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OCD and talking to a therapist about intrusive thoughts

Kate Kestrel

Hi - my son (who is in his mid twenties and is autistic) has recently started having therapy with the nhs for ocd. He’s struggled with ocd for many years. His problem with his therapist is that he cannot bring himself to tell her exactly what his intrusive thoughts are. He has been able to tell her the nature of the thoughts (ie they have a sexual component and he is incredibly embarrassed to talk about them) but he can’t tell her exactly what they are. This is partly due to embarrassment and shame about them, and partly because he fears that if he says them then something might happen. I’m sure that these fears are incredibly common and I’ve assured him she won’t be shocked or judge him - but he still can’t bring himself to tell her exactly what they are.

He’s had 2 sessions with her - but she’s already really pressuring him and threatening to stop treating him if he doesn’t tell her what his intrusive thoughts are if he doesn’t tell her in the next session (which is this week). 
She has even said (I’m paraphrasing) ‘there are lots of people who want and need  to have this therapy and if your not willing to commit then…..etc etc’. 

Because he’s autistic he feels terrible about being told he’s ’doing the wrong thing’ or being a bad person - and he feels really judged and pressured by her. What can we do? 

Has anyone else had this problem - and how did you resolve it?

My son’s life is made a misery by his OCD and I don’t want this therapist to discharge him without helping him at all. 
Thanks. 

  • in reply to Oscar

    Thank you Oscar - I appreciate that. Turns out these appointments were just part of the assessment to see if they would put him on the waiting list. They eventually agreed today to put him on the waiting list - which is over a year long. He’s already waited well over a year to get to the assessment- and she was reluctant to put him on the waiting list today because she said he wasn’t opening up enough. He’s exhausted. He’s never got the proper help he needs for any of his difficulties. We both feel so weary with the lack of help when you really need it.

  • What a very difficult situation all round. 

    Just thinking about your son's situation:

    "embarrassment and shame about his thoughts". If I understand it, the thoughts which are part of his OCD. OCD which the therapist is there to help with. Perhaps the therapist needs to know in order to understand and then help your son.  It must be a very pressured situation for your son.  I might feel better if my thoughts could be written down,  said over the phone or even when I was facing away from the therapist.

    "partly because he fears that if he says them then something might happen." I haven't always been sure what I could say, wanted to say, was expected to say to some therapists. I had fears too and no-one to allay them.  However, I do wished I could have told someone who could have allayed my fears. 

    I wish your son and you progress with therapy and his OCD.      

      

  • in reply to Bunny

    Thanks Bunny. Yes - I thought about that too and asked him - but he said that wouldn’t make it any easier. 

  • in reply to Lonehare12

    Thank you for your reply - I really appreciate your supportive comments - and yes, it doesn’t feel very therapeutic to my son! He feels so judged and criticised- he really is doing his best but he’s so scared to speak about it. Surely she should be able to understand that and have ways to support him through the process? She keeps saying how “disappointed “ she is in him - which makes him feel terrible. I also asked him about writing it down - but he doesn’t feel able to do that either. It’s so difficult for him. 

  • That’s a tough one. I don’t think the therapist is being very therapeutic, the only possible explanation for her behaviour is that she wants to help the most she can and she knows she has limited time. I know this is allowing her a little bit of grace but I think she must know that pressure has the potential to close down an autistic client.

    I think I would feel better if I could write down what I needed to say.

    I hope a therapist responds to this thread and helps youPurple heart

  • Might he feel more comfortable sharing the details with a male therapist? Perhaps he could ask for a swap?