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Obsessed with past
Obsessive Compulsive Disorder
Aug 12 2012, 19:48
I don't know if I have OCD. I did have a clincal psychologist tell me that he thought I probably did, but I haven't been consistent with treatment, and I have never actually been diagnosed.
I have been diagnosed with GAD.
I obsess about a job that I had in the past. I was an RN on a cancer floor. It was hell. It pushed me to my edge until I broke. I became suicidal, yada yada, spent a week in a mental hospital. I'm guessing many here know the drill.
It has been almost 3 years since then. I can't let that job go. I still dream about it. I constantly think about it. If I wake up in the middle of the night, I can't get back to sleep because my mind won't quit the thoughts. The thoughts cause intense anxiety, and self loathing. I, for the first time in my life, feel genuine hatred toward the people of the company that I worked for, even for just being involved. That's crazy, but it's how I feel. I can't even drive past the hospital without a surge of anxiety and uncomfortable thoughts. Please, I just want to talk. I don't have the money or the time to see a psychologist.
Aug 12 2012, 20:22
I'm rolling my eyes. OCD. Maybe you're just bereaved. Nobody *likes* cancer. It understandably changes one's life to see it up close. I took care of a patient with cancer everywhere. Her family took all measures (no matter how ridiculous). The day before she died she was vomiting fecal matter. She had a peg tube, a foley, an an al tube, numerous IVs, and O2. She was so unhappy. She was well enough to make her wishes known to the doctors but the doctors were listening to her family and keeping her alive and in pain. Cancer is horrific. Did your psychiatrist who thought you have OCD stop to validate any of your feelings?
Ginny 'not a shrink but I know how awful cancer is'
Aug 12 2012, 20:33
Well, I do know how awful cancer is as well. And this is going to sound awful, but it wasn't working with cancer patients that bothered me. In fact I still work with cancer patients occasionally, the worst kinds, and I deal with it fine.
Sorry, I was just so busy venting about my problems, I probably didn't explain myself well enough.
My main problem was the fact that no matter how fast I went, it wasn't good enough. We had too many patients, difficult, complex, cancer patients. I am UBER meticulous, and have difficulty being flexible in the least. I was always behind. I hardly EVER took a lunch break. I worked 13-14 hour shifts. I don't think my co-workers liked me, because the more stressed out I get, the more OCD and incapable I get. I also get micromanaging, which isn't fun for people who I was delegating to. I don't miss one rule, I don't leave out one jot or tittle in my work. I noticed other nurses were somehow able to handle a patient load and then some. I started to notice they were cutting some corners, which I was completely incapable of doing. I worked myself until I was physically, mentally, and psychologically drained. Never bonded with my co-workers, was constantly in patient's rooms (which people acted like it was a bad thing), but there was so much to do!!! I actually, a lot of times, wouldn't even stop to go to the bathroom. I didn't think I had time. I held in the pee so long, that I still have to tell myself when I need to go to the bathroom.
Embarrassingly, My bladder actually released, full on released, on me twice during the year and a half I worked on that floor. I didn't even feel like I had to go, and then, it just went. So I had to get new pants from the laundry, and it was of course extremely embarrassing.
I don't have dreams about the cancer patients, I knew I was a good nurse, and I took care of them well. I have dreams about rude co-workers, angry doctors, just not having enough time to get it all done, physical exhaustion and hunger, and loosing control of my bladder in front of everyone.
It's true, anyone who went through that would probably be scarred a bit....but plenty of people worked and work on that floor and didn't have that experience.
Aug 12 2012, 22:02
So, you're talking about OCD the personality disorder and not the other OCD? have you looked up both? They are different.***
thanks for clarifying. I don't know though. I worked nursing and on a bad floor the job *is* impossible, and yet they have employees and those employees will find time to chat on their cell phones and whatever else, while skipping their two-hour rounds and denying covering their CNAs for breaks and skipping their assessments at the beginning of shift, going straight to giving meds, etc- I've even had nurses refuse to help me turn a 200+ pound man who was pooping constantly to clean him up. I guess what I'm saying is, some people are also insensitive and sloppy. On a poorly staffed floor maybe you were just trying to be competent. ?
