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Extremely Scared: I Felt Indifferent Toward An Obsession

Question:

Dear Dr Schwartz,

I am a male university student and suffer from OCD. Last year, I had the obsession that I might have written a false self-accusation (based on the paranoid thought that somebody had deceitfully incriminated me for a crime that he had committed) and forgotten about (or repressed) the details. Last December, after two months of constant rumination about that assumed self-accusation, accompanied by a high level of anxiety, my feelings changed to occasional indifference!! At the same time, I was feeling tired and depressed, lacking the drive to organize my day. The indifference seemed to finally give me some relief from the very distressing thoughts that had tormented me before. I even felt indifferent toward a previously feared consequence of the assumed self-accusation, namely imprisonment!

 However, the occasional indifference only lasted for a few days: When I remembered the Wikipedia article on intrusive thoughts, which states, “A patient should be concerned that intrusive thoughts are dangerous if the person does not feel upset by the thoughts, or rather finds them pleasurable,” I was extremely shocked and feared that my indifference might mean that my OCD had turned into some uncontrollable condition, perhaps even some sort of psychosis.

Two weeks later I had a series of intrusive thoughts concerning self-accusations when doing research aimed at reassuring myself that I had not accused myself. The next morning, I started to obsess that I might have accused myself the day before and that I had not memorized it correctly because I actually only had one or two hours of sleep in the night following the intrusive thoughts.

But, this time the obsessions proved to be worse than everything I had ever experienced so far — because now I KNEW that I had felt indifferent toward some obsessions in the past. SO I COULD NOT REASSURE MYSELF ANYMORE WITH THE ARGUMENT THAT SOMEONE WHO IS APPALLED BY HIS THOUGHTS WILL SURELY NEVER ACT UPON THEM. And that argument had been very important for me when trying to fight back my OCD! Soon, my OCD made me doubt whether I had only felt indifferent toward the consequences of an assumed act in the past, or whether I had also felt indifferent toward acting upon my intrusive thoughts in general. Worse, I even began to doubt whether it had only been indifference, or even some sort of pleasure!!!

Since then, I have been analyzing my former feelings of indifference every day, trying to find out why I felt that way, and trying to reassure myself that it was merely a response to intense fear. Can such an occasional feeling of indifference occur in patients with OCD? If so, how does it develop?

Thanks.

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Answer:

In my opinion your E.Mail question is an excellent example of obsessional thinking. Your problem is not indifference to a particular obsessional thought. Your problem is that you are obsessing over obsessional thoughts. Its a “double whammy” for you: obsessing over obsessing.

Generally speaking, obsessional thinking is a cover for deeper concerns, usually issues that cause great anxiety. Sometimes, obsessional thinking are symptomatic of paranoid thinking.

Regardless, I believe it would be a good idea for you to do two things: 1. Seek a consultation with a good psychiatrist. The reason being is that you may need medication to lower the level of your depression and obsessions. 2. Find a good Clinical Psychologist who uses Cognitive Behavioral Psychotherapy (CBT) to help you learn how to think more realistically.

I am fairly certain that these intrusive thoughts of your interfere with both your studies and abilities to socialize outside of classes.

You have nothing to lose but your obsessions.

Best of Luck

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