1. How OCD Can Rupture Your Relationship and 3 Vital Strategies For Staying Close
International Obsessive Compulsive Foundation Conference 2017
Heidi Hartston, PhD

3. Secure Attachment (Across the LifeSpan)
Secure Base
Slow to warm
Caregiver
inconsistent
Little emotional
sharing
Risk and
Comfort are
mixed

4. Benefits of a Secure Attachment
Better emotional health
Reduces anxiety/depression
Better distress tolerance
Happier
Higher self-esteem
Better behavioral control
Stronger immune system
Better concentration/sleep
Better school/work performance
Higher cancer recovery rates
More quickly calm fear
Cortisol buffering (hold onto wise mind)
Better response flexibility
Better attunement with others
Fight/Flight regulation
More able to delay gratification
Better pain tolerance
Better wound/surgical healing
At end of list describe mri experiment where connected couples vs disconnected ones old hands, woman in MRI gets toe shock s=when she sees the X. Less pain experienced, less anticipatory anx, less stress if holding the hand of someone who cares.
Also delaying gratification is a very big deal, as desc in dan siegels flip lid video, kids who did not eat the one marshmallow but waited instead to get two later, studied 25 years after that study, did significantly better on every measure, relationship length and satisfaction, school performance, everything. It’s a big predictor of success.

5. Dan Siegel on “Flipping Your Lid”
Benefits of relationships, attunement, compassion gives you huge advantages in dealing with anxiety.
Attunement, response flexibility (wise mind choices are easier) (marshmallow exp), calming anx (cortex shuts down cortisol- able to say my anx isn’t menaingful so Ill ignore it)
Dan uses upstairs and downstairs brain referring to: downstairs limbic system in mid brain which includes the amygdala, where fight or flight is generated versus upstairs cortex where fear and emotional impulses are dampened down, word and behavior choices are edited.

6. Vital Strategy #1 Cool Down Before You Talk Adrenaline blocks empathy
Pause
Switch from “low road” to “high road”
Pause to let your cortex (higher thinking) catch up with your emotional brain, and reason with it.

7. We Need Them We Can Make Them (Secure Attachments)
A supportive relationship is a HUGE advantage in fighting OCD.
NOT a fixer, rescuer or OCD rule follower
An empathetic listener
Anyone can develop a secure attachment
even if you’ve never had one
Partner, parent, teacher, friend, coach, spouse

8. A.R.E. Questions from Hold Me Tight by Sue Johnson
Is your partner accessible to you?
Can I get his attention easily?
Is he easy to connect with emotionally?
Will he listen to my deepest feelings? Can I trust him?
Is your partner responsive to you?
If I need comfort will he be there for me?
Does he respond to my distress signals?
Even when we fight do I know I’m important to him?
Are you emotionally engaged with each other?
Can I trust him and confide anything?
Even when we’re apart do I know we’re connected?
I know he cares about my joys, sorrows, fears.
I thought, no, hes not doing any of this for me.

9. A.R.E. Questions *Switched Around
Am I accessible to him?
Can he get my attention easily?
Am I easy to connect with emotionally?
Will I listen to his deepest feelings? Can he trust me?
Am I responsive to him?
If he needs comfort will I be there for him?
Do I respond to his distress signals?
*Even when we fight do I let him know he’s important to me?
Am I emotionally engaged with him?
Can he trust me and confide anything?
Even when we’re apart he knows we’re connected.
I let him know I care about his joys, sorrows, fears.
Then I switched around the questions and I had an eye opening moment. Adrenaline blocks empathy. My own distress was preventing me from being a connectable partner.
You get out what you put in. And I wasn;t offering him any of these things either.

10. Eye-Openers Adrenaline blocks empathy. Attachment Protest
Blame instead of attune to the other
Attachment Protest
A desperate reach actually chases them away
You get out what you put in.
All Relationships Rupture and Repair

11. Interaction Cycle Map Behaviors Behaviors Interpretations
Feelings
(secondary)
Feelings
(secondary)
This upper and lower arrangement is not a description of brain areas. This higher up area refers to the conscious, defensive, self protective responses, the ones we are more conscious of.
The lower area refers to the deeper more vulnerable feelings, pre conscious associations/interpretations,
Above the line you react to the other guy.
below the line you check in with your vulnerable self.

