Podcast Summary: The OCD Stories #525 – Charlotte’s Journey: Harm & Suicidal Themed OCD, Journaling, Therapy

Episode Overview

In this episode of The OCD Stories, host Stuart Ralph sits down with Charlotte to discuss her lived experience with obsessive-compulsive disorder (OCD). Charlotte shares her journey from childhood intrusive thoughts to adult flare-ups involving harm and suicidal themes. She openly explores her therapeutic journey through Acceptance and Commitment Therapy (ACT) and Exposure and Response Prevention (ERP), practical tools like journaling, and her ongoing path to acceptance and hope.

Key Discussion Points & Insights

1. Early Experiences with OCD

• Childhood Intrusive Thoughts:
  • Charlotte noticed “OCD tendencies from quite a young age” (01:50), including frightening intrusive thoughts and seeking reassurance from her mother.
  • Early obsessions included magical thinking: “I found school quite difficult… I had to pray before school each day… as a kind of magical thinking aspect. I kind of felt that if I prayed that I would have a good day, that nothing bad would happen.” (02:13)
• Pregnancy Fear as a Child:
  • She recalled worrying she was pregnant after tripping over a boy at age 9 or 10, leading to repeated reassurance seeking: “Looking back now, I can kind of see… you can see, like, the ridiculousness of it. But at the time I remember finding it really distressing.” (03:23)

2. Teenage Years & Harm-Themed OCD

• Major Flare-up After University Disappointment:
  • OCD “was always there in the background,” but “didn’t really bother me until I was an older teenager.” A university rejection triggered a major episode: “It is like a switch went off in my head and one moment I was okay, and the next moment I really, really wasn’t.” (04:53)
  • Nightmares of harming loved ones and obsessively fearing arrest or loss consumed her, initially not recognized as OCD due to stereotyped ideas about the disorder.
  • Self-research was a turning point: “I just googled it and I came across a forum… and that was a real pivotal moment because I just clicked that it was OCD.” (07:09)

3. OCD’s Shifting Themes

• Health Anxiety & Suicidal OCD:
  • In her late 20s/early 30s, health issues (anemia) and extreme anxiety triggered a shift: “I experienced a theme change… usually I would have harm OCD about harming others. This time… it went from ‘this isn’t OCD anymore, this is something else’… this is something you’re not going to be able to recover from.” (10:19, 13:03)
  • Progressed to suicidal OCD: “So then it went from that to kind of, I guess, suicide OCD… I was fully under its thumb because it was so sneaky.” (11:34)

4. Seeking Therapy & Finding What Works

• Navigating the Healthcare System:
  • GP recognized the need for specialized support. Charlotte worked with a psychiatrist on medication and a therapist on psychological support.
  • Difficulties switching medications during a crisis period compounded the struggle. (14:09)
• ERP & ACT in Therapy:
  • Clinical approach combined ERP and ACT, but ACT proved more effective, particularly during periods of extreme anxiety: “The only way I can describe it is it felt like I was in a state of terror that the anxiety wasn’t sort of allowed to rise and fall… my brain just couldn’t get used to that anxiety.” (15:04)
• ACT’s Impact: Acceptance and Detachment:
  • “A really key thing… about accepting the thoughts, that the thoughts are there, but that they’re not the truth.” (17:29)
  • Learning not to wait to feel ‘100% better’ before living life: “Just like still living the kind of life that I want to lead without waiting to feel 100% better.” (17:59)

5. Therapy Tools: Joy Journal & Visualization

• Joy Journal Practice:
  • Therapist recommended a daily “joy journal” (similar to gratitude practices): “At first thinking, this is not going to help me… but I started to do it, and quite quickly… it just gently reminded my brain that things can feel unbearably hard… but there’s always something good amongst the pain.” (22:05, 23:21)
• OCD Visualization:
  • Charlotte visualizes OCD as a monster on her shoulder: “The more you ignore it, the louder it gets at first, but eventually you starve it of attention and it gets tired.” (25:51)
  • Acceptance, non-engagement, and detachment are central: “The key thing… has been learning to accept that the OCD is there, but also learning that I don’t need to engage with it.” (26:20)

