Psychotherapy Resources

Ron is a former professional in a large corporation who has been derailed by severe Obsessive-Compulsive Disorder, as well as other problems with mood and anxiety. He has been assertively fighting back against his OCD.

Dear Ron,

This is what I’ve learned about the time while I was sick:

1. I can eat with contaminated hands
2. I wash the hands to avoid anxiety
3. I can touch contaminated towels and light switches
4. I can use dirty silverware.
5. I am avoiding all this to avoid anxiety, nothing legitimate.

Contamination is all in my mind, so spend little or no time doing it. Allow myself to worry but touch things anyways.

While I’ve had this infection, I’ve spent very little time worrying about being contaminated and just spent time focusing on getting better physically. I did the behaviors that make me anxious but spent no time washing and I touch contaminated articles. It’s ok to do these things because they aren’t inherently evil. When I’m home I can just “move on” or maintain what I’m doing without derailing all my energy towards being clean. I may not forget but I can just do it anyways: skip the rituals. The anxiety is like a weed that just grows out of control until I pull it out, doing the things that make me anxious.

Rewarding myself to reinforce good behaviors is ok, with little rewards. Get support from a therapist. Get busy and forget about spending all that time making myself clean. Try to forget about spreading the contamination.

In her early 20s, Maria has worked hard to gain control over her hair pulling, depression, aimlessness, dependence and loneliness.

I’ve become stronger than before. I don’t need to depend on anyone else for my own happiness. Before I only saw the negative and now I want to see the positive in life and what it could bring to me. Instead of assuming the future will hold nothing good, I want to make sure my future will be great. I am the only one who can make things better for myself.

I enjoy my friends and I want to keep spending time with them. I also want to be sure that I have time for myself. Whenever I’m upset, time alone to relax can make me feel better. When upset, I’ve learned that the best thing is to remove myself from the situation.

For me the warning signs are trying to sleep myself away from my feelings. The more time I spend in bed is the more time I’m just trying to not deal with anything. My friends make me happy so when I don’t want to see them, I should know something is wrong. When I don’t feel like seeing anyone, I should still try and be around someone, even something as little as just inviting them over for one movie. If I still don’t feel like seeing someone, I should at least get out of bed and walk around the block or hang out at the park.

I know I have to go to school and I know I have to go to work. Those are things I cannot give up on.

I don’t want to let myself down.

For most of her life, Cynthia, a health care professional in her late 50s, has battled depression and anxiety. Having developed many good coping strategies, she wants to remember how to identify the need to use them, and what they are. Her Note to Self is in the form of a spreadsheet.

• Forgetting to take meds, or forgetting if they were taken or not.
• Letting prescription run out.
• Eating a poor diet, including increased simple carbs, few vegetables, not enough water
• Nothing or minimal food prepared for work; eating off schedule
• Running out of food in house
• Overeating
• Personal papers piling up
• Not reading books, magazines, newspapers, for weeks
• Losing bills, books, notes
• Forgetting to pay bills
• Getting behind on editing/dictation work
• Letting car run out of gas
• Forgetting to make task list for week or month
• Making a task list, but forgetting to look at it
• Avoiding things that are stressful or challenging, i.e., bills, finances, exercise
• Not keeping track of or knowing how much money is spent, or what account balances are
• Failure to budget, tehn overspending
• Forgetting to pay bills
• Forgetting or sleeping through appointments on purpose because of fatigue
• Not changing sheets or towels
• Dirty kitchen
• Dirty clothes on floor
• Dirty cat litter
• Ruminating about potential job loss, financial hardship, loss of physical and mental capacity, dementia and aging
• Guilt over parents, others
• Withdrawal: not making contacts, not returning contacts, increased anger at no one or everyone

