Why Am I Stuck in A Loop?!

We unpack why OCD makes the brain feel stuck in a loop and why intrusive thoughts can create a real sense of impending doom. We explain what is happening in the brain and share practical steps for responding with more clarity and compassion. 
• defining obsessive compulsive disorder as obsessions plus compulsions and how compulsions can be mental 
• common OCD patterns like contamination fears checking symmetry rituals and reassurance seeking 
• why intrusive thoughts feel like proof you are bad and how OCD assigns false meaning 
• the danger detector loop and why it feels involuntary rather than a self-control issue 
• the sledding groove metaphor for habit pathways and how awareness starts to weaken the groove 
• how shame and fear fuel the cycle and why naming OCD reduces threat 
• when trauma family patterns autism or PANS PANDAS can shape OCD symptoms 
• Brain Lock by Dr Jeffrey Schwartz and the four steps relabel reattribute refocus revalue 
• refocusing with a replacement behavior and building distress tolerance over time 
• support options like therapy medication supplements and TMS to reduce symptom intensity 
If you like our show, please leave us a rating and review on your favorite podcast platform. Follow the show and share it with your friends. 

The book we referenced can be found here: https://jeffreymschwartz.com/brain-lock/

Laura's Free Course on Emotional Development and Regulation:
https://benavieri.com/neuroception-sign-up/

This show is sponsored by: 

Core Self 

www.coreself.org

Benavieri Counseling & Coaching
www.benavieri.com

Active Healing Psychiatric Services
www.activehealingpsych.com

Transcript

Welcome And The Big Question

Laura 0:03

Hello, and welcome to High Am I Like This, the podcast for those who didn't get enough hugs as a child. I'm Laura Wood and I'm a trauma therapist.

Michaela 0:13

And I'm Michaela Bieber of a psychiatric therapist center. So, Michaela, why are we doing this podcast? I'm so glad you asked. We all have patterns we don't fully understand. Ways we react, think, and feel that seem to show up no matter how hard we try to change them. On this podcast, we explore how our past experiences, relationships, and nervous associates we are today. Together, we ask the question we've all wondered about at some point. Why am I like this? And more importantly, how do we understand ourselves with a little more compassion?

What OCD Is And Is Not

Laura 0:50

Yes, that compassion is key. Um today we are talking about a little bit of the OCD stuff today, so that obsessive compulsive disorder. Um, and we are gonna get into the following question. Why does my brain get stuck in a loop? Why does it feel like there's impending doom? And what are some things I can do to fix it? So let's get started with what even is OCD?

Michaela 1:23

Yeah, that's a really great place to start. So obsessive compulsive disorder. So it's basically a mental health condition that has deals with uncontrolled, recurring thoughts called obsessions that are typically followed by compulsions, basically a behavior that the person has to continue to repeat to quell the anxiety that's happening when the obsessions happen. Um, you can have strictly obsessions without the compulsions as well, because sometimes worry can be, and these are kind of the harder ones to catch because worry can sometimes be the compulsion. Like I'm gonna Google a hundred times, you know, I'm gonna Google for hours and hours on end why I have a cough. Um, or if you're like, you know, so some of the common symptoms are like excessive fear about germs. So we see people like washing our hands. That's probably the most common one. People think about like symmetry, like tapping, touching, like I have to, if I bump this elbow, I have to bump, I have to also bump it on this side, or um, I have to like keep cleaning and cleaning and cleaning because they always feel dirty. Um, or checking locks and and things like that, or checking to make sure the stove was is turned off.

Laura 2:47

Mm-hmm. And also when I see people with OCD, I also notice sometimes they feel like if they don't do that thing, something really bad is gonna happen. So, like the anxiety you mentioned, it's not just, oh, I feel anxious. It's literally if I don't do this, like my family will be killed, or um, or I'll die, or um, like something catastrophic is gonna happen, or even the belief that like I did something really, really bad. And I had a childhood friend who um felt this way sometimes, where it was like if she saw a scratch um somewhere, she was like, Did I do that? Or, you know, in the book that we read, Brain Lock, um they refer to a case where people who felt like they were driving and hit somebody. So like if they go over bump, they real they think, oh, did I hit somebody? And then they have to like they obsess over that thing. Like, did I do I have to go back and check to make sure there's nobody that I hit or hurt? So it's it's not just you know, your run-of-the-mill anxiety, I guess. It's like the the that sense of impending doom kind of that comes into play.

