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Basically I try to look at the truth and common sense and evidence and then I get stuck on the feeling? Is that because my brain has been making me doubt for a year straight? Should I expect for the feeling of doubt to be there and do response prevention and keep telling myself the truth I know??

There’s no icbt therapists in Alaska . I’m having to do this all on my own.

Hi Juliannamaria, So sorry to hear that you're struggling and there are no ICBT therapists in Alaska. You could definitely try advocating with an existing OCD expert in your state to see if they would be interested in learning ICBT with you. Let them know they could seek out training as well as consultation with another ICBT provider. It sounds like the doubt is still pulling you in, and you'll need someone to work beside you to figure it out. There is still something telling you that you shouldn't trust the information you have available and you should still seek out more. When you do ICBT in therapy, there are 12 modules you work through, and by the time you get to module 8, you begin to use "reality sensing" where you identify only what you know for sure and don't go into the doubt. Oftentimes, the individual receiving therapy will encounter a "void" (a future video for sure) during this step. It's a feeling of discomfort and strangeness that occurs when using only the available information. It doesn't feel like enough. But this feeling is to be expected when the individual first returns to basically doing "nothing" in response to your obsession. Best wishes to you as you continue your journey towards recovery!

@ wow I can relate to the feeling of the “void” forsure. It almost feels dangerous like I’m missing something! Thank you for your thoughtful replies! It helps forsure.

You could definitely have more than one Vulnerable Self Theme (which has recently shifted to being called the "Feared Possible Self"). The goal, though, is still to try to look for overarching fears about the self that tends to connect multiple doubts/obsessions.

I will offer 2 options depending on the underlying issue: 1) Toxic guilt: This is when someone has become so aversive to guilt that they try to never feel it. They have not learned to tolerate it as a normal and functional human emotion and have it as their goal to always directly eliminate the feeling as soon as it shows up. In this case, we would definitely be looking at accepting one's imperfection and that one has done wrong in the past and that they should feel guilty for those "moments" of imperfection but not feel guilty "as a person" permanently. By learning to accept and tolerate guilty feelings we would be moving towards a space where one recognizes that guilt is a transitory emotion when accepted, whereas it becomes a permanent state when avoided. 2) Inferential confusion (i.e. OCD): If someone is struggling with the reasoning errors that come with OCD, one is inappropriately applying out-of-context past experiences to the present moment. One has lost trust in the person they are in the present and doesn't trust the available information they can gather about themselves in the present such as one's inner intentions and motivations. With ICBT we're looking to reconnect with the "inner senses" that tell us we are a good person who intends to do good and who will try their best to do good now and in the future. We recognize the "true self" is the person who is upset/appalled by the past behavior. This response to past behavior is more evidence of present-moment morality. This is really important information to be collected and trusted. In the case of OCD, there is reasoning leading one to doubt one's present moment goodness, and one of the arguments used to reject information in the present is past behaviors that are not relevant to the present. So, we would want to differentiate between 1 and 2, and we may even find that both are going on, in which case we would probably want to apply a mix of therapies to address both issues. I hope that helps. Basically, you no longer wish to beat up meat eaters and purify the bane that society drowns in, and have a more adult, less 16-year-old, idea for how to go about things. You have evolved as a person and can still jam out to Firestorm on occasion. Lol. Thanks for the awesome question.

I don't think that ICBT would necessarily offer coping skills. The issue is that an OCD obsession is a deep-rooted problem that really requires time and reflection to begin to weaken. I definitely recommend finding an ICBT therapist and deep diving with someone working directly with you weekly. If you're interested, here is a list of providers: icbt.online/wp-content/uploads/2024/12/INTERNATIONAL-REFERENCE-LIST-MENTAL-HEALTH-PROFESSIONALS-FOR-OBSESSIVE-COMPULSIVE-DISORDER-2024-12-19.pdf

What you'll find with ICBT is you will be working on noticing the behavior of searching, checking, and testing one's memory is a trap that only leads to more and more doubt. And it leads to the creation and imagining of "possible" memories that can then never be disproven by more searching. One thing we may work on is identifying the simple answers that are right on the surface. For example, we look at how the answer to a question like "what did you eat for breakfast this morning?" is answered simply and quickly. That's what a real memory feels like. We then compare this to the tortured thought process that is occurring in the area of the obsession that involves a blurring between the imagination and reality, and an over-reliance on what's "possible." I hope that gives a good initial impression of the work.

