Sunday, October 30, 2011

Book Review: When in Doubt, Make Belief: An OCD-Inspired Approach To Living With Uncertainty

By Jeff Bell.

Jeff begins his book by discussing 2 kinds of doubt: Intellect-based doubt and Fear-based doubt.  Intellectual doubt is the realistic doubt that helps keep us safe (do i REALLY have enough time to get across the street before the light changes)  or challenges traditions (is that really the BEST use of the world's resources?). It is rational, logical and serves humanity well.The great scientists, philosophers and revolutionaries used it to challenge the accepted view of their cultures and changed the world for the better. 

Fear-based doubt, OTOH, is the result of catastrophic, emotional or black & white thinking.  It keeps the questioner stuck in uncertainty and doing or not doing things in an excessive way to try to reduce or eliminate  the anxiety.

He explains how we can tell the difference between the 2 kinds of doubt: Does it spike our anxiety instead of promoting curiosity or caution?  Does it cause ever-more disturbing 'what-if' scenerios?  If so, it is fear-based doubt.

Once stuck within uncertainty  Bell discusses the 6 'trap doors' that people use to try to eliminate this fear-based doubt that instead only lead the doubter further down into the fear. These are checking, seeking reassurance,  ruminating, protecting, fixing and avoiding.  Doing one or more of these, in an effort to reduce uncertainty, only gives a minimal relief, while taking up lots of time and effort.  These make up the compulsions and rituals a person with ocd may perform.

The 'correct' [ocd joke] way to eliminate fear-based doubt is to use the 10 steps to MAKE BELIEF. Standing up to the doubt bullies is done by  believing in yourself and in believing in the goodness of life and in the goodness of other people.  The 10 steps are as follows:

Choose to see the universe as friendly.
Embrase the possibility in every moment.  Live in the present moment (ocd wants us to live in the past or future ) and find meaning in your life.
Affirm your own potential.  You are more than your ocd. Use Mindfulness to observe your thoughts.

Put your committments ahead of your comfort.  Learn to live with uncertainty in life. Want to be free of ocd more than you want comfort.
Keep sight of the bigger picture and the greater good. Have a sense of humour . Don't take life so seriously. Find a positive reason or purpose to help motivate yourself to NOT give in to ocd compulsions and rituals.

Exercise your freedom to choose Use your independent will to CHOOSE not to obey the ocd bully. Willfully choose to sit with your anxiety. Choose to actively practice ERPs . Delibrately expose yourself to whatever you fear just for the practise of choosing not to do the compulsions.
Picture possibility and direct your attention  Choose which thoughts and ideas you want to give attention to and which you will just acknowledge  with detachment as having crossed your mind.
Act in ways that empower.     Act, believing in the abundance of the universe, rather than the scarcity ocd wants you to feel. Believe there will always be opportunities for you. Ask yourself if you are acting out of a sense of purpose and service to empower yourself or others or out of fear and doubt to relieve anxiety.  Fake it til you make it' if necessary.

Accept and let go of what you cannot control Use your free will to accept what you can't control so you can act on what you can control. Uncertainty is inevitable (out of our control) as is the anxiety we feel at times. You suffer when you try to control the uncertainty and fall into one of the 6 trap doors (doing compulsions).Give up your obsessions to the universe and let it (Him, Her, God) take care of the results of you not doing your compulsions.
Allow for bigger plans than your own.  Don't get attached to your plan's outcome.  There may be something better in store.

Once you've used the 10 steps to stay away from the trapdoors, use the 'greater good perspective shift' Bell describes to keep you on the path to making belief.  This greater good perspective (GGP) means making decisions based on service and purpose rather than on doubt and fear  (D&F).  It means  making choices that give you the chance to serve others or bring out the best in yourself.

 The D&F framework involves deciding between a 'good' and a 'bad' choice.  For example, washing up after touching a door knob would be the 'good' choice because it would reduce the risk of making someone sick and  your anxiety will go down.  The 'bad' choice would be to not scrub because you 'might' make someone else sick and you must sit with your anxiety.

