STRATEGY #1 IGNORE OBSESSIONS
This is a time tested and widely used strategy. Here is what I often tell patients: “Treat the obsessions as you would a drunk who’s yelling obscenities at you. Suppose you were coming out of a restaurant at night, and a drunk from across the street started yelling awful things at you. What would you do? Would you run over and punch him? Would you run away as fast as you could? No, the smart thing to do is to ignore him, walk away, and after a while he will be quiet.” Ideally, this is the way we want to handle obsessions.
Interestingly, this strategy was often recommended by spiritual directors centuries ago. For one example, Richard Baxter, a famous 17th century English minister, offered this advice in his Christian Directory to those who we would now diagnose with OCD: “Take less notice of your troublesome thoughts. They are like troublesome scolds. If you answer them, they will never be done with you. But if you let them talk, and take no notice of them, they will become weary.”
Here’s what some of my group patients had to say. One student in our university health services group was struck by obsessions of loved ones becoming sick. She could only restore them to health with symmetry and counting. She was devastatingly embarrassed when, as sometimes happened, her friends made light of her rituals.
Student #1: I get these pictures in my mind of awful things happening. Usually, it’s my Mom having a heart attack. First I see it taking place really clearly. Then I have the feeling–I know it doesn’t make sense, but I definitely have the feeling–that it might come true unless I do some little “thing.” So I tap my fingers on the table eight times–always eight–and I feel better. Or else I touch everything on the table. I hate it when someone says: “What did you do that for?” That kills me. It just kills me.
Student #2: I used to have almost exactly the same obsessions. I would be afraid that something bad would happen if I didn’t arrange things a certain way. Like before I went to bed, I had to touch every single thing in my room. But now I just try to ignore those thoughts. I pretend they’re some creep who’s trying to bother me.
Ignore obsessions is an ideal coping method. It is, after all, the way most people deal with intrusive, unwanted thoughts. They say to themselves something like “that sure is a silly thought; I won’t pay it any attention”–a fitting response, because ignoring an obsession saps its strength, while fighting it only forces it to come back stronger.OCDers need to look on their obsessions in such a way as to allow them to stay in the forefront of consciousness. That way, habituation can take place and the unwanted thoughts will eventually go away on their own. The perfect attitude might be summed like this: It’s okay that I had that thought, and it’s okay if it stays. It’s no big deal. Of course, the whole problem with OCD is that a chemical disorder of the brain makes ignoring obsessions very difficult. Often it is helpful to find a metaphor that helps to put an unwanted thought in its place. It may be likened to a wino on a city street, static on the radio, flies at a picnic, or an unwanted suitor (this one works particularly well for college-age women). The response is the same: Once an obsession is recognized, pay as little attention as possible to it.
This is probably the most widely used and most effective strategy for dealing with tormenting thoughts. It’s worth working on it. Remember, we’re just after a little victory now and then. Don’t get discouraged. Like in my favorite movie, What About Bob?, just take little steps.