Michaela 4:05

Yeah, yeah. That nagging feeling that like something bad's gonna happen. Yeah, and some of the other things that can be tied into OCD in that same kind of category are like ticks, um body dysmorphic disorder, um, trichotillomania, um, or scloriation disorder, those can kind of follow similar, um, they're kind of lumped into that OCD type of um brain um category.

Laura 4:36

And trichotillomania is when we pull out our hair, right? It's the hair pulling. And then the scoriation is skin picking.

Michaela 4:43

Yes. And it doesn't have to be hair or like your hair on your head, hair, like I hear a lot of people like pull out their eyebrows or hair down below, um, their eyelashes, things like that. Um, sometimes it feels like your skin needs to be smooth. I've heard that before, where like if I find like a bump on my skin, if I have a scab, I'm picking or like something that's not doesn't feel right, my skin needs to feel right. So so we like just keep picking and picking and picking the skin because it needs to feel smooth. Mm-hmm. Mm-hmm.

Intrusive Thoughts And Catastrophe Fears

Laura 5:14

And making it sometimes there's like, I hear kind of perfectionist tendencies in there too, right? So it's like everything has to be like this perfect certain way, and if it's off, I have to fix it, I have to fix it, I have to fix it. Um and that's where like the compulsion comes in of like, I have to keep doing this thing um because it's just not right, like something's not right.

Michaela 5:38

Yeah. And I think we're gonna focus more on OCD today specifically, but that's not to be confused with OCPD, which is obsessive compulsive personality disorder. And that is more of that perfectionist is perfectionistic um like idea where like things need to be perfect, but it may not, you know, that there's different categories where that falls in, but it may not be like so much of that impending doom, like something bad's gonna happen, um, kind of thing. It's more like I'm bad if I don't, if I'm not perfect, or that if this thing's not perfect.

Laura 6:16

So we're not gonna touch so much on that part of it, but yeah, and yeah, I do still think that with OCD, there is this like sense of like there's something wrong with me, like I'm bad, though, right? Like, you know, in the context of a lot of people feel like their intrusive thoughts like make them bad people, right? So for example, some com like common intrusive thoughts could be like repeated thoughts of like hurting someone. And those thoughts can make us feel really bad about ourselves, like there's something wrong with me, like I'm a bad person. If I keep thinking over and over about hurting someone, like I must be, you know, I must be bad.

Michaela 7:01

Yeah. Am I really capable of doing this? You know, that's you know, I think like we we definitely see people that are very scared that like they're having those thoughts, which I think is part of like the the brain loop. Because I feel like we all have really weird thoughts sometimes, like, and we don't really give it much attention or we don't put a lot of stock into it. So we might think like, um, what if I what if I drove my car, you know, off the road right now? But then like be, you know, in an in a normal, not normal, but like in a in a person who doesn't have OCD, um, you know, they might go, that's weird, I wouldn't do that. And then they move on with their day. But when we have OCZ, then then like we we we get stuck in that loop, like, oh my gosh, what if I do drive my car off the road? What would happen? And we start replaying that in our head over and over again. Or if, you know, thinking that like we put some meaning to it, like get we get feared, we get scared. Like, why would I think that? And I think that that's part of that loop that kind of tells the brain this is dangerous. And, you know, so then I might have I must have, I might, I need to re remind you that this is dangerous over and over again. And so we're gonna think about it over and over again when our brain gets like overactive, when we have too much activation in the parts of the brain that do have to do with A OCD, um, like the anterior cingulate nucleus, um, and the or the anterior cingulate and the nucleus cumens. Is that right? Did I say that right? I think the catic nucleus. Yes, that's right. Um, when we get stuck into those, um thinking about those places of the brain, those being overactive, then that is gonna increase the risk of having these OCD intrusive thoughts where we start going into those loops.

Laura 8:50

Yeah, so the part of our brain that uh kind of detects danger, right? That danger detector turns on. And then the danger detector usually will send a message to the part of our brain that like creates like the does the thing that needs to address the danger, right? And then the signal gets sent back to that danger detector saying, like, okay, yes, I did the thing and now things are okay again, right? Like I like danger, address the danger. Okay, danger's addressed. Whereas in OCD, we're experiencing that loop because the danger detector gets stuck on the thing that you know tells us to do something, is then being told over and over, like, do this thing, do this thing, do this thing. And instead of that signal going back saying you did the thing, it's saying it's basically sending the danger signal back, like it's saying, Oh, you haven't done it yet, it needs to still be addressed. So it's a missing error. Right. It can't shift out of that problem mode. Mm-hmm. Yeah. And when you know, in that situation, it's not about it feels really involuntary, right? Like it feels really um difficult to stop. It's not just about like self-control, because we can't really control our our thoughts, right? We can only control our behaviors.