Have you checked out allnurses.com? It's a nursing website where people can talk candidly about their experiences, maybe it could give you a chance to evaluate your experiences against other nurses'.
I have vomited at work due to taking no-doze, too much coffee and stress and no food. My friend once wet her pants at work, too, she was so stressed. I've seen cartoons of nurses on roller skates with foley bags strapped to their legs- because the job IS stressful. My mother worked tele and never ever had a lunch break, which is why all the nurses got so pissed about no food at the nursing station- how in the hell else were they going to eat, after all?
I think you should work on this because it bothers you, but OCD? How's your home and social life?
Maybe some of it could simply be learning new skills. New reasons for NOT being uber-meticulous. For example, excessive charting--- which is common among new nurses (was this your first job?) is often counter-productive and can hurt you in a lawsuit, NOT always protect you. My manager was a proponent of 'charting by exception.' It is a very minimal method of charting. Maybe you could look it up, as well as the different OCDs and possibly also the fact that some physicians believe in OCD as a spectrum disorder (like autism). That certainly puts it in a different light than as an exclusionary, extreme diagnosis. You know what I mean?
Aug 12 2012, 22:24
Thank you Ginny. Your replies have been very helpful.
First off, I'm SO glad to hear someone say that being a nurse IS stressful. And, if it's a bad floor, darn near impossible. Add "OCPD" to that, and you can probably easily see how I got into this situation. I've been thinking the problem was entirely me, (seemed like that has been the vibe I got from people), and not the job.
I have looked at OCPD too, I'm actually willing to bet I at least have that one. Lol, as much as I hate to admit it, (these things are not my favorite parts of my personality). The main thing that makes me think I might have OCD is the fact that I CANNOT seem to stop the distressing thoughts. I relive the job constantly, every day, even after 3 years. I get up to go to my new job, and I'm crying on the way over there, about my old job..... I don't know how to stop it.
Of course, I don't expect a diagnosis from you or anything, haha. I'm just worried about it....of course I'm worried about a lot of things, as you can probably imagine....LOL.
Aug 12 2012, 23:28
"The main thing that makes me think I might have OCD is the fact that I CANNOT seem to stop the distressing thoughts. I relive the job constantly, every day, even after 3 years. I get up to go to my new job, and I'm crying on the way over there, about my old job..... I don't know how to stop it."
Perhaps some cognitive-behavioral therapy could help with the distressing thoughts. cognitive-behavioral therapy, as you may be aware, is concerned with how our thoughts influence our behavior and vice-versa. My experiences with these types of therapist have not been positive in the least and I can't honestly recommend treatment unless you want to try it. I can say, however, that cognitive-behavioral perspectives are beneficial; it's the therapists themselves that get on my nerves.
I will say that an anxiety group or any group utilizing Dialectical-Behavioral Therapy will probably help; DBT helps everything. There are workbooks available on Amazon and many of the workbooks have a special focus, such as depression or an age group such as teenagers; you may look to see if there is a special DBT workbook for people suffering from anxiety or OCD spectrum disorder. DBT will teach you to focus, mellow out, get in touch with and accept your feelings.In time, you may be able to work on distress tolerance.
Most self-help books have at least some kernel of wisdom in them although I will say that you seem fragile right now and i am concerned that you will take the treatment too much to heart and too seriously... considering yourself overly ill and forgetting the many wonderful qualities that I know must be there, which would be one reason i would strongly recommend DBT. A Bereavement/Grief/Mourning/Care giver burnout-support group may help prevent this, and if you cannot find such resources in your town, perhaps you can start your own group. Meet online (this site has a grief group) or meet in a non-busy restaurant during off hours if you can; everyone buys coffee and leaves a dollar tip for an hour, the waitress shouldn't mind having the tables taken.
