This week is OCD Awareness Week. It is a time when our goal – as therapists and as a society – is to talk more about obsessive compulsive disorder and help people understand what it is, who it affects, and why seeking treatment is worthwhile.
We’ve touched on this topic in the past, but in honor of OCD Awareness Week, it’s discuss OCD in a way that is simple, easy to understand, and helps people see why many struggle with OCD without realizing it.
Obsessions and Compulsions
Let’s start by talking about “obsessions” and “compulsions.”
Before we can talk about them, we have to first forget what the words mean in normal conversation. In normal conversation, an “obsession” is a desire. We use the term endearingly to talk about people or things that we love.
In the mental health world, an “obsession” is something entirely different. It is a recurring, intrusive thought – one that we do not want, and one that we cannot stop. It is an “obsession” because our brain cannot stop thinking about it no matter how much we want it to.
Because these are thoughts we *do not want*, they cause us to feel distress.
Because we cannot stop these thoughts, we feel distress over and over and over again.
Eventually, we find that some behavior provides some relief from the thoughts. Examples include:
Contamination Obsession – If someone has obsessions about germs or illness, they may wash their hands to feel relief.
Sin/Hell/Religious Obsession – If someone has obsessions about sinning or ending up judged by God, they may pray often.
Perfectionism Obsession – Someone that has an obsession with perfectionism may organize things or be constantly cleaning.
Compulsions can occur entirely organically. If a person has a harm obsession, and finds that they get relief from that thought when they make a noise or touch their knee, they may continue to do so to get some relief. Other times, it relates back to the obsession, like in the case of hand washing.
When these behaviors are visible, some people are encouraged to get help.
But they’re also not always visible.
The Hidden Struggles of Some OCD Types
OCD is also not always easy to see or diagnose.
One of the most common types of “compulsions” is what’s known as “checking.” Checking is where a person physically or mentally tests the obsession to make sure it’s not true. For example, a heterosexual person that has obsessions about being homosexual (again, remember that this person is likely not homosexual, it is just a recurring intrusive thought) may “check” to see if they’re homosexual by thinking about men in sexual encounters, and trying to determine if they’re aroused.
These types of checking behaviors occur entirely internally, which makes them both hard for others to notice and create a sense of extreme distress and self-judgment. People can have these obsessions about sexual violence, causing harm, causing self-injury, and more, and their “checking” behavior is imagining thoughts about it in order to see if it is real.
Not only do obsessions cause distress, but many people also worry that these obsessions mean something negative about themselves. For example, a person may have an “obsession” over sexual violence. Keep in mind that this person is typically *not* a sexually violent person, which is why the obsession causes such distress.
Internally, not only is this person experiencing distress at the obsession, but they may – because of the recurring thought – think they are a sexually violent person and be afraid to tell others. They may not seek help, worried about being branded or judged for these thoughts. Over time, it can be more and more destructive to their mental health and self-esteem.
OCD is Out There – But Not Always Seen or Understood
There was a time when obsessive compulsive disorder was not well known. Most people were unaware how many types of obsessive compulsive disorder exist or how they manifest.
Now, people are more familiar with the term “OCD” but rarely truly understand it. They may even say it as a descriptive tool. For example, they may organize a shelf a specific way and say “I’m a little OCD about this.”
True obsessive compulsive disorder can be very distressing, damaging, and challenging to those that experience it. It can also cause people to feel shame, further anxiety, depression, and more.
This OCD awareness week, it’s important to truly be aware of OCD – what it feels like, what it looks like, and what it means. The more we as a society really understand OCD, the better position we will be in to address it.
Often, when a couple seeks out couples counseling, it is because they are fighting often. They’re arguing, they’re resentful, they’re making snide comments – they see aggression and disgust in ways that cause harm in their relationship, and they want to see if there is a way to solve those issues and make the relationship work.
Still, every couple is made up of two individuals, each one that has their own desires, their own needs, their own wants, and their own feelings. While this has the potential to create frequent conflict, that conflict – while not desirable – is not always a sign of a relationship that’s struggling. While frequent conflict can be upsetting, conflict itself is something that can happen when two distinct people try to make a partnership work.
