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Contamination Fears In a Contaminated World: What’s Appropriate And What’s Compulsive?

Contamination Fears In a Contaminated World: What’s Appropriate And What’s Compulsive?

by | Anxiety, Obsession

Covid, Measles outbreaks, Mokeypox- it can feel overwhelming to manage the constant barrage of new threats. For most people, a significant behavioral change is needed to ensure safety, but for people with OCD or health anxiety, where do you draw the line? What are appropriate safety precautions, and what are compulsive safety-seeking or attempts to manage anxiety? Years ago, it would have been seen as obviously excessive for most people to wear a mask in public spaces, sanitize everything before bringing it into your home, and refuse people in your home, but now that may be exactly what’s needed to remain safe. An added component to this difficulty are the differences in how folks view these threats, complicating factors like having young children or being immunocompromised, and individual tolerance for risk. What might be excessive for one person may be necessary for another.  

 

There is no one right answer to what is an “appropriate” level of safety precaution, again because each person will have a different set of circumstances to consider. The simplest way to explore if your safety precautions are appropriate, or potentially causing you more anxiety/distress, can be boiled down to three questions: 

 

Is this in line with expert recommendations?

The more obvious way to assess your safety precautions is to find experts whose opinions and recommendations you trust. This could be medical doctors, scientists, government agencies, or ideally, a combination of several so you can ensure your information is reliable. For example, both the CDC and the Mayo Clinic advise washing your hands with soap and water for at least 20 seconds or, if that is not available, using hand sanitizer with at least 60% alcohol content. With this in mind, some folks may prefer to go a little beyond these recommendations, but it gives a good barometer for what is considered adequate for safety. 

 

Is this safety precaution causing you harm in an effort to keep you safe? 

This is truly the most important assessment. If washing your hands for 60 seconds feels more comfortable, there’s likely little harm and it could be appropriate to continue. However, if you begin using scalding water, harmful chemicals like bleach, or begin to experience peeling, cracking, or bleeding, it warrants an assessment of whether the safety precaution is appropriate. 

 

Is this causing me to be unable to engage in necessary or preferred activities?

This is a slightly more challenging assessment because nearly everyone has experienced a decrease in their ability to engage in preferred tasks, or are having to engage in them in different ways than we used to. You might have to say no to a large gathering, or only meet with friends outside and masked when you would prefer not to. If you find yourself isolating, or feeling unable to engage in activities even when risk could be mitigated, it might warrant a closer look. Another major component to this question is how much time is being spent on the safety precaution. For example, there’s a major difference between a quick wipe-down on the groceries, and a 5 hour sanitizing deep clean. If you find yourself spending considerable time on safety precautions that you would normally spend on leisure activities, it may be worth exploring. 

 

If you are noticing that your attempts to maintain safety are starting to become detrimental in other ways, please reach out, a trained therapist can help you find a balance between safety and anxiety that opens the door to joy and hope. 

 

For more information, go to https://iocdf.org/expert-opinions/expert-opinion-contamination/ 

 

 

Climate Anxiety

Climate Anxiety

by | Sep 10, 2024 |

Hope, Action, and Climate Advocacy “I thought I couldn’t make a difference because I was too small.” -Greta Thunberg   We live in the age of information, which means it is increasingly difficult to limit one’s access to breaking news. More and more we are seeing...

Get Outside For Your Brain

Get Outside For Your Brain

by | May 10, 2024 | , ,

When I am among the trees, Especially the willows and the honey locust, Equally the beech, the oaks and the pines, They give off such hints of gladness I would almost say they save me, and daily. Excerpt, "When I Am Among The Trees" by Mary Oliver We live in a world...

Deep Breathing: Why Do It?

Deep Breathing: Why Do It?

by | Jul 27, 2021 |

If you have ever felt frustrated by being told to just "take a deep breath" when you are feeling angry or anxious, you aren't alone. It's difficult to heed this advice when, in the moment, the mind and body are distracted or dysregulated. The adage of "just breathe"...