I see you cry on the way to work. Well, OK. Do you stop crying when you get to work? because you say you don't know how to stop the tears. But if you're not crying *at* your new job, then you do know how to stop the tears, in some way, and that is good.
It is also good to accept your feelings of sadness, of mourning, and this is a *learned skill* just like more intellectual and cognitive things are learned skills.....Perhaps one reason this may be so difficult for you is that not only have you had illusions shattered (nursing is not the nurturing, wonderful, etc job we'd all like to think it is), but you've also been forced to experience a part of yourself you probably never wanted to see. Angry, disillusioned, maybe even feeling incompetent underneath the rigidity. If you were raised to not admit to weakness or if you genuinely have a personality disorder, acknowledging any sense of failure could be very painful... try to remember that having a feeling does not make it so. Feelings are there to alert us to things we need to pay attention to, however.
Grappling with this is your chance to grow as a person; I know you are miserable, but I'm excited for you. the skills you will learn as you deal with this problem will give you wisdom that you will use the rest of your life and can pass on to your patients, and will probably make you more compassionate towards patients, as well. Remember, the things we see in others we see in ourselves and vice-versa; you will learn skills and you will be able to pass them on for the greater good.
Aug 12 2012, 22:10
Here's the DSM criteria (of the personality disorder)(from what I've read, people with the personality disorder do not always recognize their behaviors as irrational but this is not absolute):
To receive a diagnosis of OCPD, a person must meet four or more of the following characteristics listed in the DSM-IV-TR (2000):
is occupied with details, rules, lists, order, organization, or agenda to the point that the key part of the activity is gone;
demonstrates perfectionism that hampers with completing tasks;
is extremely dedicated to work and efficiency to the elimination of spare time activities;
is meticulous, scrupulous, and rigid about etiquettes of morality, ethics, or values;
is not capable of disposing worn out or insignificant things even when they have no sentimental meaning;
is unwilling to pass on tasks or work with others except if they surrender to exactly their way of doing things;
takes on a stingy spending style towards self and others; and
shows stiffness and stubbornness.
Aug 12 2012, 22:27
I also have a thing with counting to 7, doing things 7 times, etc. And complete rigidity on not messing up patterns. Any kind of pattern, of any kind of task. Ick. BUT, it's not nearly as bad as the thought thing.
Aug 12 2012, 22:33
Maybe it's like a spectrum like you said, and I'm somewhere in the middle? That would make sense. Thank you so much for replying, I really appreciate it!
Being that I haven't been very consistent with treatment in the past, and I don't have much time or money right now, do you have any recommendations for cheaper treatment?
Aug 12 2012, 23:41
I like two blogs and one of them has a search engine and is written by a cognitive-behavioral psychiatrist, it's called The Last Psychiatrist. Some of it is kind of overwrought but most of it is fantastic. The other blog I like is What a Shrink Thinks- not sure if it has a search engine, but it has a very practical bent.
Most insurances cover cognitive-behavioral therapy and most often it is short-term, not a huge commitment.
I've heard Lucinda Bassett is good (internet resource) but don't know for myself. Her specialty is anxiety; unless i am mistaken OCD is an anxiety disorder.
A group twice a month at 2 1/2 hours each time in Chicago for DBT is sometimes as low as $35.00 a pop. Not a lot. If this was a physical problem you'd see a doctor, right?
But i question the time/money thing, because most people make the time and money work for what they truly *want* to do, or need to do. It would be typical of OCD or OCDP to be preoccupied with other things, not wanting to make time or spend money on treatment. So if I were you I'd examine that.
Also, don't be hung up about not being consistent- that does sound like an OCD hang-up. I go to treatment for psych approx. 3 times/week and I will tell you that sometimes there just isn't that much to say, sometimes you don't get much out of it, but sometimes there is a lot; the same is true of therapists. Sometimes they help a lot, sometimes very little in session. I'm not sure consistency would be an issue with this type of problem 9straight cognitive-behavioral). You learn skills each time you go; ..... if it were a problem where you needed a certain kind of relationship with a therapist in order to grow, then you might need more consistency. But then again, for the good of the same relationship, you might need flexibility, as well. so don't let consistency be an issue.