The Problem is Not Necessarily Conflict – It’s How You Reconnect After
What matters is not necessarily the conflict itself, which is going to occur now and then even in the most loving, most successful of relationships. What often matters more is how you make up afterwards.
One term for this is “Rupture and Repair.” Conflict puts distance between two partners. Repair is how you fix the problem.
It is the “Repair” portion where many struggling couples have the most problems. Most people know how to argue. They don’t always know how to make up. To be successful, couples need to be able to navigate their challenges, listen, learn, grow, and heal. Most couples that are struggling, however:
Give up
Ignore it
Grow resentful
Hold grudges
Argue until they “win”
Rather than trying to understand their partner, they simply allow the issue to linger until it is forgotten, or hold onto it to use it again in the future.
Successful and happy couples, on the other hand, try to navigate these things together. They try to build emotional attachment with each other. They try to heal. Even if they still disagree or they can’t fix anything, they intend to at least understand each other more and feel heard.
This process – this “Repair” – not only helps solve part of the conflict but makes couples stronger. It:
Grows emotional trust and attachment.
Helps provide immediate stress reduction.
Prevents more frequent future conflict.
Often, the strength of a relationship improves considerably when you learn how to connect after in a healthy way. Conflict still arises, but how you solve that connection has real benefits on your ability to feel close, intimate, and in love.
Learning to Repair a Relationship the Right Way
Those that feel they’re really struggling in relationships benefit greatly from learning how to repair relationships more effectively. This involves truly listening and trying to understand what your partner is saying, even if you disagree, taking responsibility for your own role in the conflict, offering reassurance on the relationship, and more.
It’s a process, but it’s an effective one. In that sense, couples counseling isn’t necessarily designed to stop all conflict. Couples in love are still going to have disagreements. But, if you address them in the right way, you can heal from it and maybe even grow closer as a result. Reach out today to learn more.
Couples counseling is the best approach we have for addressing issues in an existing relationship. Couples therapy methods, like Gottman, have been extensively searched and are proven to be effective at supporting a couple that is going through challenges or feels stuck at some stage in their relationship.
But what if you’re single?
Many relationship challenges “start” before a person has even gone on the first date. From patterns to traumas to attractions, a person can learn how to have a deeply committed relationship with a partner long before they have met that person.
Here at Flourish Psychology, we encourage those that are single or dating to also consider whether or not they might benefit from *individual relationship counseling* – counseling that is focused on how to help you find and maintain a fulfilling, happy relationship and love yourself in the process.
If you’re interested in singles counseling in New York City, give us a call and let’s connect you to a therapist that is ready to address your needs.
Benefits of Singles Therapy
Often the success of a relationship starts before you’re even in one. Everything from your relationship habits to the people you choose to date to the love you have for yourself are all affected by how we are when we’re single. The more we’re in a good place psychologically, the easier it is to have more successful, committed relationships with a partner that we’re really connected with – and also to do so in a way where we are not dependent on the relationship for us to be happy.
That is why, while couples counseling is a great way to address the issues of an *existing* relationship, singles therapy is a great way to find a better relationship in the first place. This type of counseling can provide many benefits, such as:
Ability to Address Patterns of Behavior – Rather than wait to repeat a pattern, you can focus on how to address it before it starts, talking to your therapist about habits and issues that recur in relationships. This allows you to start the next relationship without those patterns present.
Ability to Address Patterns in Relationship Choice – We tend to be attracted to the same type of people over and over again, even if those people are not the best for us. Through therapy, we can help determine who you’re really meant to be with and help make sure you’re growing attracted to people that are right for you.
Learning to Love Yourself – People have more successful relationships, and are more likely to find a relationship, when they love themselves. They also are more likely to find happiness from any direction when they are also fine being alone. Indeed, you’re more likely to find someone that’s right for you when there is less pressure to be in a relationship. All of this comes from loving yourself, which is something we can work on in therapy.
