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Blog

So you think you can’t recover from mental illness… (video)

September 6, 2015
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Posted by Mark

Ruminating on reasons you can’t recover because your symptoms are different or you have very unique circumstances that prevent you from moving forward… is one of the most common symptoms. You’ll always be able to think of reasons why you can’t cut out compulsions, why you need to keep doing unhealthy things right now, why some other time in the future is going to be a much better time for recovery–our brains are so imaginative!

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Do you know how to get to a healthy place you’ve never been?

October 4, 2014
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You’re an expert in where you are now. But if you want to move to a place you’ve …

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6 Comments

on So you think you can’t recover from mental illness… (video).
  1. Person
    November 19, 2015 @ 6:11 pm
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    Reply

    So what do you say to people who continue to have debilitating symptoms, despite thorough treatment? Being consistent and compliant with various forms of CBT (ERP and ACT), mindfulness, physical activity, healthy eating, multiple medications, as well as more experimental treatments such as TMS? What do you say to people who don’t even have a chance to relapse, because treatment doesn’t sufficiently alleviate symptoms? What do you say to people who continue to suffer despite continuing to do the things you recommend?

    Your message completely ignores those people whose mental illness is refractory, and is, quite frankly, ignorant and a bit offensive. While you may have personal experience of recovery, and I understand that your video is probably addressed to people who have not yet tried or have not yet been compliant with standard OCD treatments, the issue of ‘recovery’ is more complicated than this video makes it appear.

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    • Mark
      November 19, 2015 @ 8:55 pm
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      Reply

      Thanks for your questions. Here are some of my thoughts on them:

      So what do you say to people who continue to have debilitating symptoms, despite thorough treatment?
      If somebody is working with a therapist and things are getting worse, there’s four areas I always suggest people look at to uncover the barriers that are getting in the way of progress: the therapist, the patient, possibly both of them, or the environment.

      Being consistent and compliant with various forms of CBT (ERP and ACT), mindfulness, physical activity, healthy eating, multiple medications, as well as more experimental treatments such as TMS?
      I’m assuming that you’re dealing with OCD because you mentioned it later in your comment so I’m going to speak specifically about OCD here: from that list of things you mentioned, many aren’t proven methods for treating OCD. In fact, if somebody isn’t getting expert advice on things like mindfulness, exercise, and healthy eating, I would expect them to simply become new ways of practicing compulsions. Personally, I have no experience with any medications or TMS, but I am familiar with the research, and it wouldn’t be a statistical anomaly if those delivered no results. I’ll talk about ERP and ACT in the next answer…

      What do you say to people who don’t even have a chance to relapse, because treatment doesn’t sufficiently alleviate symptoms?
      There’s a quote you’ll often see in ACT books that “the solution is the problem”. That’s specifically referring to attempts to “solve” feelings/thoughts/urges that people dislike. Acceptance and Commitment Therapy is all about learning to accept whatever you’re experiencing, recognizing that those experiences aren’t things you have to get rid. The compulsions are the symptoms, not the internal experiences you dislike. In many ways, OCD is all about trying to cope with, check on, or control uncertainty, anxiety, and other feelings we don’t like. The more we engage in compulsions as a reaction to those feelings, the more we experience them. With ERP and ACT, the focus is on cutting out compulsions while experiencing those feelings/thoughts/urges we dislike. So if you’re encountering difficulty eliminating the compulsions, that’s where I’d suggest working with your therapist to figure out ways to make it easier to eliminate compulsions. But, just like with physical fitness, keep in mind that building better mental fitness does involve doing a lot of difficult exercises. Cutting out compulsions through ERP or ACT is almost certainly going to be accompanied by extreme levels of anxiety. It does involve choosing to experience feelings we dislike so that in the future, we experience them less.

      What do you say to people who continue to suffer despite continuing to do the things you recommend?
      What I always recommend is to cut out coping, checking, and controlling compulsions in reaction to uncertainty, anxiety, and other feelings you dislike, and then to act according to your values to help yourself be healthy and happy over the long-term. Personally, what I like about that approach is that each day, regardless of what’s going on in my head, I can do the things I value. I’ve found it immensely freeing to cut out compulsions and change my relationship with all of the thoughts, images, urges, and feelings that I tried to avoid and control in the past. Learning to accept whatever I’m experiencing as I do the things I value has been life changing. But if people cut out all of their compulsions and change how they relate to the stuff in their heads and they start doing the things they value, but they’re still suffering, then maybe they’ll find a different approach more useful.

      All the best as your journey continues.