Aug 16 2012, 22:14
Hey- I thought of you today and did a search on the computer and found this, note how short this woman's time in therapy was:
Taming Obsessive Thoughts
Obsessive thinking can be tamed using cognitive-behavioral techniques.
Published on June 28, 2010 by Robert London, MD in Two-Minute Shrink
Have you ever gotten a thought stuck in your brain, akin to an awful pop tune from the eighties that just keeps replaying in your mind and won't go away? A person I'll call Rachel came to me to help her with a horrifying obsessive thought that was starting to affect her daily functioning. In it, she was being destroyed by a plague of locusts, much like the one that had attacked Egypt in biblical times.
A successful physics professor at a West Coast university, Rachel needed professional help for this recurring, obsessive thought, which had become so vivid over the years that living with it had become almost unbearable. She tried five years of psychotherapy, and then switched to a psychiatrist, who recommended medications that were ineffective and caused unpleasant side effects. Finally, the patient tried a "geographic cure"-- a sabbatical to New York. But Rachel continued to experience the terrifying obsessive thoughts. At that point, she was referred to me.
As always, I took a thorough history. I then explained the type of treatment I had in mind. The time frame was to be three or four sessions lasting 90 minutes each. I planned to apply two cognitive techniques and one behavior modification strategy to treat the patient's obsessive thoughts.
First, we discussed the P&P (possibility and probability) concept. There was certainly a possibility that the locusts could attack her (this generated some humor), but the probability of this happening was significantly slim. As a physicist, she easily related to that concept. That discussion lasted about 30 minutes.
Next, we discussed Newton's third law of motion: For every action, there is an equal and opposite reaction. When translated into her treatment strategy, this became "for every thought, there is an equal and opposite thought."
She easily accepted that theory, and it helped to relieve the anxiety of her obsessive thoughts. Taken further, that concept evolved into thinking that for every thought there is a lesser thought -- and possibly even no thought. The no-thought concept helps the patient get long-term relief from the obsessive thought.
Finally, we applied the practice of thought stopping. Thought stopping is a method in which the patient induces the thought that is so distressful and is then taught how to stop it. We used guided imagery to induce the terrifying thought of the locust attack.
Here's how it worked: I asked Rachel to imagine a large movie screen, onto which I invited her to project the scene she had so often envisioned. As she progressed into this stressful imagery, I made a loud noise by hitting my desk with a ruler and simultaneously shouting "Stop!" In that procedure, the image she was thinking or projecting was automatically interrupted, blocked, and stopped. We practiced several times. After six trials, I stopped using the ruler and just shouted "Stop!" It worked. As we proceeded through this technique, Rachel began to take over the entire strategy and began to shout the word "Stop" to control the obsessive thought.
Moving along, we reached a point at which she was able to subvocalize the word "stop" and get the same result as if an outside force had interrupted, blocked, and stopped the thought.
Rachel's treatment was completed in three 90-minute visits. She was quite pleased that she had gained control over her obsessive thoughts. To reinforce our work together, we audio taped the sessions so she could review them whenever the obsessive thinking began to recur. Having learned how to use the movie-screen approach to project an obsessive thought, Rachel now had a tool she could use on her own. I explained that she could also change images from the obsessive thought to a pleasant scene to help reduce the anxiety that the thought produced.
When Rachel returned to her university, she resumed her thriving and demanding academic career free of that terrifying obsessive thought.
Behavioral treatments like these are hard work, for both the therapist and the patient. Often, we need to structure the treatment to the patient's thinking, career, and lifestyle, as I did in this case by using the laws of physics for the physics professor. In this, as in so many cases, I am continually amazed at how resilient and changeable the human mind is when people really want to heal, and customized cognitive and behavioral approaches have proven time and again to provide a quick and effective solution.
* * * * *
Hi, it's Ginny again. Don't be afraid to use a professional to help with techniques if it is hard for you to do this on your own.