If you struggle with OCD, you’ve probably searched online for answers to the questions that consume you. Finding virtual communities of like-minded sufferers can make you feel less isolated, especially if your worries involve the very common but shameful-to-admit obsessions such as doubts about sexuality and thoughts about violence. But extensive researching and comparing yourself to others with similar symptoms—even if your efforts seem to give you some relief—can make your OCD much worse in the long run.
Here’s why the Internet can be problematic for someone with OCD:
1) Much of the information you’ll find is wrong.
This is hardly groundbreaking news, but I can’t emphasize it too much. One of my patients recently told me about a blog (which I won’t name) written by someone with OCD. Even under my careful professional scrutiny, it looked pretty helpful at first glance. There were some informative discussions about the symptoms of OCD and the importance of seeking treatment from an experienced cognitive-behavioral therapist.
But then I scrolled to a post the author had clearly meant to be reassuring (if you’ve been under my tutelage for any time at all, you’ll know where I’m going with this) but was completely off base in its message.
She had done an “informal survey” of 4 of her friends, two identified as gay and two as straight but with the type of OCD causing them to wonder if they really might be gay. She proceeded to list the differences she found between them: how certain they were about their attraction to individuals of the same/opposite sex, when they first “knew” (in the case of the two gay respondents), whether they sometimes found individuals of the same/opposite sex attractive in the absence of sexual feelings towards them, and so on. And then she went on to draw some conclusions clearly designed to be comforting to people with OCD doubting their sexual identity.
2) Advice, however well intended, can reinforce compulsions.
Aside from the obviously unscientific nature of her “study” (a comically small and biased sample, for starters), her attempt to ease the suffering of OCD doubters was misguided. It provided some with relief and had exactly the opposite effect for others, as evidenced by the varied responses to the post. Many even questioned whether they actually had OCD because they weren’t exactly like the people she described.
That’s what OCD does! It makes you wonder and doubt, dragging you down the rabbit hole of uncertainty. And the well-meaning blogger (who claims to be “cured” of her own OCD) unwittingly served as its accomplice by encouraging others to seek reassurance with “facts” and comparisons—thereby perpetuating the “checking compulsions” her followers had certainly already been relying on to make themselves feel less anxious.
So if you’re struggling with distressing thoughts and find yourself tempted to Google for answers, I recommend you consult one site and one site only (or none at all, if you won’t be able to keep yourself from looking further): the International OCD Foundation (iocdf.org). You’ll find credible information and a referral database of reputable professionals skilled in treating OCD.
You can’t walk past the magazines in the supermarket, go out to dinner with friends or check your Instagram feed or Facebook these days without being bombarded by diets aimed to cure whatever ails you. All these plans—whether they’re gluten-free, Paleo, organic, vegetarian, or vegan—involve eliminating foods purported to cause a host of health problems.
One such popular program goes so far as to promise it will “change your life in 30 days,” offering testimonials (which, I might point out, do not count as scientific evidence) from participants who claim it has cured them of a long list of so-called “lifestyle-related diseases.” These include but are not limited to: high blood pressure and high cholesterol, diabetes (both Type 1 and Type 2), asthma, allergies, infertility, depression, bipolar disorder, arthritis, ADHD, and inflammatory bowel disease. The psychiatric literature, last I heard, doesn’t consider depression, bipolar disorder, or ADHD lifestyle-related diseases. That’s a topic for another post. But for now, I’ll get back to the subject at hand.
Even the widespread trend towards “clean eating”—whose proponents like to think of it not as a diet, but as a lifestyle choice or even a movement—comes with rules. Eat lots of fruits and vegetables. Eat only “whole” meats, preferably organic, whose sources you know. Eat only whole grains. Avoid all processed and refined foods (e.g., sugar, baked goods, white flour, white rice, empty-caloric junk foods). Avoid saturated and trans-fats. Drink at least 8 cups of water a day.
“What’s wrong with trying to follow a healthy eating plan?” you might ask. And my answer would be, “Nothing. Usually.”
But if you tend to become fixated on avoiding specific foods because you’re excessively concerned about controlling your weight or think they might cause cancer or other diseases, be careful. Even a so-called “non-diet” like the clean-eating approach can lead to emotional struggles for perfectionistic people prone to eating disorders or health anxiety.
