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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 > I think I might have ocd?
Expert: Richard Niemeyer - 10/24/2009
Question
I've had problems with disturbing thoughts all my life, I often think of family members and having sex with them, and it disgusts me. For the past year I've been terrified that I have been attracted to cats. I don't want to hold them, let them lay on me or anything. I get so sick at the thought. I started having hand washing problems when I was a about 9, and I still have them now and I'm 21, I wash my hands about 4 times depending on how dirty I think they are, they have pretty much constantly been red and cracked and dry and sometimes bleeding for the past 12 years. It's also not uncommon for me to spend 2 hours in the shower, it's seems impossible to be in there for less than an hour. I also have to say or do things in certain orders or it feels weird and wrong. I used to be obsessed with counting things when I was a child. And I'm terrified of getting germs on other people. I also annoy the crap out of people, whenever I think I'm dirty I have to admit it so other people will know. I also have a problem with if I'm not sure if something happened I have to admit it just incase. I am 21 years old and I still sleep with a stuffed animal I was given when I was 4, I feel like I can't live without it. I also have problems with collecting stuff I don't need, but it's nowhere near as bad as it was when I was a teenager. I'm terrified of lying to people, often times I will say: "that's not verbatim", "I'm not 100% sure" etc. and it makes me feel better, I reread things over and over and over to make sure they are 100% correct and even then I'm not sure. I also seem to have the wrong reactions to situations, when me and my boyfriend were together, and we had a fight, I would want to have sex. There's more but I don't want this to be too long.
Me and my boyfriend were together for 3 years and we broke up yesterday. About a month ago, the thought popped in my head that "I might not love him." I have been physically sick over it for the past month, and the uncertainty is killing me, In my mind I think a month should be more than enough time to decide, the thought of not loving him just kills me, and I feel the same way about losing him. He couldn't take it anymore and he broke up with me after a month of idks, I'm not sures, I thinks, and maybe's. All I do day in day out, all day everyday is wonder why I feel this way, I keep coming up with reasons but they always change and it kills me. The uncertainty is driving me crazy, and I'm pretty sure that If I wanted to get away from him that bad that it wouldn't matter, I would've just done it. I wake up in the morning and my stomach drops, I'm always nauesous, and anxious/nervous all the time. idk if I have ocd or not, but to know that this can be helped will make me feel so much better. I know I can't be told if I'm in love by anyone or not but I just want to be 100% certain. because not being 100% certain makes me feel like a liar.
Answer
Hi Jackie,
It was good to read your story and get a feel of how much this has been bothering you. It really sounds like it has been so hard for so long.
I want to address the end of your question first. Then we can go back and work through some of the things you said at the beginning.
You had said that your unsure if you had OCD and would feel so good knowing if it's something that could be helped. Both those questions are pretty easy to answer. Yes you do have OCD and Yes it is something that you can be helped with.
OCD is extremely frustrating and perplexing because the person suffering from it gets all these bizarre thoughts that they know don't represent what they really think, but they still can't get rid of the fear of them. You had described this pretty clearly when you talked about being afraid that your attracted to cats and get thoughts about having sex with family members. You had mentioned how this disgusts you, but the thoughts continue to assault you anyway. That's the irrational nature of OCD. The good news for you, and a truth that you can hold on to as you seek out help is, that you do have OCD, that these thoughts are not your own, that they are not true, but rather are a product of OCD and nothing more. That truth won't cure you, but hopefully it will give you enough strength to seek help and perform the exercises that will help you get better.
The best advice I have for you is to seek out a good Cognitive Behavioral Therapist who is skilled at working with people with OCD. Cognitive Behavioral Therapy, or Cognitive Therapy is the most effective form of treatment for OCD. Most people, if they follow through with therapy and work really hard at it can get significant, if not complete improvement from their symptoms. Therapy does take a lot of work, and it can be very frightening to go in for therapy, but it would be the best thing for you. It would be likely that you could begin to see some improvements almost right away.
Ok, so let me just break down a little of what you said. There are several classic symptoms of OCD that you described in your question, the first being repeated intrusive thoughts and images. You described how your plagued with the thought, "oh no, what if I'm attracted to cats?) and intrusive images of having sex with family members. Did you know that you are not alone when it comes to having these disturbing thoughts and images? When I was researching OCD in school, I came across numerous studies that demonstrated unequivocally that intrusive, disturbing thoughts are a universal phenomenon that everyone experiences! From time to time, everyone has a nasty thought or image come across their mind. Some of the most common ones related to sex. Other common ones relate to harming loved ones. A person without OCD, however, gets these terrible thoughts, but they are able disregard them as unimportant and forget about them. The only difference with someone with OCD, is that they are unable to forget about them and they get "stuck" in the persons mind. Since they get "stuck", the person figures that they must actually mean something for real, and that's when the terrible feelings and the guilt and shame kick in.
You also mentioned about hand washing and long showers. This is probably one of the most common symptoms of OCD. Again, everyone gets thoughts of being dirty and contaminated, but the person with OCD can't get those thoughts out of their mind. The only way that they can get some relief is to wash their hands, but since washing their hands made them feel better, it reinforces the idea that their hands really were dirty in the first place. That thoughts makes them feel bad again, so they wash their hands again. . . and the cycle repeats itself. This fear is heightened when you worry about getting other people sick because then there is guilt associated with it and feelings of incredible responsibility.
Another symptom of OCD you mentioned is feeling the need to be certain about everything. This is called, "The Intolerance of Uncertainty"
When someone can't make up their mind, can't decide on something, or is over sensitive to about being correct/truthful, it's usually because their mind is playing subtle tricks on them. For example: When you're stuck and unable to decide on something, pay careful attention to your thoughts. You'll likely find yourself thinking of all the terrible consequences that might happen if you make the wrong decision. Someone with OCD might have a whole string of negative thoughts in an instant. . . many times without even knowing it. It might go something like, "Should I stay with my boyfriend?" "Oh no, what happens if I do and it turns out I don't really love him? Then I'll be miserable later on in life, then our kids will be unhappy, then they'll grow up and hate me, then my life will be ruined" That's just an example that might not apply to you, but that's the sort of mental train that happens: We think of all the most terrible things that could go wrong with each scenario and it leaves us unable to pick any, because they all have outcomes that leave us miserable and alone.
The primary goal of therapy would be helping you find that all of the terrible thoughts and images that your having are just that: terrible thoughts and images that have no real meaning or truth. The way that someone discovers that intrusive thoughts and images have no real meaning is for them to face their fears. Ironically, it is the act of avoiding fears that keep them coming back. When you avoid thoughts and fears, it subtly confirms that they have merit and meaning. . . because if they didn't have merit and meaning, there would be no reason to avoid them. (That's what an OCD mind tells us anyway). So the way to take the power away from the thoughts is to stop avoiding them!
This is often really hard to do on your own, because the thoughts seem so real and are so terrifying. This is where it's good to get a therapist to help you and instruct you on how to best face your fears. After some hard work of facing your fears, your intrusive thoughts and repetitive tendencies will start to go away, but it really does take a lot of effort.
If you are unable to find a good therapist or just want to learn more, you might consider one of two books, "Stop Obsessing" by Edna Foa, and "When Panic Attacks" by David Burns. These explain OCD and anxiety really well and also give a lot of tools and techniques to defeat your OCD.
Good Luck, Let me know how things go for you or if you have any other questions,
Rich
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