Is this an Aspergers thing or an OCD thing?

Hi, I have this exact same issue. It’s horrible and I wouldn’t wish it on anyone, but it is a relief to finally find that I’m not the only one. I am diagnosed with ocd and awaiting an Autism assessment. I have also been wondering if it is ocd or if it is actually a sensory issue related to Autism. I don’t have any obsessive thoughts or anxiety about having an accident. It’s more about the physical feeling and it feeling ‘right’. I also get stuck in this cycle for an hour or more most nights before bed. I found an article on sensorimotor obsessions which is quite helpful https://iocdf.org/expert-opinions/when-automatic-bodily-processes-become-conscious-how-to-disengage-from-sensorimotor-obsessions/ 

However, I disagree with the end section saying that it is linked to obsessive thoughts/anxiety as for me it is just about it physically feeling right. I hope this helps you to at least not feel alone in this situation. 

This may be psychological, however it may also be physical. Sorry, I cannot tell if you are male or female. If male, it is worth pressing for more scans and exams to see if you either have a stricture or enlarged prostrate, both of which can make you feel like you need to go to the loo plus lessened flow, my husband took ages to diagnose as nothing showed up on blood or urinary tests. 

I'd say in my experience ASD, anxiety, and OCD are linked. I have had a similar thing when I'm anxious. Anxiety can make you have toilet related problems. If I'm going to do something that makes me anxious I will have to drain every drop of water out of my bladder to the best of my ability. It's a ritual. I've never wet myself in public, even as a child, to the best of my memory, at least when sober. Probably twice when totally wasted, and totally, totally wasted at that.

I worry that the urge to go to the toilet will be a distraction, god knows why, I can hold my water in, and think straight when I do. Also I suffer insomnia, so I will keep getting up, because in my mind the urge becomes a distraction which stops me getting off to sleep. Then it becomes a cycle.

I'd say that for me a number of factors all play in, ASD (routine, sensory input), OCD (ritual, which also can be an autistic trait, feelings of dread if the ritual isn't fullfilled), insomnia (which causes anxiety, which makes me feel like I need the toilet, which makes me sleep less, which in turn makes the symptoms of my ASD worse, which makes me anxious, and so on and so on), then the main culprit, anxiety, which is the driving force between all of it.

I'd say changing my routine helped. I don't drink any tea, (which is a diuretic, as is coffee), hours before bed or an appointment, social engagement, e.t.c.. I also try not to go to the toilet for a few hours before bed, I do my meditation, then have a massive piss before bed. It tricks my bladder into feeling empty somehow. I think it's a case of sort of training yourself to do it, it's like as if you are teaching yourself a new thing, like learning a new sport. You need to build yourself up slowly, bit by bit, like weight training. Start off lightly, then take more and more time between going. It will drive you nuts at first, but the pay off is worth it. You need to replace one ritual with another.

I totally empathise, it's hell. The ironic thing is because we are so vigilant we are the most unlikely to do it. You need to stop trying to control it, to have more control, that's ironic too. I'm much better nowadays, I can fight the initial urge, then it seems to just go.

Good luck, I hope I could be of help. If not I hope you can find your own way around it.

All the best.

The good news is that you are self aware that you have OCD and you want to do something about it. 

My suggestion is to do as much Internet research as possible and try to cure yourself.  While seeking professional advice at the same time.

OCD with bodily functions seems quite common and unfortunately disruptive to a normal life.

NAS49781 said:

But they ignored me and put me into CBT. My first appointment, I went in and explained my problem to the therapist who literally sat there and said to me, "That makes no sense." I nearly burst into tears - it's hard enough having to explain my problem to a stranger - for them to basically tell me I'm crazy just made me feel 10x worse. I didn't continue going to my appointments after that.

I understand how awful this must have felt. I also have experienced trying very hard to tell people my problems, but was not understood.

Anyway, I think the most common and useful CBT to treat OCD is called exposure and response prevention therapy (ERP).

www.mind.org.uk/.../

ERP is a type of CBT that is recommended for treating OCD. ERP works by helping you confront your obsessions and resist the urge to carry out compulsions.

During ERP your therapist will support you to deliberately put yourself in a situation that would usually make you feel anxious. Instead of performing your usual compulsion you will be encouraged to try and tolerate the anxiety. Your therapist may even suggest that you do something that makes you feel even more anxious.

ERP helps you to see that the uncomfortable feelings will eventually go away even if you don't perform a compulsion. As ERP continues people find that their obsessions cause them less anxiety and the anxiety they do feel goes away faster. They feel less need to do compulsions. This is called habituation.

You would always start by confronting situations you find easy and building up slowly to more difficult situations.

I find your situation very understandable. I don't have the exact same problem, but can relate. I have similar problems when I am anxious (e.g., eye blinking, finger tapping, repeatedly checking things, etc). I had these problems since childhood, and I used to think it might be OCD, but I also realised that I only did these things when anxious, and there was no clear obsession but just the repeating behaviours, so it seemed more ASD-related. I understand these behaviours take up a lot of time and can be quite frustrating. I hadn't been very active in seeking help - and I think it's really good that you are doing so! (I should be more proactive like you are). I think whether you see an OCD specialist or Asperger specialist, you can always mention the other condition as a possibility, as that might provide the therapist with a better picture of how you are feeling. I think it was quite bad that the therapist you saw told you it made no sense - it doesn't seem like the proper CBT that is usually used for treating OCD. I hope you will be able to find a more understanding therapist.