• House cleaning every two weeks
• Betty Brigade for office and office systems
• Music lessons every two weeks
• Volunteer two hours a week
• Massage once a month
• Manicure/pedicure as needed
• Hair cut/color every three weeks
• Blackberry, with time management/scheduling apps a work in progress
• Wireless set up for computer
• Have clean house/car windows
• Have clean kitchen sink
• FlyLady [organization guru] - have checked it out
• Do minimal household tasks daily: litter, dishes/sink, mail sorting/mail and bill follow up, so things don’t build up
• Skim new magazines, note interesting articles, leave on coffee table to read. If not read in one-three weeks, recycle them to someone else.
• Spread out necessary tasks over the week, if possible, so weekends aren’t ruined
• Go to bed on work days at set time
• Reduce number of emails received and written, same for texting
• Limit number of events scheduled on work days, i.e., one or no meetings or events after work, and only limited
• Enjoy day off, and try not to use this day for tasks
• Watch out for over-scheduling extra work shifts
• Have clean/simple clothes ready for week
• Have simple containers of food, frozen if needed, ready for week
• Limited computer time - too hard on back, arms, neck, eyes and psyche
• Work on a more ergonomic office set up, and brighter, but serene lighting in office
• List of friends/family to contact/call and some plan for doing this
• Quiet time/spiritual time
• When agitated, angry, anxious, try lifting some weights (5 or 8 lb. weights at home), or doing some squats or knee raises, etc.
• Try to have a simple, inexpensive trip in the works a lot of the time, so there’s always something to look forward to
• Audio books to listen to while walking

• Spiritual guidance
• Exercise plan with some intro sessions with trainer
• Food plan
• Writing more letters

Dear Joanna,

I am writing you a letter to let you know how proud I am of you for the recent success you have had with the positive changes you are making in your life. Today I had a revelation that one of the things that has led to this success is your ability to ask for help when you need it. It doesn’t mean that you are unable to do something, but it is an excellent achievement that you have the ability to realize that you don’t need to do everything.

I also want to remind you that although things are going great today, it may not always be that way. If you should hit a bump in the road I want you to remember that you have had great success with these changes and that you should not abandon these positive changes or feel like you have failed in someway because life hasn’t happen as you planned it. If you should have a horribly bad day, or “slip up” as it were so that you see yourself acting out in a way that is reflective of “old Joanna” don’t beat yourself up about it. This is a work in progress. You are doing a great job and things with work, Mark, and your Thesis are all going great right now. Don’t let yourself minimize these huge wins by letting one setback define your progress. Don’t give up on these positive changes because they may not always work, they DO work. Don’t let a couple of exceptions to the rule allow you to give up on the accomplishments you have made.

Things with work are improving but they will not always go so smoothly, things with Mark are going great but there will be ups and downs, the Thesis is moving right along, but there could be speed bumps along the way. I am writing this letter to you to remind you that you have enjoyed considerable success and have made huge strides in your personal, work, and academic life and that you should embrace that when you are in the middle of a crisis. Having a bad day is part of life, having a rough week is ok, its part of life. Getting through those times is the only way to enjoy the successes like you are experiencing now.

Keep working hard! This letter is not an excuse or a rationalization for you to make mistakes. It is a reminder that no one is perfect so you should not hold yourself to an unattainable expectation. Keep asking people for help, it is not a sign of weakness it is a sign of strength that you can plan and prioritize your life in a way that includes people in your life to help you succeed. Remember that life is full of compromises, and although I want you to stand up for what you believe in, I also want you to get what you need out of life and out of difficult situations, so keep your end goal in mind. Do not be sarcastic and negative toward people that anger you. If you need their help or cooperation to meet your goals, it is unlikely for them to respond as you want them to if this is your attitude. Be polite, you do not have to make a friend of someone that you need to accomplish a goal, but you may need their cooperation so be kind and patient.

Read this letter as often as you need to. Make revisions as necessary. Remember that when things are looking bad that the changes you are making DO work. This letter to you is proof of that. It is not a fluke. You are fantastic self. You have worked hard to make changes in your life to make your life better and make life with you better. Please stay the course even if you are quick to dismiss this progress. Please read this letter and remember that you are doing a good job. If an obstacle presents itself, find a new way to meet your goals. You may have to ask for help, that’s ok! If there is something that has got you stumped or you have had an exceedingly bad day, read this letter and get some perspective. You have lots of people in your life that love you and will help you if you just ask.

Signing out self,

Joanna

Beth has struggled with irrational, intrusive, distressing thoughts caused by Obsessive Compulsive Disorder.