Addressing Existing Mental Health Challenges – It’s hard to manage a relationship of any kind when you’re already struggling with mental health issues. If you have anxiety, depression, or something else, therapy can help address it before you’re in a relationship so that it’s not a barrier to finding happiness.
Gaining More Self-Awareness – Relationships often require truly knowing and understanding yourself and your actions. But self-awareness is hard, and many people that are single for a long time become more hardened in their ways. Therapy can help people build the ability to be more self-aware, resulting in the ability to be objective about behaviors in the relationship.
Prepping Your Relationship Skills – You don’t have to be in a relationship to work on things like attachment issues, communication skills, how to open yourself up to intimacy, and more. Those can all come beforehand, as you learn more about yourself.
The idea behind relationship therapy is to have a more successful relationship. But there is no rule that you have to currently be in a relationship to benefit. If anything, the best relationships start when you’re at a place in your life where you feel your best about yourself.
If you are single or dating, and feel like you’re ready for something more, consider singles therapy with Flourish Psychology. Reach out today to learn more.
It is important, for the health of a relationship, to see your relationship as a “we” rather than a “me.” We have to understand and recognize that, even though this is two individuals, the success of the relationship requires viewing it as its own single entity.
Indeed, there is even an argument to be made that changing your language from “me” and “you” to “we” and “us” can have substantial benefits.
Still, we also know that this IS two different people. Each person has their own history. They have their own likes and dislikes. They have their own personality and, frequently, they have their own traumas.
It is not uncommon within the context of couples counseling to notice that something is standing in the way of progress. Often, that “something” is a person’s individual mental health. For example, if one person has trauma in their past that causes high or specific emotions to be triggered, it may be difficult to create change within the relationship.
EMDR and Therapy to Support Couples Counseling
Let’s talk about trauma, specifically. When a person experiences a traumatic event, studies have shown that the memory of the event fragments into different areas of the brain, and is thus incapable of being processed and moved towards the long term storage centers of our memory. It’s why many people feel emotions (and even memories) of still experiencing the event as if it was still going on, or “like it was yesterday.”
Couples counseling can help to health challenges between a couple, but it is not going to process traumatic memories. For that, you may need something like Eye Movement Desensitization and Reprocessing (EMDR).
EMDR is a highly effective approach to dealing with trauma. Your therapist – one that specializes in EMDR – safely and comfortably walks you through the event while performing eye movements and rhythmic motions to help you process the event and move it to long term storage.
EMDR is a separate service. But when one – or both – individuals in couples counseling are struggling with unresolved trauma, EMDR offers a solution that can solve that part of the challenge so that you both can focus on the rest of couples therapy.
Trauma – and, by extension, EMDR – is not the only issue or solution either. Many relationships are affected by other mental health issues as well, such as:
Anxiety
Depression
Work Stress
Attachment
We are more likely to have trouble in a relationship if we’re affected by these issues, especially if they’re untreated. Thus, providing someone with individual therapy – EMDR or otherwise – can be a very helpful part of trying to address a couple’s issues.
Relationships Are Where Two Become One – But Are Still Two
Interestingly, a part of couples counseling is to try to help both partners realize that they are, in many ways, a single entity. We have them change their language from “Me” and “I” to “We” and “Us” because couples are more likely to be successful when they recognize that they are a team, and a single thing in many ways.
Still, these are still two people, and two people are going to have their own needs. So, while couples counseling can be used to address the needs of the couple, sometimes you have to look at yourself as an individual to determine what you need to help you move forward.
How Our Interpretation of Language Can Be a Relationship Tipping Point
We are couples counselors in New York City, and part of our role here at Flourish Psychology is to help couples better understand how the way they communicate affects their relationship. One concept that we may point out is “sentiment override.” It is a process where our partner’s speech is put through a filter designed to turn it into something positive or negative.
To understand this, imagine your partner asks you one of the following common questions:
Did you remember to take the trash out?
Did you make dinner?
Did you do your work today?
Did you do the dishes?
Picture your partner asking you one of these questions and then think about your response.
Do you feel like it’s a common, helpful reminder? Do you feel like your partner is just wondering if you completed this task?