6. Family Support & Avoiding Reassurance

• Parental support was always open and close, but as Charlotte learned more, she helped her family avoid giving reassurance: “It’s a very easy trap to fall into… but they’re all very aware of what not to do… definitely no reassurance.” (25:12)

7. Day-to-Day Strategies

• Staying present—especially with her young niece—acts as a mindfulness anchor: “Children are such a great way of keeping you in the present moment.” (28:05)
• Self-compassion for setbacks: “I can be really hard on myself… I had to be really careful with myself in just learning to step back, take a breath and be like, do you know what? It’s been a difficult day… there’s always tomorrow I can start again.” (29:03, 30:40)

Notable Quotes & Memorable Moments

• On Realizing It’s OCD
  “I just googled it… and that was a real pivotal moment because I just clicked that it was OCD. Of course it is. And I think just knowing that it was OCD at that point in my life really helped me to step back from it.” (07:09)
• On Acceptance and Commitment Therapy’s Value
  “Accepting the thoughts, that the thoughts are there, but that they’re not the truth. Because that was what I had always done. I had always just taken what I was being… this is what's truth. So just kind of really learning to take a step back and detach…” (17:29)
• On the Joy Journal
  “I started to do it, and quite quickly… it just gently reminded my brain that things can feel unbearably hard and… there’s always something good amongst the pain.” (23:21)
• A Quote that Inspired Hope

  “Let everything happen to you. Beauty and terror, just keep going. No feeling is final.” — Rainer Maria Rilke (31:01)
  “I've always managed to just carry on, put one foot in front of the other… No feeling is final… there’s always been another day.” (31:01, 32:48)

• What She’d Tell Her Younger Self
  “It’s okay to be different. Different doesn’t mean bad… Celebrate the fact that you're different, you see the world in a different way.” (33:00)

Important Timestamps

| Timestamp (MM:SS) | Segment | |-----------------------|------------------------------------------------------------------------------| | 01:50 | Charlotte’s earliest OCD memories and magical thinking | | 03:23 | Childhood pregnancy worry and reassurance | | 04:53 | “Switch” moment after university disappointment & harm-themed OCD | | 07:09 | Realizing OCD through a support forum—pivotal moment | | 10:19 | Adult flare-up, health concerns, theme shift | | 11:34 | Extensive description of harm/suicidal themed OCD and mental health impact | | 14:09 | Therapy and challenges with medication, specialist referrals | | 15:04, 17:29 | ACT, exposure, and acceptance—what worked and why | | 22:05, 23:21 | Joy Journal practice—initial skepticism and eventual benefit | | 25:51 | Visualizing OCD, personifying and “starving” the monster | | 28:05 | Staying present with her niece—children as a mindfulness anchor | | 29:03, 30:40 | Self-compassion, overcoming setbacks | | 31:01 | Rilke quote: “Let everything happen to you…” | | 33:00 | Advice to her 20-year-old self—embracing difference | | 35:28 | Favorite poetry line for hope: “Listen, I love you. Joy is coming.” |

Takeaways & Listener Value

• OCD Themes Are Fluid: Charlotte’s story illustrates how OCD can shift themes over time, but underlying patterns—such as reassurance seeking—remain consistent.
• Diagnosis Brings Relief and Direction: Naming OCD, even via a forum or self-research, can be a major turning point toward hope and recovery.
• Therapy is Personal: ERP and ACT provide frameworks, but their usefulness varies. ACT’s emphasis on acceptance, distancing from thoughts, and values-driven living suited Charlotte’s needs, especially during intense anxiety.
• Practical Tools Matter: Techniques like journaling and visualization can feel hokey at first but may become powerful aids with persistence.
• Support Systems Need Education: Family and friends may instinctively reassure; education about OCD’s mechanisms supports more effective help.
• Acceptance is a Lifelong Skill: Embracing one’s differences and learning to detach from OCD’s narratives—while holding onto hope and joy—frame Charlotte’s ongoing recovery.

Memorable Ending Quotes

• On getting through difficulty:
  “No feeling is final.” (31:13)
• On hope and beauty:
  “Listen, I love you. Joy is coming.” (35:28)

Charlotte’s story offers practical hope to anyone navigating the complexities of OCD. Her experience is a testament to the possibility of meaningful life and joy, even when anxiety and intrusive thoughts feel overwhelming.