Penny Lewis Psychologist Brisbane
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When OCD attacks your relationship - What to do?

16/10/2018

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​I have had an interest in treating OCD for more than 25 years and seen it take many forms. Common obsessions have included concerns about contamination from chemicals, sticky substances or germs; being infected with AIDS or herpes, accidentally harming or attacking loved ones or strangers, questioning one’s sexual orientation, being possessed, being a paedophile or rapist, flooding or burning the house down, being burgled, losing valuables, things being out of order or not “feeling right”. 

These intrusive thoughts then lead to all sorts of rituals including excessive hand washing; checking appliances, belongings, taps, lights, locks, seeking reassurance about what just happened; ritualised excessive praying; repeating behaviours a certain number of times and retracing ones steps or movements (either physically or in one’s mind) or re-reading emails, assignments, text books and letters.
 
The lives of these tortured souls become more and more narrow as they start to avoid situations that could trigger their obsessions. It can get to the point where some sufferers become unable to leave their room or perform basic activities we take for granted. The obsessions can limit behaviours such as showering, shopping, reading or writing, catching up with friends, preparing food or eating out, driving or catching public transport, using public toilets and cleaning the house. 
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​OCD tends to both wax and wane for the sufferer, becoming worse at times of increased stress. The tendency to obsess often arrives before the subject of its attention does.  If you have a mind inclined to obsess, it tends to look for a place to land – and relationships are a rich place for it to find a landing ground.
 
“Relationship obsessive compulsive disorder” or ROCD is a relatively new phenomenon. It was first described as recently as 2012.  However, it is receiving increasing attention by researchers and clinicians. When I started working in the OCD field, this condition was unheard of. However, recently, in one week, I had three clients who were referred for ROCD!
 
Essentially, ROCD is excessive ruminating about your feelings towards your partner or your partner’s feelings towards you, or the “rightness” of the relationship experience. ROCD, can cause you to spend hours analysing your feelings, or your partner’s flaws. It can lead to fears about your own inadequacies and whether you are about to be dumped or fears about future regrets. ROCD also leads to a great deal of reassurance seeking from your partner, friends and family or through internet searches. 
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It's all about Doubt
It is doubt that gives ROCD oxygen. So why has ROCD arrived now? Is it because the current generation have witnessed so many parents separate that they worry about making the same mistake?  They are acutely aware of the impact on the rest of their life and the lives of children they might have.
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Combine this with easy access to the internet with a plethora of YouTube videos, quizzes and articles by relationship therapists and dating coaches. All offering advice to guide you in working out if you are with a “quality” partner or in a good relationship. While it is important to learn what we can about relationships and how to choose a healthy one, if you have a tendency to obsess, it may be better to see these experts in person than trawl the net and feed the doubt.
 
And then you have social media encouraging you to compare yourself and your partner with everyone else, promoting feelings of inadequacy and self-consciousness. And finally, we are now living in a world of internet dating and dating Apps where the options for choosing a partner have increased exponentially. Research has long demonstrated that the more choice you have, the harder it is to make a decision. This is known as the “paradox of choice” where more choice leads to less satisfaction. Again, it feeds us doubt. 
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All of these factors have created the perfect storm for those with the psychological and biological factors which predispose them to develop OCD, to have ROCD.

​Warning Signs
There is no doubt (no pun intended) that choosing a life partner requires considered reflection. Doubts about your partner are normal during the dating phase, times of conflict and just before making a major commitment like moving in together, or marrying. So, what distinguishes these normal intrusions from ROCD?  
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​Some warning signs of ROCD include:
  • Spending a lot of time (more than an hour a day) ruminating about it
  • Trying to counter the doubts by suppressing them or having thoughts to counteract them
  • Constantly monitoring your feelings about and sexual attraction for your partner (nothing will kill this more quickly!)
  • Excessively comparing your partner with others, or past relationships or characters in movies and novels
  • Avoiding situations and people that might trigger your doubts
  • Avoiding physical or emotional intimacy with your partner for fear he/she may end up being hurt
  • Excessive time spent doing things designed to relieve your doubts like seeking reassurance from others
  • Repeatedly asking your partner to confirm their love for you
  • Confessing your doubts to your partner
  • The doubts are unwanted and distressing
  • The doubts are interfering with other aspects of your life (like work, study, family, socialising)
  • The intrusive thoughts conflict with your values (e.g. you would not normally be concerned about this “flaw” in a person)
  • The intrusive thoughts conflict with a part of you that knows that you have a reasonably good relationship
  • The worries may be in the form of images, thoughts and urges, rather than just a verbal thought
  • Other OCD symptoms or a past history of OCD
  • A history of similar ruminations in previous relationships
​It can be very tricky if you have both ROCD and real concerns about your relationship. If this is the case, I suggest you postpone any decisions about ending the relationship until after you have had treatment for your ROCD, so your decision can be more reality based.
 
