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About Richard Niemeyer
Expertise
I can answer questions related to obsessions and compulsions, troubling and intrusive thoughts, and treatment techniques and relevant OCD research. I can answer questions related to the causes of OCD and intrusive thoughts and other related OCD theories. I can answer questions regarding the neurological mechanisms of anti-anxiety medications. I can also answer OCD questions of a religious nature (Christian). I cannot give suggestions on which medications to take, as I am not a medical doctor. I cannot answer questions related to hoarding.
Experience
I have experience working in the mental health and mental rehabilitation field. Intrusive thoughts and OCD were a primary area of study for me during graduate school.
Organizations
American Psychological Association
National Association of Social Workers
Education/Credentials
Master of Social Work- University of Pennsylvania
Bachelor of Science in Bible- Philadelphia Biblical University
Licensed Social Worker- State Board of Social Workers, Marriage and Family Therapists and Professional Counselors (Pennsylvania)
Past/Present Clients
I have worked with clients diagnosed with Obsessive Compulsive disorder and other anxiety disorders
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You are here: Experts > Health/Fitness > Mental Health > OCD - Obsessive Compulsive Disorder > regarding ocd
Expert: Richard Niemeyer - 10/22/2009
Question
QUESTION: Dear sir,
I am suffering from ocd from past 3-4 years almost and still struggling with that. Also I have read a lot about the ocd from whatever source i got the information like newspaper,journals,internet,doctors. I m a 28 year old unmarried, had a job but quit that in order to pursue studies for higher services.I have diagnosed and took medications from two different psychiatrist but had a no of side effects which interfered in my studies and other life processes.I have read about CBT and other response prevention therapy and used it also a bit but could not last longer with that and again trap by those unwanted rituals.Sir as i remember it all started with compulsive washing of hands I had fear of dirt,germs which made me wash again and again and it increased exponentially with passage of time.later i also started using detergents to clean making my skin pathetic and uncomfortable even for myself. my only intention was to clean.Later i saw the zone of ocd and its activities have enlarged and there was an increase of other kinds of rituals and it includes repeating anything which i do. Like i didnt like some persons,and mentally assigned some no to them which were related to them in some way like their date of birth,their roll no etc many of such kind infact my mind always try to build relations among things which can include any like some objects which are also related to the persons in some or other way.now performing my other activities if that things come into my mind i repeat the very thing in order to nullify.Nullifying was necessary in the sense for me that if I proceed with the activity ignoring the disliked person,object or number than I totally loose the interest, zeal, enthusiasm of doing that smtimes abandoning the task even if that activity is most important to me and my life also i was having the fear that if i ll do the activity/task/work the credit will go to him ie the person whom i dnt like thus because of this losed many important works from doing.I know sir all this makes nosense but still i m unable to control and defeat by my mind.so whenever this thing came in my mind i usully repeat that like if climbing staircase if the persons(whom i dnt like) or any of related thing/object/number/image comes in my mind i again go down and climb again to make sure this time it does not come again same thing happen while keeping things,packing luggage,touching something to endless examples.It also happened on roads like while driving over a crack, a small barrier, a line,painted divider if that person/image/object/number comes into my mind i turn back and again overdrive that place again to make sure it does not come again.you wont believe but i have wasted litres of petrol/gas on this useless thing.The core of all such activity why i think i do that i have already explained u above. repeating these things instilled a fear in me and later i avoided driving,riding bikes specially when its more thus confining myself to a room.Its difficult to actually to explain the pain i had while narrating all these incidents.It happened in my college days but till now i m suffering from these though i have reduced a bit but i still feel ashamed and embarrasing when i d toperform these repeating rituals in public place.later this behaviour increased and now it includes masturbation also and i masturbate till the time when i dnt wipe those disliked people/image/object with the one whom i can like atleadt 5 in a row but if those person appear again which happens 99 times i've to masturbate again and this may happen several times in a day resulting in loss of strength and energy if i cud not succeed i regain the strength and repeat it again and till i dnt succeed i dnt involve myself or doany productive activity.after masturbation i think to start afresh that is from scratch.Dear sir this obsession and repeating masturbation has became a real menace for me now a days.I resist and cud do a bit by using relaxation techniques,pranayam etc but it changes it forms everytime. i m almost dishearten to live a fruitful and peaceful life.I have visited your site several times before but writing to u with all hopes and looking forward for ur guidance and solutions.
thanks and regards.
Rahul,
Delhi, India.
ANSWER: Hi Rahul,
Thanks for writing. Yes it is difficult to explain the pain and embarrassment of obsessions and rituals while writing. I think you did a good job of capturing a sense of the trouble you are having. You mentioned that you sometimes get relief, but just as you are the nature of the obsessions and compulsions change, and you are stuck in the cycle once again. This is the nature of OCD, it defies logic and normal reasoning. It won't matter what situation you put yourself, even if you lock yourself in your room all the time, you will still find some kind of ritual you need to do.