Using the GGP,  your decision would be between: 'good'- wash up to keep someone from getting sick and ' greater good'  - don't scrub because you will be on time to xyz function, you will be 'in charge' of your actions.   Bell believes that purpose and service are better motivators than fear and doubt. 

Making believe is not something you do once and then receive the benefits of forever after.  [oh, rats.]You must practice these steps over and over again.The more you work on these steps the easier they become. And when you make a mistake, you also know your way out of the traps.

Bell believes that as students of life, you, not your doubt (ocd) bully is in charge of your decisions and therefore your life.  At the end of the day ask yourself 3 qu: In what ways did I demonstrate a passion for life, kindness to others and kindness to myself. By choosing to make believe you will continue to move forward in life, not staying stuck in fear and doubt.

I really enjoyed the book.  He writes in a way that is clear and helpful.  I, too, found that it is more motivating to have a positive reason to not do a compulsion.  His view of having a higher purpose- even if it is only empowering myself, gave me more ideas to use when i must decide whether to enter one of the 6 trapdoors or not.

 In fact i used it last night.  I went to V.V. (used clothes store) again yest. but didn't change when i got home. I just put a sweatshirt on over my shirt.  When my daughter went to bed last night i debated whether to cuddle her in bed or not ( in case I contaminated the bed.)  I realized that cuddling with my dd was a 'greater good' than a 'cleaner' bed, and so i did that instead.

A Good Week.

Well 2 good things happened this week.  I am finally able to comment under my own name.  It has something to do with signing in under the right email address. 

And i went back to value village today to finish my homework assignment.  This time, tho while i washed my hands when i got home, i didn't change my pants.   I did put a sweatshirt over my t shirt so i could feel a little better (and be warm in my house.)  The anxiety has worn off.  Maybe next time i won't worry about my shirt either.

Thursday, October 27, 2011

My homework this week is to go to Value Village 2 times.   I have put it off. Then a couple of nights ago i tried to get my daughter to eat a piece of mac and cheese ( she's a VERY picky eater. )  and if she did i'd go to v.v. and see if the toy she wanted was still there.  She did (and hated it and spit it out) and so now i had to keep my end of the bargain.

But first make that thot record on paper, not just in my head.

Situation: go to used clothes store.
Moods:  anxiety & dread- 120+ %
Automatic thots:  The stuff in the store is dirty.  It could have come from old people's homes who died/ went to nursing homes and by this time had mice, mold and other gross critters in their houses.
What does this mean for my future: I will have to buy only new stuff unless i know the person it came from.  Can't roam around in used book stores anymore. 
What am i afraid might happen: My house will get contaminated by the 'what-if's'.
What is the worst thing that could happen if above is true:  I would have to clean my house top to bottom.
What does this mean about people in general: they like mice.
What images or memories do i have in this situation: Cleaning out my inlaw's house and garage.  When we got to the garage to clean up dh's grandma's stuff that was stored there, mice had gotten into it. ( I kept some christmas ornaments that dh remembered from his childhood but even after cleaning them i have a hard time putting them out.  Some years they get used; others they don't.)  I was afraid to go back to the basement after that in case there were droppings there i hadn't noticed before.  I refused to clean up anymore of the house.
Evidence that supports the hot thot:  The store has a funny smell. 
Evidence that does NOT support the hot thot:  They wash the clothes first ( i hope).  Most people get rid of toys etc. as their kids get older or they don't want stuff anymore.  Ditto for the adults too.  I USED to shop there (in a different city).
Alternative/ Balanced thots:  I plan on washing the toys/ clothes later before DD plays with them.  DD will be happy.
Rate moods now: 35%- but i'm not in front of the store yet.

( NB i added a couple of things to it as i was copying it down )

So i put on a baggy sweat shirt that was easier to wash than a coat.  It also had a big pocket in the front to hold my credit card so as not to get my purse 'dirty' and a large cloth bag to put the stuff in (so as not to get the car 'dirty'.  I was prepared.

No couch in the entrance way.  So far so good.  I went to the toy section and looked them over.  No My Little Pony stuff there today.  At least not that i could SEE.  I'd have to touch the bags to find stuff behind the first bags.  Ug, but ok. The bags should be clean, right?  Still nothing.  i guess it was sold already.  i find a purple shirt dd would like and pick that up too.

