Normally, a course of cognitive therapy as practiced today aims to challenge the rationality of an obsessional fear. The therapist teaches the OCD sufferer to question the truth of an obsession at the moment it strikes, and to replace it with a more logical and realistic assessment of the situation. In the therapy of trust, the emphasis is shifted. Rather than the rationality of an obsessional fear being questioned, it is who should take responsibility for it. The following is a three step method for Christian OCD sufferers to employ.
- Step #1
- Step #2
- Step #3
Recognize obsessions when they strike
In order to put obsessions in proper perspective, one must first be able to quickly identify them. Fortunately, this is usually not difficult. Obsessional thoughts are intrusive, repetitive, completely unwanted, and recognized (at least in a moment of quiet reflection) as being inappropriate to be thinking. They possess a unique quality that psychiatrists refer to as “ego-alien”: It is as if they come from outside one’s normal sense of self. My patients say that the easiest way to recognize obsessions is the intense, overwhelming pressure felt to put them right. As one student put it: “I know it’s OCD when I respond to it like it’s the most important thing in my life.” Another student remarked: “I know it’s OCD when I feel great urgency. I have to do something right now, because waiting could cause immense harm.” There is a characteristic “feel” to obsessions. Once you know it, obsessions can be quickly and confidently identified.
Transfer responsibility to God
Recent psychological research suggests that individuals suffer from obsessions because of an excessive sense of responsibility for harm to self or others. The tormenting thoughts can be put to rest when the responsibility for harm is transferred to another person.
(For a discussion of the role of personal responsibility in OCD click here)
In the therapy of trust, the responsibility for the feared outcome of an obsession is transferred to God. A person suffering from fire obsessions, for instance, turns to God and allows him to take responsibility for the prevention of fire. The individual tormented by contamination obsessions gives to God the responsibility for whether or not he will get a disease. The person who fears she has offended God leaves responsibility for any offense to God.
Sometimes the focus of fear is not completely obvious. A student of mine, for instance, suffered the obsessional idea that she would jump out of her fourth-floor dorm window. It turned out, surprisingly, that she was not particularly afraid of the act of jumping, or even of dying. Rather, it was that her parents would be devastated if she did. In applying the therapy of trust to this case, therefore, what would be transferred to God would be the responsibility for her parents’ feelings.
Most of us are familiar with the image of Jesus found in Revelation: “Behold, I stand at the door and knock” (3:20 KJV). This is a helpful picture to keep in mind when employing the therapy of trust. We simply invite Jesus into our lives, share our obsessional fear with him, and give him the responsibility for it: “Here, Jesus, you look after this.” It is also helpful to remember Mary’s words to Jesus at the wedding in Cana. Mary, acting just like an OCD sufferer would have, first takes responsibility on herself for the fact that the wine has run out. But then, in order to deal with this situation, she simply turns to Jesus and says, “They have no wine” (John 2:3 KJV). Then she goes away and leaves Jesus alone. She doesn’t press the point or repeat it; she doesn’t demand proof that he will get more wine, or even that he has heard her. This is what the Christian OCDer must do: simply leave the matter to Jesus.
Prove your trust; resist compulsions
Compulsions are acts done over and over to lessen the anxiety of an obsession. OCD sufferers need to make a concerted effort to lessen their performance, because they consume time, cause embarrassment, injure health, and in the long run cause obsessions to become even stronger. For religious individuals, there is yet another reason to limit compulsions: to prove their trust in God.
When Luther said that we are saved by faith alone, he did not mean that we sit on our hands. “Demonstrate by your works that you have faith,” he writes. “Don’t be lazy or idle. Get busy and work.” Saint Thérèse puts it this way: “We must prove our love by all the good works of which we are capable.” Devout individuals with OCD must work to resist compulsions. In doing so they demonstrate or prove, both to God and to themselves, how much they trust him and love him.
On a practical level, one cannot spend all day in a frenzy battling compulsions. What I recommend to my patients is trying to win small victories over OCD a couple of times every day: by shortening the amount of time spent on a ritual by a few minutes, or, even better, by postponing it for fifteen minutes. When an obsessional fear strikes and you are drawn to perform compulsions, try telling yourself: “Right now it is more important for me to trust in God than to make certain that my fear does not come true.”
THE RIGHT TYPE OF FAITH
Theologian Martin Buber illuminates the issue. In his seminal book, Two Types of Faith, Buber begins with this proposition: “There are two, and only two, types of faith: The one from the fact that I trust someone . . . the other from the fact that I acknowledge a thing to be true.” Religious faith, according to Buber, always involves, most basically, either trusting in God or believing in a revealed truth. It is the first type of faith, he is displayed on every page of the Old Testament, as well as in most every sermon by Jesus. It involves unconditional trust in a God who is personal, vital, loving, and trustworthy.
This has great relevance for OCD sufferers. One of the things most puzzling about them is their inability to be reassured about their obsessional fears. People with religious obsessions can be told again and again that Jesus died for them, and that salvation awaits them, yet they still have agonizing doubts. Obsessionals, in fact, have great difficulty in believing in any fact that directly opposes one of their obsessions. OCD sufferers cannot even take as a fact what they see with their own eyes: they can stare straight at a light switch, see that it is off, and yet fear that it is on. OCD sufferers have a hard time believing in facts. They are doubters. Yet they are very good at trusting in others. It is trust in the person of God—in his power and his mercy—that OCD sufferers must rely on.
For instance, in the case of a person who obsesses that a fire will start in her stove, the right kind of faith is to leave the possibility of a fire with God. If God should, for God’s own reasons, want a fire to start, then he will start one. If he doesn’t, he won’t. The wrong kind of faith is to have “faith” that a fire won’t start. For another example. Suppose a person obsesses that he has lost his salvation, and will go to hell. The right type of faith is to leave his eternal destiny in the hands of God.
The OCDer is called to a deep kind of faith: trust in the ultimate power and mercy of God. We can be greatly consoled by a confident hope that God will prevent an obsessional fear from being realized, a hope that is based on our trust in God’s mercy and love. But we can’t have factual certainty.