Book Review: The Mindfulness Workbook For OCD: A Guide to Overcoming Obsessions & Compulsions Using Mindfulness and Cognitive Behavioral Therapy

By Jon Hershfield & Tom Corboy

When I received this book I had 2 different thoughts.  The first was that I wanted to actually work thru the workbook, not just read it and comment on it.  The second thought was that I figured I'd have to look back at my past to see how this book could or would have helped me with my OCD journey had I had it earlier in my battle.  So I worked thru the exercises.  Some of them I found I was answering them with past thoughts, like I figured I would.  I  don't have H-OCD anymore, although I did during my university years.  I didn't know then what it was.  I had been taught that bad thoughts were sins, so I just felt guilty and tried to keep them out of my mind, or at least way in the back where I could function normally and do my school work. (The workbook talks about using guilt as a ritual in its section on Scrupulosity OCD). 

  But then I remembered that I still have a few OCD rituals I do because I haven't yet get  managed  to eradicate them.  They have too many of what I think are 'real' not 'OCD' thoughts.  Garbage cans and bags are (sometimes) dirty, right?  Laundry is 'dirty' right, especially if I put in towels I used to wipe my hands dry after doing a ritual-  they could have any left-over contamination on them.  The black marks inside books have to be something disgusting, even if they're not old dried up mouse droppings. Hence, one must wash after  touching them- and in the case of garbage or laundry change clothes in case they got contaminated too.  So I realized that for at least some of the exercises (the Contamination OCD ones) I could answer with current problems and see how the book helps me.    (See  http://myjourneythruocd.blogspot.ca/2014/06/keeping-my-mind-focused.html for how I used what I learned from this workbook to help me overcome 1 of my remaining contamination fears.) 



The Mindfulness Workbook for OCD is divided into 3 parts.  The first discusses the OCD mind and that people with OCD pay attention to thoughts that others either ignore or don't even register that they have.  The authors assert  that feelings and sensations are just that.  Feelings aren't facts and thoughts don't need to be acted upon no matter how intense they are. 
They describe my daily life for years: 

'If you live with OCD it's likely that you often wake up feeling guilty and spend your day investigating yourself and trying to find a way of appropriately sentencing yourself for the crime.  Or maybe you just feel that something is off.'( pg. 11) 

People can suffer from different thought distortions.  They include: Black & White or All or Nothing Thinking,  Catastrophizing or Jumping to Conclusions, Magnifying, Discounting the Positive, Emotional Reasoning, Tunnel Vision, Shoulding or Perfectionism, Comparing, Mind Reading, Hyper-responsibility, Magical Thinking. OCD uses these thought distortions to get you to do rituals.  It's challenging these types of thoughts that give us the courage to do the next part of Cognitive Therapy- ERP or sitting with the thought and feeling the discomfort instead of performing a ritual. 

 They demonstrate how thought records are done- the same as I do, except that they don't rate the mood at the beginning of the exercise and your mood at the end, to see whether your anxiety has decreased. See here: http://myjourneythruocd.blogspot.ca/2011/06/i-cant-comment-on-anyones-blog-except.html or  http://myjourneythruocd.blogspot.ca/2011/10/my-homework-this-week-is-to-go-to-value.html  for a thought record sample.

The authors talk about how meditating on your breath helps you strengthen your ability to come back to the present moment rather than being lost in an obsessive thought. 
Chapter 3 discusses what people can and can't control and how it's behavior that changes the intensity of the obsessive thoughts.  While people with OCD try and try (usu. unsuccessfully) to control their thoughts so everything will go well without having to do rituals, Hershfield & Corboy say that it's behavior that can be controlled.  Thoughts, feelings, bodily sensations come and go. While we can control our emotions some of the time,  we only have 100% control of our behaviors.  When the behavior is changed through Exposure-Response Prevention therapy, ( i.e. you don't do the  ritual, but just sit with the dread and emotions until they dissipate), " then your mind has to admit that compulsions are a choice.  If that's true, it must mean that the obsessions are not as automatically important as previously assumed. If that's true, then they may not be worth any response..." (p45)  Instead of sitting with your obsessive thoughts, sit with that one for a while! 