 Then i look at the books.  Origionally i had decided NOT to do that in case they were old and moldy, but i figured the children's books should be alright.  I found some that dd likes to listen to and picked them up too.  Then i went back to the toy section and found some little doggie stuff she'd love to have.  i cashed out, but had to open my wallet to get another credit card, but didn't worry about it there.  Put the stuff in my big shopping bag and put it all in the trunk.

  Went home.  Took off sweatshirt, washed hands.  Did NOT wash car , or front door handle. Didn't feel THAT dirty. However, i put a blanket on my pants before putting my computer on my lap- just in case.  After dd went to bed we put the toys in the sink with dish detergent to soak over night, dh wiped the books off with windex and i put the shirt and bag in the basement laundry.  We washed up (him, his hands, me up to my elbows, i put all my clothes in the laundry and got ready for bed. 

Better turn-out than last time.  Still not sure whether to call the store clean or not so i didn't schedule any other errands for on the way home, and i kept debating about whether to change my pants and t-shirt too.  Deliberately didn't touch library books the rest of the evening in case i changed my mind and THEY became contaminated.

One more time to go.  this time i'll look for clothes for me to try on -maybe.  And will i change clothes when i get home? 

Calling all computer savvy people:

I can blog.  Obviously.  However, i can only comment on my own blog under the name 'anonymous'.

On some people's blogs ( The Blue Morpho, Into My Own, ) i can comment under my name automatically, picture and all. 

However, on most other people's blogs  i must sign in under 'anonymous'.  And if the blogger hasn't allowed for anonymous writers ( and i can certainly understand why, in blogs this personal), i can only read and not comment at all.  I've also tried to sign in under open id url, but that didn't work either. So 'Just Me and my OCD' and 'I Am Not My OCD", i do read your blogs and have tried to comment but so far no luck.

Anyone have any idea what is going on?  How can i fix this?

Thursday, October 20, 2011

Is ERP Another Word For Abusing Yourself?

My erp this week, as if i haven't been traumatized enuf already, was to go to Value Village, a used clothes store.  Now, once upon a time gone by i used to go there and buy clothes, take them home and wash them and then wear them.  Not a big problem.  I went to other used clothes stores too.  Only condition was they had to look clean and neat.  In fact when i was younger and our son a child, that's how he got his snow suits etc.  So i've had a long history with used clothes and not had too much a problem.  Haven't stepped inside one in 5 yrs. Not since ocd bit me in the brain. 

I had done some pre-thinking.  Coming up with reasons why it would be nice to go to value village.  (not too difficult- i get to pick the style of clothes i like and the prices are cheap.) I looked at the store on line but VV has a particular smell to it that the internet pic's didn't bring across.  Or else my extra-sensitive - pregnancy -nose is at it again.  Imagined walking in the store.  No big trauma in my mind, so i thot 'this will be ok, easy even.'  HA!

Anyway i didn't get there til after everyone had come home from work and school.  I should have gone alone but i thot it'd be nice to have a little support.  It all went well until we parked in front of the store.  I just stared at it. I said to Bruce (husband) that maybe we should start at the bank down a bit in the strip mall, work our way to V.V.  Nope, it was raining so he was going directly there.  i followed along behind.  In the front door was a green couch.  It looked ok but you never know.  After all it's used by who-knows-who.  ( i manage to keep this voice down to a dull roar at hotels, where the couches have also been used by people i don't know).  So from where i am it looks like my daughter is swinging her hat against the couch.  Strike 1.

 We get into the store and i just stand there and smell it and look around and wander.  Hubby and daughter are down by the toy section because i guess they don't get the words 'children's clothes' very well.  So when i finally got them back to the kiddie clothes section KD ducks under all the clothes and makes sure she is completely enveloped in OCD.  Me, i am about to shriek, freak or just run screaming, so i turn around to get away from my daughter before i grab her and just haul her out of the rack of clothes.  I calm myself down and then decide it will be ok.  KD comes up to me wraps her arms around me and gives me a HUGE ocd hug.  So now i, too am contaminated.  It's what i came for, right?  Not exactly.  I wanted a little integration.  Touch some clothes with my HANDS, not my whole body, try some on and maybe buy one.  Nope, she ensures i get the full-body contact.  So we look for something for her to wear but she's not interested.  (of course not, her task to throw me under the rack is now complete).  So i go to look at pants.

