STRATEGY #2 RATIONAL ARGUMENT
This is an absolutely foundational strategy. It is the approach that is employed in standard (secular) cognitive-behavioral therapy for OCD. We put the obsession in perspective by reminding ourselves that it is the result of a biochemical brain disorder. The tormenting thought is present entirely because our brains are not doing their job. They are not dismissing fearful thoughts of personal responsibility when they should.
The power of this approach cannot be underestimated. Not long ago I was working with the pastor of a large church who suffered from a number of blasphemous and violent obsessions that were highly disturbing. I must admit I was feeling rather good about reminding him of various biblical passages that shed light on how to fight this enemy, pointing out ways that we can effectively transfer responsibility to God for their occurrence, and so on. He improved a great deal. At our last session, I asked him what had been most helpful. He replied, “Doc, it was that you reminded me that those thoughts are just crazy!” I was put in my place.
Here’s some thoughts about this from group members:
A young homemaker explained: I’m still washing my hands a lot when I’m around food. Like when I make breakfast: I wash before I take the bread out of the bread box. Then I wash again before I open the bread, because I touched the bread box and might have gotten them dirty. Then I wash again before I take the bread out of the toaster, because by then they feel dirty again. Then I wash before I get my juice and again after I’ve poured it…get the picture?
Group member 2: Do you really think you will get contaminated? Why don’t you argue with those thoughts? You’ve got to keep telling yourself that they don’t make sense.
Group member 3: What I do when I get one of my contamination obsessions is to sit myself down and say to myself: “This isn’t logical. It’s just another of your obsessions.” I psych myself up. Even though I’m worrying about germs I make myself eat by telling myself: “The food isn’t contaminated, it’s all in your mind.” It works. It really does.
Group member 1: Could you give a try to not washing at all while you are making breakfast? Just don’t wash, no matter what. Argue back to the obsessions when they happen.
After this discussion the homemaker was able to make progress by consistently confronting her obsessions: “I’ve never heard of anybody getting sick from this; there is clearly no need to wash all the time. Other people don’t do this, so I don’t need to either.” A nineteen-year-old student had a number of obsessions when she parked her car, including that the emergency brake was not fully engaged, and that the gearshift lever was not in the “park” position. To counteract these fears, she checked the brake over and over, and often sat for five minutes or more staring at the gearshift indicator. She stared, she said, in order to insert a clear picture in her mind of the car being in park, so that if she was later surprised by the obsession she could recall the picture and be reassured that the car would not drift downhill and injure someone.
After a couple of months attending group, hearing how other people put obsessions in perspective through rational argument, she began to make excellent progress. Remembering what she had learned, she confronted her compulsions by telling herself: “I’ve checked hundreds of times, and the car has always been in park. I do not need to check again. Or she would say: This is an irrational compulsion, stop it. Or: I know this is OCD, and I know that I’ve got to get going. So do it.”
In rational argument, OCDers learn to have discussions, “self-talk,” about what is reasonable and what is not. They learn how to stand up to obsessions by logically considering their content. Rational argument is best employed as soon as obsessions hit, before compulsions get started. Sometimes, because compulsions become such strongly ingrained habits, there seems to be no time. Yet there is always a microsecond available to interrupt the split-second program of obsession leading to compulsion with a byte of clear thinking. Slip in a little reason here, and the first step has been taken to bringing OCD under control.
Rational argument is often the keystone to developing a workable, long-term approach to OCD. It is the strategy that usually emphasized the most in my groups, and it forms the foundation for many of the other strategies that will be mentioned in this chapter. Here are some more quick reminders, gathered from group, useful for putting obsessions in rational perspective. These can be really helpful. I advise you to work with them.