Michaela 10:22

Yeah, and what we do with those thoughts is what kind of keeps us stuck in that loop. Because the more that we kind of strengthen that pathway in the brain to say, like, okay, I'm gonna keep doing this and I'm gonna keep doing this over and over and over again, then the more we can't shift out of that.

Speaker 2 10:40

Mm-hmm.

Laura 10:41

Because those ridges, yeah, those ridges that we're so when we when we do a thing, creates a ridge, right? When we like listen to the signal, we have a behavior loop and we do that thing, it creates that ridge in our brain, right? And then there's it deepens and deepens and deepens, it gets stronger and stronger and stronger that connection. So I I kind of think of it as like if you're um going down a sledding hill, you're you know, going down that same path over and over and over. It makes the sled like it makes it deeper and deeper and deeper and deeper and harder to like shift out of that path. If you want to go on a different path, you're kind of stuck in that path. And so you have to really work hard to stay out of that groove in the snow and stay on a different path. And that's kind of how I think about when we when we continually do a behavior as in response to stimulus, we're making that ridge over and over and over. And it becomes harder to do something different because that path is so clearly the path, right? It's like, well, this is the obvious path. I'm gonna do the obvious thing.

Michaela 11:49

Yeah. Oh, I really like that um visualization. I think that that can be really helpful for people to think about, you know, going down the sledding path and the ridge that's kind of being created. That's really good. Um, and I think that sometimes being able to kind of visualize it can help us to move away from it, you know, to be like, okay, I'm, you know, if I do this again, then I'm strengthening that groove. And then if I try to do something else, then I'm trying to decrease that groove. Um when it comes to OCD, we're going to there's going to be times where we we do the thing, but it's really, you know, trying to shift out of that that helps us kind of re-um unenforce that pathway and try to reinforce a new one.

The Stuck Alarm System Explained

Laura 12:38

And even doing the thing with a different level of awareness creates is a change in response, right? So when we do it automatically, we're not engaging the parts of our brain that are learning from the process. We're only engaging our, you know, our default mode network, like we're just doing the thing that is um that is underneath our consciousness, right? So when we follow the compulsion without awareness, we're just living in that pathway. But when we follow the compulsion with awareness and make it more clear what's happening. So when we're telling our, like, even if I'm washing my hands for the fifth time and I'm saying I'm doing this because of my OCD, that's still a different process than when I did the thing, you know, without letting myself know that it's because of my OCD. So even just lifting your, so you're lifting yourself out of that groove just a little bit, you're taking yourself out of the automatic process and making it a manual experience that is teaching you something. And then if the next time I think, oh, I'm doing this because of my OCD, oh, I'm doing this because of my OCD, if I am recognizing it's that OCD, then eventually that recognition kind of gets added to the pathway. So now I have this new opportunity, this this new pathway that says, okay, when you have a compulsion, it's recognized that it's OCD. That situation takes time, right? But we can learn from that and our brain can actually change.

Michaela 14:17

Yeah, that's so powerful. And I think that that's like can give hope to people because I think that when people are suffering from OCD, it really is painful. Like there's a lot of um suffering that happens when we get stuck in these loops, and you know, can kind of give hope to think that like there is possible possibility for change. Like you don't have to stay stuck.

Laura 14:42

Yeah, and it takes a lot of mental energy. That was one thing that I took away from the book as we were reading. Um, it talks about these steps in the process of making change, and we'll talk a little bit about the steps a little later. But what's important to note is that it takes a lot of mental energy to make a new path, to use that mindful awareness because there's so many things, and we've talked about all this on the podcast before, there's so many most, so much stimuli happening in our lives at all times that like it's impossible to be consciously, cognitively, mindfully aware of everything all the time. It would just be overload, it's too much. And so our brain is like a computer. Once it's programmed, it just goes runs in the background, right? And you're not thinking about it, it's just doing its thing in the background and updating and you know, doing all this stuff. And when we um when we're trying to write new code, you know, you have to think about it. It can be tedious. Like think about um, you know, programming something to do, uh, you know, if I'm thinking about programming as something on my computer or like building a website or um making like those things are complex and tedious and like detail-oriented, and you have to pay close attention to every single little detail of the process in order to make sure that it operates properly, right? So that takes a lot of energy. The same is true for our brains when we're writing new code, we're writing new programs, we have to really think about every step in the process. Like, okay, this is what's happening. I need to um take a different action. When I take that different action, I'm going to feel a certain way. And so in the bookie notes, a lot of distress kind of comes up. Um, and so we have to learn how to tolerate that distress.

