Relabeling Worries & Habits


This isn’t me—it’s OCD.
Do you have thoughts that repeat themselves over and over? Are you
plagued by repetitious habits that are getting out of control? If so, you may
have a problem called obsessive-compulsive disorder (OCD). Just by
distinguishing constructive worries from unfounded obsessions and healthy
habits from unnecessary compulsion, you can start to change! Excessive
concern about doing something wrong, being sick, hurting others, looking
just right, saving things, being clean, orderly, or germ-free, and preventing
misfortune are common sources of obsessions and compulsions.

Relabeling concerns and tiresome habits as obsessions and compulsions
reduces their power and sets the stage for change:

I know my fear that dirt will infect me is just an obsession and that my hands
aren’t actually contaminated, even though I’m compulsively washing them.

DISTINGUISH OCD FROM RELATED DISORDERS

OCD is easy to confuse with related disorders. Misdiagnosis can cause
additional worries and delay proper treatment. Knowing what OCD is not will
help relabel what actually is troubling you or help you find additional
needed treatment:

• Depression can cause people to have repetitive thoughts of being
  bad, defective, or unworthy. Excessive feelings of guilt, self-hate, and
  shame are a part of depression. In more severe cases, people may
  seriously consider suicide. Although, people with OCD fear that they
  may hurt themselves, they have no desire to do so. The stress of
  OCD can lead to symptoms of depression: decreased energy,
  interest, and desire to be with people and even crying spells.

• Panic disorder can cause people to have constant concern about
  dying, going crazy, or appearing foolish because of unnecessary
  concern about symptoms that result from a surge of adrenaline.
  When people with OCD are unable to (perform rituals that) ensure
  cleanliness, safety, and security, they may feel such intense anxiety
  that they panic.

• Trichotillomania causes people to repeatedly pull out their hair
  resulting in noticeable loss. Because low levels of the
  neurotransmitter serotonin may be a factor in trichotillomania, OCD,
  panic disorder, and depression, the same medications can reduce
  symptoms in each of them.

• Problems with impulse control can cause people to give in to urges.
  Yielding to cravings to overeat, have sex, spend money, or gamble
  temporarily relieves stress. People with OCD strive for perfection and
  are constantly battling the possibility of “undesired” impulse. Rather
  than indulging impulses, they are often overcontrolled.

• Personality disorders can cause people to act compulsively. They
  may clean, wash, check, or hoard unnecessarily. Instead of feeling
  exhausted, they feel good about their rituals or they place many
  demands on others. Their compulsions may help them avoid feeling
  worthless or having contact with others.

• Neurological tics cause repetitive movements and sounds. These
  happen automatically and have no thought or intention associated
  with them. Compulsions are purposeful and attempt to relieve anxiety
  related to an obsessive thought. Often, people with tics also have
  obsessions and compulsions. In both conditions, the part of the brain
  that controls muscle movement and error detection may not be
  properly regulated. However, obsessions and compulsions can fade
  when they are postponed, but the “urge” to tic increases when it is
  delayed. Therefore, each of these problems requires different
  treatment approaches.

Tic Checklist

Directions: Help recognize repetitious behaviors that are tics rather than
compulsions. Check any of the following that you do.

Simple motor:
             Eye blinks
             Jaw jerks
             Arm movements
             Grimacing        
             Eye widening
             Hand jerks
             Finger movement
             Tongue thrusting        
             Nodding
             Shoulder jerks
             Leg movements
             Tensing body parts        
             Head turning
             Stomach jerks
             Other:

Complex motor:
             Tapping
             Hopping
             Stomping
             Squinting        
             Hitting self
             Slamming things
             Pushing on eyes
             Grooming hair        
             Funny expressions
             Cracking joints
             Touching body parts
             Counting        
             Obscene gestures
             Picking at things
             Other:

Simple vocal:
             Coughing
             Hawking
             Squeaking        
             Snorting
             Grunting
             Squealing        
             Throat clearing
             Gnashing teeth
             Blowing across upper lip        
             “Aaaaaa”
             “Ttttuh”
             “Uh uh uh”
             Other:

Complex vocal:
             “Uh huh”
             “You bet”
             “All right”
             “Yeah, yeah”        
             Swearing
             Racial slurs
             Common insults
             Obscene noises        
             Repeating sentences after others        
             Repeating one’s own sentences
             Other:

Sometimes, people can be trained to substitute an inconspicuous toe twitch
for more obvious tics.  “Practicing” a tic at a convenient time may reduce
the need to produce it when it would be bothersome.  The same
medications are not generally used to treat tics and OCD.

TOURETTE RESOURCES

Tourette Syndrome (TS) is a neurological disorder characterized by tics—
involuntary, rapid, sudden movements, or vocalizations that occur
repeatedly in the same way. The cause is genetic and may be related to
how the neurotransmitters, dopamine and serotonin are used in the body.

For further information see:

Http://members.tripod.com/~tourette13
www.fairlite.com/trich

alt.support.tourette—an online newsgroup dedicated to Tourette Syndrome.

Living with Tourette Syndrome by Elaine Shimberg, (Simon & Schuster,
1995).

Children with Tourette Syndrome, A Parent’s Guide by Tracy Haerle and
Eisenreich, (Woodbine House, 1992).



Reference
   
Jeffrey M. Schwartz identifies relabeling as one of the “4-R’s of recovery”
from OCD in his book Brain Lock (HarperCollins, 1996). The rhyme “This
isn’t me, it’s my OCD” also comes from Brain Lock.