ROCD is treated with a combination of psychological strategies. These include learning about problematic beliefs which turn normal intrusions into obsessions; ways of challenging and managing intrusive thoughts; imaginal and real exposure to feared situations while stopping compulsive behaviours (like reassurance seeking) that maintain the ROCD.  Training in mindfulness skills to make it easier to let the thoughts come and go without engaging with them can also be helpful.
 
For more comprehensive information about ROCD and treatment, I recommend this website which was developed by the leading researchers in this field and contains numerous resources including information about the App they developed to assist ROCD sufferers.
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The “Magazine Interview” – How to re-connect with your partner

24/9/2013

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Recently I was scanning the local free weekly magazine during my lunch break. I usually go straight to the recipes and restaurant reviews as food is one of my passions.  But along the way, I am sometimes drawn to read a regular column which highlights a happy partnership - a romantic and/or business relationship between two people.  It may be a couple in love or two family members or friends who complement each other in their work together. 
 
Happy partnerships
Each is interviewed to tell the story of how they came together in the partnership and why it works so well personally and business wise. Often there is a love story in there as they share how they met and what they love and appreciate most about their partner. It is set up in the form of “She says” “He says”, with each partner giving their separate glowing account of their partner and their relationship.

Accentuate the positive
This reminded me of what I do in therapy with couples who are caught up in the negative and have lost touch with why they want to stay together.  I ask them to tell me the story of how they came to be together and what they like most about each other. It occurred to me that the magazine interview is a good format to do this as it encourages people to accentuate the positives in their relationship.  Clearly a relationship has negatives too, but when you are being interviewed for a magazine, you tend to overlook these, just as you do when you first fall in love. 

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Rose coloured glasses?
Before you question the value of formulating a rose coloured version of your relationship, consider that the way our brain works. Neuroscientists acknowledge that our brains have a negativity bias, where we naturally notice and remember the negative. This has survival value – much safer to remember there was a sabre tooth tiger at the waterhole yesterday than a beautiful sunset.  

Be mindful of the positive
As the Neuropsychologist Rick Hanson says – “The mind is Velcro for the negative and Teflon for the positive”. Thus, we do need to actively choose to be mindful of the positive, as awareness of the negative comes without effort and sticks.   

Positive to negative ratios
Further support of this approach to life comes from recent studies in the field of positive psychology. Researchers have found that people who “flourish” in life are more attentive to pleasant versus unpleasant experiences, with a ratio of three to one. Those who “languish” have a ratio closer to one positive to one negative.

And also consider the research by one of the leading couple therapists in the world - John Gottman. He found that happy couples maintain interest and soothing during a conflict by having a ratio of five positive statements to one negative. They also use positive emotions to de-escalate conflict so they are calm enough to resolve the issue. So doing anything that makes you feel better and more able to access the positive will help when your relationship is not going so smoothly.

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A soothing resource
This ”magazine interview” tool could be a resource for any couple to access and enrich their relationship. Consider taking some time to imagine what you would say about your partner if interviewed and even giving your partner a copy of your “interview”.  The one rule, aside from highlighting the positive, is that it must all be true and sincerely believed.

Written, spoken or imagined
Your “magazine interview” could be done formally and explicitly, so that each of you writes a short “essay” about what you would say if interviewed. You could then give it to your partner to read.  Or you could take some time to sit with each other and talk about what you might say if interviewed. This could become a regular connecting ritual where you may share what you have appreciated most about your partner/relationship over the past month.

 It could also be done more informally and on the go at times of irritation or after conflict when you are just wanting to shift into a more loving and positive mindset about your partner. So you could just imagine what you would say if being interviewed. You may never share this, but just use it yourself as a calming tool.

Experiment with it. You may be surprised at what you discover. See below for three examples  of these magazine interviews.

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How to cope with a relationship break up

27/11/2012

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A clean break or stay friends?
If a relationship breakup is painful, is it better to have a clean break and no contact with an ex, or to try to stay friends? This is a question I am often asked.  Intuitively I felt that it would be less painful and speed up the recovery process if all contact was ceased (at least until the feelings for the ex had receded). It seemed to me that maintaining contact would keep alive the hope that the ex may yet change their mind and is still a possible partner. This would make it harder to get over the break up and delay the process of grieving and moving on.
Up until now, I had no scientific basis for this idea. However, recently I came across what the neuroscientists have to say about love attachments, and how they are formed and broken within the brain. 