Then comes the work of listing compulsions that you do or situations you avoid so you don't have to do a ritual, then begin exposing yourself to these one at a time without doing the corresponding ritual.  For thought -OCD's or harm OCD, the authors teach a method of imagining that you have acted upon the horrible thought .   Then you practice sitting with the emotions and feelings. Over and over until your mind gets bored with the thought and "  OCD ...finally falls from exhaustion.  You may be sore and mentally bloodied but are the one remains standing in the end.  This is because of the reality behind mindfulness: thoughts cannot kill you"  (p.53)


A quote I found very interesting probably because my daughter usually does this to deal with her OCD is found on page 60 as follows:  " When you avoid something, you aren't returning a message of safety; you are returning a message of narrowly escaped danger."
Part Two of the book goes into detail about many different types of OCD -even some that are not mentioned very often,  or that are usually slipped in under another heading.  Their list is as follows: Contamination, Responsibility/Checking,  'Just Right', Harm, Sexual Orientation, Pedophile, Relationship, Scrupulosity and Hyperawareness OCD.  Each chapter includes examples, how to use mindfulness and acceptance and thought records to focus on the thoughts and then use Exposure & Response Prevention (ERP) to overcome them.
The last part of this workbook is about how you deal with the OCD diagnosis- advantages and disadvantages of sharing your diagnosis, explaining OCD to others, how to deal with OCD flare -ups and stressors (including hormones)  after you have 'finished' your therapy program.
They give on-line and book resources to follow up with.  However while giving the American and the British OCD Foundation websites, they omit Canada's which is: http://canadianocdnetwork.com/.  And while they give discussion boards for OCD, they have neglected the blogging world where people with OCD share their journey and struggles living with and overcoming OCD. Just search blogger & OCD.  My blog is http://myjourneythruocd.blogspot.ca/2014/06/keeping-my-mind-focused.html   Reading others' blogs about OCD was very helpful to me as I didn't feel alone anymore.  Personally I found the forum sites I visited 5 years ago very negative and whining, while the bloggers were upbeat  and often funny- unless it was a bad day.  Hopefully the forums have become more positive and focused on healing too. 


A final quote:  '
Mindfulness is about seeing that [OCD] pain land on your satellite and accepting it with open arms. Let it wash over you. Let it be rain that slips across you and down a gutter, instead of snow that builds and builds until you are crushed and buried. Let your fear of resisting compulsions be replaced by a curiosity with what's on the other side.' (pg.77)
An excellent workbook that deals directly with OCD.
Disclosure note:  I received this copy free from Harbinger Press to do a book review on it.

Keeping My Mind Focused

I've been reading and working thru a workbook called The Mindfulness Workbook for OCD- book review in progress, coming soon.  They really want you to practice focusing on the present/ the task, not on your intense, possibly out-of-control  feelings.  One of the things the authors say is that: intensity of feelings does NOT equal truthfulness  of the thought.  I've been thinking on that and the papers-not-floating-into-the-vase experiment I commented on a few days ago.  I really want to be able to do laundry without showering or being hyper aware that I'm not touching  the laundry bag, washer or clothes except with my hands.


 I've been already not concerned about laundry just strewn on the floor, under the bed etc. because those would be my non-contaminating daughter's or just clothes abandoned due to laziness.  The problem comes with the clothes I put into the laundry bags.  Sometimes I put towels that I've used to wash hands after doing something I think is contaminating (ie. laundry).  So just in case some of  the 'contamination' didn't wash off in the water/ soap part, it might have been wiped off in the drying part.  So that towel 'might' be contaminated.  So far, until last Tues. nothing seemed to blast thru my mind that 'might-be' doesn't equal 'toxic waste'.  I also throw damp washcloths etc. in that may have been used to clean up a spill.  Actually I often try to put those on the metal parts of the bags (they're 3 cloth bags attached to a metal frame) so they can dry.  As I am chucking them onto the bags, I might miss and thus there could be damp laundry stewing in the bags for up to a week.  This also equals 'contaminated' in my mind, even tho I've seen no mold coming from that practise yet.   This leads me to today's experiment:


Still wearing pj's, I grabbed the laundry from my daughter's room and shoved  it in the machine . Repeat for the laundry pile in our room (sometimes the bags get full and I also tell my husband not to put his pants in the bags because it fills them up too fast.).  That was easy.  Made sure the laundry touched my clothes.


 Now for the potentially contaminated stuff in the laundry sack.  I undid the bag without touching the metal ( that's for next time's ERP)  and made sure my pj's touched the bag.  I stuffed it in the washer and then put laundry already on the dryer and washer into  it.  I wiped off  the machines -just -in case-  my usual routine-  and went upstars to wash up.  So far so good.  Didn't feel contaminated at all.  Just a twinge of dread.  But off course I hadn't done anything yet.  I still could just throw my pj's in the laundry, have a shower and be just fine.  But I didn't.  I washed my hands to the elbows and then the dread started.  "But you want to use a towel and throw it in the laundry- just-in-case, right" says OCD.  " DO NOT use the towel on the rack."  I caved in and listened.  I let my hands air dry. 

