STRATEGY #4 TAKE CONTROL: STAND UP TO OCD
A group member once reported to us that she stopped rituals in their tracks by saying firmly: “Stand up to OCD. Don’t even get started.” This is one of my favorite strategies, perhaps because I’m a bit of a wimp. In any case, everyone needs to use it now and then. Many of my patients report that they have learned to recognize the “feel” of an obsession. They know it’s coming before it is fully formed, because they detect a familiar, foreboding apprehension. Being able to detect an obsession in this way is extremely valuable, because the quicker OCD is confronted the better.
Heather, a junior majoring in human development and family studies, was tormented by terrible, violent images of being choked–by ropes, belts, and coat hangers. To ward these off, she put her hand to her neck and massaged it, or tried to imagine that she was magically protected by steel shields. On one occasion she reported that as soon as she had awakened on the previous Saturday she had been immediately overwhelmed by images of strangulation that drove her to spend all morning clinging desperately to protective rituals. She tried to distract herself by watching TV and listening to music, yet the dreadful images seemed only to increase to new levels of heart-stopping repulsiveness. All she could think was “Oh, man, what’s next?”
At that point, however, Heather remembered what another student had said in group: “You can’t let OCD control you; you have to keep up the fight.” She said to herself: I’m not going to have a terrible day. I’m going to take control. She made a list of goals to accomplish, starting with going to the library. As she got started, the obsessions “backed off.” She was able to “push through” the fearful thoughts each time they began to recur. The key for her was to boss back her OCD, to be master of the situation.
A truck driver, suffering obsessions that his shoes were full of fleas and mites, scrubbed his feet nightly with alcohol which left them painfully cracked and fissured. Even though it was obvious to him that his compulsive washing was irrational, he told our group that it had simply never occurred to him that he could resist it. He had just assumed that if he did so, something terrible would happen. Once encouraged to take control of his rituals, he made surprisingly quick progress. After one month he was able to go a whole week without scrubbing. He reported to our group that as soon as his obsessions would begin, he just said to himself, “To hell with those obsessions; I’m not going to start that washing!”
So, here’s the message: Man up OCDers! Take the fight to compulsions and avoidances.