# OCD? Thinking out loud?



## royalblue45 (Nov 18, 2014)

I have really bad intrusive thoughts and I'm always afraid I say them out loud. I'm constantly biting my tongue,rolling my tongue back, and covering my mouth with my hand or arm. It's just really mentally exhausting constantly trying to be super aware all the time. I'm seeking therapy because this issue has been off and on for a couple years now. I'm just so worried I'm going to say my intrusive thoughts out loud without realizing it and it's driving me crazy. It's giving me a ton of social anxiety. I dread going to school everyday because of this.I guess what I'm trying to ask is: is it possible to somehow say something very bad or embarassing without realizing? Does anyone have any advice?


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## SplendidBob (May 28, 2014)

Yep, but its going to be counter to what you want it to be 

The more you try to reassure yourself that you aren't saying things out loud, the more you will worry about it. Looking for reassurance is the exact opposite thing from what you need to be doing.

Reassurance that you haven't said something *is the compulsion*, as is mentally checking to determine whether you in fact said something. In order to be free from this you need to reach the point where you _don't care_ if you said this stuff out loud. Easier said than done of course, but what you need to do is to try to observe the need to reassure yourself, and try not to do any such reassurance where you are able.

If you find a therapist who attempts to reassure you that you won't say anything, you have found the wrong therapist imo(its going to be hard to find one that understands OCD properly)


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## SplendidBob (May 28, 2014)

Should probably clarify my last post, as perhaps it sounds cruel or something.. with OCD you have obsessions and compulsions, most assume that to have this you need to have physical compulsions, such as hand washing, checking the cooker is turned off etc, but you actually get mental compulsions as well.

The cycle is fed because no amount of reassurance from the compulsions helps in the long term, in fact by providing reassurance you are giving the subconscious (or automatic) parts of your brain the feedback that the thing you are worrying about _is indeed important_.

In short, you could consider the part of the brain that deals with the reassurance to be broken, thus, although you feel slightly better short term after the compulsion, because it doesn't work properly long term it will only make it worse.

Thus, for the OP, we have obsessions and compulsions:

OBSESSIONS:

'What if I say these intrusive thoughts out loud?' (no doubt they are of an embarrassing nature, as is the way with OCD)

COMPULSIONS:

1)Frequent checking to make sure he didn't say it out loud. 
2)Ruminating over the evidence that he didn't say it out loud ('did anyone notice'?) etc
3)Physical compulsions such as covering his mouth with his arm, biting tongue, rolling tongue
4)Asking for reassurance and trying to find out if you can say things out loud without realising.

Basically any of the compulsions will provide very limited temporary benefit, and the drive to do them will be VERY strong. In the long run they are just feeding the obsession by providing evidence to the (very primitive) part of the brain that handles threats. This part of the brain doesn't rationalise, its just like threat x frequency = size of issue (or similar). So spamming the compulsions ramps up the frequency making it a 'bigger deal'. The more you do the compulsions the more you will need to do them and the more disabling they will be. The less you do them the less you will need to do them and the less disabling they will be. Realise the compulsions are the problem, not the obsession.

How to deal with this particular variety of OCD:

1)Reduce the compulsions where you are able and 'live' with the discomfort as much as possible. So gradually start reducing compulsions (I suggest the very physical ones, like covering the mouth as they will be easier to not do), then move onto the others, using things like distraction to help with the mental ones.
2)Resist the urge especially to ask for reassurance on whether you did speak them out loud and whether its possible. This will not help you (trust me, I have a similar variety of OCD and its the opposite of what you need to do).
3)A method that might work, albeit a very difficult one (and I wouldn't try without a decent therapist) would be a form of 'shame attacking'. Basically design an exposure system where you actually do say things out loud, starting from things you are only very mildly embarrassed about, and ending up with saying the intrusive thoughts which bother you the most. This is ofc risky, and you would need to go very slowly. I would definitely not try something like this without the guidance of a good therapist, or it might backfire.

1) and 2) you can do though.

A word of caution regarding therapists. Please be careful. Therapists typically don't understand OCD. If they don't understand OCD the therapies will likely be of the form of trying to reassure you you won't say things out loud. This will make you worse. You can very easily determine how good a therapist is with OCD, if you ask them to explain how OCD works, if they describe something like the above and limiting compulsions then it good, if they don't, find a different one. (I have a 1/4 hit rate with therapists who understood OCD)

Hope this is some help to you


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## Bluelion (Nov 14, 2014)

I saw your post and I thought it might help if I told you that my wife has OCD. She has a brain injury as well. She was in a coma at age 19. She says things that can be complex, out there or even feel hurtful. When she actually means to jab me is very hard to say. I can say 2 things I know- I know she and I both have physical limitations. No one on this planet has "arrived" at a place of wholeness. Everyone is unworthy of being a judge over all matters and that gives YOU the right to be as you are. People will treat you well, bad, colorfully, ignore you... But it is your choice to to jump in and live or take a break. You can do a lot. When my wife says to me, like, that she thinks I am a jerk- right after putting dinner in front of me- I am unable to smile. I get up, try not to retaliate and go for a walk. I come back and say some **** like, "What a Smurfy night!". And there are days I walk 8 times and back. I listen to the radio in the car, or blog. There is no "fixing" some of it. But I do not abandon her. 

You do not deserve to be abandoned. The people that are "normal" do not exist.


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