Michaela 16:36

Yeah, absolutely. Well, and that made me think of like, you know, the first step is actually getting diagnosed correctly with having OCD. And I think, you know, there's a couple of reasons why, you know, maybe it would get missed. One is because we're not looking for it, right? We're just we just think it's anxiety. Um maybe, you know, when we're suffering with OCD and we're having some of those like really um taboo thoughts, like it's hard to let people know that we're thinking about hurting people or we're thinking about sexual things that are inappropriate. And we, you know, because we have that shame around the thoughts, maybe we we don't feel comfortable opening up about them initially. And so um that might be, you know, so part of it is just like getting getting that accurate diagnosis so that you can start working on the process of like doing things that are healing. Um, and then you know, in the book we talked about like the you're you mentioned the four-step process, and you know, the first step in that in is like relabeling. And you kind of even just mentioned this when you were talking about being mindfully aware of like this is my OCD thought, and and basically saying like this is this is real or fake, you know, real or fake. It's you know, this is fake, it's an OCD thought, it's not real, the you know, it's just a thought, it doesn't mean that it has truth.

The Brain Lock Four-Step Method

Laura 18:04

Mm-hmm. And that's really hard, you know, when you're trying to not believe. So I've also heard this quote, don't believe everything you think, right? When you're trying not to believe your thoughts, like there's this um inkling of, can I even trust myself? You know, so that kind of makes it more complicated. But what you're basically saying is like, am I worried about something bad happening because that's a true worry, or am I worried about something that bad happening because my brain is misfiring? And so we the one of the challenges there is that we don't trust our intuition or we don't trust ourselves anymore to basically make those judgment calls. But one thing in the book that he mentions is if it's if you think it might be OCD, it is OCD. Like attribute it to the OCD if you think, oh, this might just be an OCD thought. Like you're probably right. And I often, with you know, with my clients who are experiencing a variety of different distress, um I often say to ask inside, you know, like what is happening, what part of my brain is telling me this and why is it telling me this? And so when that's when we're doing that, we're actually checking in with our brain, and a lot of the time the answer is right. And so if I'm checking in with my brain and it's saying, like, oh, this is probably OCD, or this might be OCD, or is this OCD, you know, then we might listen to that part that says that it's OCD and kind of move forward. And then I like one of the things that happens after that, which is we recognize our capacity to deal with the the bad thing that happens. You know, we recognize that like I can't this, I can't control every possible bad thing that happens. And if something bad did happen, I would be made aware of it and I could deal with it because I have st I have um you know capabilities and capacity and skills and strengths, and I could get through something really hard.

Michaela 20:13

Yeah. Yeah, I like the I've always I don't know where this came from, but I like the saying you have to like you gotta name it to tame it.

Speaker 2 20:21

Mm-hmm.

Michaela 20:22

Dr. Dan Siegel. Oh, there you go. I was like, I know I've heard it somewhere. I don't know who said it. Um, but I I like I like that, and I think it rings very true here in OCD as well as other things, you know. But um anxiety, you know, all forms of anxiety steal our capacity to believe that we can handle things. And so that makes sense that it would that would be happening here too. And I can see why that'd be really scary because you don't want to be responsible for something really bad happening, right? Like I if I if I don't retrace my steps five times and get my steps just right, then something bad's gonna happen to my family, and that's gonna be hard to live with if you really believed that. But the fact is, is that that's not real, that's a fake thought. You can't cause something bad to happen because you didn't do the right steps, right? You don't have control over those things. Your brain wants you to believe that you do.