7 Skills to Try When You Feel “Overwhelmed”

7 Skills to Try When You Feel “Overwhelmed”

by | Oct 29, 2020 | ,

Have you ever felt completely overcome by an intense emotions? Have feelings at times felt challenging to manage and overcome? The experience of being “overwhelmed” is uncomfortable and impactful in your life at work, home, or school.   Defining "Overwhelm" Emotional...

Burnout Risk: 10 Signs You’re Addicted to Working

Burnout Risk: 10 Signs You’re Addicted to Working

by | Aug 5, 2019 |

We live in a society that worships the overachiever. Burning the candle at both ends and denying yourself pleasure until the work gets done is seen as honorable. And while having a good work ethic is definitely key to living your best life, it is also important to...

Making New “Glory Days”: How to Stop Obsessing About Youthful Successes

Making New “Glory Days”: How to Stop Obsessing About Youthful Successes

by | Obsession, Self-Esteem

“Ahh, the good ol’ days.” How often have we heard or uttered this familiar phrase? It can be a source of great pleasure and amusement to reminisce on a time when we were younger, remembering a special event or activity.

We tend to look at our past experiences through a filter that magnifies the positive while diminishing the negative. While there’s no harm in basking in a memory, it can be harmful if you spend so much time looking at your past, that you neglect your present and future.

If you’re someone who spends too much time thinking about the “glory days” of your youth, you might think it’s because your life has become dull and monotonous. With the carefree days of your youth behind you, you might long to be back in that time period to escape your present. But if you take a closer look and examine your life, you may be surprised to notice that you look back not because your past was so great, but rather because your present is not.

The more time you spend reminiscing, the worse your current life becomes, neglected by daydreaming of the past instead of imagining new heights to which you can aspire.

Get Rid of Unneeded Memorabilia

Sometimes a memento is a special memory of a special time, and sometimes it’s just an object that’s imprisoning you in your past. Getting rid of an excess of items associated with the past will help you stop living in days gone by, and free you to live in and enjoy the present.

Fully Appreciate Each Day

As Eleanor Roosevelt once said, “The purpose of life is to live it, to taste experience to the utmost, to reach out eagerly and without fear for newer and richer experience.” One way to stop living in the past is to enjoy and appreciate each day. Start keeping a journal and jot down three things you’re grateful for each day. Take a walk, or cook a special meal. Enjoy the sights, sounds and smells of every day.

Make Future Plans

Nothing can keep you from looking to the past quite like looking to the future. Plan a vacation or create a goal you want to reach in the near and distant future. Maybe you want to learn a new language, start playing the piano, or read all the classic novels. There’s a lot of life waiting to be lived, so make the most of it.

While there’s certainly nothing wrong with a moment of nostalgia, it’s important to live in the present, and spend your time enjoying your life as you live it. If you make the effort to create a better life for yourself today and in the future, you’ll not only bring yourself great happiness and satisfaction, but you’ll create many more memories to relish in the days to come.

If you’re struggling and looking for support and guidance to create a better, more satisfying life, a licensed professional can help. Call our office today and let’s schedule a time to talk.

How To Stop Beating Yourself Up

How To Stop Beating Yourself Up

by | Jul 22, 2019 | , ,

When was the last time you heard from your inner critic? You know, that voice in your head that constantly judges you, puts you down and compares you to others. The one that tells you you’re not good enough or smart enough and says things you would never dream of...

Q & A with TMS NW: Everything You’ve Wanted to Know about Transcranial Magnetic Stimulation (TMS)

Q & A with TMS NW: Everything You’ve Wanted to Know about Transcranial Magnetic Stimulation (TMS)

by | Depression, Obsession

Have you tried (and tried) medication management for your depression or OCD but never received full results? We invited Piper Buersmeyer, Julia Swofford, and Brendan Roe from TMS NW to provide this Q & A about Transcranial Magnetic Stimulation (TMS), a non-medication alternative for treating chronic depression and OCD. After reading the article, if you’d like more information about TMS, we encourage you to reach out to TMS NW, local in Vancouver, WA.