Love and Neuroscience
Psychiatrist Dr  Norman Doidge, in his book The brain that changes itself, describes how the connections in the brain are "plastic" and changeable rather than set. Doidge says that when you lose a loved one, you need to cull and reorganize these connections so that new connections and a new love can be formed. He suggests that falling out of love with a past love requires unlearning the pattern of attraction to that love. Old attachment networks need to be broken so new bonds can be formed. 

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Use it or lose it
To unlearn the love attachments, Doidge argues that you must first unlearn the idea that the person is in your life and is there for you. This is where the adage about the brain - “Use it or Lose it” comes in. If you stop activating brain pathways of connection and attachment with this person, the circuits will die off to make room for new pathways to be formed.

Stop contact with your ex
So it would make sense that stopping contact with your ex will help with the unlearning of the love circuits in your brain connected to your ex. This may mean “defriending” them on Facebook for an agreed period of time - I suggest you start with three months and then re- evaluate. You must also resist any urges to check up on what they are doing on Facebook or other social network sites.

Just friends in the future?
If you think you would ultimately like to be “just friends” with your ex, discuss this with them before you temporarily “defriend” them. This will avoid them being offended and you can make an agreement to cease contact for a period of time. You can agree to check in every three to six months with a view to resuming a friendship in the future once you feel the love bonds are unlearned.

And then grieve and rewire your brain
Obviously, getting over your ex will involve more than just ceasing contact. You cannot move on and get over the break up unless you also do the painful work of grieving for the loss of the relationship. Doidge suggests that in order for the brain to grieve and let go of a love, it needs to rewire billions of brain connections. This is done by turning on the relevant brain networks by bringing up vivid memories of the loved one, reliving them and then letting the memory go.

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Remember the good and the bad
When doing this, it is important to recall both positive and negative memories and feelings. So when you are trying to get over someone, rather than just focusing on how your ex let you down and how much better you are without him or her, you also need to recall what you will miss and those really special times you shared. This will hurt.When doing this, it is important to recall both positive and negative memories and feelings. So when you are trying to get over someone, rather than just focusing on how your ex let you down and how much better you are without him or her, you also need to recall what you will miss and those really special times you shared.  This will hurt. 

Talk and journal
How is this best done? Talking to others about your memories is the most common way to get over someone, although finding an interested listener may be difficult. Also, there may be certain memories you wish to keep private, especially from mutual friends of your ex. You may also risk tiring friends with the finer details of all the ups and downs of your past relationship. One way of dealing with this on your own is to start a private “break up” journal to express whatever feelings you have and recall whatever you can about your time with your ex without any need to sensor what you say. It is important to set aside time for this as well as engage fully with your life outside of these special grieving times.

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EMDR can help
Another way is to seek help from a therapist to help with getting over the painful feelings of hurt and loss.  The fastest and most effective way I have to help clients if they want to speed up this process is a therapy called EMDR (Eye Movement Desensitization Reprocessing).  EMDR will allow you to rapidly recall the memories, process them and let the associated emotional pain go. 

This therapy was initially developed to treat trauma and has much research to back up its effectiveness in this area. I find it incredibly effective with grief and loss as well as trauma. Compared to more traditional therapies, I see it as a turbo charged form of therapy as I find it works rapidly to help with resolving issues that in the past would have taken much longer. 

The pain fades
My clients tell me that the pain of the break up, and any feelings of jealousy when they see their ex with a new partner, feels more distant and no longer upsets them. It is like a movie that was once sharply focused and brightly coloured has now faded into a black and white still and blurry photo. The ex is not forgotten. It is just no longer upsetting to think about him or her.

Perhaps EMDR is so fast because it uses both sides of the brain to help people process painful feelings and memories rather than the usual “talk therapy” which mainly uses the left side of the brain. EMDR also has the advantage that most of the memory reviewing is done inside your head without having to slow down and explain everything to the listener. 

You’ll fall in love again
Even though it may be hard to imagine, you can get over a painful break up and fall just as deeply in love again because of the amazing neuroplastic qualities of the brain. You don’t have to look far to see examples of this in action. Just listen to the heart wrenching lyrics of Adeles’ song Someone Like you  and then hear her being interviewed about the new love of her life who (in her mind)  far exceeds the subject of her song. You too can make this shift so that the pain of a break up will become a dim memory.


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