The change stalls are all grungy looking inside and have black spots/ marks on the floor and in the corners.  I make Bruce look in and ensure that the dirt in the corner is not really mold. So i have these 4 squares (2x2) tiles i feel are clean enuf to stand on to change.  Isn't there some rule about having to have at least 1 meticulously clean change room for ocd disadvantaged people?  There should be. 

I try a few pairs of pants on and discover i have no idea what size i am anymore. I have gained a ton of weight in the past 3 yrs. Partly my fault, and partly ocd drug's fault.  I am working on that. Not hard enuf, tho, apparently.

So after all that we leave with nothing. I sat in the car staring out the front window the whole way home.  I was in shock.  Not thrilled, or exhilerated like i sometimes am.  Just in shock.  I asked Bruce on the way home if it was ok to change into pj's when we get home.  It's only 7:30, mind you.  He says yes, it is.  I throw all my clothes in the laundry becasue i don't want ocd reminders on me.  That worked fine for me.  But KD, altho she washed her hands and got into her pj's too, had a head of hair/ face still full of OCD.  This was ok as long as she was watching tv and i was upstairs.  When she came upstairs and wanted to snuggle with me it became a problem.  I told her that i was scared to hug her because of her hair.  She sat for a time and then disappeared into the bathroom.  When she came out she said she'd washed her hair and her hands so i wouldn't be scared anymore.  I let her hug me even tho ocd didn't really think that wiping her hair a few times with her hands really constituted cleaning it. I thot it was nice of her to care, since mostly she doesn't. (she's 5) I even lay in bed with her and read to her. 

When that was done i changed my pj top and decided that was all i could do about/ for ocd today.  Not sure if that was a success story or not.  i certainly didn't like the idea of 'contaminating' my whole house to desensitize myself.  Maybe that was just too much fo r one week.  I still have the anxiety or stress horemones or whatever coursing thru my body.  i hope they leave soon.  At least by tomorrow.

Tuesday, October 18, 2011

Garbage Delight pt. 2

So i went out tonight to pick up all the dirty paper towels that the birds had strewn around.  Only i didn't know how to do it without stepping on areas that might have been touched by the paper towels as they blew along on the ground.  So i took off my shoes and since they were summery and open i pulled off my socks too and threw them in the garbage can with the shoes and the paper towels.  But there was no bag to take the bin to the house with (since i didn't want to touch it with my ocd-ish hands).  I washed really well and changed into pj's but still had ocd-ish feelings of being dirty.  i put clean sox on too cause i had to walk back to the house in my bare feet.  Well, i sure learned the hard way how NOT to put out the garbage.... At least i didn't have a shower, altho i wanted to really, really really badly.  still do. 

Ocd has cost me lots of money in things i throw out. :(
I also spent a lot of time while reading this morning tearing up.
Tomorrow is the day before my next therapy appt.  I am supposed to have gone into Value Village ( a used clothing store) as my next ERP. I don't know if i'll be doing that.  If i feel tomorrow like i felt today and like i feel tonight i won't have the energy to do it.

Ocd sucks.

Garbage Delight

So last night was garbage take-out night.  Special worry because I also had to take garbage from the basement. That can had towels in it that had acquired fuzzy black spots (from hanging wet over my laundry basket for days). In my book that was mold so this bag needed extra care. All day I thot about how to get it out of the house , finally deciding that if i took it out of the can, put it into another garbage bag upside down then it would be good enuf. I did that, wiped down that can and the walls and floor around it  Because the outside can was already full and it was rainy and supposed to be raining the next few days I just put the bag on the ground hoping the rain would keep the crows/ ravens away.  By this time tho i was tired. Showering took 45 min. But as i was drying off I (or rather OCD) decided that the towel should go into the laundry 'in case' some dirt was still left on me- how that could be after 40 minutes only OCD can say -but i bought into it, instead of telling ocd brain to shut up. So i threw the towel onto the laundry pile which then blasted a puff of air at me. This meant that i should wash my arms - 'just in case' - OCD said. Obediently, and without thinking, i went to do it- i was tired and so just wanted to get done- but then soap bubbles started coming out of the sink hole ( is there mold down that hole?) and i had had it. Anxiety went sky-hi. I moved to another sink, after washing down the original soap pump and sink handle, and tried again to wash my arms 'properly'. Since the kitchen sink has no soap-bubble drain hole near the top, i managed to get washed and dressed in my pj's by 8:40. i was tired. It was now over 2 hours since i started. Ocd is sooo exhausting. I was in bed by 9:15 reading a book to my 5 year-old daughter.   Thinking about how to do the garbage 'right' sure sucks!!!

