I am one of those OCD sufferers to have covert and overt compulsions, meaning some of my compulsions manifest physically while others are in my head, like mental counting. This makes me think that CBT therapy may not be so helpful for me since the psychologist much of the time monitors the patient during an exposure. Additionally, some things I fear that cause my anxiety are not easily proven wrong, like my fears of the paranormal. So, how do I really let this stuff go?
I came across a very interesting excerpt from O’Dwyer, Anne-Marie Carter, Obsessive–compulsive disorder and delusions revisited, The British Journal of Psychiatry (2000) 176: 281-284 that discuss some of this:
Some OCD sufferers exhibit what is known as overvalued ideas. In such cases, the person with OCD will truly be uncertain whether the fears that cause them to perform their compulsions are irrational or not. After some discussion, it is possible to convince the individual that their fears may be unfounded. It may be more difficult to do ERP therapy on such patients, because they may be, at least initially, unwilling to cooperate. For this reason OCD has often been likened to a disease of pathological doubt, in which the sufferer, while not usually delusional, is often unable to realize fully what sorts of dreaded events are reasonably possible and which are not. There are severe cases when the sufferer has an unshakeable belief within the context of OCD which is difficult to differentiate from psychosis.
Sometimes after I fly into what I call a blind panic, I look back and feel like I was delusional. I also feel lately that my memory is quite poor, and I have to wonder if this is my fault. In trying to let go of obsessions, I feel like I may have sort of trained my mind to forget in general. I feel like this is probably extreme, but OCD makes me feel like any emotional pain could lead to awful anxiety and so I try to avoid it.
I am now trying to learn that not all anxiety is bad and feeling some discomfort is probably ok, but at the same time, not beat myself up during this process.