Rick was eighteen when he came in for his first session. His main goal was to learn ways to get rid of his “bad” thoughts and the anxiety and guilt that accompanied those obsessions. “They are torturing me,” he said. We reviewed the OCD cycle and learned the necessary steps to start interrupting it.
Rick knew the triggers that caused his obsessive thoughts and how they brought excruciating anxiety and guilt. He was surprised to learn that his singing, praying, and reciting were compulsions that were reinforcing the OCD cycle. He mistakenly believed that compulsions were supposed to be “weird” or silly behaviors. He found out that anything he did to find relief was actually a compulsion.
He said, “Sometimes I analyze my thoughts and try to figure out why I’m thinking such thoughts. I go back in time to know for sure if I actually did something bad.” I explained that going back in time and trying to “take apart” his thoughts were also compulsions. Rick said that he spent many hours looking for reassurance everywhere he could.
At the beginning of treatment, I explained that diabetes or asthma sufferers learn skills to cope with their illness and are able live a functioning, happy life. He could likewise do the same thing with OCD. Rick was able to decrease many of his compulsions, but not seeking for reassurance was the most difficult one for him.
I used the following metaphors to emphasize how seeking for reassurance would impede progress in his treatment:
A few years ago, we couldn’t get enough of vampires when Bella and Edward entered our lives. Well, how do “normal” vampires survive? They thrive on and love human blood. That is what they need to survive, isn’t it?
OCD is like a vampire. It loves, lives, thrives, and grows when you look for reassurance, rationalize, analyze, and ruminate all day long. That’s OCD’s blood. If you want to strengthen OCD, you know what to do.
If you don’t like vampires, you may remember reading the children’s classic, “If you give a mouse a cookie.” When Laura Joffe Numeroff wrote this delightful book, she had no idea it would also be used to treat clients with OCD as well as entertaining millions of young children and their parents. Yes, I compare the cute little mouse to OCD because it makes so many demands! All you need to do is examine the last page and see what I mean. The kid is exhausted trying to give the mouse everything it wants. OCD likewise makes incredible demands on you. Complying with OCD is exhausting and the sad part is –the asking never ends. The cycle repeats again and again!
Then there is “A Big Fat Enormous Lie” by Marjorie Weinman Sharmat. This is a wonderful book to illustrate the point and still bring up a smile. It is about a child who lies. The lie grows and grows the more the child lies. When he realizes that the lie can shrink by telling the truth, he sort of tries to tell the truth. Little by little the child becomes truthful and the lie disappears…sort of. The last page of the book shows the lie lurking behind a bush. Waiting for the child to make a false move and reappear in his life.
What is the take away message? First of all, OCD is that –a big fat enormous lie! It is difficult to believe one’s thoughts can be lies, but OCD is making you believe that! It takes time to understand this concept. Your goals can be to accept the risk that OCD is lying to you, ignore the lies, and prevent yourself from doing compulsions. Thus, hindering OCD’s growth.
The second message is that one must not get too comfortable and believe that OCD is not going to come back once you’ve improved your condition. When you get complacent and stop practicing the skills you’ve learned, OCD will surprise you!
Next time you want to take your thoughts apart, remember how OCD is like a vampire, a mouse or a lie. Your compulsions are allowing OCD to be in charge of your life. Your urgency to look for reassurance either through your own thinking, actions, people, books, and the internet will only feed OCD and make it like a vile vampire. OCD is demanding, it makes you feel exhausted and worst of all, by complying to its lies, your brain pathways will not change.
The desire to figure out your thoughts may be irresistible, but it is not the best option to get better. There are skills you can learn and apply which will lead you to a happier life. There is hope –but there is no magic wand. It takes hard work, and you can learn to starve OCD, ignore it, and dwarf it.
You can do it!