Dear Beth,

I know you don’t feel like yourself right now, and I’m going to reassure you in an odd way: You’re not. The pain and torment you feel, that keeps you from relaxing - it’s not going to last. It’s not the real you. I know "this time it might last forever"... It won’t. Just like in the past, it’ll start to fade, slowly at first; then you won’t remember what it felt like to be panicky or what was bothering you.

Here’s the thing to remember - this time you’re way better off. I know because I’m the one telling you. It’s hard to see some of the little thought exercises as useful, but they are. Remember: OCD is a dysfunction in the way your brain fires off its signals - not a revelation of the real you. How do you/I know? It’s obvious. Right now I’m feeling like myself and I know you’re not. Don’t be afraid of the intrusive thoughts. I know it’s tough talking coming from someone who’s not going through it now, but we are, after all, the same person. Don’t force them to go away. Don’t think you can control them, let them come and let them go. It’s not your job nor is it within your capability to control them and trying only makes it worse.

So, whatever’s bugging you may be different than last time, but ultimately it’s the same thing. No different. You’ll get past this, too.

Let it come, let it go. Breathe. Remember who you are.

Tom struggled with severe depression following a relationship breakup as well as with body dysmorphic disorder, a belief that a minor or even non-existent physical "flaw" is hideous.

Dear Tom,

If I am reading this letter, I have probably found myself in a difficult situation, and am finding it hard to cope with. I understand that it’s perfectly normal to experience these emotions, but I must also understand that these emotions have had a profound effect on my well-being in the past. They cause me to reflect negatively upon myself. I’ve created this letter to remind myself of who I really am, and to prevent myself from falling into the same holes that I’ve been in before. I have so many positive aspects to my life.

First, I must understand that I am writing this letter from a more healthy state of mind. These are the thoughts and feelings that I should focus on, when life becomes difficult to cope with. I know that it may become difficult to believe, but I must truly understand that I will always possess these great qualities. No external factors can change these most basic aspects of my personality.

I put myself in very challenging situations, and strongly believe that I have the fortitude to pull myself through, and come out on top. I put myself in situations that other people would shy away from, and that’s what helps me build my confidence. Experiencing the unknown is what gives me confidence in new areas, and that is part of who I am. Don’t ever let anyone tell you, or begin to believe that you lack confidence, or that you’re too shy, or that you don’t have the fortitude to complete something. You’re a very strong person, who has every reason to believe in yourself, and absolutely no reason not to.

I am wonderful with people, whether they are strangers or close friends. I have an attractive personality which allows me to emotionally connect with others, and has helped me through many experiences. When I am faced with difficult situations, I have the confidence to know that my personality can defuse the situation, and things can be brought back to normal. Don’t ever let anyone intimidate you, or lead you to believe that you’re less of a person than they are. You have proven yourself time and time again, so there is no reason to believe otherwise.

I am a physically attractive person, and I have ample evidence to support this. When I look in the mirror I feel good about myself, and I am pleased with who I am. If I had the opportunity to look like another person, I would definitely turn it down. I want to look like me. My physical attractiveness is one of the qualities that draws people to me, and I’ve had many wonderful people drawn into my life. So if the quality of people in my life is related to my overall attractiveness, then I should never believe that I am unattractive in any capacity. The evidence is there. Believe it.

Wealth should never be a concern of mine. .Just because I don’t have a nice car and a nice house right now, I shouldn’t feel bad about it. Almost all of the people I know don’t have nice cars or nice homes yet, and if they do, then they’re overwhelmed with debt. I should be thankful that I’m smart enough to avoid all of that debt. I’ve made a good decision that will pay off for me in the future. I shouldn’t feel ashamed about being poor. It’s only temporary, and most people I know are poor anyway, so anyone who looks down on me should feel ashamed of themselves.

I should never believe that I am anything less than an amazing person, with many wonderful qualities. I have no reason to ever feel that I am socially inept, unattractive, weak, or deprived in any fashion. Anyone who sees anything less than my true self has their own issues that are creating that perception, and that is their issue, not mine. I have the ability to be a very happy person, and I have no reason to get down on myself. I shouldn’t squander all of the wonderful things I have going for me, so to not take advantage of the wonderful life I have would be a waste.