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Dr. Keane
Dr. Keane, Therapist
Category: Mental Health
Satisfied Customers: 1372
Experience:  Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
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I've always had OCD since I was around 19, and since I had

Customer Question

I've always had OCD since I was around 19, and since I had my baby, the OCD themes changed to my mistakes with my child. I've done things on purpose with my son, that haunt me every second of every day. I have 3 incidents that replay in my head every moment of every day. I analyze my actions over and over. I decide what I did was ok, until I analyze it again, and decide it wasn't ok. My ambivalence constantly tortures me. I've been in counseling since I was 20 and nothing helps. I've come to just live with the OCD and accept it will never go away, and as my son grows older, I know will add more and more incidents to obsess about. Here are the things I'm embarrassed, ashamed, and sad about every day. These incidents rotate depending on different triggers.
The first incident was on Halloween. My son was asleep in my bed and I was just about done with my Halloween makeup when my son woke up. He usually has to be nursed right when he wakes up because he gets really upset, but I just needed literally one minute to finish my makeup. I put him in a bouncy chair next to me while I did my makeup and he screamed and cried so hard. I couldn't leave my baby to cry, so I picked him up, nursed him, and not wanting to put him in the awful torture chair again, frantically looked for something that would keep him happy for a minute. I saw my makeup case. He loves playing with my makeup case, and I haven't ever seen him stick anything in his mouth, so I decided that for one minute, he could safely play with the makeup case while I finished my eyeliner. I put him on the floor a few feet from me with the makeup, and he was happy. Phew. I quickly finished my eyeliner, just trying to hurry and worrying in the back of my mind if he was ok, but didn't even think to look back at him every few seconds. My only objective was to finish what I was doing and get back to him. He was fine when I returned to him, happily playing with a Q tip. We got our Spiderman themed costumes on and had a great night. The next morning, I got a sick feeling in my stomach when I remembered what I had done. I told my husband about it, and he thought it was fine since our son plays with the makeup all the time. I looked at the makeup case again, and I found a cough drop. An evil choking hazard that kills children or makes them brain dead when they choke on them and can't get any oxygen. Just look up Lily Higgins. She's paralyzed for life. I spend hours a day looking up the words "choking hazards", "cough drop", "child died from cough drop" on Google just to torture myself and prove to myself that what I did was wrong. I'd rather let a baby play with something unsafe than let him cry for a moment? Where's my logic? When I finally calm down from my daily panic attacks, I tell myself, "The only thing that matters is that he's ok.", similar to your lyric, "at least the baby didn't die."
The second incident is the infamous Old Navy incident. There was an awkwardly set up display of pants in the kids' section and I was determined to find a pair large enough to squeeze my fat, postpartum ass into, since it would make me feel skinny again since I used to fit into kids' pants pre-baby(I'm 5'0" and just over 100 lbs.). I didn't see how I could look at the display so i decided to park the cart with my baby behind me, and then walk forward to look at the pants. I rationalized that he'll be ok for a second. The even dumber thing was that I parked the cart so that he could not see me, and I could not see him, since we were back to back to each other. I frantically searched for a pair of pants, paranoid that I couldn't see my baby, but feeling stuck with my decision. A little girl with her mom approached the cart and said, "Look at the cute baby, mom!" That snapped me immediately out of it. I imagined how that looked to the mom and the girl, a child in a cart with her mother facing the opposite direction and not in her line of view. I started babywearing when I shopped after that. I feared getting distracted again and someone stealing my child from a cart. I Google "child stolen from shopping cart" or "shopping cart abduction" almost daily. I've had my husband block Google and Facebook so I can't search or ask people what they think about the incident or other incidents.
The last one is the one I'm very ashamed of. I intentionally left my baby in the car. We were getting ready to drive off when I remembered that I'd used the stove before we left and wasn't sure if I'd shut it off. Pre-baby, I've left the stove on with food in it overnight while I slept, so I don't play around with stoves being left on. I decided that I probably shut it off, and started to leave. I had a terrible image of my house burning down with our dog in it, so I decided I needed to check it. But, the baby's carseat was heavy! I barely got it into the car (seriously, they aren't very friendly to mothers who are the size of middle schooler
Submitted: 8 months ago.
Category: Mental Health
Expert:  Dr. Z replied 8 months ago.

*This website DOES NOT constitute treatment and only provides information and advice in a Q&A format. For treatment (therapy and/or medications) you must go to a licensed professional in your area. Please note that anything said here is not private or confidential, as this is a public forum.

Hello and thank you for using JustAnswer. May I ask, what is your specific mental health question that you would like an answer to in regards ***** ***** situation?