Laura 21:23

Yeah. And when you get in contact with your value system and your true self, like your whole, you know, your most centered and grounded self, that self knows that that's not possible, right? That self knows that you aren't in control of something that's happening, you know, a hundred miles away, or that self knows that you're aware enough and you're present enough and you're capable enough to take care of something bad if it does happen and that it's not your fault. I think sometimes. Where some traumas can come in and then feed the content of these intrusive thoughts, like that can be really difficult and may need more treatment too, like additional that layer of trauma treatment, right? Because as we when we experience traumas, we often, as part of our survival of that trauma, we often attribute the trauma to us. We say, it's my fault that that happened as a way of like retaking control. So we say, it's my fault that that happened. And if I could change, then I could make it never happen again. Or if I could change, then I could make it not hurt as badly. Right. So some of those beliefs, those internal core beliefs that we develop when we've experienced trauma can be can make it really tricky to get ourselves out of that. Oh, it will be my fault, or I'll be responsible for this really bad thing to happen.

Michaela 22:52

Sure. Well, and that just made me think about how like OCD or certain mental health uh conditions tend to run in families. And so if we grew up watching some form of OCD and our parents or our grandparents and things like that, then you know, then that can tend to be something that we think is just the reality of what people do. You know?

Laura 23:14

Yeah, it makes it expected, it makes it standard, normal, um, just the way brains work.

Michaela 23:23

Yeah. And then that made me that leads me to think about like the other side of this is like, you know, we're thinking about um basal ganglia encephalitis or pain or pans pandas. And this is a a different form of OCD, similar, same symptoms, but um typically occurs after a strap infection or a viral infection can happen after COVID or um mycoplaspneumonia is also something that we look for in people. Um, and it's kind of like this this thing where um the kids spine one day and then they get sick, and then all of a sudden they're like washing their hands like crazy or doing rituals, um, just really repetitive, like all of a sudden abrupt onset, where other times, like in typical OCD, it's something that just gradually increases and increases and increases. The other thing that I see OCD oftenly often associated with is actually autism spectrum disorder, um, in in the way that they um the brain is trying to control things, and OCD tends to be kind of this natural um thing that kind of occurs after that fact because it's like you want to control your environment. And so then we start seeing more gradual onsets of uh of intrusive thoughts that lead to compulsions in in that as well.

Laura 24:50

Mm-hmm. Yeah, it's an attempt to control the outside to regulate the inside. Yeah. And we we can learn skills along the way to regulate the inside without changing what's on the outside. And that process is really hard with OCD because those thoughts are still coming up. They're still firing, right? It doesn't settle right away. It takes time for those thoughts to settle. And so relabeling and giving it, you know, letting letting ourselves know, oh, these thoughts are just coming up right now because um of my OCD. It's kind of like when my stomach growls, like, oh, my stomach's growling, I just have to let that happen, right? Like my stomach's growling because I'm hungry. I don't, I know that I don't like think there's something wrong. I don't, I'm not alarmed. I just I already know what that is, and so I'm okay. I just have to let that happen. So it's kind of like your brain growling.

Michaela 25:45

Yeah, I like that. And then so what is step two then?

Laura 25:51

Step two is to reattribute, right? So it's similar to relabeling, but reattribute is like you're making, you're basically making a different cause. So instead of saying, um, you know, I'm bad is why I'm having these thoughts, it's my brain is misfiring, and that's why so relabeling is saying, oh, this is my OCD. Reattributing is saying, oh, it's my I have this OCD because my brain is misfiring, right? So this is a chemical thing, this is a brain thing, this isn't a um, this isn't a me thing. My I am not my thoughts.

Michaela 26:26

Right. And I think that that allows us to increase curiosity about what's going on for us in that moment, you know, being curious about what, why am I having this thought, you know, what's going on in my brain that this would be the case, right?

Laura 26:40

Yeah, because a lot of the time we try to solve, we try to figure out why is it happening, why am I like this, right? Try to figure out why is this happening, where is it coming from? And what that does is it gives it more meaning than it really has, and it gives it more value and truth than it really has. So if we're assuming, if we're digging in for the reason why we have this thought, then we're automatically basically saying this thought is important, you know, we're making it important. Whereas in reattribute, we're basically saying this is just a glitch. It's not important, it's just a thing that happens, it's a hiccup, it's a stomach growl, it's a, you know, it's a yawn, it's a it's a glitch, it's just a thing that's coming up that doesn't have a reason other than that thing, other than the brain glitch.