Since i went to bed so early, i figured i better get up at a decent time of day. Unfortunately, my counsellor doesn't think 10:30 meets that qualification. So i was up at before 7:30, giving my daughter breakfast and getting her ready for school. Everything's fine? Nope, saw my husband putting some garbage into the empty milk box we have on the counter to scrape left-over oatmeal into from daughter's bowl, so it doesn't clog the sink. From my angle it looked like he TOUCHED the box. "Eww" screached OCD into my head. I retorted with, He'll be upset and tell me that he did NOT touch anything, so i'll ignore it.' 'Uh, huh' says ocd. They both leave and i watch them thru the window ( what else am i supposed to do at this time of the night?). So i saw the neighbors come out of their house. The mom has a garbage bag in her hand and the daughter comes across the street to the bus stop WHERE MY FAMILY IS STANDING. ' See that? screams OCD,' i hope she doesn't touch her". Mom puts the garbage in a can and goes back in the house. "Ug, now their door knob is dirty" What if dear daughter wants to go play there? Or worse, their daughter comes over here??" And then not-so-dear husband-with-the-dirty-hands goes in my car and into my trunk. OCD now has a major temper tantrum in my head because my car was clean and safe for me to use. Then hubby blythely gets into his car and drives off, leaving me dealing with OCD -brain all by myself.

And 10 or so minutes after everyone left, i heard a crow squack.  Sure enuf, paper towels were all over the place.  I should have just put it on top of the other bag in the can last night.However,I was too anxiety ridden or something to remember that crows, unlike hummingbirds, can't hover in the air to poke holes into the sides of a bag sitting on top of a garbage can with a lid over it.   So guess who gets to deal with more yuk garbage?? blech. But not yet.
So do i run out and wash my car door handle and the trunk pull etc?  Couldn't call hubby for another 20 minutes until he actually arrives at work. I decided to sit with it and do nothing, and see how long that lasted. (One of Jeff Schwartz' ideas from Brain Lock.) I read a book while i waited and the urge to scream, call hubby etc. decreased. 2 hrs later  i realized the feelings had gone down a lot. But again i'm left feeling exhausted. So it's not a happy win. I did do better than last night.

Saturday, October 15, 2011

Reviews of OCD literature esp. relating how they mean 'cured'.

I read a book called Saving Sammy written by his mother, Beth Maloney. It was a very fascinating book. He Here is the summary from

The summer before entering sixth grade, Sammy suddenly began to exhibit disturbing behavior. He walked and ate with his eyes shut, refused to bathe, burst into fits of rage, slithered against walls, and used his limbs instead of his hands to touch light switches, doorknobs, and faucets.
Sammy’s mother, Beth, watched helplessly as her middle child descended into madness. Sammy was soon diagnosed with OCD and later with Tourette syndrome. Unwilling to accept the doctors’ prognoses for lifelong mental illness and repeated hospitalizations, Beth fought to uncover what was causing this decline. Racing against time as Sammy slipped further from reality, Beth’s quest took her to the center of the medical community’s raging debate about whether mental illness can be caused by infection. Beth searched until she found two cutting-edge doctors who answered that question with a definitive yes. Together, they CUREDSammy. Five years later, he remains symptom free.

He had strep virus or the antibodies running thru his system. They weren't giving him strep throat but were causing the ocd. He still has to watch his stress levels and stuff, but if there's a flare-up he goes back on the meds until it settles down again.