Any time perfectionists impose all-or-nothing restrictions on themselves, they run the risk of getting upset and ditching the diet altogether if they think they’ve broken the rules. It doesn’t even have to constitute a major transgression, such as picking up a Big Mac, fries, and large Coke from the MacDonald’s drive-through on the way home from work. If you’re evaluating your food choices from the perspective of a black-and-white mentality (and comparing them with the colorful Instagram images of the kale smoothies, grain bowls, and lush farmers market produce others appear to be eating), you could easily beat yourself up for popping a handful of M&Ms at the movies or having white rice with your homemade, clean Pad Thai. Then you might decide you’ve blown it for the day (or week), and let loose with a full-blown binge. You’ll feel guilty, vow to atone and never stray again, and set yourself up for the next self-punishing cycle of deprivation and excess.
Let me make my position clear before the critics jump on me for questioning sound nutritional practices. I’m not suggesting you go overboard with the junk food and the trans-fats. I’m not urging you to forego whole grains in favor of Wonder Bread. I’m not recommending you trade your bottled water for a Big Gulp. I’m not even telling you the clean-eating lifestyle is bad. (Though I might be telling you not to drink the diet Kool-Aid du jour without seriously evaluating its claims from an evidence-based perspective).
But when food—no matter how nutritionally pure, unadulterated, and good for your body it may be—becomes a source of internal conflict, guilt and anxiety, you might want to think about what it’s doing to your mind.
As with most things in life, moderation and flexibility are the keys to emotional wellbeing. Your mindset about eating is just as important for your health as the foods you eat. Sadly, Instagram can’t capture that.
One of the most frequent questions I hear from people considering CBT is: “Can you help me get rid of my anxiety?”
I wish I could answer with an unqualified “Yes!” But I’m a psychologist, not a purveyor of snake oil, and professional ethics require me to set reasonable expectations for treatment.
Wiping out anxiety completely isn’t a realistic therapeutic goal. It’s also not in anyone’s best interest to aim for total mental control. Like it or not, anxiety—whether a hard-wired physical response to an objective threat or the product of an over-active imagination—plays an important role in everyone’s emotional repertoire. So we all need to negotiate a peaceful coexistence with it.
A few weeks ago I had the chance to test out my own advice about meeting fears head on. I was at the highest point in LA’s Runyon Canyon enjoying the vista of the city spread out beneath me and the Hollywood sign in the distance on a perfect Southern California day. I sat on a rock soaking up the warmth of the sun and giving the experience my full, mindful attention. Then I started on the descent.
That’s when the panic gripped me.
Heights have always made me nervous, and I’ve never liked hiking downhill. But this time I wasn’t just cautiously inching my way down the slope in my typical fashion. I froze completely. My heart pounded. My mouth dried up. I felt dizzy. I couldn’t figure out how to put one foot in front of the other.
The steep dirt path littered with jagged rocks made my anxious brain conjure up images of slipping and plunging forward and cracking open my head and lying in a pool of blood. Not likely. But it could happen.
Oh, wait! It had happened —just a few months earlier, on a perfectly flat walk only two blocks from my house when I tripped on an uneven patch of sidewalk and landed in the emergency room.
OK, so my fears weren’t entirely irrational (an argument I hear frequently from people with anxiety reluctant to approach triggering situations). But, still, I had to make my way down the mountain.
So I decided to recruit the mindfulness skills I’d just been practicing. I didn’t try to relax. I didn’t tell myself I had nothing to worry about (because, really, how could I possibly reassure myself given the evidence to the contrary?). I didn’t try to push away the gory images. I didn’t attempt to slide down on my butt crab-style, a technique I’ve employed in the past to navigate precipices. I didn’t try to take a calming breath or grab onto my husband’s arm for support (not a viable option anyway because he was focused on his own worries about slipping and dropping his camera).
What did I do? I gave myself permission to be scared. I decided not to care about how slowly I was going and made room for the faster hikers to pass me. I looked down at the path in front of me. I concentrated on finding a place to plant my foot and took a step. Then another. And another. Until I finally reached the bottom.
And the next day, I went back and climbed to the top again. The view was breathtaking
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