Customer: replied 8 months ago.
I left the baby in the car, lock the door took the keys check the stove and came back. I was happy with the decision at the time but then the next day I realize the full impact of leaving a child in the car. Even my therapist agreed that that wasn't a good idea to do. She says that children should never be left in the car alone. My therapist is doing mindfulness therapy with me now in the past I've done CBT, and EM DR. I also have C – PTSD, and because of that I tend to make decisions quickly and don't really think of the consequences. I leave the stove on almost every day when I'm cooking until I realize something is burning. So I'm quite spacey. My decisions aren't that terrible but I don't want to panic and make wrong decisions that hurt my child. My husband has had to block Google and Facebook, which I've been using the latter as a way to escape googling the obsessions, however Facebook has turned into an obsession as well. My therapist suggested using a timer but I can't seem to commit to doing that. It's like I am tempted to do the unhealthy thing even though I know that the compulsions are not helping anything it's like I don't care and I continue to do them even though I'm missing out on time with my son and constantly doing my college schoolwork at the very last minute. I feel like there's no hope for me because I've been through 10 years of therapy and no one can figure out what to do for me. My current therapist says I need to have intellectual stimulation as I am extremely intellectual and enjoyed conversing with others about academic subjects. However I find myself going back to the unhealthy obsessions even though I want to have hobbies like anthropology which is what I'm studying in college. I find the compulsions such a distraction that I can't do what I want in life. In the past my obsessions dealt with relationship OCD where I was either not trusting myself around other men or not trusting my partners. It seems that my themes just jump from one to another, whatever is most prevalent at the time. I also had obsessions about embarrassing myself at work around coworkers. Medication is not an option for me as I am against it with breast-feeding, even though there are some possibly some safe options. Any suggestions for my therapist I try to find a way around to continue the obsessions so I doubt sometimes that I'm even trying to get better. I like to defy what I know is healthy, like limits on the computer. I know I'm not finding any new information about leaving children in the car, and I frustrate myself that I'm researching the same subject again but do not know how to stop. Sorry for typos- using speech to text.
Customer: replied 8 months ago.
Question I asked to another specialist but she hasn't answered my followup question. I don't know how to implement her suggestion: Hi Stacey,I’ve been doing “exposure scripts” unbeknownst to myself relating to my OCD event. I let my 11 month old son play with choking hazards to keep him happy while I got ready because I was stressed that he was crying, and I knew my makeup box was something that would help him calm down. I think what I did was fine, but I should have looked at what was in the box because there were some dangerous items that he could have choked on, including a cough drop. So to “punish” myself, I started making myself imagine my son choked to death, died, and I had to go to his funeral and see his dead body, my story was in the news and people were going to judge me as a negligent mother, and seeing all his items around the house would make me sad and remind me of him. Is this basically an exposure script? Because all it did was make me become jaded to the exposure scenario, but I still think about the event itself and Google to remind me that kids die every day from choking on items, especially cough drops. At the doctor’s office they even ask the question on the intake form, “Have you removed choking hazards from your baby?” And I say yes. The problem is I still let my son play with the choking hazards. It’s as if I didn’t learn my lesson, OCD doesn’t rule my actions. I don’t understand why I continue to do risky things even though I have OCD. It’s as if OCD doesn’t stop me in the moment, but then I ruminate later on when I can’t do anything about it. I recently fell asleep (on purpose) with my baby in a baby carrier which is risky because the child can get in a position where he can get stuck and suffocate, but because I am used to sleeping with him, I decided it was safe if I laid on my back and his face was to the side and not pressed against my chest. It was totally fine (as soon as the baby moved, I woke up), but all of babywearing safety rules say not to do it. I’m actually pretty impulsive in the moment of decisions, and then later I ruminate about what I’ve done. Why is this different than most people who have OCD? I’m pretty fearless about life, but then I get OCD about different events later in the day, week, or month. It truly scares me that I’m impulsive. I’ve left the stove on several times in the last few months( just from getting distracted from other things going on at the moment and OCD thoughts), which I’m surprised I haven’t developed OCD about. I do check the stove after I’m done cooking, but not more than once, and not even consistently, hence leaving it on several times. I don’t feel grounded at all.Stacey Wochner March 19, 2016 at 7:54 pm - Reply
Hi Antoinette, You feel guilt after taking a calculated risk with your baby. When you feel the guilt after the fact, you punish yourself by thinking of all the ways that he could have died. While this is an uncomfortable process, you feel a little better that you haven’t let yourself get away with what you did unpunished. This is actually a compulsion and not an exposure in this case. Exposure script in this case would be to write anything that makes you think you are letting yourself off the hook unpunished. The script in this case would be writing what would increase your guilt until the writing no longer triggers guilt. The OCD will target the ‘gray area’ things that people allow themselves to do with their kids. An example might be leaving a 3 year old in the bath alone for a minute while going to grab something. The could drown, but I bet many parents do it. And if you asked your doctor, they would probably tell you not to. I’m guessing these gray area moments are your main triggers.
Customer: replied 8 months ago.
What to do to recover from this OCD so that I can enjoy my time with my son. SUggestions for my therapist.
Expert:  Dr. Z replied 8 months ago.

