Monday, October 17, 2016

Mental Checking . . . Ruminating . . . Whatever You Want To Call It

If you have OCD, you know all about checking. Even if you don't, maybe you've seen depictions in the media of people checking door locks, knobs and anything with a switch over and over again. While that's a fair portrayal of some manifestations of OCD, some of us have a sneakier way of checking, and it's a bit harder to get a grasp on than checking physical objects. Mental checking happens all inside of our heads, and it's much like not thinking of an elephant when someone tells you not to think of an elephant.

Mental checks, which can be a bit like ruminating and run together with anxious ruminations, are questions people with OCD ask themselves in order to seek reassurance for an intrusive thought. For example, I could have the intrusive thought that I might stab myself with a knife without thinking about it. Common mental checks I will perform after having these thoughts include scanning my mind to see if I feel like I'm losing it enough to randomly stab myself or looking for feelings that I want to stab myself. I may also physically avoid knives if the anxiety gets intense, but that's the avoidance feature of anxiety, not checking.

I will often do mental checks of my sanity, as ludicrous as that may sound. I also often scan for bodily sensations. I have a strong aversion to just about every sensation I've ever felt while having panic attacks, so I check for those. Do I feel sweaty? Is it from exertion or am I panicking? Do I feel nauseous? Are my thoughts racing? Sometimes, I'll check so many times in one day, it's hard to tell if I ever stopped. Other days, I might only check once or twice.

Part of treatment for OCD is exposure and response prevention. Checking is a response to the exposed stimulus–be it a thought or an action like going to a crowded store or eating without washing your hands. What makes response prevention difficult for mental checking is that trying not to think about something is an effort in futility. I've yet to find the answer for this problem. I've met with some success trying radical acceptance, turning the thoughts into something ridiculous and distraction, which I know some would frown on, but this is my treatment spaghetti soup. Whatever works for me is happening.

It might be tough to get a handle on mental checks, but I believe its doable. Everything comes with practice. It might take years. This is life. It's not like I have anything more important to do.