Michaela 27:34

Right. And that reduction in shame reduces the anxiety response, which then reduces the need for your brain to go, hey, I'm gonna keep telling you about this. Let's do this over and over again, right? The more we be like, hey, it's just a thought, random thought. I can move on, the better the the less we can kind of go down that pathway. It's gonna keep us out of the groove, right?

Laura 28:02

Yeah, there's safety in the reattributing and relabeling because what we're doing is we're taking that shame and fear away. We're saying, I don't have to be afraid of this because it's not a threat. And when I'm not threatened, I can engage my brain in a different capacity than I can when I'm threatened. When I'm threatened, I have limited capacity for engagement. But when I'm not threatened, I have maximum capacity for engagement. I have access to my skills, my memories, my coping mechanisms, my um, my interests, my values, my true self. So eliminating that threat is really helpful in that process.

Michaela 28:44

Yeah, that makes a lot of sense. So then after we can name it and then we can reattribute it, then we want to refocus on something else so that we don't engage in the pattern.

Laura 28:59

Yeah. So we want to engage in a different activity, a different, we want to engage in a different behavior. So we change our behavior. The way the it kind of frames it is like we change our behavior to change our brain. So the new behavior is what we want to get into, the new groove. We want to create a new groove with the new behavior. So when I have this thought, it's gonna my automatic behavior is gonna be something different in the future once I've practiced this enough. So um, refocusing is not just distracting. Refocusing is engaging in something that is constructive, that is helpful, that brings joy, that brings um happiness, that is interesting. So I could read a book, I could um do something productive, I could garden, I could do a little bit of work, I could um go for a walk, I could play with my dogs, right? Like I'm thinking of all kinds of things that I could do to refocus my energy and attention. Because when we when we focus our attention on something, we're telling our brain that that thing is important. So similarly to the react the reattribute step, we're deep, we're taking away the focus, we're saying, hey, this is not important. Now, what with refocus, we're saying this is important. And when we tell our brain something is important, our brain is going to seek that out more often. And it's going to give us more opportunities to engage in that content and engage in that thing because it's going to um, it wants us to be successful. Our brain does. It wants us to um to have all the opportunities that we need in order to be successful. And so when we say, oh, this is important, pay attention to this, then I'm gonna notice it more often. It's kind of like when I, you know, I'm gonna go buy a white car. Now all of a sudden I see a thousand white cars. Um, because I told my brain that that white car is important. I said, I want that. I I want to pay attention to that. And so I just notice it more often.

Michaela 31:02

Yeah, absolutely. I feel like this is probably one of the hardest steps in this process, though, I imagine, because um our brain is like, but no, I want, but you're supposed to do this other thing. You're supposed to wash your hands five times, you're supposed to, you know, bleach your apartment or douse everything in alcohol or you know, rubbing alcohol to clean it or whatever. Um, you know, and so I think that there's a lot of discomfort that comes in the especially in the early phases of this of this step. It's not an easy um, it's not as easy as it sounds.

Laura 31:41

Yeah, and I think that's important to call out. Like we were talking about earlier, there's a lot of distress that comes with this. There's a lot of internal distress that we are trying to tolerate, that we're learning to tolerate. So learning to tolerate that distress comes from um comes from the inside, not the outside. But when we choose to refocus on something that's helpful on the outside, that can help us with this process too, right? So for example, if I um choose to engage in something that's a grounding experience for me, like, oh, I'm going to take my dog for a walk. Like, I have to pay attention to my dog. I have to pay attention. I have to be present with this animal in order to take them for a walk safely, right? I can't just be distracted and thinking about, you know, what's going on in my brain. So that's how that can be helpful because you're you are using the outside to regulate the inside a little bit. So you're kind of bringing that step in to the you're it's a replacement behavior. Um instead of engaging in the compulsive behavior, you're engaging in the replacement behavior. And the replacement behavior is, you know, hopefully activating some of those same areas in your brain that the compulsion is coming from and kind of maybe drowning that out a little bit.

Michaela 33:00

Yeah. I imagine that this is probably like if people get to this stage and they feel kind of stuck, like they're too dysregulated, this would be a good opportunity to use medications to support the ner the nervous system and decrease or like improve tolerance for the anxiety um or even supplements. Like I have a number of different supplements that I use that, especially in kids, can be all that we really need to take that edge off to improve um the intrusive thoughts and um reduce the anxious distress that happens when we don't just do the thing that our kids are telling us to do.