I still feel stuck in the ocd bubble of both. And as a parent this feel sickening and debilitating.

Any advice or guidance would be SO appreciated. I’m normally a logical and smart person but with these themes I just can’t shake the fear of it. I even have fear I could ever believe thoughts so crazy and worry and fear what my brain could come up with next. This is debilitating ocd as well. Like these episodes bordered psychosis level detachment both times. But the FEELING was so strong I believed both episodes almost completely.

I wish I could believe my reality more. My heart starts beating so fast and I get so scared with both of those thoughts. It’s like it doesn’t matter how much factual info I have , because the feeling is so strong I can’t make progress anymore. I feel like it broke me. Iv had smaller triggers and icbt has made me completey stay out of my imagination and has worked. But the level of severity and almost a ptsd I have with these topics, nothing seems to be working. I just want to feel like I believe the facts. So then I think what if it is true and possible. 😢

Hi Julianne, Sorry OCD has been so rough lately. Keep in mind that you are describing a situation where you are becoming absorbed in doubts about the treatment itself: What if I never stop doubting? What if having doubts make me a terrible person? What if I could worry about anything? What if my doubts have broken me? What if I'm not making progress? In ICBT we typically say that you are making contact with your imagination as soon as you ask the "what if." And we are always working towards not asking the 'what if' in the first place. It's important to recognize that once you are in the bubble with the above concerns, you have most likely entered into a state of constant "checking" to see if you are worried or not, if you are anxious or not, if you are getting better or not. Once someone is in a state of constant checking, there is no longer any learning that is occurring, and therapy sessions can become one big test to see if you will worry about something new or not. Make sure you work with a therapist on identify any checking/testing compulsions and begin refraining from these compulsions so that you can return to learning about OCD and learning about yourself and practicing skills, not just checking and testing for worries. That would be my initial advice. Keep in mind that you bring up a lot of complex questions that can only be explored with in-depth conversations in the therapy setting. But I hope this helps to answer some of your questions.

Absolutely!

Absolutely!

Thanks! I'm doing one every 2 weeks right now, which seems totally doable!

Sorry, Reid Wilson I think. But you get the idea haha

Good point. I hadn't thought about Reid Wilson's approach, but I think there is definitely overlap. And he is one of my favorites!

Somatic OCD is one of those terms that can be used in different ways. What would be a more specific example of an obsession in this area to discuss?

@ so like, hyper-awareness of different bodily sensations such as blinking and breathing. Also known as sensorimotor ocd. Often has thoughts with it like “what if this never goes away?” “What if I’m stuck like this forever?”

@@OCDspace412was looking on your channel for the same information as this commenter

Thanks for letting me know. I'm happy the presentation has been working for you!

Awesome to hear it. ICBT has been such a great option for many!

So happy this helped. It's important to recognize that Health Anxiety is a debilitating condition, and that it's not your intention to be consumed by this worry!

Thanks! That's such a great realization to be making!

Glad the video was helpful. This treatment approach has a lot of parts to it, so I'm happy these little nuggets are still useful.

For me personally this makes more sense than ERP. Thank you for these videos.

Awesome. Happy it helped!

No problem. Thanks for watching!

Absolutely. Contamination is actually a pretty wide range of OCD concerns so it would be tailored to each issue. For example, some people simply doubt whether they are "dirty" or not. They might not believe their own eyes when they look at their hands and they appear clean. Others may doubt whether they may have a dangerous invisible substance or germ on their hands. In all situations, we can still see the problem is a distrust and doubt of the available information and a desire to perpetually seek out more information than is available through the senses. A lack of trust in one's "common sense" can also often play a big part with contamination. Someone with contamination is often living in a way that they would not recommend to others, which is an indication that their common sense is not being applied to themselves.

The key is to connect with a professional to really discuss these questions in depth and get the diagnostic clarity you seek. 1. If you're struggling with a lack of trust in the information you have available and your ability to make sense of that information, that's probably an indicator this could be OCD. 2. Reading about things can worsen worry only when one is still susceptible to doubting. Once one has learned to stay out of doubt, and the imagination, there's nothing to stop one from reading anything they wish. 3. And with the thoughts about God, an important step in OCD treatment is to differentiate between real thoughts, that include motivation and intention, and imagined thoughts, that are simply a thought that one "tries out" just to see what would happen.

