What Makes OCD Worse and How CBT Can Help
That set of rules that you need to follow so that something awful doesn't happen. The complex ritual that needs to be done a certain number of times in a specific way in order for you to feel reassured that nothing bad will happen. Asking your partner for reassurance that you washed your hands despite knowing you have washed them 3 times already. Having to say certain words and phrases out loud. All of these types of behaviours help you to feel relief from the anxiety when your OCD gets triggered. But are they really helping or making things worse long term? Keep reading to find out...
What is OCD?
Obsessive compulsive disorder is a common mental health condition that involves the presence of intrusive thoughts that feel really upsetting and anxiety provoking to the person having them. Sometimes people with OCD also develop certain behaviours that have to be done a certain number of times or in specific ways in order for the anxiety to go away.
For example, if you experience intrusive thoughts about having run someone over while driving, you may find yourself driving back to the spot where you think it happened and checking the area multiple times before feeling reassured that you didn’t hit anyone. In other cases, people do not engage in any compulsive behaviours to relieve their anxiety, but may worry obsessively about the intrusive thought and what it says about them as a person.
Intrusive Thoughts are Normal
Recent research has shown that everyone experiences intrusive thoughts, even people who don’t struggle with OCD. An intrusive thought is any unwanted thought that you experience as upsetting. We have millions of thoughts every second, most of which are unconscious. Of the thoughts you become aware of, some of these are non sensical, illogical, or not reflective of the person you are.
The difference between people who go on to develop OCD versus those who don’t comes down to the ability to quickly brush off intrusive thoughts as random or unimportant. If you struggle with OCD however, you are more likely to give a lot of importance to your intrusive thoughts, and think that it is a sign of something negative about you as a person or your character.
If you have OCD, you are also likely to behave as if the thought was actually a fact. For example, someone who has an intrusive thought of possibly having run someone over while driving, will often doubt themselves and go back to check multiple times and behave in the same manner as if they had actually hit someone. In reality, having thoughts can be a world away from acting on them, but when you have OCD it can be hard to separate thoughts from action. This can leave you feeling guilty and blaming yourself for even having such thoughts, even though it is normal for everyone to have intrusive thoughts at times.
Why Your Assumptions about Intrusive Thoughts Matter
With OCD, you’re more likely to think your intrusive thoughts say something about you as a person and draw conclusions about yourself based on the thought. In reality, your intrusive thoughts don’t have to command your attention. Although it may not feel like you have a choice of engaging with the thought, it may feel easier to let go of it if you are able to brush it off as just a random thought, and not a sign of anything bigger.
Compulsive Behaviours Worsen OCD
Some people with OCD will engage in compulsive behaviours, that is, certain actions or words that they feel they HAVE to do or say, in a specific way, in order for their anxiety to go away. This often works in the short term, but long term only reinforces a false idea that is the intrusive thought that is causing the anxiety. In reality, it is usually the way you are choosing to react to the thought that is anxiety provoking.
For example, someone who has the thought they will be sick from cleaning and cooking chicken for dinner may feel a strong urge to take a shower and wash their hair to de contaminate themselves, as well as to deep clean the kitchen from top to bottom. This will temporarily relieve the anxiety associated with the fear, but will only reinforce it long term. By engaging with the intrusive thought and giving into a temporary urge to neutralise the anxiety, you are not able to consider that nothing bad will actually happen and that the anxiety will subside anyway with time.
How CBT Can Help You Break Free of OCD
The good news is that psychological research has identified some highly effective therapies for OCD. While OCD can feel like it is taking over your life with its rules and rituals, you can find relief from it with the right specialist and therapy approach.
CBT is a type of talking therapy that involves a learning to identify and challenge intrusive thoughts by testing out your fears, combined with weekly experiments to help you monitor your anxiety levels while you refrain from engaging in compulsive behaviours. The combination of challenging the intrusive thoughts, testing them out, and preventing compulsive behaviour help you retrain your brain so that you can break free from OCD.
In CBT, it is a combination of self awareness and learning of coping skills that bring about positive change. It is an active therapy that is fairly structured and requires you to be ready to confront your fears and try out new skills in between sessions.
As an anxiety specialist, I regularly work with people who have OCD using a CBT treatment plan that is personalised for each person and their unique concerns. When CBT is done well, it is collaborative, respectful, validating, and doesn’t feel robotic or rigid. With a highly trained specialist therapist, you can feel confident knowing that you won’t be getting a one size fits all approach!
