarantees!!!!! and most

people can just brush the doubt off and go on with

life. OCers have a real hard time with doubt. They

want certainty -- and one of the main objectives of

the therapy is to teach them that they cannot have

certainty!!!

So-- he sat with the trash can for maybe 5 mins the

first time. By the second and third time I was having

him hold his hands ON the INSIDE of the can where it

was pretty gross -- and for longer periods.

Then I really started trying to INCREASE his anxiety

while doing the exercise by saying there was E-coli

and horrible gross germs on the can (as he was

touching it) and that he might spread those germs

around and " WE'RE All GOING TO DIE!!! "

I would of course be laughing while saying this. And

he would be laughing.

Humor has been the best thing we've discovered!!!!

It's also possible to " model " the expected behavior in

the beginning of exposures to show the person that a

" normal " person would be willing to do whatever you're

asking them to do. I think before the first trash can

exposure I actually touched the can and then put my

hands on my face or something -- to give him

confidence.

It was kind of gross but I knew it wouldn't kill me

and it might help improve his entire life.

Or you could model a shower where you just soap up the

most important parts and rinse quick and get out.

I can't remember what other fears you're dealing with.

I could try to ask someone on the other site what

they would do for therapy in the case of being afraid

of leaving a wet spot if you want me to.

Tamar Chansky's book gives examples and of course can

explain all this alot better. What a good therapist

is supposed to help with the most (I think)) is

finding out what EXACTLY the fears are, because it's

pretty hard to know what " script " the therapy should

follow until you get to the bottom of the fear.

The therapy above is the " B " part of CBT (Behavior).

The " C " (Cognitive) part of the CBT would be where the

therapist helps the person correct any thoughts which

are incorrect -- like thinking it's important to stay

away from all germs. Or thinking it's important to

wash every square inch of one's body in the shower.

Ian's therapist pointed out that exposure to some

germs is important for the development of a healthy

and strong immune system.

This was going to be short! Oh well. That's why they

write books about this instead of explaining it in an

email.

Lynn

--- jtlt@... wrote:

>

> In a message dated 6/8/2006 8:08:55 A.M. Eastern

> Standard Time,

> @... writes:

>

> Seems the doc is still trying to focus on

> relaxing/de-stressing. I

> *think* what I would do is give it another 2 appts

> and then see if

> she moves past this towards more CBT/ERP for the

> OCD.

>

>

> --

>

> Thanks for the response. I know how much detail is

> given by different folks

> on this board, so just a reminder.... our

> psychologist does not do ERP. She

> doesn't believe it's the most effective way to deal

> with OCD, so she doesn't

> do it. ****** I know, I know******* but she was the

> ONLY choice we had if

> we wanted a doc who had any experience at all with

> OCD. She was IT.

>

> So, you see my frustration when I say my dd just

> learned the 2nd of only 3

> " tools " this doctor says she teaches. Let's just

> say, I don't have a whole

> lot of hope for the last " tool " , given what we've

> seen so far.

>

> What were the " tools " your son's doctor taught him

> in CBT to help with his

> OCD??? Specifically.... did he suggest the same

> type of deep-breath

> relaxation? did he suggest the tense/relax muscle

> thing that our doc did? What is

> there BESIDES breathing ???

>

> I brought up switching docs again with my daughter

> yesterday. Of course, I

> was stupid & tried to have this conversation on the

> way home from therapy

> yesterday -- which made her immediately blow up at

> me. She HATES going to these

> appts. Yesterday was especially bad because we went

> from the psychologist

> directly to the psychiatrist... literally... drove

> from one appt directly to

> the other. We had about 20 mins kill before the 2nd

> appt, my husband got off

> work early & met us (mostly for moral support - I

> wanted to adamantly refuse

> any increase in meds for her.... I always seem to

> cave in with this woman.)