Train your mind Change your brain by Sharon Begley says this about ocd:

P8: The brain can be rewired. It can quiet circuits that once crackled with the aberrant activity that characterizes depression & cut pathological connections that keep the brain in the some-thing-is-wrong state that is ocd. The adult brain retains much of the plasticity of the devloping brain incl. the power to repair damaged regions, to grow new neurons

P139 Schwartz had another objection to erp: it’s cruelty. He looked for alternatives that were both more humane and more effective.

p 141 Willful, mindful effort can alter brain function. Mental action can alter the brain chemistry of an ocd patient.
So if mental action changes brain function does that mean drug free, or what? I'm getting Schwartz' books to see if i can find this answer. So far i found a summary of his and his collegue Dr Gladding's ideas from Brain Lock & You Are Not Your Brain at the website: Here is a short summary of the info found there:
OCD is caused by damage to a specific part of the brain called the basal ganglia. Thus, OCD is a biological disorder, rather than a "mental problem." Scientists proposed that any damage to the basal ganglia might result in the onset of OCD symptoms. Physical damage to a brain structure results in a neuropsychological condition.
Although the patient realizesthat these obsessions and compulsions are "unwanted, unreasonable and excessive," they cannot stop listening to the thoughts and acting on them because of the pure feeling of dread the patient experiences until the compulsions are correctly performed.
Researchers postulated that OCD occurs as a result of the OFC and ACG [parts of the brain]being overstimulated. If they are stimulated beyond normal ranges (hyperexcited), they cannot accurately detect errors and may fire at inappropriate times. Thus, they would send excessive, erroneous messages to the basal ganglia that there was a problem. This is exactly what patients report, a sense of "dread and an intractable feeling that ‘something is wrong’."
Medications passively alter brain chemistry and decrease the intensity of OCD signals, while in CBT patients consciously alter their brain chemistry by changing their responses to obsessive thoughts.
Train yourself to say, "I don't think or feel that my hands are dirty. I'm having an obsession that my hands are dirty."
We now know that these urges are caused by biological imbalances in the brain. By calling them what they really are--obsessions and compulsions--you begin to understand that they are simply false messages coming from the brain.
Just relabeling these thoughts and urges won't make them go away. The worst thing you can do is to try to make them vanish. It won't work because the thoughts and urges have a biological cause that is beyond your control. What you can control is your behavioral response to those urges.
STEP 2: Reattribute
"It's not me--it's my OCD." It is a reminder that OCD thoughts and urges are not meaningful, that they are false messages from the brain. "My hands are dirty" can be so powerful and overwhelming. Understanding why the thought is so strong and why it won't go away is the key to increasing your willpower and enabling you to fight off the urge to wash or check.
Deep inside the brain lies a structure called the caudate nucleus. In people with OCD, the caudate nucleus [C.N.] may be malfunctioning. Think of the C.N. as a processing center or filtering station for the very complicated messages generated by the front part of the brain. Together with the putamen, which lies next to it, the C.N. functions like an automatic transmission in a car. The C.N. and the putamen together take in messages from very complicated parts of the brain--those that control body movement, physical feelings, and the thinking and planning that involve those movements and feelings. They function in unison like an automatic transmission, assuring the smooth transition from one behavior to another. Typically, when anyone decides to make a movement, intruding movements and misdirected feelings are filtered out automatically so that the desired movement can be performed rapidly and efficiently.
In OCD, the problem seems to be that the smooth, efficient filtering and the shifting of thoughts and behavior are disrupted by a glitch in the C.N.
As a result of this malfunction, the front of the brain becomes overactive and uses excessive energy. It's like having your car stuck in a ditch. You spin and spin and spin your wheels, but without traction you can't get out of that ditch. With OCD, too much energy is being used in a frontal part of the brain called the orbital cortex. It's as if the orbital cortex, which has an error-detection circuit, becomes stuck in gear. This is probably why OCD causes people to get a "something is wrong" feeling that won't go away. You have to do the work to get it out of gear--to shift the gears. You have a manual transmission. People with OCD can teach themselves how to shift gears through self-directed behavior therapy. In doing so, they can actually fix this broken gearshift in the brain. We now know that you can change your own brain biochemistry.
Using the Reattribute step will also help you to avoid performing rituals. Knowing that the urge to get that "right feeling" is caused by a biochemical imbalance in the brain, you can learn to ignore the urge and move on. You will actually change your brain and make the feeling lessen.
Step 3: Refocus
This is what we mean by shifting gears: Do another behavior. This. Takes. Hard. Work. The Refocus step is where the real work is done. Mental exercise is like a physical workout. In Refocusing, you must shift the gears yourself. With effort and focused mindfulness, you are going to do what the C.N.normally does easily which is to let you know when to switch to another behavior. After a while a person gets a "feel" for when he's scrubbed enough. But people with OCD can't get the feeling that something is done once it's done. The automatic pilot is broken.
The idea is to work around the OCD thoughts and urges by shifting attention to something else, Any constructive, pleasant behavior will do. Hobbies are particularly good. For example, you may decide to take a walk, exercise, listen to music, read, play a computer game .
When the thought comes, you first Re-label it as an obsessive thought or a compulsive urge and then Reattribute it to the fact that you have OCD--a medical problem. Then Refocus your attention to this other behavior that you have chosen. As you keep practicing, the same amount of effort will result in a greater decrease in intensity.
Sometimes the urge will be too strong, and you will perform the compulsion. Never perform the compulsion without some time delay. This is not an invitation to beat yourself up. Just continue to Relabel the behavior and to acknowledge that this time the OCD overwhelmed you. Remind yourself "I'm not washing my hands because they are dirty, but because of my OCD. The OCD won this round, but next time I'll wait longer." Relabeling a behavior as a compulsive behavior is a form of behavior therapy and is much better than doing a compulsion without making a clear mental note about what it is.
If your problem is checking the door lock, try to lock the door with extra attention and mindful awareness the first time. This way, you'll have a good mental picture to refer to when the compulsive urge arises. Anticipating that the urge to check is going to arise in you, you will be able to Relabel it immediately and say, "That's an obsessive idea. It is OCD." You will Refocus and begin to "work around" the OCD urges by doing another behavior, with a ready mental picture.
Step 4: Revalue
For obsessive thoughts, Two substeps--the two A's--aid you in Step 2: Anticipate and Accept Anticipate means "be prepared," know the feeling is coming, so be ready for it; don't be taken by surprise. Accept means don't waste energy beating yourself up because you have these bad feelings. You know what's causing them and that you have to work around them. You want to stop reacting each time as though it were a new thought, something unexpected. Refuse to let it shock you.
So it sounds to me that he is saying that you can be med-free and after a while mostly symptom free, with a system in place for dealing with any thots that DO occur. However i will see what the actual book says since this is a summary of a summary.