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      • Person
        November 19, 2015 @ 9:23 pm
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        Reply

        I guess what I was really trying to say is that sometimes it doesn’t matter how hard someone works- sometimes (for what I acknowledge is a minority of people) the hardest thing to accept is that mental illness will be chronic for them.

        On a personal note, I generally agree with most of what you say- particularly regarding cutting out compulsions and accepting that thoughts can’t be controlled. It just that your views on recovery come across as way too ‘black and white’ for my taste.

        Best wishes to you as well.

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  2. Paul
    March 2, 2016 @ 7:46 am
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    Reply

    Hi Mark

    I find your positive energy to be really refreshing and it has personally helped me to look at my OCD in a completely different way. I thank you so so much for all your positive encouragement your videos have been an anchor for me through difficult times. But the “person” above seems like the old dilemma (no offense meant) you cannot please everyone. The whole issue of making a problem complex is the PROBLEM, what Mark is saying is OCD is all the same, and it is if you can look at it from more of a external perspective, when you personalize it and make it your own precious problem the OCD bug has got you????

    This is why OCD is so hard to fix you have to think out of the box….

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  3. Ilya
    June 1, 2016 @ 8:09 am
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    Reply

    Greetings from Russia. Thank you for your help Mark. It works!

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  4. sulaksana
    June 2, 2016 @ 10:42 am
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    Reply

    thanks for your video man… i have ocd when i was kid almost 8 years i live with ocd,it’s hard if i live without ocd,i am trying to make my ocd gone is difficult, my friend say i am a frick sick person,now i am try live normal but it’s difficult

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Knives out. Dice up a recovery salad. #mentalhea Knives out. Dice up a recovery salad. 

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You don't have to listen to your brain's reasons! You don't have to listen to your brain's reasons! This isn't different. You know it was going to pull this trick. Where do you want to go? What do you want to give your time and energy to?

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This also applies if it did happen. You can do stu This also applies if it did happen. You can do stuff differently up there!

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From last night's Twitch stream exploring examples From last night's Twitch stream exploring examples of Exposure Therapy vs ERP vs ACT. No actual cookies were harmed in the making of this theoretical example. Obviously, in reality, you would gather up every crumb of that cookie and eat it (while contacting the closeness of death and the wonders of life in that moment).

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Don't turn into a ruminating centipede. It'll feel Don't turn into a ruminating centipede. It'll feel like you're going somewhere. If you just think a little more about it, you'll finally solve it! But not really...

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Don't get stuck on the smelly pile of crap this we Don't get stuck on the smelly pile of crap this week. Yes, it smells. Yes, it's a crap disorder. Yes, you hate it and want to chase solutions to make it go away. But focus on changing the big systems producing the pile of crap symptoms you hate. What's feeding that system?

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Closure smosure. We have experiences that are pain Closure smosure. We have experiences that are painful. We can touch that pain, be honest about it. It can be painful and we can do things in the present that matter to us. It can be painful and we can make choices in the present that align with what we value, that create and build the things we want to see in the world.

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All of the stuff you're doing in your head: that's All of the stuff you're doing in your head: that's practice. Whatever you're doing up there, you're getting skilled at that. What do you want to get skilled at today?

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You don't wait to feel strong before lifting weigh You don't wait to feel strong before lifting weights. The strength comes after, and even then, you'll just keep on pursuing more exercises that make you feel weak, that make you sweat and gasp for breath. You go towards the difficult experience. You fuel that and support that. So why would you take the opposite approach with emotions?

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If I’m trying to be optimistic that good things If I’m trying to be optimistic that good things will happen, I’ve actually thrown away any power I have. I’ll need things I don’t control to magically turn out in my favor. It’s a lottery mentality.

So I bring power back to me. I’m optimistic that I will learn and build skills to handle the dumpster fire in a shit storm that is this world. I will practice skills and nourish my needs so I’m prepared for whatever happens. I want challenging situations that don’t go “right” so I can learn to handle them. I’m optimistic about my capacity to try new things, to discover limits, to enforce boundaries, and make difficult changes that help me thrive in any situation.

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It is so useful to recognize how seemingly "normal It is so useful to recognize how seemingly "normal" checking and controlling fuels the symptoms we hate. If you're struggling with things like derealization / depersonalization, or fears around sexuality, losing your mind, developing psychosis, and anything else that involves losing control of you and your identity, look broadly at how you interact with uncertainty in your life. The brain is simply being logical. If I react to uncertainty about a door lock, or an email, how can I not react to an uncertainty about my existence?! The time we spend on uncertainties that don't trouble us much is what causes the uncertainties that do trouble us.

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