Obsessions are heartless intruders.  They come from outside of ourselves (“egodystonic”), and then relentlessly force their way in.   We try to resist them, but they only grow stronger.  Over and over we do things to put them right, yet they return with increased vengeance. It’s no wonder that the word obsession comes from the Latin “obsidere,” meaning “to besiege,” as an enemy would attack a city in order to force surrender.

How do OCD sufferers meet this enemy? Typically, in a confused, scattered state of mind fueled by high anxiety–some token resistance, followed by full-out surrender to compulsive activities.  This is chicken soup for this enemy. What is necessary is to adopt a warfare frame of mind; to stand up to OCD and fight it off using the right strategy of combat.

I first became aware of the importance of the warfare outlook when I talked with psychiatrist John March, author of several excellent books on OCD. He told me that he chose the title of his first book, How I Ran OCD off My Land, because of the wonderfully insightful comment made by child with OCD. The boy had explained to him that he had figured out how to deal with OCD only after he came to look on it as a “bad guy who was invading his ranch.” Once he had grasped the idea that he was in a fight, he was able to strike back using therapeutic techniques.

When you’re in a battle, you get extra surge of energy. That’s important in treating OCD, because tolerating anxiety and resisting compulsions requires effort. Further, the warfare mentality increases focus and concentration. That’s important, because therapy is counter intuitive. We don’t fight OCD by attempting to force obsessions from our minds. Rather, we learn to ignore obsessions and turn our effort to fighting compulsions. The importance of employing the right strategy in fighting OCD cannot be overemphasized. Once again, we do not directly fight obsessions. What we fight are compulsions.

Among Christians an important consideration sometimes arises. Since the “enemy” in the Bible is Satan, who we are fighting here?  Some of my patients strongly sense that the OCD battle is with Satan. Furthermore, most of the great saints who suffered from what we now call OCD did view their obsessions as issuing from the devil. This view works for some, and doesn’t for others. Personifying OCD in this manner can make OCD seem a more real and accessible enemy, which is helpful.  On the other hand, introducing a Satan into OCD therapy can touch off a boatload of fears and even introduce new obsessions. From an OCD therapy standpoint, I don’t think it matters too much who is seen as the enemy, whether OCD itself, or a demonic spirit. The important thing is to see the conflict as being between yourself and a force outside yourself.

How about prayer, mindfulness, calm reflection, comforting bible study, and other approaches that emphasize security and trust rather than warfare?  All good. Approaches to OCD are not mutually exclusive. Some mornings you can just wake up and say, “I’m not going to allow OCD to kick me around today, I’m going to fight it and get some work done!” Some mornings you wake up and what you need is peace. I would say, however, that people who feel beaten down and discouraged about OCD need to kick themselves into the warfare outlook whenever they can. The bottom line on which strategies to emphasize in treating OCD is simple. Emphasize that which makes you better at tolerating obsessions and limiting compulsions.

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