Medication TMS And Other Supports

Laura 33:43

Yeah, I'm glad you brought that up because medication has a role in limiting or lessening the distress level, right? Like we need that support sometimes. We need that, um, it takes the edge off, it takes the um it it just dampens that a little bit. It's like oven mitts, like you're putting on oven mitts so that you don't get burned, right? Like I can't touch the stove or I can't take that pan off the stove without my oven mitts. So the medication can be the oven mitt so that you can then do the other behavior.

Michaela 34:20

Yeah. The other thing is is TMS, um, transcranial magnetic stimulation um is FDA cleared in um to help improve OCD in adults, although, you know, we it's off label in children, but um, you know, there's definitely some uh benefits that can come from TMS with OCD as well, kind of helping you to again decrease the symptoms and increase your ability to engage in something like the four-step process, psychotherapy, whatever.

Laura 35:01

Yeah, absolutely. Use the tools that you have access to. That's my thing is always like you have resources, internal and external, right? And so some of those external resources like medication, TMS, therapy, behavior therapy, reading books, trying these four steps on your own, like those are external resources that are there to support you. And when you are relabeling and reattributing, you're taking away the blame and shame. And so it's like, it's not that there's something wrong with you, it's that we all need support and resources in order to survive and thrive. So utilizing those supports and resources doesn't mean anything bad about us.

Michaela 35:42

Correct. Yeah. Yeah. And the whole goal is to use these actions to decrease the rumination. So when you're refocusing and taking your dog for a walk or knitting or playing music and dancing, um, you know, whatever it is that you decide that you can do for that 15 minutes, then you can go, all right, I didn't do the thing for 15 minutes and nothing bad happened. And I'm and then you can go, okay, I'm anxious and I need to do the thing, or you can go, I had can wait, I don't have to do it for another, I can do another 15 minutes of something, or I feel pretty good. I can go on with my day, you know. And ideally, the longer we are in using these, you know, patterns of trying to reduce the OCD symptoms, the the easier it becomes and the easier it becomes because you're able to go down that other pathway.

Laura 36:39

Mm-hmm. Yeah. And then the last step is to revalue. And that goes back to what you're talking about making it less important. Like revaluing is like saying this thought, this compulsion, this belief, this whatever's coming up for me isn't me. It's not my true self, it's not reflective on me, right? Like it doesn't mean anything about me. So it doesn't have that value. Whereas before treatment or before we recognize these things are OCD, we often assign them a lot of value. They have they have a heavy weight and importance. And so we want to take away that importance. We want to say, this isn't important, this is just OCD, this is just a brain misfire, right? So all these steps kind of work together. And so revaluing is saying, I am not this thought or behavior. I am bigger than that. I can do more than just this automatic pathway. This automatic pathway is not important. And the more you do that, the weaker that thought becomes, the weaker the distress becomes, it kind of dampens and lessens that level of urgency that comes up with it.

Michaela 37:53

Yeah, absolutely. And so the initially the OCD thought triggers this threat state, you know, puts us into that fight or flight. And we talk a lot about polyvagal nervous systems, things like that. The compulsions are an attempt to regulate the nervous system because the thought triggered the threat state. And now the rituals are being used in the short term to just kind of keep soothing, keep soothing, keep soothing that anxious distress. And it continues to teach the brain that the world is dangerous, right? And so the rituals that you know keep you keep performing over and over again aren't fixing the problem. It's feeding the alarm state where you're continuing to say, in that, I need to do this to survive.

Book Recommendation And Closing

Laura 38:44

Yeah, that's really well stated. I think, you know, it's that threat response, the response to the threat, and then the replacement response to the safety of relabeling and reattributing, right? Is gonna be the sort of the new way forward. Exactly. Yeah. Well, I think that might be a good place to leave it today. Um thank you so much for this conversation. This was very enlightening. And the book that we're referencing is Brain Lock by Dr. Jeffrey Schwartz. I'll put the um you know, I'll put the link in the show notes so that you can check it out if this is something that you want to learn more about. Um and thank you so much for listening to Why Am I Like This? If you like our show, please leave us a rating and review on your favorite podcast platform. Follow the show and share it with your friends. This episode was written and produced by me, Laura Wood, and Michaela Beaver. Our theme song is Making Ends Meet by Thick as Thieves, and a special thanks to Core Self, Benavieri Counseling and Active Healing Psychiatric Services for sponsoring our show.