Hi Trapped, i'm sorry to hear about your problems with anxiety. I also experienced arrythmia in the past 2 years (i'm not sure if this is the same as ectopic beats, but it sounds like it could be). In my case cutting down coffee to zero for several months and reintroducing it in low amounts (1 cup per day) stopped it- at least it does not bother me anymore. If you drink coffee or other caffeine, i'd start there. Like Gil i am still fighting, had some success and some falls, but overall the trajectory is up. I think there can be a place for distractions that are not pmo. I watched a bunch of movies i hadn't had time to watch (because of work and pmo) in the early days, drank more wine with dinner (1.5 glasses instead of 1), ate more chocolate, drank more coffee. I'm not advocating that, just observing what happened. Saville also started getting dopamine in other ways (chocolate)- but you know what, anything is better than feeding the bad wolf of pmo. Sleep is so important (probably more than we know) and meditation too (my next step). Welcome back- you can overcome these difficulties- believe it!