A student came up with an unusual, yet effective, method for dealing with OCD. This young man had suffered from obsessional fears since childhood. He had received a good deal of therapy over the years, and had employed exposure and response prevention techniques with much success. When he came to see me, however, he was in a panic because of a new obsession. It was so sinful, he reported, that he could not use ERP to treat it. He was reduced to the compulsive use of counter-images, reassurance, and rote prayers, which, he realized, were only making his tormenting thoughts come back stronger.
The new obsession involved particularly vile, intrusive images. In theory, he should have purposefully exposed himself to them and resisted compulsions, thereby habituating to the fear of them. But, he explained, there is a clear Biblical injunction against taking such action: “Jesus says that your thoughts are the equivalent of actions. So, from God’s standpoint, if I think I’m doing something, I am doing it.” In my sessions, I can usually help a person frame even the worst obsession in such a manner as to allow exposure to take place. It can be looked on, for instance, as an attack by the enemy which, rather than running away from, we deliberately provoke. But, no luck with that.
More than a few Christians run into this same problem. I often get calls from people who have just quit therapy, because their counselor encouraged them pursue an ERP activity that they deemed too sinful. In the last analysis, this view must be respected. The student, however, did find an approach that allowed him to expose himself to his obsessional fear, and which didn’t violate his principles. He called it the “one-and-a-half-minute rule.” Only an OCDer would ever develop a rule that lasts not one minute, not a couple of minutes, but exactly one-and-a-half minutes. How great is that? The main thing is that it works for him. This is what he shared with me.
“When the thoughts come on strong, I let them be there. I let myself really feel them, one after another. I don’t purposefully think them, which would be a sin. I kind of label them, and I pay attention to how I’m responding to them. I make note of my heart beat, my muscle tension, and most of all the terrible fear I’m feeling that I’m a sinner. I say to myself, ‘Here’s that really bad image. Here’s that idea that because I’m having the images, I really want to do it. Now, here’s the idea that I don’t really have OCD and this is really my true self. Here’s the one that maybe I was never saved in the first place…and so on.’ It’s the uncertainty that is so terrifying, and I focus on it. I allow it. It is very real. I just sit there shaking. I can only keep this up for a short time, but it seems real long. I do it for one-and-a-half-minutes.”