But then I started pushing back.  I was thirsty and picked up a cup with a bit of water left in it.  At this point I could just put it on the counter with the dirty dishes, but I didn't.  I went to the fridge, opened it and got some more water.  The hard part about this is that even after the dread leaves, I remember what I've touched and so, I  often have to stomp out more OCD thots later on.  Sometimes I just cave in, if I'm not feeling energetic enough to do battle again.  I let the fridge door touch  my pj's and came to work on this blog.  I just touched my shirt all over  to make sure I couldn't tell myself later that my pants barely touched any dirty laundry-that  I held it in my arms against my shirt and thus the computer didn't get contaminated..   


While writing this down (which takes time because my curser jumps all over the keyboard so I keep having to redo what I've written), the dread has left.  The next 'dread' spike will come when I throw my pj's on the perfectly clean bed.  Which brings me to another point made in 'The Mindfulness Workbook for OCD'  and that is this:  Perfection is  an impossible state to continue in. Once you've 'reached' perfection, the only place from there is down.  So a just-clean shirt can only get dirtier! Perfection is a false goal...  an OCD goal, that can never be attained, only OCD fails to say that part.


So I'm now supposed to go throw my pj's on the bed and pick them up tonight and wear them and sleep where I threw them.   I'm soooo tempted to let that go till the next ERP but that will just stretch out the agony.  Remember, Karin,  intensity of feelings does not equal truthfulness of feelings.. Repeat. 




Update:
Not only did I put my pj's on the bed, but I laid in it first & I touched my library book (oh no!) and my breathing mask.  Had a shower and didn't wash the faucet handle before I came out - 1st recontamination.  Had a drink and came on the computer -2nd recontamination, 3rd recontamination.  


One thing I noticed is the more I paid attention and focused on what I was doing (ie drying off) the louder that is and the quieter OCD and dread were.  Which maked it easier to continue what I was doing and ignore ocd. 


Also,  what I thought I'd never be able do- not worry when I'm doing laundry (once upon a time, long ago, before contamination OCD hit, laundry was my favorite chore.)   I am hopeful that one day I can do again!  Up until now, I thought that my new laundry routine was just a 'scar' from having ocd, it doesn't take up much extra time but it'll always be different than it was.   Now, maybe not.

A Picture is Worth a Thousand Rituals

My daughter also has OCD.  Today at therapy Eric, her therapist did an interesting object lesson.  He had a bunch of cut papers in front of him. He told my daughter that they represented germs.  Some germs are healthy ( ie stomach bacteria)  and some germs cause things like the flu.  So he had us put happy faces on some papers (for harmless germs) and sad faces on others (for dangerous germs).  So we did.  Then he told us to try and drop them into a vase.   We did.  Only a few floated in.  Even at the end when I  picked a handful off the floor and dropped them all at the same time only a couple made it into the jar.  6 in fact out of 66 papers.  Two of them had happy faces on them,   That meant only 4 out of 66 germs were actually going to hurt a person..  So OCD, which says all germs are dangerous and all germs are on that apple, is not telling the truth.  Most germs fall by the wayside.


Hmmmm goes Karin.  That's a new way of looking at things.  My picture was that germs were like peanut butter (or jam, for any peanut allergists out there). Once I  touched something contaminated they all stuck to me  and then would proceed  to dirty up every thing I touched afterwards- unless I washed NOW, or I could wash the whole house later.


But this picture of a vase with germs trying to touch it and only a few getting in ( or picture a hand held out for all the germs to fall onto and only a few do) is a whole different way of looking at contamination OCD.
Can this work for my  laundry?  For the garbage cans?  for the black marks in the seams of library books?
It sort of did.  I was reading this evening and sure enough up pops a black spot in the middle of the seam of a page.  I ignored it.  After all, if 4/66 = 2/33  that is way less than 50% chance o f that piece of dirt  having enough germs on it to make the rest of my house dirty.  I didn't touch it ( I don't think), mind you.  I guess that would be the next step.   I have stopped reading books because of that.


Same for laundry?  If a piece of dirty laundry touches my clothes, does that make them dirty?  I say (or OCD says)  YES.  But it the above scene is true, then the amount of contaminating harmful germs isn't enough to worry about.   I could just wash my hands- which would have the most contact with the clothes and detergent bottles etc.  That's what I  used to do, in that long- ago world of PRE - contamination OCD.
What do you think?  This could save a lot of showering or clothes changing.

Happy Birthday- An Art Birthday Party

I'm still having problems getting pictures to post to my blog.  But I wanted to get this up now because it might be a while before I sort out the picture problem, as I'm not very computer savvy.  DS is coming home in August, so it might take til then, unless I suddenly find the right website to solve my problem.