Unfortunately given the severity of your OCD symptoms, it is unlikely that you will find relief with just therapy alone. If there has not been reasonable progress after 1 year of therapy than most research suggests that there will not be any further benefits from therapy treatment. Even though you are against the use of psychotropic medications, I would strongly urge you to consider talking to a psychiatrist about the use of psychotropic medications that can treat OCD and not impact your breast feeding. Now with that being said your therapist can try to implement more Exposure Response Prevention (ERP) techniques in combination with the CBT as this combination has been shown to be very effective in treating OCD. In addition, your doctor may want to consider switching you from CBT oriented treatment as it has not been helpful and you both can explore the use of Mindfulness and Acceptance and Commitment Therapy (ACT) as these two therapy modalities has been shown to be effective in treating OCD when CBT fails. Still though, I would strongly encourage you to reconsider the use of medications as most likely any therapy modalitiy change or adjustment would only bring you limited relief.

Customer: replied 8 months ago.
you think my symptoms are that strong? What gives you the indication that they require medication? Also, did you read my 3rd response to another therapist and can you help give an example of what ERP looks like for "real event" OCD since there are not any physical compulsions?
Customer: replied 8 months ago.
do you agree that more intellectual stimulation can help an individual with a high IQ to "keep busy?" My therapist seems to think that I am not being stimulated to the level that my brain needs to operate at. She suggested joining MENSA.
Customer: replied 8 months ago.
I am doing mindfulness therapy now. It doesn't help me to make better decisions in the moment.
Expert:  Dr. Z replied 8 months ago.

If you are still suffering from OCD to this degree and you have been in therapy for 10 years than yes that usually indicates that there should be a medication element to your regimen Therapy for 10 years is typically too long for treatment of OCD and at this point it is only having minimal benefit at most for you. As an example for ERP, your therapist could discuss the worst case scenarios involving your child, but you cannot agree and you cannot research them on the internet as you would have to find another way to deal with said fears. So you would be exposed to the stimulus of the fear, but your response would be adapted to be less overwhelming and more therapeutic.

The intellectual stimulation is probably not going to help because even the smartest people in the world need down time and that is when your OCD will be more prominent. Intellectual stimulation is just going to be a distraction from your own OCD thoughts and tendencies, but it will only be temporary.

And like I said before most likely any therapy adjustments or new therapy modalities will have minimal and limited benefit

Customer: replied 8 months ago.
but the therapist above said I use that erp method as a compulsion, "You feel guilt after taking a calculated risk with your baby. When you feel the guilt after the fact, you punish yourself by thinking of all the ways that he could have died. While this is an uncomfortable process, you feel a little better that you haven’t let yourself get away with what you did unpunished. This is actually a compulsion and not an exposure in this case. Exposure script in this case would be to write anything that makes you think you are letting yourself off the hook unpunished. The script in this case would be writing what would increase your guilt until the writing no longer triggers guilt. " So i don't think your exposure will work. Any other suggestions for ERP?
Expert:  Dr. Z replied 8 months ago.

I only used an example of what ERP can be like, there are multiple methods for ERP. This is only a Q&A website, not a treatment website, so you will have to discuss the use of ERP for your treatment. But again, I feel you are setting yourself up to fail as therapy has reached its limit for you and you need to consider other options for treatment.

Customer: replied 8 months ago.
i am asking specifically what a "getting off the hook" ERP exposure script looks like. No one can figure out what ERP looks like for my type of OCD.
Expert:  Dr. Z replied 8 months ago.

I am not your treatment psychologist, so I do not know what your specific ERP will look like since I have never assessed you or spent time with you in one on one therapy. This is why you and your therapist need to continue working and trying different approaches to see what works best for you and your particular issues.

Customer: replied 8 months ago.
OK, thanks. I gave you an ample picture of how I punish myself by thinking of all the ways my son could die, so I think you'd be able to provide an example of how ERP can look for my situation, given that exposing myself to my fears is actually a compulsion. I also think that not everyone can do medication, as it did not work for me in the past. I think not every psychologist would agree with you that medication is the only way. Not satisfied with the answer :(
Expert:  Dr. Z replied 8 months ago.

I am sorry you feel that way, but after 10 years with therapy and struggling with OCD for approximately 12 years suggests that you do require the use of medication management and most research would agree with me on that. Good luck to you and I wish you all the best.

Customer: replied 8 months ago.
Thanks!
Expert:  Dr. Z replied 8 months ago.

have a good day

Customer: replied 8 months ago.
You too!
Expert:  Dr. Z replied 8 months ago.

I will be signing off. If you have any other "general" mental health questions please feel free to ask.

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