STRATEGY #3 THAT’S NOT ME! IT’S OCD
This is a strategy that works particularly well with blasphemous, violent, and sexual obsessions…those that are strongly egodystonic, those that you say, “Why in heck am I thinking this terrible thought!?” Usually it is not helpful to consider these sorts of thoughts closely, other than to recognize that they are from OCD. For instance, the strategy “Whatever happens, happens” usually doesn’t work. These thoughts are not from you and you are never going to act on them. Make that assumption and try to stick to it.
In group, a thirty-two year old mother named Karen suffered sexual obsessions so intensely guilt-provoking that she would do anything to prevent them from forming in her mind.
Karen: I’ll be changing my baby’s diapers when suddenly I begin to have a bad sexual thought. I don’t even know exactly what it is, because I don’t let myself think it. I stop it before it gets started. I’ll say prayers over and over. I’ll watch TV. When nothing else works, I’ll even start to imagine killing myself. It’s not that I want to hurt myself–I wouldn’t because of my baby–but if I put a strong image into my mind of chopping my own head off, it keeps the other thoughts away. Yesterday I spent all day long thinking about that. I absolutely won’t let those sexual thoughts come into my mind no matter what. No way.
Group member #2 I used to get the same kind of thoughts. I would be changing diapers, and I would worry that I was doing it in a sexual way, or maybe that, somehow, I was enjoying it sexually. Those thoughts used to really bother me. I would do all kinds of rituals to stop them. I drove my husband crazy asking him for reassurance that they weren’t true. What has been most helpful is realizing that they don’t come from me. Those thoughts are not who I really am. If I think about it deep and hard I know I wouldn’t do anything sexual to my baby. That’s just not me. It’s OCD.
Karen employed That’s not me! It’s OCD from that day on. It must be acknowledged that not too long ago (i.e., when I was in training) mental health professionals not only eschewed this strategy but contradicted it. Freud hypothesized that self-tormenting thoughts were due to unconscious conflicts caused by repressed urges, an idea that was accepted by several generations of American psychiatrists and psychologists. As a result, people like Anna were told that yes, they did have violent, murderous, urges deep down inside them, and that really, the only way to overcome these urges was through years of psychoanalysis. Untold numbers of OCDers were caused harm by this mistaken idea.
The leaders in the field now recognize that obsessions do not issue from one’s deepest self. They are passing thoughts that gain significance only because of the OCDer’s neurochemical inability to process fearful thoughts. Neuropsychiatrist Jeff Schwartz, author of the recent, highly successful OCD book Brain lock, emphasizes that OCDers of all ages should remind themselves “That’s not me: It’s my brain sending me a false message.” Schwartz encourages patients to see OCD as a war. In order to fight it, OCDers must maintain “mindful awareness” of the fact that it is not themselves but a biochemical disorder that is the cause of OCD’s symptoms. Duke’s John March, leading expert in the treatment of childhood OCD and author of How I Chased OCD Off My Land, teaches children to give OCD a name, such as “butt head,” “stupid,” or “the playground bully.” Doing this, he explains, helps children get distance from OCD, and motivates them to fight the disorder using behavior therapy.