I'm glad that you have been proactive with trying to learn about CBT and Exposure and Response Prevention: Here are a few links to keep researching.
http://www.camh.net/About_Addiction_Mental_Health/Mental_Health_Information/OCD/...
http://www.cognitivebehaviorexperts.com/inside_page.asp?InsidePageID=3
http://www.ehow.com/how_2303604_do-exposure-response-prevention-therapy.html
If you are able to purchase a book. I think the best book for you would be "Stop Obsessing" by Edna Foa. This book explains every step for starting at home therapy for OCD. It even breaks it down to different types of OCD i.e. washing, checking, ordering, repeating etc. This book is on sale at Amazon right now for $3.97. It is definitely good to have a guide to help you through therapy. The guide can be a book like this, if you are unable to find a good cognitive therapist who is skilled at helping people with OCD.
Exposure and response prevention is a method for retraining your brain to think about situations in a non-threatening way. Just as you explained, that your symptoms started out small and grew over time, therapy must start small and grow over time. OCD is not something that developed overnight, so you must make a commitment to practice exercises every single day for a significant amount of time. Exposure therapy will not work if you stick at it only for a week or two. Exposure therapy must become part of you lifestyle and it may need to remain part of your life style for the rest of your life (not as intensely as at the beginning of course).
Once you make a commitment to participate in exposure and response prevention exercises, it might be good to let trusted friends or family know, so that they will give you the time and space to complete your therapy each day. Another extremely important tip is to keep a written log of all you exposure therapy exercises. The time you spent on them. How long each day you resisted performing a particular ritual. The OCD mind is already so jumbled up with stressful thoughts, that it is imperative write as much detail about your exercises down. (This way they get out of your mind and on paper).
Don't expect your anxiety or desire to perform rituals to get better at the beginning. The goal of exposure therapy is to make you as anxious as possible. Don't give up if you do not see improvement, even after several weeks. Keep working at the exposure therapy every single day. Each day also research deeper into exposure therapy techniques, try new ones, practice old ones, become your own expert.
When people dedicate themselves to exposure and response prevention it has an extremely high success rate. If it does not work, it is usually because the individual has stopped practicing their exercises, or stopped trying to find new exercises that take them further in their studies.
In summary, try to find a good OCD therapist. It is well worth the monetary investment. If you cannot find one or afford one, buy a good book, like the one I mentioned and commit yourself to learning and practicing the exercises in it every single day. It takes time, a lot of effort, and a little bit of courage, but the bennifits are great.
Let me know if I can help you with anything else or clarify something,
Good Luck, Rich
---------- FOLLOW-UP ----------
QUESTION: Dear sir, thanks a lot for your valuable and timely advice.The links you provided would be of immense help and I'll try to use those techniques but its really difficult to continue because in the end mind comes out victorious making one performing those compulsions.This i can say because of my past trials though it was not intense and without strategy.I'll try CBT and ERP therapy for a longer period now.Also sir with all efforts I have sometimes succeeded myself in stopping rituals but than as i felt it becomes a mental war.Means all prevention is at the cost of a continuing battle with my own thoughts thus resulting in lot of mental stress.I know that all problems lies with my pattern of thinking, so is there any technique by which i can think normally like everybody. Why I always link different events/image/objects which ultimately correlates with my obsession and than endless rituals? Is there any way to prevent intrusive and recurring thoughts? Need your valuable guidance,sir.
Answer
Hi Raul,
Thanks for your follow up. Linking all your thoughts, images, object etc. are all part of the nature of OCD. Like I said, OCD is not logical. . . it defies logic and can be very confusing. . . because the things that you try to do to help yourself, can end up becoming part of your obsession and rituals. This is why it is critical that you seek some kind of guidance. If you are able to seek out a therapist, that is usually the best option. Not all therapists or psychiatrists are experienced in dealing with the peculiarities of OCD, so if you look for one, be sure they are experts in this area. It has also been shown that Cognitive Behavioral Therapy is the most effective in treating OCD. So again, if you seek out a therapist, try to find one familiar with these techniques.
If you are not able to seek out formal treatment (or even if you are able to) I would recommend getting the book that I had mentioned. If you are unable to get that book, then go to a bookstore and find a book that deals specifically with your problem. If you are unable to find or purchase a book, then do exhaustive searches online for information about your particular problem. You can even start with Wikipedia, follow the links, use the "further reading" section and the "references section" Try to find online support groups. Search mental health sites like NIMH (National Institute of Mental Health). There are many online societies that only research OCD. Use Google scholar to find articles. The thing to remember is that you need to be pro-active about finding resources and help. OCD will not go away on it's own. Rather, it takes exhausting effort and dedication with the proper guidance. I think you have demonstrated a dedication, but I'm not sure you have found the right resources yet. Keep looking, don't give up, and I think you will be able to find relief. Oh, One more thing. See if you can find a show called "Obsessed" online. It's on the American Channel "A&E" Perhaps check their website. It is a show which document people with obsessive compulsive disorder and follows them through treatment. If you can get your hands on some of those episodes, they would probably provide a lot of incite.
Good Luck, Raul, keep searching, Rich
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