Or do you feel like, if your partner asked you this question, it’s because they don’t believe in you. That they’re asking you because they don’t trust you and think you forgot. Or they’re asking you to nag you and bother you until you do what they say.
In these situations, a simple question is leading to two completely different reactions. In one, it is a harmless reminder or even a question that they’re asking just to know. In the other, that exact same question is being interpreted as an insult, jab, or to start conflict.
This is the “Sentiment Override.” It’s a cognitive filter that we add to our relationships that determines whether or not an ambiguous or harmless sentence from our partner is being interpreted positively or negatively (Positive Sentiment Override or Negative Sentiment Override). It also creates a self-fulfilling prophecy. Luckily, it is something that is possible to change.
More About Sentiment Override
The concept of Sentiment Override was developed by John Gottman, one of the most well known experts in the field of relationships and couples counseling. Gottman’s theory is that many couples have this pervasive “cognitive bias” that they use to interpret their partner’s words, actions, or even neutral behavior.
It’s like seeing the entire relationship through one lens, and everything that occurs is filtered through that lens.
It’s not limited to language either. One partner may be on their phone, and the other may interpret that as being upset at them. Or they may not text back right away and they interpret that as wanting to be alone or away from their partner.
Positive Sentiment Override (PSO) – The relationship’s “emotional bank account” (the goodwill and trust we have for our partner) is in good standing. You give your partner the benefit of the doubt. A neutral or slightly negative behavior is interpreted within a context of overall good intentions.
Negative Sentiment Override (NSO) – The relationship’s emotional bank account is overdrawn. You assume the worst. Even a positive or neutral behavior is interpreted through a filter of suspicion and negativity.
Keep in mind that we’re not saying that your reaction is necessarily wrong. Some partners are trying to start conflict when they ask a question like that. Maybe they do not trust that you took the trash out and are asking it with the intention of calling attention to your failures. That does happen, and within the couples counseling process, we make it a goal to address that.
Still, it’s easy to envision why it is emotionally unhealthy for us to interpret questions, statements, actions, or behaviors negatively. In fact, even in situations where a partner does have negative intentions with some of their questions, typically not all of their questions and statements are negative. But if we have this negative sentiment override filter, all of them will be interpreted in this way.
Why Does Negative Sentiment Override Matter?
NSO is not one small issue of many. Research has shown that it can actually be a fairly significant predictor of divorce. That is because it is can create issues between couples that are related to further challenges:
Criticism
Contempt
Defensiveness
Stonewalling
Within the neuroscience world, couples that are showing signs of NSO tend to have higher levels of stress hormones and increased heart rate compared to couple sin PSO. Their bodies are literally preparing to fight. That makes it much harder to listen, empathize, and problem solve.
So, if we are showing signs of NSO, then we need to find ways to increase PSO. The more positive interactions we have and the more we experience a sense of good will from our partners, the more connected we will feel and the less stress we will experience. This stops a cycle of negativity and helps the relationship heal and grow.
Repairing NSO Individually and Through Couples Counseling
Most relationship problems are cyclical, and NSO is no different. There is a reason that this is often addressed in couples counseling, because it can be hard to break the cycle when you’re both so committed to how you feel.
The first step is to recognize that it is a problem with BOTH partners. It is not one person’s fault. It is a relational dynamic – something that you have created together through your interactions.
The next step is to rebuild that emotional bank account – to build trust and good will towards each other so that you have more positive experiences to look back on and access.
Our therapists and couples counselors use their own approaches based on your needs to address this, but part of the process that Gottman recommends is spending more time per week (they call this the “Magic 5 Hours”) building positive connection through affection, getting to know new things about each other, learning to express appreciation, and prioritizing weekly fun dates.
When we create more positive experiences and interactions, we then change this cycle of negative filtering, and can build most trust in our partner’s intentions.
Help for Your Relationship with Flourish Psychology
Relationships are more likely to struggle with there are recurring negative patterns. Breaking that cycle is important for developing better habits and rebuilding the relationship’s trust and, ultimately, it’s Positive Sentiment Override.