The key is recognizing that "searching" your memory is an unnecessary "overuse" of the senses. We do not have to go looking for things in life. Our senses will inform us if there is something to concern ourselves with. If you happen to be someone with a history of being imprisoned for things you can't remember doing, then I guess it would be reasonable to think that you'll soon be arrested again for another thing you don't remember doing. But my guess is there isn't a "forgetting serious crimes I've committed" problem in your life.

We're always looking to identify what is "known," and separate this out from the doubt. In the situation you describe, "maybe I'm just brushing something off" has all the telltale signs of a doubt. And it sounds like the thing you know before you doubt is the fact that you're fine and don't have any reason to engage with negative possibilitiies. I think you might be ready to run my next video titled: "Watch Out for this OCD Trick: Maybe you're just brushing something off."

@ Haha I will, thanks a lot for your reply!

That could definitely become an OCD issue, but I would recommend discussing this with a therapist who is trained and knowledgeable to work with OCD, and in particular, False Memory OCD. Someone specializing in ICBT who understands the imaginal element of OCD could be particularly helpful. The key is learning to know the difference between a real thought and an imagined thought. In OCD, the 2 start to get confused.

I understand! The main issue I had stemmed from a thought saying what if I was assaulted and then I remember thinking I'm going to think this is real in the morning. So like my brain knows the thought was a what if but then I couldn't stop obsessing over whether something happened or not and trying to figure it out . I've been diagnosed with OCD but this has been a thought pops up whenever Im feeling anxious. I originally had the thought over ten years ago. Hope that makes sense? I've had therapy before but wanted to see if OCD can manifest that way !! Thanks so much x

As with any area of life, journaling can help you increase your awareness of thought and behavior patterns. It won't get rid of your OCD, mind you, but sometimes increasing awareness is a critical step to recovery.

@@OCDspace412 thank you sir

Sure thing!

False memory can definitely be an obsession around recent memories as well as an older memory. One of the initial goals of ICBT is to understand the arguments that lock you into obsessional doubt. "You're just using OCD as an excuse" would definitely be one of those arguments. Notice how a commitment to this line of faulty reasoning would lock you into obsessional doubt for the remainder of your life. Over time another goal of ICBT is to reconnect with the true self and to trust your inner motivations. For example, at some point you have to answer the question "Am I actually using OCD as an excuse?" When clients put these sorts of arguments into words, I like to ask them, "Well, are you (using OCD as an excuse)?" The answer is always no, once they've learned to identify and trust their inner motivations and have practiced not going into the doubt.

@@OCDspace412 I am still figuring out the answer to Am I using it as an excuse. And the answer I gave to it is I had previous similar thoughts if they were not true definitely it is not and If it was true . I wouldn't be desperate to seek reassurance. But still it goes no where. What if I have done it or Maybe I am enjoying ocd . That's the thought I get back but if you would have asked me this question my answer would be no. I can't do that horrible thing. Its horrible even to think about it yet alone do it .

@@Ffhhjikktehkhh When you are "figuring something out" that is typically a sign of OCD - i.e. obsessional doubting the most realistic conclusion that all of the actual, real-world evidence (or lack thereof) is pointing to. Imagined possible memories that you are reviewing to try and decide if they are real or not are not evidence. Your true distaste for an action is evidence pointing t the real self, that takes work to trust again. Treatment would allow you to identify if you are actually someone who goes around trying to conceal prior bad deeds by looking up mental health disorders that would make good excuses.

@@OCDspace412 thank you very much

@@Ffhhjikktehkhh You got it!

You're welcome!

Thank you. Hoping you find a way to recovery. ICBT could be really helpful for that specific issue.

Ahh yes. Such a trick for so many. I'll add that to the list.

That would definitely be a helpful topic to cover

Thanks. I'm happy they're helping!

from an ICBT standpoint, we would look at the reasoning that is linking the trigger to the doubt. In this case (which we might call magical thinking) the logic tends to be "somehow" it will happen. So as long as the "somehow" argument keeps working, the link will remain. This logic can begin to be challenged by forcing oneself to come up with the actual story of how this one thing would lead to the other. This can begin to inject your actual beliefs and your common sense into the thought process, which OCD is currently keeping out.

@@OCDspace412 Thanks for the reply. That's a very good point.

@@eonskrin4720 You got it. Good luck with this tricky issue!

