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Over the past couple of years, I’ve noticed that the people who tame OCD most effectively are those who make three strategic shifts in their attitude toward not only exposure and response prevention (ERP) therapy, the evidence-based therapy for OCD, but to life itself.
Here's what they do.
Sacrifice comfort for meaning.
Everyone wants to be comfortable. But for those of us with OCD, seeking comfort paradoxically leads to continued discomfort. If you’re trying to get comfortable, that means you’re hoping to reduce your anxiety by doing a compulsion, making your OCD worse and all but guaranteeing you more discomfort in the near future.
Trying to get comfortable doesn’t work if you want to tame OCD.
People who win against OCD wrap themselves up in discomfort, actively searching for ways to get uncomfortable as a new way of life. They create a tectonic shift in how they approach their days, going from “I hope nothing triggers my OCD today” to “I'm going to look for opportunities to make my OCD anxious and uncertain. I hope I'm bombarded by so many triggers that OCD passes out!”
This “go for the gusto” attitude is exhausting, yes, but it’s also exhausting for OCD. OCD thrives in a carefully curated, avoidance-centric world where it knows what to expect, like a snow globe perched just out of reach so that careless children can’t upset its delicate winter scene. But the attitude taken by successful OCD tamers is that they are going to turn OCD’s world upside down. They are going to give the snow globe to the kids because, hey, snow globes are meant to be shaken.
If this sounds like a radical attitude that’s not all that practical, consider what Susan David says in her TED Talk, "The gift and power of emotional courage": “Discomfort is the price of admission to a meaningful life.” People who win against OCD sacrifice comfort for meaning.
But do it self-compassionately.
In case you’re thinking that to adopt this attitude successfully you have to “go for the gusto” all the time, you don’t. We don’t want to do things in a black-and-white way because that’s more rigid, OCD-influenced thinking. Part of cultivating meaning in your life is learning to value and take care of yourself. Being self-compassionate also turns OCD’s world upside down because OCD thrives on you treating you like it treats you.
Sometimes you’ll be tired because ERP done well is exhausting (have I mentioned that?), or some days OCD will be winning or life will be generally stressful and you’ll need a break. So take one! Or two or five or however many you need. Treat yourself compassionately, give yourself a break, and then get back to turning OCD’s world on end with renewed zeal and energy.
Apply skills broadly to break rigid OCD patterns.
When I first started working with clients on ERP therapy, I used a hierarchy, which is a list of feared situations or triggers, to help guide clients in how to pick daily exposure homework. We now know from the theory of inhibitory learning that doing exposures that combine fears on different levels of the hierarchy and in a variety of contexts (in different locations, with different people, while you’re feeling different ways, etc.), can assist with optimal learning. And what you’re learning is that you can indeed handle uncertainty—which is what ERP is all about.
Now I encourage clients to use life, combined with their new “let’s do this!” attitude, to guide how they do exposures. What categories of things would they like to do without so much interference from OCD? For instance, a client may want to go to the grocery store without OCD constantly telling her she is going to snap and kill everyone she sees. Therefore, she starts going to the store and instead of averting her eyes, she looks for people and finds excuses to get close to them as she shops. But she doesn’t stop there—she begins to see the pattern that OCD wants her to live by (avoid contact with people as much as possible) and purposely disrupts that pattern not only at the grocery store but throughout her day:
- She sits close to her kids as they do homework.
- She cuddles up to her husband in bed.
- She makes lots of trips to the break room at work to congregate with coworkers.
- That elevator that’s wall-to-wall people? You got it. She jumps right in.
She dives into this new lifestyle because these activities both break OCD’s pattern and give meaning to her life.
Does all this make her anxious? You bet. But that’s fine because that’s what she wants. And she’s not “doing therapy homework.” She’s owning getting better by recognizing and breaking the rigidly controlled patterns that have been carefully crafted by OCD. She’s learned a set of skills and she’s applying those skills broadly. And not because her therapist is telling her to. But because she’s sick and tired of living a constricted, fear-driven life, which brings me to the third paradigm shift of successful OCD tamers.
Change from a victim into a survivor.
In 2005, on the brink of despair, I wrote a letter to my parents about the devastation OCD was causing in my life, which is published in chapter 8 of Is Fred in the Refrigerator?: Taming OCD and Reclaiming My Life:
I’ve been sobbing for hours. Sobbing because I [kicked] a hole in the wall… Sobbing because I’m tired of being me. I’m just tired…
What a shame OCD is ruining my life. OCD makes you afraid to love anyone or anything, because the worry that accompanies love is more a punishment than the love is a reward. I feel so alone and scared and hopeless. I’m not quite sure of the point of my life, since I have to give up so much to maintain my sanity.
I felt like a victim because I was a victim to a cruel disorder that wouldn’t stop holding me hostage. The prevailing question of my life was: “How much more is OCD going to take from me?”
However, over the course of the following years, I wearied of being a victim. Once I learned how to do ERP, I turned into a survivor. The question at the top of the mind for OCD survivors is: “How much more am I going to allow it take?” And the clear answer is a resounding: “It’s had enough. I’m not letting OCD take anything more.”
This is the essence of my "Shoulders Back" strategy: Put your shoulders back and act like you, not your OCD, is in charge. Shoulders Back is a confident move that at times can feel almost arrogant. However, OCD is an aggressive, arrogant disorder, and with Shoulders Back you’re communicating that you’re going to face it head-on with a powerful stance and attitude (see my "Making OCD Pass Out" video for a demonstration). OCD won’t back down right away, but by telling it with your posture and your actions that you aren’t doing what it says anymore, it slowly but surely learns that you are not its victim.
You are a survivor.
Special thanks to my friend and fellow Psychology Today blogger Dr. Reid Wilson, whose IOCDF Service Award acceptance speech showcasing 8 self-help principles for OCD guided my thinking for this post. My blogs are not a replacement for therapy, and I encourage all readers who have OCD to find a trained ERP therapist.
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