Katrina had her 8th birthday party the day after her dance recital.  As I said before,  was supposed to be a simple party, but then I got excited after looking on the internet at other people's parties.  We made most of the decorations and the cake and goodies ourselves (usu. we buy the cake - I'd hate to make something and it either not turn out, or someone gets sick (I'm guessing OCD sneaks in there).
Bruce said he'd make the cake- a layered, multicoloured one.  I bought cookies and icing and nerd candies and made art palette cookies.  We made rice krispie squares and put icing on to look like paint brushes.  I bought pitchers and cups in 3 colours- pink blue and green at the dollar store and filled them with cranberry juice (pink), grape juice (blue) and apple juice (green).


I bought tissue paper and string and made green, pink purple and blue tassels hanging from the ceiling.  In the living room I cut orange, yellow and red tissue paper and folded them over the string into   triangles.  We made paint tubes from construction paper and had streamers coming out the opening of the tubes, to puddle on the floor below.  I took calendars of paintings by Monet, Van Gogh and Krieghoff , (which I already had ) tore them  and put them up in place of our pictures. I covered tables with coloured table cloths, put markers in containers in a row along one of the tables ready for the activity. I put a sign on a chair saying  Welcome to *** (address)  Art Gallery.  Open Sunday from   ***(time of party).  Special Guest Artists featured: *** and wrote down the names of the party guests.


We bought clear garbage bags as clothes- savers for the painting activities.




Activity 1:  Painting a Birdhouse.  Bird houses came from the dollar store, as did the paint palettes. We put the basic colours in the palette and by using white or black the kids could create their own shades.  Before the party DH spray painted all the houses so they would be white.
Activity 2: Shaving Cream Painting.  Idea from:  http://www.kidspot.com.au/kids-activities-and-games/art-activities+43/shaving-cream-painting+12123.htm.  This was a little messy but the kids enjoyed it.  Dried pictures went into their goody bags.  I showed them how it could be hung up in a frame.  We used food colour as the paint and rulers to wipe the shaving cream off the paper you put onto the painted shaving cream.  Cardboard isn't as flimsy, and wont rip the paperbut we used sketch book paper, a little stronger than regular computer paper.  We put the shaving cream onto a large piece of finger painting paper instead of in a pan.
Activity 3:  Marker Wheel Art:  Idea from: http://elementaryartfun.blogspot.ca/search/label/Coffee%20Filter%20Circles Making the circles was fun.  But there wasn't time at the end to use them to create pictures.  Art put into their goody bags when dried.
Game:  Draw a mustache on the Mona Lisa.  My husband got a picture of the Mona Lisa off the internet, and blew it up on  a colour photo copier at work.  Blind folded kids drew a mustache on the picture. 
Dress Up & Picture.  This was supposed to be a relay  race outside but it is black fly season and the bugs were bad, so we just took pictures of the kids dressed up as an artist:  smock (from dollar store),  artist hat (dollar store),  purple or red boa (dollar store) and a black mustache (made from construction paper) and holding a paint brush (from dollar store).  Originally the kids were to dress in the outfit and pick up a paint brush, run to a paint can (ice cream container covered by construction paper), drop it in, undress sit down as next person did it.  We were also running late so didn't do the relay.
Activity 4:  Origami.  Katrina is into origami and wanted to do some at her party so we found this  you tube channel:  https://www.youtube.com/watch?v=PcCS86eikJs.  Its fairly simple but I pre-folded many of the sheets so the kids could get an easy start- a straight fold is important.  We didn't get to putting the star together, so I gave out the website for the kids to do it at home.  They all were looking forward to the next activity so I didn't want to cancel this one to finish the origami.
Activity 5:   Picasso Pops.  Bruce and Katrina had tried this out before and she brought the results to school. So all the kids knew this was coming. Here are the instructions:  http://www.bhg.com/recipe/candy/picasso-pops/#comments
Mints turn out rather strong, so buy hard fruit flavoured candy.  Crush them ahead of time.


Cake and presents:  The parents were already starting to arrive.  The party  should have been 3 hours long, not 2 and a half hours.  The kids were thrilled with their suckers.


Goody Bags:  I bought brightly coloured gift bags and put in a cup- with-straw-attached of the same colour (both from the dollar store).  Because we didn't get to painting on the canvases I put them into the bag too (again from the dollar store).  Their birdhouse and finished art completed the bag.


I had a blast!  We had tried out most of the activities with Katrina beforehand, so she said she was bored.  She made a pretty birdhouse- so she wasn't all bored.




We still have most of the decorations up as they look too pretty to take down!