Sometimes, when a relationship is struggling, we can feel uncomfortable around our partner. We can feel like at any moment, we’re going to do something that is going to cause some type of conflict, and that there is almost nothing we can do to avoid it.
This is the origin of a popular phase in relationships, “walking on eggshells.” It is about feeling like you’re always on high alert not to start a fight, and that no matter what you try you’re going to break something that will cause you to argue or upset each other.
This is often one of the main signs that a relationship is struggling and may benefit from couples counseling and other interventions. Today, let’s talk about what “walking on eggshells” really means, how it affects people psychologically, and what we can do about it.
The Psychological Roots of “Walking on Eggshells”
When we use the phrase “walking on eggshells” we are referring to a feeling – a feeling that you are on the verge of another conflict of some kind. So, when a person feels that way, they have a fear of conflict. They are:
Trying to avoid anger, criticism, or emotional outbursts from a partner.
They reacting to past negative reactions (for example, frequent occurrences of something small starting a much larger argument).
They are afraid of rejection, abandonment, or someone’s power over their emotional and mental health.
Walking on eggshells is, in many ways, a form of anxiety. It is a sign that you’re feeling nervous about something occurring. It is also something that puts a person on edge to such a degree that, depending on the relationship dynamics, you may also end up putting your partner on edge as you wait for them to get upset at you (though this all depends on the types of conflicts you are having).
When someone is “walking on eggshells,” they are overanalyzing their words and actions to avoid upsetting a partner, they are suppressing their emotions or opinions to prevent conflict, and they feel tense and drained even when no conflict occurs.
Why This is a Psychological as Well as Relationship Problem
It is not difficult to envision how and why this is an issue within a relationship. When at least one partner is walking on eggshells, if not both, that means that there are more conflicts and that there is a wedge that is affecting trust within the couple.
But let’s talk about its direct effect on you. If you are the one walking on eggshells:
You’re experiencing chronic stress and anxiety.
You’re experiencing something that can be defined as a “trauma response.”
You’re experiencing a loss of power within a relationship.
You’re losing your sense of self and identity, possibly unable to share your real self.
You’re building up resentment that could spill out for a long time.
You’re typically censoring yourself and your feelings.
Chronic stress is its own significant problem. The longer a person lives with stress, the more they are at risk for anxiety and depression. It also can make a relationship feel naturally harmful in ways that continue to damage a person’s self-esteem and self-confidence.
Walking on eggshells can also be a sign of abuse, if this is a one-sided dynamic where one partner tries to appease another while showing fear about what the other partner will do. It can also be a mutual issue. Constant, ongoing conflict over small things can create the feeling in both partners. This is especially common when communication has broken down and neither partner is listening to each other.
Every relationship is different, so what “walking on eggshells” means may vary depending on the relationship dynamic. But in any scenario, it is something that causes significant problems within a relationship.
Breaking the Cycle Through Couples Counseling and Psychotherapy
Walking on eggshells, as a feeling and behavior, is unsustainable. The longer a person feels that way, the more it becomes constant and ongoing stress and resentment.
Yet one issue standing in the way of stopping it is that it is indicative of a lack of safe communication. If both partners felt free to easily talk to each other, then it would be unlikely that they would feel like they’re walking on eggshells. The very feeling like someone is walking on eggshells means that communication has broken down and one of the best ways to fix that is to create a safe space to begin conversations again.
Couples counseling, specifically, creates a safe and unbiased space to chat. Then, should conflict arise, the therapist can help ease the situation while also helping both partners say how they feel and understand each other better.
In addition, psychotherapy can be a very useful tool for understanding your own emotions and trauma. Those that are in – or are leaving – abuse relationships find that it can help them re-discover themselves and gain the strength they need to move forward. Those that are not in abusive relationships but just anxious in their own can get support for their overall mental health, including their stress and anxiety, to better feel comfortable in their day to day lives.
Working with a therapist can be immensely beneficial on both an individual and a relationship level, and creates the safe space that you need to move forward. Reach out today to get started.
Location: 300 Cadman Plaza West Floor 12 - Brooklyn, NY 11201
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