Thank you so much for sharing that. Happy these videos have been helpful!

So sorry to hear about the turmoil you're going through. There is hope. If you haven't already, make sure you find yourself a good therapist to help you through recovery!

I just feel am alone in this and nobody’s ever had this thought. Am afraid it’s real

I can definitely do that! Thanks for the suggestion.

ICBT could potentially help with those situations if they are truly OCD (and not Generalized Anxiety). The distinguishing factor is that OCD gets people focused on remote possibilities that don't have substantial real-world support. Generalized Anxiety situations are more of an "overestimation of threat" and are usually a response to something actually occurring in reality.

Thanks. Very happy to be helping!

We would first rule out "guilt avoidance' or 'guilt sensitivity' and help someone integrate this normal emotion back into their normal everyday experience, as a healthy emotional signal that can be resolved once it's accepted and processed. From an ICBT perspective, we'd then notice how a story is being constructed that paints the event as somehow permanently corrupting of the individual. It's just one event and not universally defining of a person (i.e. the event does not equal the self). That's a few initial things that come to mind for starters, but it would be a therapeutic process of digging into the obsessional doubt, which in this case is probably most evident in the formulation of a rigid story that is being overused to explain things.

My pleasure!

I'm not overly familiar with that model, but it sounds like a really interesting comparison. ICBT is based on a psychological construct called Inferential Confusing, which frames OCD as a reasoning problem. The individual's doubt is actually an inference, or conclusion, supported by a reasoning process. According to this model, someone with OCD does not necessarily have any impairment with their perception or their senses (including their "internal" senses like desire, preference, etc), but they have locked themselves into ignoring, overlooking, and otherwise rejecting this sensory information. We can very easily see how someone with OCD is not having a universal problem accessing sensory information. Someone with POCD might be experiencing doubt about what they prefer sexually, or someone with Scrupulosity might be experiencing doubt around what their intentions are, but these same individuals can easily say what their preferred food is and their motivations and intentions behind a million other daily tasks. So we work on re-acquainting, oneself with and trusting, the available information. To use the POCD example again, if you were to ask the person if they want to harm a child, there would be an emphatic "no" response. We would work on noticing the fact that they momentarily accessed their true desire, and it's something that is simple and effortless to access. Excessive testing, checking, and going deeper, only leads one away from the simple truth and into a state of imaginal absorption and disocciation. Again, without knowing a whole lot about SPIS (I'd be interested in learning more) there could be some interesting areas of overlap.

@@OCDspace412 Υou are right. Ι have read the clinician's book and some extra materials about i-cbt, but when i visited my psychiatrist he suggested the SPIS as an explanatory model of ocd. However, this model contradicts what i-cbt proposes, precisely in the point that the person with ocd has very good access to his senses, internal and external, except in some cases where due to a vulnerable self theme and through inferential confusion he experiences doubts as a result of a reasoning process. But if we accept that the SPIS model is valid, then we must recognise that people with ocd experience attenuated access to their internal states, and thus to their senses. This, however, is exactly the opposite of what the inferential confusion model proposes; how can these two models coexist in clinical practice when they have such substantial differences? I am very confused. Thank you.

Thanks for the comment. I would argue that many obsessions fall into the same boat. Someone with health OCD would say that they can't know why they may be experiencing a particular sensation or pain on a given day. Someone with scrupulosity would say that they can't know what God is thinking about their actions. With false memory OCD, it's important to recognize that actual evidence would have to come from the world outside of your head. Someone who is actively checking and testing their memory is going to generate possible "memories" that will be unreliable. This is what we call overusing the senses. In ICBT treatment, we would counterbalance this obsessional narrative with alternate stories (to prove there are many possibilities and explanations for internal experiences), a focus on trusting the "true self," including one's intentions and a trust in one's common sense to sort through it all. But it's definitely a process!

Great explanation regarding one of the toughest themes

So happy that you've found the channel. For many people with OCD, ICBT can really click and be a game changer.

I tell OCD clinicians that they should be acquainted with all of the different treatment approaches, because different individuals may respond to different treatments. ERP still has mountains of evidence behind it, and many people have greatly benefited from this approach and may not need ICBT. That being said, ICBT has completely changed the way I view OCD, and when I do introduce "exposures" into treatment it's not really even exposure anymore. It's more like behavioral change, or behavioral experiments. There are some aspects of ERP (being told to tolerate uncertainty) that I think have been harmful to certain people, and I think the field of OCD treatment is really reconsidering this strategy, among other things, at least with certain obsessions.