To be Cured or Not to be Cured, that is MY question.

This week i made a decision to up my meds again. I also started reading lots of books, websites about ocd because i wanted to figure out where i had gotten the seemingly impossible goal of being 'cured' of ocd, that i was going for.

 To me, cured means done with, able to live relatively normal life, no meds, only a few random ocd thots going thru my head every few months like other people may have.  That i could change my brain to meet and conquer this challenge.  And lots of books talk about  'curing' the person with ocd.  But maybe their idea of cured is different from mine.  I suppose if I  am taking a dose of medicine that makes most of my ocd thots disappear and do cbt/erp to get rid of the remaining ones that is 'cured', just not the way i defined it. I never thot i'd be totally free of ocd thots (who is) but free enuf that i'd easily notice one and be able to target it fairly quickly and dispose of it in a few hours not a few years.

So i have a pile of books from the library and some on interlibrary loan that i will be reading to see what their 'cured' means.  I don't want to be aiming for an impossible goal, but neither do i want to sell myself short- esp. on the meds thing.  I have been on meds of one kind or another for ocd now for around 5 years and so i don't even know if they are affecting me adversely anymore. I was too scared to drop the final pill to see what would happen.  Would the ocd have come back to the way it was 5 yrs ago?  It takes time to get the pills out  of the body, and if the ocd is back it takes another 6 wks or so of re-admitting the pills and i was just too scared to take the final step.  Oh well.  I guess i'm not as much of a guinea pig as i thot i was.