12. Ruptures Behaviors Withdraw in Anxiety Interpretations Interpretations
Feelings
(secondary)
Feelings
(secondary)
This upper and lower arrangement is not a description of brain areas. This higher up area refers to the conscious, defensive, self protective responses, the ones we are more conscious of.
The lower area refers to the deeper more vulnerable feelings, pre conscious associations/interpretations,
Above the line you react to the other guy.
below the line you check in with your vulnerable self.

13. Ruptures Mult. Texts to check where you are Behaviors Interpretations
Feelings
(secondary)
Feelings
(secondary)
This upper and lower arrangement is not a description of brain areas. This higher up area refers to the conscious, defensive, self protective responses, the ones we are more conscious of.
The lower area refers to the deeper more vulnerable feelings, pre conscious associations/interpretations,
Above the line you react to the other guy.
below the line you check in with your vulnerable self.

14. Ruptures Behaviors Asks partner to do OCD rules Interpretations
Feelings
(secondary)
Feelings
(secondary)
This upper and lower arrangement is not a description of brain areas. This higher up area refers to the conscious, defensive, self protective responses, the ones we are more conscious of.
The lower area refers to the deeper more vulnerable feelings, pre conscious associations/interpretations,
Above the line you react to the other guy.
below the line you check in with your vulnerable self.
OCD doesn’t cause relationship ruptures, but it’s a starting place to see what the cycle is, what is happening inside each person during an OCD interaction

15. Ruptures Refuse to do OCD rules Behaviors Interpretations
Feelings
(secondary)
Feelings
(secondary)
This upper and lower arrangement is not a description of brain areas. This higher up area refers to the conscious, defensive, self protective responses, the ones we are more conscious of.
The lower area refers to the deeper more vulnerable feelings, pre conscious associations/interpretations,
Above the line you react to the other guy.
below the line you check in with your vulnerable self.
OCD doesn’t cause relationship ruptures, but it’s a starting place to see what the cycle is, what is happening inside each person during an OCD interaction

16. “Inner Child” From Burning Man 2015

17. Map Out The Repair Behaviors Behaviors Interpretations Interpretations
Feelings
(secondary)
Feelings
(secondary)
Feelings
(primary)
Feelings
(primary)
Attachment Need
Attachment Need

18. Vital Strategy #2 Drop Down To Your Vulnerable Stuff
This changes the conversation
“Take the elevator down”
What do you really feel?
scared, hurt, lonely…
Pause to let your cortex (higher thinking) catch up with your emotional brain, and reason with it.

19. Map Out The Repair Behaviors You’re never there for me!
Interpretations
Interpretations
Feelings
(secondary)
Feelings
(secondary)
Feelings
(primary)
Feelings
(primary)
Attachment Need
Attachment Need

20. Map Out The Repair Behaviors Withdraws in fear Interpretations
Feelings
(secondary)
Feelings
(secondary)
Feelings
(primary)
Feelings
(primary)
Attachment Need
Attachment Need

21. Vital Strategy #3 Read Distress Signals Instead of Villainizing
There are softer feelings under anger
Attachment protest
Pause to let your cortex (higher thinking) catch up with your emotional brain, and reason with it.

22. Map Out The Repair Behaviors Refuses to do OCD rules Interpretations
Feelings
(secondary)
Feelings
(secondary)
Feelings
(primary)
Feelings
(primary)
Attachment Need
Attachment Need

23. Ex: Map Out Your Fight What they said What I said My Interp.
Their Interp.
My Feelings
Their Feelings
Their Feelings (Deeper)
My Feelings (Deeper)
This upper and lower arrangement is not a description of brain areas. This higher up area refers to the conscious, defensive, self protective responses, the ones we are more conscious of.
The lower area refers to the deeper more vulnerable feelings, pre conscious associations/interpretations,
Above the line you react to the other guy.
below the line you check in with your vulnerable self.
What I really needed to hear
What they really needed to hear

24. Three Vital Strategies
Cool down before you talk
Adrenaline blocks empathy
Drop down to YOUR vulnerable stuff
This is when the conversation really changes
Read distress signals instead of villainizing
There are softer feelings under that anger
“Attachment Protest”

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