OCD and Christianity

Last week I was talking to an OCDer with the obsessional fear that she is not contributing enough to her church, because what she gives is less than a full ten percent tithe.  She worries that she is displeasing God. What blessings will she miss?  What if something terrible happens? When the obsession strikes, fearful images run rampant in her mind: losing her job, a fire in her house, her son in a car accident. She reminds herself over and over: “My pastor said it was enough. I have other responsibilities. Everyone understands my situation.” After a half an hour, drained of energy, the fear usually lets up; but only to come back with a vengeance.

The big problem is her mental ritual: compulsively reassuring herself. This compulsion, just like repeated hand -washing and all others, has the devastating effect of making a fear stronger. What started, perhaps, as a reasonable concern has turned into an irrational terror. In our work together, we have been trying to find ways to break her destructive ritual. Any time you can shorten or postpone a compulsion it is a victory. She told me how she finally realized the importance of this.

“I had this idea,” she explained to me. “Obsessions are like lawyers. Once you start talking to them, you can’t get away from them. They bring up all  kinds of different problems, and nothing gets clarified. They’re always saying, ‘Well, on the one hand this might happen, but on the other that.’ You’re worse off than when you started.” She had finally discovered that what worked best was not to engage the obsession in conversation at all. “Now I just say, ‘I’m not talking to you!’”

A similar line of thought, employing a rather imaginative metaphor, was expressed by a suburban homemaker with an obsessional fear of hurting people’s feelings. Every day, sometimes every hour, she needed to repeat conversations over and over in her mind in order to make sure that she had not offended anyone. “I know that If I get going with repeats of conversations in my head,” she told me, “I’m never going to stop. So, I’ve learned to tell myself, ‘There is no off-ramp on Compulsion Crescent!’” Compulsion Crescent, as she explains it, is a Kafkaesque street that, once driven onto, you can never get off. You keep driving around and around forever, looking for an exit. What a great image!

It is well to keep this in mind: Obsessions will always argue endlessly with you. Once you engage them in conversation, they will point out critical difficulties in whatever course of action you favor, raise your anxiety to new levels, and prevent you from making any confident decision. If you drive into their trap, you’ll keep going in circles.

Here’s the strategy. First, as soon as an obsessional fear strikes, make the call that it is an obsession. (Rules: If you have previously labeled the fear as an obsession; or if it ‘feels’ like an obsession, or if you think it ‘probably is’ an obsession, then it is an obsession.) Then say, “This fear can bother me as much as it wants; but I’m not going to talk to it, I’m not going to go there. I’m going to do something else.”

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