CBT therapy specialising in anxiety disorders
Obsessive Compulsive Disorder (OCD) can be a difficult, confusing experience. Just like any other anxiety disorder it is born from fear and just like any other anxiety disorder recovery begins with understanding. An excellent place to start is the OCD International Foundation www.iocdf.org
What is OCD ?
OCD is a mental health condition where a person has obsessive thoughts and compulsive activity. An obsession is an unwanted and unpleasant thought, image or urge that repeatedly enters a person's mind, causing feelings of anxiety, disgust or unease. OCD causes misery to millions of people each year and to overcome it will require you to work differently with uncertainty and doubts.
Here's how it works. You experience an unwanted thought which suggests the possibility of a catastrophic problem. For instance:
What if I left the cooker on, and the house burns down?
What if I got white spirit or bleach on my hands, and my family get poisoned?
What's stopping me from taking the carving knife and stabbing my kids?
What if I got poked by a needle infected with HIV?
What if I ran over a pedestrian and didn't notice?
These are thoughts about catastrophes. Naturally, you want to set them aside, and assure yourself that all is well. And you try. You try very hard, very repetitively, to persuade yourself that all is well. You probably recognize that the thoughts are pretty exaggerated, even silly. But you keep trying to get rid of them. You try to feel absolutely sure that they're false. Even though you've never experienced these problems in the past, you want somehow to be certain that they will never happen in the future.
You treat these thoughts like Danger
You end up treating these thought as if they were a mortal threat, a wild dog that has to be killed or captured. You fight the thoughts. And you lose every time. Fighting thoughts is always a losing game. When you deliberately and forcefully try not to think of, say, an umperlumpa, your head will soon be filled with umperlumpas! You have to change the pattern if you're going to overcome OCD.
Types of OCD
Some people struggle in their heads, without any change in their visible behavior. For instance, a person who is afflicted with thoughts of killing loved ones or accidentally burning down the neighborhood may continually think about it in an effort to reassure himself, or to somehow 'undo' the thoughts, but otherwise doesn't do anything differently. This is what therapists usually refer to as an 'obsessive only' type.
Others take specific actions they hope will get rid of the thoughts. A person who fears stabbing loved ones may put all the knives away, or avoid the kitchen, in an effort to get rid of the thoughts. A person who fears accidental fires will repeatedly check the cooker to make sure it's off, even if he hasn't used it that day. These actions are what therapists refer to as 'rituals'.
In both cases, the person is desperately trying to stop thinking the unpleasant thought. The behavioural rituals, such as repeated checking of an appliance, are aimed at the same purpose as the invisible arguing with your thoughts. Either way, however, the thoughts typically become more persistent as a result. The efforts to get rid of the thoughts just make them more persistent. If you're going to overcome OCD, you need to change this pattern.
Why do I have these thoughts?
We still don't know very much for sure about why some people get OCD and others don't. However, it does seem clear that some form of biological or genetic predisposition is involved. It's useful to know this, because people with OCD often feel guilty about it. You don't get OCD by doing something wrong. OCD is your problem, but don't get confused into thinking it's somehow your fault. The presence of upsetting or abhorrent thoughts is not what distinguishes OCD sufferers from others. Studies indicate that the obsessive thoughts of OCD are actually common in the general population of people without OCD or any anxiety disorder. What sets people apart is not the presence or absence of these thoughts. The hallmark of OCD is getting into a struggle with the thoughts. The struggle is what makes them more persistent and chronic. To overcome OCD, you need to let go of the struggle.
How can I solve this?
OCD is an anxiety disorder, not a catastrophe disorder. To overcome OCD, you need to work with the anxiety of the thoughts, not the threats they make. You're not up against the catastrophes depicted in your thoughts. You're up against the thoughts, and how it feels to experience the thoughts. OCD is all about anxiety. The specific content of the thoughts - whether they're about an accidental fire, the murder of a loved one, a pregnancy or a venereal disease - doesn't matter. These thoughts are all symptoms of anxiety, the same way that the physical symptoms of a panic attack - heart racing, laboured breathing, sweating, jelly legs - are all symptoms of anxiety as well. Ritualising (or thought stopping, or distraction) isn't the only way to reduce the anxiety. It might seem like the fastest, when you're terribly upset by some thought, but even this probably isn't true most of the time. The path to recovery involves making changes in your daily behavior which enable you to accept, rather than resist, the obsessive thoughts. The more you can accept the thoughts, and the less you fight them, the better you will do. You don't have to accept the catastrophic predictions of the thoughts - just the fact that you have these thoughts. This is easy to say, harder to do. OCD is a treatable problem, but it takes persistance and hard work.
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