@@OCDspace412 Interesting. So in the context of an exposure, it doesn't really make sense to simply "tolerate the uncertainty", because the root cause of that uncertainty is some kind of obsessional doubt that needs to be confronted directly?

@@zorzod497 Yes. The issue is that people without OCD (as well as people with OCD in all other areas of their life outside of their obsession) don't get through the day by "tolerating the uncertainty" that they might want to hurt themselves or others, might have done something awful in the past, might have cancer, might be going to hell, might be in the wrong relationship, etc. etc. It just doesn't make sense to live that way, especially if you can identify the beliefs driving the individual to doubt themself. The only reasonable way forward is to live your life like these things aren't happening, until you get undeniable information that tells you that one of these things is happening.

@@OCDspace412 I see your point. I guess what's confusing to me is that I still think the "normal person" is still technically tolerating uncertainty in regards to, say, cancer. As in, they aren't 100% certain they don't have cancer, and they are tolerating that in a way that someone with OCD might not. But I guess the difference is that when someone with OCD "tolerates uncertainty", it's more like tolerating severe uncertainty as opposed to like "baseline" uncertainty (?) if that makes any sense. Anyways, thanks for the help!

@@zorzod497 I don't believe that people sleep at night just because they are able to accept that they might have cancer. I think people can sleep at night because they assume they don't have cancer until they receive information telling them that they do. Even for those with OCD, this is how they are living in all areas outside of their obsession. Assuming you're okay, until there is information otherwise.

You may find that you need a variety of approaches for your specific issue. ICBT is appropriate for Inferential Confusion, when there is an issue with doubting the evidence that exists in the present. For example, there might be evidence that when one focuses completely on the present moment, attention can be controlled (and this skill can be practiced and improved), and one is fully capable of directing attention at the thoughts or at something else. In this case, the possibility being considered may be largely future oriented (I'll never stop thinking about this thought). But it should also be considered if one has developed a more 'phobic" response to internal thoughts or feelings, in which case exposure, and interoceptive exposure may be helpful. I also think ACT can always be a good tool. Good luck! I hope that helps.

@@OCDspace412 Thanks, this is helpful! I'm happy to hear that folks are recommending a variety of approaches and not being dogmatic about one way. Cheers!

@@OCDspace412 "Attention can be controlled (and this skill can be practiced and improved) and one is fully capable of directing attention at the thoughts or at something else." sounds confusing and also promising. :)

@@OCDspace412 "the possibility being considered may be largely future oriented" - right, if I was certain it would be temporary there would be no cause for fear. ERP/ACT/mindfulness would say "maybe, maybe not, proceed with your life despite the thoughts being there." I-CBT seems to be saying, "learn more about what gets you to the 'what-if I never stop thinking about this', recognize that doubt, and don't engage further." Definitely a challenge!

@@robyroby162 Totally agree!

Nothing yet, but I'll add that to the list.

So happy you're finding a path forward. It is an incredibly difficult doubt to shake!

The emotions are powerful controllers indeed.

Sorry to hear that. I hope you've been able to find yourself good support.

Hang in there! If you haven't already, check out a phenomenon called Anxiety Sensitivity. One of the categories of Anxiety Sensitivity is a fear that certain anxiety/panic symptoms could be indicative of heart problems: www.psychologytoday.com/us/blog/insight-therapy/202002/anxiety-sensitivity-when-what-we-fear-is-fear-itself.

It would depend on the nature of the obsession. If it really is a more textbook OCD situation with a primary doubt that is something like "what if this never goes away" or "what if I am never able to stop noticing something" and this doubt is fueling the OCD, then ICBT would be an appropriate way to treat the obsessional doubt. ICBT would be particularly helpful if there is a distrust in the self as someone who might never be able to control their attention." ICBT would work on resolving this doubt and distrust through identifying the selective and biased nature of all of the attention being focused on this one experience/process over a million others. So, I guess my answer is...it depends on an evaluation of the nature of the OCD? You can read more on ICBT here: iocdf.org/

Thanks for sharing your story, and that's great that you found an ICBT therapist!

So happy to hear that. Thanks for the feedback!

Happy to hear that the health OCD sounds like it's in the past tense!

Awesome. Thanks and welcome aboard!