OCD is a shape-shifter. Its content often changes, especially with primarily internal obsessions and compulsions (involving thoughts about harm, sexual orientation, and relationships). For many with the disorder, addressing the ever changing obtrusive thoughts is like playing Whack-a-Mole.
The internet is full of articles about “hOCD,”(OCD about sexual orientation), “rOCD,” (OCD about the “rightness” of a relationship) and “Pure O” (obsessions in the absence of compulsions) OCD. Although these designations can be appealing if you’re trying to make sense of distressing thoughts, I find this alphabet-soup approach to OCD problematic for several reasons.
Addressing the form OCD takes is important only in designing a treatment plan for ERP (Exposure/Response Prevention). To keep the OCD from becoming a pattern in which one obsession dissipates only to have another pop up, focus on accepting uncertainty.
Here’s how to begin the process of response-prevention:
1) Refrain from checking and analyzing.
2)Acknowledge that OCD is causing you to doubt yourself and that no amount of research will help you arrive at an answer you’ll believe.
3)Don’t try to categorize your OCD.
4)Give up trying to figure out if your fears are justified.
5)Stop seeking advice from internet forums.
Taking these steps will start you on the path to recovery and keep the moles from lying in wait to ambush you.
The people I treat for OCD hate it when someone says, “I’m so OCD!,” usually as a way of explaining pickiness or excessive neatness. I do, too. Not only does the comment minimize the severe suffering a person with actual OCD experiences; it also perpetuates a number of prevalent misconceptions about the disorder.
These myths do a disservice to those in the grips of OCD. Let’s set the record straight.
OCD is a tyrant. It will control you with threats of the most horrific consequences if you don’t follow its commands.
“Don’t touch that or you’ll get sick and die.”
“Go back and check the stove five…no, ten…no, fifteen times or the apartment building will burn down and it will be your fault.”
“Don’t hug your niece. If you put your hand in the wrong place, she’ll be scarred for life.”
“That bump you felt while you were driving was a body. The police will arrest you for a hit-and-run and you’ll go to jail for the rest of your life.”
“You had a bad thought while you were in church. If you don’t repeat the prayer the right way, you’ll go to hell for eternity.”
Who wouldn’t be terrified by such thoughts? They may seem preposterous to people who don’t suffer from OCD, but to those who do, they’re grimly familiar.
To break free from OCD, you have to refuse to follow its orders. Its demands are unreasonable. You may think you can appease it to arrive at an uneasy truce. But unless you say no to the rituals, OCD will keep escalating its requirements and make you its prisoner.
So you have to stand firm. Push back. Do the opposite.
Terrifying? Yes! But it’s a tactic—called “response prevention”—that works.
In his book, Stopping the Noise in Your Head: the New Way to Overcome Anxiety and Worry, psychologist Reid Wilson outlines specific steps you can take to break free from the tyranny of anxiety. One of the messages he drives home is that OCD worries are NOT ABOUT THE CONTENT despite what OCD is brainwashing you into believing.
So if you’re doing rituals to protect yourself from contamination, repugnant or blasphemous thoughts, or the risk of being responsible for harming others, you can shift your perspective instead of blindly following OCD’s orders. Don’t try to convince yourself you’re protecting yourself from the content of your fears; instead, remind yourself you’re doing compulsive behaviors to eliminate doubt about something that feels threatening.
Practice moving towards those feelings of uncertainty, and you’ll be on your way to freeing yourself from the stranglehold of OCD.
This blog is intended solely for the purpose of entertainment and education. All remarks are meant as general information and should not be taken as personal diagnostic or therapeutic advice. If you choose to comment on a post, please do not include any information that could identify you as a patient or potential patient. Also, please refrain from making any testimonials about me or my practice, as my professional code of ethics does not permit me to publish such statements. Comments that I deem inappropriate for this forum will not be published.