> anyway, we took dd for a huge, gianormously

> fattening ice cream sundae at the

> restaurant next door -- hoping it would help smooth

> things over between appts

> ( I think the sugar-induced coma helped a little :-)

> HA )

>

> Long story longer -- dd again screeched at me, " WHY

> DO I ALWAYS HAVE TO

> SWITCH & GO TO SOMEONE NEW JUST WHEN I GET USED TO A

> DOCTOR????!!!!! "

>

> Which is mildly amusing because we've only switched

> once. The first one

> knew NOTHING of OCD... at all .... she actually

> suggested we go elsewhere. At

> any rate - I'm just going to make an appt at that

> other psychologist's office

> that I found who actually offers both CBT & ERP.

> She wasn't listed on the OC

> Foundation's doc list when I first looked, but then

> was added later. My

> husband & I will go & check her out and talk to her

> first. If we think it would

> be a 'match' with my dd, I think we'll just say

> " hey, this is the way it

> is... you're going " and then hold on for the big

> blow.

> LT

>

>

>

>

> [Non-text portions of this message have been

> removed]

>

>

[Guest guest]

LT,

I agree with Sandy. You need to take to her to ERP expert even

though she complains. For example, Do you take a child's opinion to

take her to the right specialist if it is a Physical health problem.

You should treat this as same. ERP really helps if you take her to

the one who knows about it.

SU

> >

> > Well, dd had her 2nd actual therapy appt yesterday with the

> psychologist.

> > When she asked my daughter if she had been practicing/using the

> breathing

> > technique she showed her last time, my dd was truthful & said

> sometimes, not

> > always (practicing) and never tried using it.

> >

> > The doc was ok with this (sometimes I think she's TOO ok with

it,

> quite

> > frankly.) I actually raised that concern during the session.

My

> daughter

> > adamantly stated that this breathing thing just isn't going to

> work for her - the

> > doc basically rolled over & said " oh sweetie, that's ok, it

> doesn't work for

> > everyone... yada yada yada. " I simply could NOT hold my tongue

> at that point

> > & blurted out ( I almost feel bad for doing it, because I'm

sure

> I had a ARE

> > YOU A WHACK JOB OR WHAT, tone in my voice...) " How can it

> be 'ok' to say it

> > doesn't work if she hasn't even TRIED it yet??.......... " then

I

> went into a

> > rant session about how I really had a problem with the fact

that

> my dd has

> > completely shut down the idea of using something she hasn't

even

> tried yet -

> > blah blah blah.

> >

> > Thankfully the doc ended up agreeing with me & told my daughter

> that I was

> > probably right - she should at least TRY it before she discounts

> it. Ok, so -

> > on to learning the 2nd " tool " ... wherein lies the " frustrated "

> part of my

> > subject line.....................

> >

> > The doc had her lay on the couch & do this long, involved

process

> of

> > mentally 'sectioning' her body into parts 1, 2, 3,.. etc from

toes

> to head and then

> > had her tense up muscles in each section, one at a time, then

> relaxing

> > them... all the while going through a detailed story about

laying

> on the beach...

> > warm sand pouring over each body part... blah blah blah. The

> entire process

> > took several minutes - maybe 10. Which, yes, it made my

daughter

> relaxed, but

> > is HARDLY what you can put to use in the middle of day when

she's

> stressing

> > out at school about sitting on the seat at her desk or going to

> the bathroom

> > between classes, etc.

> >

> > I mean, I get the reason for doing it, I really do -- but being

> that this

> > is the 2nd of only 3 " tools " this doctor is teaching her --- I

am

> VERY

> > dissolutioned about this " therapy. "

> >

> > I just have to know exactly what methods everyone else's

> psychologists are

> > teaching them -- I mean... in detail... exactly what techniques

do

> they tell

> > your kids to try? Is it all the same as what we're getting???

I

> really,

> > really want to know what other doctors do. Yes, I know about

> ERP. I know it's

> > considered essential.... but I'm only referring to the CBT part

> of therapy

> > right now. I need something to compare to what we're seeing

> here. Maybe then I

> > can mentally justify what we're being told. I admit (again)

I'm

> very new to

> > all this - even though dd has been diagnosed since Nov/Dec last

> year, this

> > is only our 2nd therapy session. I have nothing to base an

> opinion of this

> > therapy on.

> >

> > AAARRRRRRGGGGGGHHHHHHHHHH...................

> > LT (<----- banging head on desk)

> >

> >

> >