CBT and Overcoming Obsessive Thoughts About Elbows, Ears, and Breathing

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Reader’s Question

I’m a 32-year-old male, and I’ve been battling anxiety for about 10 years. When I first got help I was put on Celexa and talked to a therapist. With time, I felt a lot better.

I went many years feeling good until about three years ago when I started having obsessive thoughts that really bothered me. I talked to my doctor, and we decided to increase my meds. Things got better for a while, but then the thoughts came back, so we increased meds again. The thoughts kept bothering me so about 6 months ago we decided to switch to Zoloft and see if it would help. I also started to talk to a therapist again because I finally have health insurance. Zoloft keeps my physical symptoms under control (difficulty breathing, dizziness, sweating, etc.), but it’s the mental symptoms that are really hard to deal with.

I’m really frustrated because I can’t seem to get rid of these disturbing thoughts. At times it feels like I’m losing my mind.

In the past few years a few thoughts that have really bothered me. First I was bothered by elbows. I know it’s really crazy, but I was taking a shower feeling really anxious, and my elbow suddenly felt really weird to me. For months, the thought kept bothering me. It made no sense but I just kept thinking about it. That finally passed, and then I started the same feelings about ears. I dealt with that for many months until it finally went away. Then about a year ago it switched to breathing. I’ve been battling this thought on and off for about a year, and it’s really breaking me down. The thought was first triggered by a movie I saw. In the film a human is teleported to Mars by a superhero. Once they arrive, the human starts gasping for air, and the superhero suddenly realizes to put a force field around her so she can breath. That scene really stuck with me, and I started to think about breathing. I have dealt with the feeling of not being able to breathe ever since I first got an anxiety attack, but this is different. Now I think these horrible thoughts of earth without air. Before I would think: “What if I couldn’t breathe?” But now it’s this horrible thought of what if there was no air to breathe.

It really disturbs me, and I can’t seem to let go of these obsessive thoughts. When a thought like this comes I feel almost paralyzed by it. I know it’s irrational and that I shouldn’t focus on such thoughts, but it just keeps coming. I really need some assurance and hope that I can get through this. I am a very spiritual person, and I’ve been praying that God will help me through this in any way possible — therapy, meds, etc. Any words of hope are greatly appreciated.

Psychologist’s Reply

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Sometimes anxiety disorders can be difficult to overcome. But one sure way to experience self-defeat in the effort is to get caught in the vicious cycle that can occur between the the disturbing symptoms and the anxious, emotional reactions we have toward them. Compounding the negative responses we have to the symptoms are the anxiety-fueling apprehensive thoughts you can find yourself having.

As your experience demonstrates, medication alone is usually not the answer to dealing with such problems. But as comforting as traditional talk therapy can be in dealing with the emotional issues that frequently accompany anxiety problems, research indicates that a particular kind of therapy, Cognitive-Behavioral Therapy (CBT), is particularly effective in training your brain to reduce the thoughts and curb the responses that fuel the vicious cycle you describe. So, talk to your doctor and therapist about the overall approach to dealing with your concerns. And remember, you can use CBT techniques and principles anytime, anywhere, on your own and without the immediate supervision of your doctor or therapist. Research has shown that the techniques actually produce the same changes in the brain that other successful treatments do. You have every reason to be hopeful. CBT methods are straightforward and simple to apply. The hard part is practice, practice, practice!

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