 

What is TMS?

TMS stands for Transcranial Magnetic Stimulation. Brainsway’s Deep TMS is a non-invasive treatment that uses an MRI strength magnet to either stimulate the part of the brain that causes depression or calm down the area of the brain that causes OCD.  TMS is a safe and evidence-based outpatient procedure that encourages rewiring and improved firing of neurons.

 

Who is eligible?

TMS is indicated by the FDA for the treatment of depressive episodes in adult patients suffering from Major Depressive Disorder who have failed to achieve satisfactory improvement from previous therapy and medication treatment. It is newly FDA cleared in 2018 for the treatment of obsessive compulsive disorder that has been resistant to treatment with therapy and medication.

TMS should NOT be used if you have metal implants in or around your head (except for standard amalgam dental fillings). These include but are not limited to a cochlear implant, implanted cardioverter defibrillator (ICD), pacemaker, deep brain stimulator, vagus nerve stimulator, or metal aneurysm clips or coils, staples, or stents. TMS should not be used in patients with an active seizure disorder.

 

How does TMS work?

In each TMS therapy session, the patient is comfortably seated in a chair and a custom cloth cap is placed onto the head followed by a cushioned helmet. The helmet houses a coil that generates brief magnetic pulses, at a similar amplitude to that used in magnetic resonance imaging (MRI) systems. The rapid magnetic pulse that runs through the coil wire produces an electric field that passes unimpeded through the brain.

During the TMS session, patients hear a tapping sound and feel a tapping sensation in the head area. The patient wears earplugs during treatment. Patients can drive to and from sessions and can immediately resume their daily routines.

 

How frequent are sessions?

TMS requires daily sessions Monday through Friday over 6-9 weeks. Treatment sessions build on one another, so it is best to follow the recommended treatment course. Some clients also benefit from maintenance or repeated treatment.

 

What are the most common side effects?

The most common side effect is temporary, mild pain or discomfort at the area of the treatment site and occurs only during the TMS session. This typically happens only during the first week of TMS  treatment. Other side effects may include muscle twitching, headache and jaw pain, and also typically resolve after the first few days.

 

How does TMS compare to ECT?

TMS and ECT are very different from one another. Brainsway Deep TMS therapy does not require hospitalization or anesthesia, and does not entail risks for memory loss, systemic side effects or an indefinite drug regimen. In contrast to electroconvulsive therapy, TMS does not induce convulsions/seizures. Seizure risk is very low with TMS.

 

How is deep TMS different than traditional TMS?

Deep TMS offers effective results in almost half the time of other treatments (19 minutes per session compared to 37 with traditional TMS). Deep TMS penetrates more deeply and broad than traditional TMS and therefore is more robust and effective.

 

Is TMS effective?

Yes. Brainsway Deep TMS therapy has been tested in over 60 clinical trials. An extensive multi-center study for treating treatment-resistant depression, with Brainsway Deep TMS, enrolling 230 patients, Brainsway Deep TMS therapy significantly reduced depressive symptoms and generated improvement. Following this study, the FDA approved Brainsway Deep TMS therapy for major depressive disorder in patients who did not benefit from any number of previous medication treatments. Approximately one out of three patients treated with TMS therapy experience complete remission of symptoms at the end of six weeks. It is important to note that some clients may experience a partial response during the initial 36 treatments followed by a robust response in the weeks following the completion of treatment.

 

What else is TMS approved for?

In the U.S. FDA approved indications include depression and OCD. TMS is considered investigational as a treatment for all other indications, including but not limited to: smoking cessation, PTSD, bipolar disorder, schizophrenia, bulimia nervosa, migraines, fibromyalgia, panic disorder, Parkinson’s disease, alcohol dependence, chronic pain, Alzheimer’s, ADHD and Autism.

 

Will I be able to stop medication?

It is possible to achieve and sustain remission from depression following TMS treatment. This can mean medication doses can be lowered or tapered off completely.  This all depends on the client’s needs. Clients are stabilized on their regimen prior to treatment medications are continued during the treatment.

 

Will my health insurance cover TMS treatment?

Health insurance companies cover TMS for patients who meet that insurance’s specific requirements. Most insurances require a diagnosis of either depression or OCD, failure of at 3-5 antidepressants, sometimes from multiple families of medications, and a history of at least six weeks of outpatient psychotherapy. If you typically have a co-pay for office visits, you will also have this for each TMS treatment. Your insurance will not cover your copay, and payment of copays is due at time of service. If TMS NW is out of network for your insurance, you may be able to contact your insurance and ask for a single case agreement.  Otherwise, it will be considered out of network and coverage from your insurance is likely minimal to no coverage at all.

Insurance TMS NW Accepts

  • Aetna
  • Blue Cross Blue Shield
  • Bridgespan
  • First Choice
  • LIfewise
  • MODA
  • Pacific Source/Reliant
  • Premera BCBS
  • Regence BCBS
  • Molina

TMS NW is not affiliated with Star Meadow Counseling. To contact TMS NW directly, you can call them at 360-719-2449 or view their website: https://tms-nw.com/. 

How to Ruminate Purposefully

How to Ruminate Purposefully

by | Anxiety, Coping, Depression, Obsession

Do your thoughts ever end up stuck in the past, replaying a conversation or event in your head?

Susan Nolen-Hoeksema from Yale University describes ruminating as “a mode of responding to distress that involves repetitively and passively focusing on symptoms of distress and on the possible causes and consequences of these symptoms.”

You’ll know you are ruminating when:

  • You replay the same old memory over and over, like watching a video on a loop
  • You examine the memory in detail, play-by-play
  • You think (and re-think) about what you could have said or done differently to cause a different result
  • You try to remember exactly how another person reacted in order to evaluate yourself

Most people do not enter into ruminating thoughts on purpose. Instead, ruminating tends to be an automatic response and force of habit. You might even ruminate without realizing it consciously until you start feeling slightly (or a lot) embarrassed, anxious, disappointed in yourself, or guilty. Because the thoughts operate on auto-pilot, they are often unproductive. The thoughts can leave you with hyper-judgmental inner thoughts that have gone nowhere to propel you forward.

Have you ever paused to wonder: WHY ARE THESE THOUGHTS HAPPENING TO ME? WHAT’S THE POINT?

In her book, “The Language of Emotions,” Karla McClaren suggests ruminating might not only be replaying the past, but is in fact is the brain looking for NEW information. This new information might be of help to you in future, similar circumstances.

What if ruminating thoughts bring with them a powerful GIFT? What if you could channel their efforts into something that DOES help and DOES move you forward?

Here are some tips for ruminating more effectively and purposefully:

  1. Notice when you are ruminating and name it: “I’m ruminating.” This will help you shift into on-purpose self-reflection and away from a spiral into automatic negative thinking.
  2. Reflect back looking for learning points. What would I have done or said differently if I had a do-over? What did I miss that I’d want to watch for in the future?
  3. Avoid judging yourself. Labeling yourself harshly (Example: “failure”) serves no practical purpose and only causes you harm. In fact, rumination that is laden with negativity about yourself amplifies your experience of depression or anxiety.
  4. Be kind to yourself and intentional about practicing self-compassion. That means assuming the best about why you did or said what you did in those moments. In that moment, you probably did the best with what you knew. If practicing self-compassion is difficult for you, a counselor may be able to help.
  5. Some events we ruminate on were not in our control. Don’t take ownership of stuff that’s not yours, especially if it’s related to an experience of abuse.
  6. Know when to stop. The moment you realize that reflecting back is not helpful (HINT: You’re finding no further learning points), call it quits. There are a number of different strategies you can take to help you let go of unhelpful intrusive thoughts. Try out a cognitive defusion technique, prayer, or confirm to yourself out-loud: “These are just thoughts. They’re not helping anymore. I’m letting them go.” Some intrusive thoughts are harder to shake than others, especially if they’ve been around for a long time or if there’s trauma involved. Be patient with yourself and don’t be afraid to ask a counselor for help.

 

If you’d like assistance shifting out of a destructive pattern of rumination, a therapist at Star Meadow Counseling might be able to help. We love to see clients shift ruminations into something more constructive, useful, healing, and less self-critical.

THOUGHT DEFUSION: An Alternative Approach to Handling Intrusive Negative Thoughts

THOUGHT DEFUSION: An Alternative Approach to Handling Intrusive Negative Thoughts

by | Coping, Depression, Obsession

Automatic negative thoughts are a natural part of the human experience. For the most part, we don’t conjure them up or think them on purpose. They happen instinctively.

 Negative thoughts get directed toward ourselves (“I can’t believe I’m running late again today! I’m going to get fired!”), toward others (“There’s Jim, walking in late; he’s so lazy.”), and toward our environment (“Stupid Portland traffic! It’s making me late!”). Sometimes negative thoughts are so pervasive that they can tank your mood for the day, or leave you stuck in a spiral of worries. These natural, instinctive thoughts can take on a life of their own!

In the book, “The Happiness Trap,” Steven C. Hayes describes what happens when we become “fused” with our negative thoughts:

  • Thoughts are reality: as if the awful thing we are imagining is actually happening
  • Thoughts are the truth: we completely buy-in
  • Thoughts are important: we treat them seriously and urgently, giving them our full attention
  • Thoughts are orders: we must obey them
  • Thoughts are wise: we assume they know best and we follow their advice
  • Thoughts are threats: we let them bother us or terrify us

He suggests that some “fused” thoughts may be helpful and others might not be as helpful. Those thoughts that ARE helpful and constructive are worth giving your time and emotional energy. For example, the thought that says “I can’t believe I’m running late again today” might prompt you to examine your morning routine, adjusting it to allow for more margin.

On the other hand, some thoughts are downright self-defeating and serve no useful purpose but to shame you, worry you, or leave you feeling stuck. It’s up to you to determine which thoughts are, in fact, not helpful. Those will be the thoughts you might be ready to “defuse” or disconnect from.

Here are some creative strategies for creating distance for those pesky negative thoughts that you need some space from:

  • Label your thoughts as thoughts (Example: “I’m having a thought that I’m worthless” feels different than “I’m worthless”).
  • Imagine your thoughts like clouds in the sky, just passing by. They can come and go as fast or slow as they please, simply watch and observe them without judgment. Become a fly on the wall observing thoughts, labeling them (“there’s a thought”), and letting them go on their way. Some thoughts are recurring visitors, appearing over and over. That’s okay! You can simply notice them and watch them pass on by.
  • Try out one of your particularly “fused” negative thoughts using the voice of a movie or cartoon character (how does it feel differently to say the negative thought using the voice of Micky Mouse or the voice of Al Pacino from The Godfather?).
  • Try singing the thought to the tune of “Happy Birthday” or “Jingle Bells.” Does it still feel the same?
  • Don’t only observe your thoughts, but also try shifting your focus to observing your body. Notice your breath–See if you can track your breath from the moment it enters your nose (cool and refreshing) to the moment it exits your mouth (warm and rushing). Notice how your feet feel in your shoes, where you feel tension, and where you feel at ease.

If you’d like to learn more about thought defusion, “The Happiness Trap” is an excellent resource guide. Thought defusion skills are an integrated part of Acceptance and Commitment Therapy (ACT). Cognitive-Behavioral Therapy (CBT) is another therapeutic approach that has been specifically designed for helping shift unhelpful, negative thought patterns in a more direct manner. A professional counselor can guide you in customizing coping skills so that you can shift out of negative thought ruts and feel free from their persistent haunting.